Travel Medicine: Down, But Far From Out
How September 11th Affected Travel Medicine
We asked ISTM members around the world how the terrorism attacks affected them.
Here are representative answers:
…We are travel medicine specialists - not interventional cardiologists. How can our daily lives not change? Our travel clinic sits practically at a standstill. The robustness of a travel clinic practice is a major reflection of the economy and the joie de vivre (or lack thereof) of the population it serves. While we hope and expect that with time things will settle down and that travel will again be more commonplace, we may not be able to count on the logarithmic growth that we have seen in the last decades.
…Travel will return and, likely, faster than we anticipate. "Travel" reflects important instincts in the human psyche: curiosity, self-betterment, recreation, and pleasure, to name a few. The downturn in travel that we are witnessing is a reflex reaction to an incalculable calamity: fear that such events may recur, disillusionment with the world that people perform such deeds, and guilt about going about our business and pleasures at a time when many are grieving. …As travel health professionals we should help counteract the psychological trauma, as we do for fear of flying, for example. We need to reassure the public that hysteria is not the solution to a disaster, that travel is reasonably safe, and that travel is important for our own well being and for the psychological and economic well being of the world.
…Globalization of the world's economy, the result of advances in electronic communication and technology, depends on travel. Before too long we will see a return in business travel, and then in leisure travel.
…It may be time for us to re-focus our skills and talents and broaden our view of travel medicine to include others who have not shared center stage with vacationers and business travelers. I am referring to the migrants and refugees whose numbers are only likely to increase during these times - a cause which has been championed by a small but vocal constituency of the ISTM, including some of its more prominent members. Our expertise can also be utilized by those who are involved in military deployment - our advice on health issues related to military travel can be quite valuable.
…The ISTM is strong. Travel medicine is strong. Our skills and expertise will continue to be needed. Let us use the strength of our numbers to get the message to our membership that the ISTM will be there standing behind every member during these difficult times.
…A member from California is looking for a locum tenens to cover his practice while he is called up to serve in the military.
…I share the optimism that the current turn down in travel is temporary. We should be prudent, but we should not overreact. The terrorists would prefer that we overreact.
…Last week-end, I visited an Art Gallery here in Montreal. When I asked about an expensive piece, the owner commented: "This year, many families are going to spend large amount of money on art instead of travel. It's much safer, isn't it?"
…In the past few days there have been many calls regarding getting smallpox and anthrax vaccine… Over the past few years we had calls from military reservists trying to AVOID the anthrax vaccine.
…Our corporation (in New York) lost 5 employees and a building. Our business travel has been greatly curtailed although a few trips are still on. For now, there seems to be more reliance on teleconferencing and email. A large group of expatriates that was going to have orientation and pre-travel care in New York is going directly to the foreign assignment country, so I have spent a large amount of time evaluating people by email and telephone. I have counseled them about which immunizations they need, facilitated referrals on short notice to travel health care providers in their areas, and tried to make them aware of health risks and health resources abroad… Now we see in the clinic people who witnessed the disaster and are suffering from somatic problems. For some, there is the fear of flying again, of helping their families to be comfortable with the resumption of business travel. Our staff has tried to help by listening, sharing practical information for dealing with post-trauma stress, and referring employees to group support sessions which we have set up.
…We should not rush to decisions now regarding CISTM8, our Conference in New York in 2003. There is a good chance that conditions will be much improved by then.
…It is difficult to predict what the world will be like in the year 2003, let alone in New York, but I have no doubt tourism will rebound. It already has. The American Society of Travel Agents (ASTA) scheduled to hold their 70th World Congress in Seville, Spain next month announced they are pulling out of Seville and moving their conference to New York the first week in November.
…ISTM is already looking into methods of insuring CISTM8 in case the meeting has to be cancelled… The finances of our Society are heavily dependent on our conference. We must also use this as a wake-up call to look at other ways to diversify our income sources… perhaps obtaining Foundation grants to fund research and training in some of the humanitarian sub-specialties of travel medicine such as migration and refugee medicine.
…We should take out insurance to protect our 2003 New York meeting against cancellation due to terrorism. However, such policies are now more expensive and have "exclusions" which are conditions under which a claim is not recognized. War is chief among these. Cancellation insurance, which previously cost about $8-10K for our event budget size has doubled since the attacks. In addition, there are now "terrorism exclusions" which relates to any actual act or fear of such an act or any retaliatory action by any person, state or country… However, insurance is still the prudent purchase as it will protect ISTM from other unforeseen event that might hinder attendance and threaten revenues - strikes, weather, loss of facilities, for example.
…Coming soon after the royal massacre here in Nepal, the bombings in New York and Washington left everyone numb for the second time. In the wake of this, hotel and trip cancellations have approached 50%. The tourism sector is laying off people or cutting their salaries. Tourism is the number one foreign exchange earner for our country.
…My practice is predominately infectious diseases in an academic setting. Travel medicine is a sort of avocation, albeit a very important one. We can adjust easily to a smaller case load of travelers without laying off anyone.
… The downturn in travel will be relatively temporary. A lot will depend on evolving circumstances and the perception by travelers of whatever action the U.S. government takes. Aggressive military action might actually increase the fear of traveling.
…Everyone here in London is very pessimistic about the immediate future of the travel industry; and whether this is the end of carefree international travel as we know it… We get several enquiries a day about anthrax vaccine and antibiotic prophylaxis.
…Leisure travel is down in the U.K. but many of the journalists I look after are on the move, and I hope and pray that they will be safe. I cannot bring myself to be remotely concerned about the business side of things just yet, given the horrendous loss of life and suffering in New York, and whatever may be yet to come. It makes some of the health risks we worry about seem pathetically insignificant.
…How wonderful that the next meeting of the ISTM will be in New York.
...There certainly has been a decline in the number of both business and pleasure travelers seen in my clinic (Canada), perhaps by about 30%. Many of the pleasure travelers I see labor over the idea of whether or not to go. Many do not have cancellation insurance. "Ethnic" travelers have decreased particularly. I see many Muslims who travel to East Africa and Pakistan.
…I can recall other times when travel seemed unsafe - Y2K, the Gulf War - it creates a pent up demand, as most of those people will eventually travel and spend their money when things blow over. One only hopes that they blow over this time.
…Some companies here in South Africa have suspended their corporate travel, though there are others who absolutely need to be "on site" as part of their work. Many companies have set dates - the end of October, for example, to resume travel.
…Here in Sweden, both corporate executives and backpackers who come to our travel clinic are asking a question that we almost never heard before, "Am I doing the right thing in traveling abroad?"
…There has been a significant decrease in travel to Israel, which already had decreased during the previous year because of the Intifada. Now Israelis are traveling abroad less. Several airlines have changed their flight schedule to avoid their aircrews staying overnight in Israel. This increases the atmosphere of tension and uncertainty. The terrorist attack has had a profound effect, as the perpetrators surmised it would.
… Our organization sponsors more than 6,000 international travels per year. Our employees are from 50 different countries, and although everyone condemned the attack, there are large cultural differences in the way they have reacted. We live in a country (Pacific Rim) where terrorism is almost routine. Some of our staff have witnessed terrorism in this country or while on mission. In the month since 9/11 we haven't noted any difference in the pre or post travel pathologies, and the number of psychologically effected staff has remained very marginal. We have cancelled travel to countries surrounding Afghanistan, but other destinations travels have remained unchanged. The slightly higher level of air travel stress after Sept 11 returned to normal in less than 3 weeks. Everyone is aware of the higher risk that may effect international travel over the next few months, but almost everyone is also confident that tightened security measures will control the risk.
Summary of other replies, from Austria, Canada, France, Germany, Nepal, Spain, Sweden, and the US: … about a 30% drop in visits in the weeks after September 11th, and a further drop after the bombings of Afghanistan… Some travelers are returning home sooner that planned… Decrease in travel greater among the wealthy than among backpackers…
