The Responsible Traveler

ISTM has embarked on a Responsible Traveler initiative. As medical professionals, it is our responsibility not only to keep travelers
healthy but to encourage them to respect local people as well as the environment during their journeys.

The World Tourism Organization has established a code of ethics to promote sustainable and respectful tourism. We can play a key role by disseminating educational information on travel ethics. Promoting respectful behavior of travelers will help reduce the growing resentment toward tourists in host countries, preserve host countries' cultures and environments, and ensure a safer and more rewarding experience for all travelers.

Please promote responsible travel by distributing these guidelines to travelers. The guidelines are available in two forms:

• The entire Responsible Traveler initiative, about 1300 words.
• A shortened version: Seven Tips for Responsible Travel. This is printed on an attractive, 7 x 20 cm (3 inch x 8 inch) firm yellow card that makes for a handy bookmark, especially appropriate for use when reading travel guides.

The text of both forms is printed below. Both items are available on our website, and can be downloaded and reproduced. A supply of cards is also available from the ISTM office. One hundred cards will be sent free of charge to any member requesting them. There will be a small charge for orders of more than 100 cards.

Submitted by:

Louis Loutan MD, MPH Santanu Chatterjee, MD

Immediate Past-president, ISTM Committee Chair, Host Country

A Brief Guideline to the Health Issues and Cultural Codes of Traveling from the International Society of Travel Medicine

Cultural, hygienic, and ethical differences often pose challenges to travelers whether travelers are traveling within their own country or across the ocean.

Taking precautionary measures to avoid health problems - gastrointestinal disorders and infections, for example - are important but do not cover all the challenges that may occur on trips. Beyond health issues, it is important for travelers to educate themselves about other crucial information regarding their destinations in order to avoid unintentional conflicts or disrespect for the people of the host countries.

Over the years, tourism has brought millions of much needed revenue to economically-challenged countries. While contributing to these countries' economy, tourists have, unfortunately, often brought and acquired diseases and have used and abused valuable resources such as water and electricity. And because of the building of resorts and time-share condominiums, local residents have often found that tourism takes away much of the affordable land, causing housing costs to rise to levels out-of-reach for many local residents.

The International Society for Travel Medicine has created a guide for "The Responsible Traveler" to help ensure that cross-cultural travel remains safe and beneficial to tourists as well as to the people of host countries.

l. Be an Informed Traveler

Did you know that there are countries where tipping is frowned upon, where sitting with your legs crossed is considered rude, or where you should ask permission before you can take a photo? The more you know about host countries the more fulfilling trips become.

• Utilize the Internet and the vast array of guidebooks to educate yourself about the cultural and ethical codes of the countries you are visiting as well as the potential health risks and lifestyle that you are likely to encounter in these host countries. By educating yourself about and being respectful of the host countries' lifestyles and cultural codes, you can remain a "good neighbor" while keeping travel safe, having fun and learning about the host countries.
• With most Western societies used to a rapid pace, some adjustment may have to be made to acclimatize yourself to the slower, more relaxed pace of another country. Realizing that you will need to exercise patience before you embark on your journey may eliminate much frustration during your trip.
• Be open-minded. Many aspects of life will be different when you leave home. One of the main reasons for travel is to learn about and experience these differences.

2. Know the Dos and Don'ts of a Country

• In many countries, the dress code is much more conservative than in Western cultures. Some countries frown upon women exposing their shoulders or baring their legs. Therefore, when visiting these countries, you should be respectful of the culture and adhere to dress codes. Public displays of affection often cause embarrassment for local residents. Signs of anger may also be perceived as offensive.
• Listen to the way the local people address each other, their elders, and people with religious affiliations. By being respectful of titles and mannerisms, you can avoid creating ill will unintentionally.
• Gestures can be misinterpreted or may carry a different meaning in other countries. For example, in some countries pointing your finger at an object or when asking directions is considered rude. Using one's flat hand may be more acceptable.
• Be aware and respectful of religious holidays and observances and the customs that accompany those events.
• Don't take souvenirs from historical, cultural, natural or archaeological sites.

3. Respect Your Host Country

More people are visiting third-world and developing countries for romantic getaways or adventure trips. These countries present special challenges. You need to be mindful of the health and medical hazards that accompany visiting countries with less advanced medical care. The fact that you are able to visit exotic places means that you have the income to afford such luxuries, which may not be the case with many of the residents of the host country. By understanding and being respectful of the socio-economic differences between countries, travelers will enjoy their trips more and improve the economic situation in that country.

• Avoid obvious displays of wealth or handing out money. Such activities create immediate barriers and build resentment between you and local people.
• Bargain for purchases only if it is an acceptable custom, but do not be too aggressive. For many local people, these sales are their livelihood.
• Never exploit residents of your host country. If a service is provided, make sure that person has been monetarily cared for - either by the hotel or by tipping in a manner that is appropriate by local costumes. Many local tourism employees receive very low pay for long hours. Make sure that you reciprocate when they provide assistance that helps make your trip go smoothly.
• Sex travel and child prostitution are unacceptable practices. Moreover, they are risky for the traveler.
• Support local communities, hotels, restaurants and churches whenever possible. This helps the host country economically and allows you to fully embrace the feel of the local culture.
• Minimize the use of resources. Don't insist on a daily bath if water is a scare commodity.
• Minimize polluting whenever possible. Re-use towels and bed sheets to reduce the use of laundry soap.

4. Stay Healthy

While you may be concerned about the health hazards posed to you, you may not realize that you may present health issues to the people in the country you are they visit, especially in developing countries.

• Safeguard your own and your hosts' health as you would at home,
• Sexually transmitted diseases are particularly linked to travel. Avoid unsafe sex to protect yourself and your partner.
• Flu epidemics in susceptible local populations have been linked to tourism (on cruise ships, for example). Get vaccinated, when indicated.
• Colds are a common problem among tourists. Sharing a cold is particularly easy when in crowded conditions such as a market or on a bus. Try to avoid spreading your cold by washing your hands with soap and water and limiting personal contact with others.
• Gastrointestinal disorders are very common ailments among travelers. While few cases should cause concern, be sure to bring anti-diarrhea medications. Try to maintain the same high level of hygiene that you would at home.
• Poor working conditions of tourism employees often have serious health implications, such as frost bite in cold environments or decompression sickness in scuba guides. Be aware of possible health problems in employees and help them get the proper medical attention when necessary.
• Consult a travel health professional before leaving home. They can provide advice for staying healthy, give vaccinations and provide medications.
• Remember you are visiting someone else's home. Respect them and be considerate so that they can make your trip a pleasant, enjoyable experience.

For more information to help you be a responsible traveler, visit:

www.ippg.net
www.ecpat.net
www.icrtourism.org
www. iipt.org

If you need medical assistance away from home, please consult the ISTM website for information on contacting a travel health professional near you.

(This is the bookmark-like card available from the ISTM office.)

The Responsible Traveler Seven Tips for Responsible Travel (International Society of Travel Medicine) Be informed. Travel allows us to discover natural beauties, historical sites and above all the diversity of other societies and people. Be an informed traveler before leaving home and discover what the people you'll meet at your destination can teach you. Be open-minded and patient. Experience other cultures and lifestyles. Be respectful. Local people welcome you. Show them gratitude and respect. Respect also local customs: the way you dress, behavior in religious sites, displays of affection. Avoid exploitation. As travelers we are perceived as rich. Be generous in a constructive way by promoting the local economy. Avoid and denounce exploitation of the local people (e.g., low salaries, overwork, child abuse and sex). Protect the environment. Avoid overuse of water, wasting food, littering and damaging sites. Leave a good impression. A positive experience with local people will pave the way for those coming after you leave. Respect and mutual discovery will make your trip a wonderful experience and will promote your security and your health too! So enjoy yourself and have a good trip! The International Society of Travel Medicine www.istm.org