My name is Annemarie de Gouw, I am the assistant team leader of the travelers care team of the GGD Hart voor Brabant in the Netherlands.

In the Netherlands there are 430 municipalities, they have the legal task to promote and protect the health of citizens against disease and disasters. Therefor municipal health services, (GGD), were founded. Each municipality is affiliated with one of the 25 local health services.

My team travelers care consists 2 doctors and 14 specially trained nurses. We see 25.000 travelers a year, averaged 15 appointments scheduled during a 4 hours shift. The nurses in the Netherlands independently carry out a consultation according to the federal guidelines.

These directives are drawn up by the national coordination center for travelers care, the LCR. Everyone in the Netherlands who is dealing with travelers care, such as the GGD, but also the travel clinics, the academic hospitals, the military, and the companies that have employees abroad is represented, that makes the LCR policy broad accepted. In the Netherlands travelers doctors and nurses are registered at the LCR.

During the office hours there always is a travelers care doctor who can be reached by telephone for questions that are not clear in the protocol or transcend the competence of a nurse. In some cases, the presence of a doctor is required, such as people known with an allergy. Calamities, such as collapse, the nurses can handle themselves. Every year I organize an emergency training where we exercise with a lotus victim (people who can portraying a victim realistic as possible).

Information is an important part of the consultation. With a specially developed information booklet "travel in the (sub) tropics" very focused advice is given. The starting point always is: Who is this traveler, Where he goes to and What will he do there. Annually the text of the information booklet is reviewed critically, I am sitting in the editorial since 2004.

At the training center of travel nurse I teach about giving information. I believe that there is still many health profit archived when the traveler gets specific information. Within our team I am working on a research about giving information, started in November 2011.

The Commission advising travelers is the official Professional Association for all travelers nurses in our country. As the secretary of the commission I work for the professionalization of our work as travel nurses. At the moment we are preparing the right to write a recipe for nurses according to the rules of the LCR protocol.

There is still a lot of work to do, that’s why I like my job.

My name is Lino André Silva, I am 33 years old, from Oporto, north of Portugal.

I am a Nurse practitioner, in a specialized hospital for infectious diseases (Joaquim Urbano Hospital- Porto), and I work as a Travel Nurse Advisor in our International Vaccination Center.

For the last 5 years, the hospital has trained me in travel health and tropical medicine by sending me to tropical institutes and hospitals in Portugal, Spain, England, Tanzania and Angola. The training has improved my travel health knowledge and my ability to prepare workers, travelers, and volunteers, to go abroad, so they are knowledgeable about how to reduce their risks from travel health problems.

In my experience, the former Portuguese colonies are our major challenges in regards to travel medicine and post-travel consultation. More than 90%, of all our preparations are to Angola, Mozambique, Guinea Bissau, Cape Vert, Sao Tome and Principe which totals approximately 3000 people every year. In the last 4 years we assisted a massive emigration of Portuguese workers to these former colonies with working contracts of 3 years. Our concern and objective is the prevention of imported tropical diseases, some of which are completely forgotten for years.

In Portugal the importance of travel medicine is increasing every year, yet unfortunately in nursing schools we don't study this topic. The Portuguese Nursing Association does not either recognize travel medicine as a specialty in nursing. The positive public exposure by ISTM of nurses in travel medicine may help change the mentality of the leading heads of nursing in Portugal by illustrating the importance of the role of the nurse in travel health advising.

I run a travel clinic in the Southwest of England and lecture on the subjects of travel, wilderness and expedition medicine. I balance my travel medicine clinical and educational commitments with an Emergency Department Charge Nurse post. This combination of specialities allows me to provide medical support for UK expedition companies, either remotely or as the onsite expedition medic or leader.

My interest in Travel Medicine began in 1997 when I began working in an Emergency Department, specialising in Wilderness and Expedition Medicine. After a number of expeditions I completed the Diplomas in Tropical Nursing and Travel Medicine before completing a BSc (Hons) in Emergency Care.

All aspects of travel medicine interest me, but I do have special interests in tropical and expedition medicine. I have been fortunate enough not only to teach wilderness medicine to some fascinating individuals, but also to provide expedition medical support in some of the most amazing places on the planet. I have written for a number of publications on this subject, including the Oxford Handbook of Expedition and Wilderness Medicine and the forthcoming 6th edition of Wilderness Medicine by Paul Auerbach.

My passions in life are travel, adventure and outdoor sports; these activities give me an enthusiasm and energy for life, helping me to inspire my family and friends.

I am the Director of Fleet Medical Operations at Holland America Line, a cruise ship company. I worked for five years doing clinical cruise ship nursing before moving into management of the same. My job today includes ensuring the implementation of medical care on board as per accepted medical guidelines, being aware of any current or emerging worldwide health issues, and knowing international immunization requirements for both staff and guests for every sailing. My team works to make sure vaccination information is passed on to the guests before they travel. Our ships carry anywhere from 1200 to 2300 guests and 500 – 900 + crew. Guests and crew come from all over the world.

Today, most cruise ships provide excellent routine and emergency medical care. We adhere to the Health Care Guidelines for Cruise Ship Medical Facilities which are supported by the American College of Emergency Physicians. The work on board ranges from providing medication refills for medicines forgotten at home, to treating an acute MI in the middle of a 6 day ocean crossing. For those reasons, the pharmacy on board is quite extensive and includes everything from aspirin to thrombolytics.

Travel medicine is a fundamental component of my job. I must make sure that the ship satisfies the health requirements of every port it docks at. Some countries have very strict regulations and others are much more lenient so expectations at ports can range from a full health inspection to just a review of the pharmacy procedures and/or patient log sheets. The challenge is to anticipate the actions of local public health officials, since the expectations are inconsistent from country to country. Public health is a top priority of course so I must also ensure that we adhere to WHO (and Vessel Sanitation/CDC; Ship San in Europe, ANVISA in Brazil, as well as many other recognized health authorities) guidelines as they relate to maritime travel.

Myself, I love college football! Living in Washington State, we are blessed with beautiful mountains and I enjoy spending as much time as possible at our mountain cabin with my husband. I am also actively involved with Washington State University and serve on a number of different Executive Boards.