Thirty million Americans travel or live abroad annually for business or pleasure. A rapidly increasing proportion of these people travel to regions where health and environmental conditions can be far less than we are used to in the USA and these can endanger the health and welfare of travelers.
Traditionally, as a group, Americans have not been adventurous travelers; however, this is now changing with people seeking more and more exotic locales to visit. Humid tropical jungles, parched deserts, the frozen poles, and the highest mountains are all fair game for Americans hunting new thrills and pleasure. With a tradition of traveling to safe areas, we tend to follow old habits of preparation that may have served well for Europe, but can fail us when heading to the Amazon. Conditions differ widely around the world; diseases and lack of resources can test even experienced travelers, and proper preparation is essential.
Different parts of the world have different environments and differing socioeconomic conditions. These factors are intimately tied-in to the health and well-being of local populations, which will naturally affect visitors to these regions. Factors to consider are the temperature, humidity, pollution level (air, water, etc.), altitude, rainfall, season, poverty, warfare, crime, epidemics, and societal infrastructure. These vary from country to country and even within countries -- but this is hardly limited to the tropics. For example, the former Soviet republics have disintegrating infrastructures, with the result that violent crime, motor vehicle accidents and diseases such as diphtheria are on the rise. The medical establishment can no longer cope adequately with these problems and the level of care is plummeting.
To put this picture in perspective, in reality the greatest threats to the health and welfare of travelers are motor vehicle accidents followed by the same diseases that would affect people if they were home. For example, a person with angina has as much or possibly more of a risk of a heart attack as back home. Lower in risk are diseases of travel and injuries resulting from crime or combat-related violence, even through these get the greatest press.
Diseases often change faster than governments. Indeed, it is most difficult even for most doctors to stay abreast of rapidly changing disease patterns and epidemics, which may change from month to month, week to week, even day to day. Many of these diseases have for the most part been eliminated from industrial nations, some are newly emerging diseases which we know little about, and many of these are serious.
There are several ways to deal with these issues. First, and the most extreme, is to stay home. I mention this option first because it is absurd and should be dispensed with as quickly as possible. Few activities in life offer as much as travel: it is the best teacher, the best destroyer of bigotry, and the finest way to put life in perspective and show all the richness that life offers. Second, you could "Mr. Magoo" your way through your travels, blithely ignoring all risks and threats, either pretending they don't exist or not taking the effort to prepare for them. This is as bad as not leaving home, perhaps even worse. Many people gamble on their health in this way, and too many lose. The Muslim sage, Mushariff-ud-Din, said almost a thousand year ago "A traveler without knowledge is like a bird without wings."
A beautiful and apt sentiment which leads us to the third option for the traveler is to intelligently prepare for a journey by reading about the culture, the environment and the health situations present in the lands to be visited. By reading and talking to travelers and qualified consultants -- i.e. a travel agent, a travel medicine physician -- you can gain an understanding of what may face you and how to prepare for your journey. This knowledge improves the chances of you being able to fully appreciate what you will experience on your journey by staying safe and healthy throughout the way. Preparation shows responsibility -- an indispensable asset for traveling.
Preparation requires certain foresight and decisions on your part. Of course, there is the primary decision of where to go. Next, how to get there, followed by where you will stay and how you will travel. Preparing for unforeseen obstacles and staying flexible are vital for enjoyment of the journey and for insuring one's health and safety while abroad. In terms of health preparation it is wise to be fit before you leave -- this reduces your chances of illness while traveling. Before your trip, see a doctor who specializes in and has been trained in tropical medicine and travel diseases and who stays up-to-date on the ever changing disease courses around the world.
Routine vaccines need to be brought up to date and specific travel vaccines should be administered as needed. Any current illness should be brought under control. You should also be sure to take enough of your medications on the trip. It is a good idea to take "just in case" medicines for certain ailments, like dysentery, which may occur while abroad when your are far from medical help. Since, the risks of these ailments vary with the the type of travel and the area, you should discuss these potential illnesses with your travel medicine specialist who will also advise you on the types of exotic diseases you might encounter and how to avoid them.
Take a first aid kit, and some additional travel health essentials -- such as insect protections and sunscreen. Take care of dental problems before you leave and carry extra eyeglasses if you wear them. Make sure you have health and evacuation insurance that will cover you while abroad: you would be shocked at how much emergency evacuation can cost you if you don't have insurance coverage. Before your trip it pays to travel learn where you can seek help if you get ill or injured while abroad.
Be warned that few American doctors know much about the fields of travel and tropical medicine -- for most doctors, the last time they heard of tropical or travel-related diseases was when they were in medical school! The American Society of Tropical Medicine & Hygiene has a list of recommended specialists around the country who meet their standards; the Society also issues a Certificate of Knowledge in Clinical Tropical Medicine and Traveler's Health for physicians which serves as a basic standard by which you can judge the reliability of the physician you are seeing. Ask if your doctor has it.
With education, vaccinations, travel counseling, and common sense ( THE most important piece of luggage you need to carry) you will have taken the most important steps to ensure a healthy, safe trip. As with all thing in life, nothing is certain; but you will have the peace of mind knowing that you are as ready and safe as possible -- so enjoy your travels!
Healthy Travels!
© 1996 Alan Spira M.D., The Travel Medicine Center Beverly Hills, California.
More Topics on Travel Medicine
Dr. Spira can be reached through Armchair World at travelmed@armchair.com.
Homepage | More Travel Medicine| Armchair World Directory
We appreciate any comments or questions you might have. Our e-mail address is comments@armchair.com.
You can also fill out our feedback form for
sending us your comments. You may also reach us directly at 310-477-8960 in Los
Angeles, California.
Thanks!