Educating the Traveler

Keeping travelers healthy, safe and comfortable is one of the missions of our Society. NewsShare intends to offer you help with this. Many travel clinic physicians tell us that after talking to clients about immunizations, diarrhea, malaria and sex precautions, there is often little time left to talk about safety and comfort, topics as important as the others but less succinct. Here is what one expert talks to his clients about and the handouts he distributes. (Please share with us what your clinic does!)

From Mark Wise in Canada

More than likely, those of us who advise travelers spend most of our time dealing with vaccine-preventable diseases, food and water-borne diseases and insect-borne diseases. Very little time is devoted to counseling travelers about the other risks, such as motor vehicle accidents and other forms of personal injury, which account for at least 25% of the mortality in international travelers. This may be due to a lack of time to spend with each traveler, and also, I believe, because most people traveling to the tropics, and many travel health professionals, perceive "exotic" infections to be their major enemy.

While we can not counsel travelers regarding every potential hazard that they may face when traveling overseas, a few minutes should be spent on two important topics:

• Common sense.
• The interrelationship between a traveler's safety and the economic, political and social conditions that prevail in the country to be visited.

While these concepts may be obvious to most of us, they are not to many travelers, even experienced ones. Common sense is by far the greatest asset when it comes to minimizing the risk of most serious accidents and death. This is not a "tropical" concept, but one that applies at home as well. Poverty, for example, is an important cause for crime, disease, and dangerous roads. Political instability results in poorly enforced laws or no laws. Also, as lesser developed countries continue to "develop," some situations will probably get worse - more vehicular traffic on poorly designed roads, and more air pollution.

It is always wise for travel medicine advisors to discuss these issues with their potential travelers and to provide some written information on the measures that can be taken to maximize one's safety abroad. Here is what we give our clients:

Dear Traveler - The following is a list of suggestions to maximize your safety while abroad. They may not all apply to you. Travel advisory reports for each country are available from the Department of Foreign Affairs at http://voyage.dfait-maeci.gc.ca/destinations/menu_e.htm.

Your valuables:

• Make copies of your passport's identification page - carry one separately from your passport and leave one at home. Leave a copy of your itinerary, if you have one, at home.
• Keep medications in their original labeled container. If you are carrying narcotic medications, carry an explanatory note from your doctor.
• If you are carrying syringes for a medical condition, e.g. diabetes, or in the event of trauma, be sure that you have a signed, stamped, official looking letter from your doctor.
• Carry traveler's cheques, credit cards or debit cards, and only enough cash for the next day or two's activities. Make copies of all of your cards before leaving home.
• Try not to carry your passport, travel tickets, I.D., cash, credit cards, etc. all in one place.
• Carry your valuables in a waist pouch, not around your neck, ankle, neck, or in your back pocket.
• Never count your money in public.
• Keep your valuables in the hotel safe when possible.
• Change money only with authorized agents, not in dark alleys or hotel washrooms with unauthorized ones.

Rules of the road:

• Try to avoid driving in rural areas at night.
• Do not mix alcohol with driving.
• Beware of local buses - they are often overcrowded, poorly maintained, and in a great hurry. Some buses will be safer than others, though slightly more expensive.
• Avoid motorcycles if you can. Wear a helmet if you must drive one.
• At least look for a seatbelt, though you may not find one.
• Use a local driver if possible.
• There are many more things on the road in some countries - people, cows, baboons, potholes…. Drive slowly!

Your behavior:

• Never take anything, even an envelope, across a border for someone else.
• Choose your travel companions wisely. Travel in groups if possible.
• Always ask, or get some sort of implied consent, before taking pictures of local people, military installations, government buildings, etc.
• Keep your alcohol consumption down when you're out and about.
• Beware of "scams" - e.g. "Excuse me. I seem to have dropped my baby on its head. Can you please bend over and get him while I check out your back pocket!" or "I'm terribly sorry I spilled that ketchup all over your dress. Perhaps you could reach into your purse for a tissue!"
• Be particularly vigilant at train and bus stations and airport check-ins.
• You probably already look like a tourist (with money). Don't make it more obvious than it already is. Leave your jewelry at home. Dress conservatively.
• Do not walk alone and at night, in places that might not be safe (e.g. downtown, the beach).
• Do not open your hotel room door unless you absolutely know who is on the other side.
• Learn a few key phrases of the country in which you are traveling.
• Do not do drugs. You will be subject to the law of the land if you are caught.
• Take along adequate travel insurance. Read the small print.
• If you are in a "high-risk" area (e.g. working in Colombia), special measures, e.g. changing your route to work each day, should be taken. Advance planning is necessary.
• Carry a good luck charm!

References:

Bon Voyage - Department of Foreign Affairs and International Trade

Travel Information and Advisory Reports - Department of Foreign Affairs and International Trade (http://voyage.dfait-maeci.gc.ca/destinations/menu_e.htm)

MacPherson, D., Gushulak, B. et al. Death and dying abroad - the Canadian Experience. Journal of Travel Medicine, Sept./Oct. 2000

Hargarten, S. Gursu, K. Travel Related Injuries, Epidemiology and Prevention, Textbook of Travel Medicine and Health, Chapter 21