Namaste! Are you contemplating a trip to Nepal?
I travelled there recently with my husband and 2 teen daughters (in December), to trek up to Annapurna Base Camp (ABC), and we have fallen in love with the place! Having previously enjoyed family multi-day hiking trips in New Zealand and Tasmania, we decided trekking in Nepal would foster some interesting new challenges and cultural aspects for our next adventure.
Dr Jo-Anne Grey
MBBS FRACGP MPH DTMH CTH®
TMA member based in Melbourne
Since the bottom fell out of international travel with the global spread of the SARS-CoV2 and the subsequent declaration of the pandemic by the WHO, my life as a day-to-day travel medicine practitioner has changed dramatically. As part of the Victorian Department of Health and Human Services COVID-19 response workforce, I now spend my days in Melbourne’s quarantine hotels, conducting telehealth consultations with returned travellers in their hotel rooms and donning and doffing PPE to make “house calls” to rooms where necessary.
Read More »Dr Jo Grey
TMA Brisbane
Earlier this year, I accepted an invitation to spend two weeks on Guadalcanal Island, part of the Solomon Islands group supervising medical students from Bond University on an elective placement. The students were seeking a doctor to accompany them who would be happy to work alongside and supervise them in a tropical, low-resource environment. I happily accepted, having worked and travelled previously in other Pacific nations, but never visited the Solomon Islands – what a great opportunity! What a challenge!
The placement was a student initiative, organised by Bushfire, the Bond University Rural Health Club. This year is only the second year that this student-run initiative has taken place, following on from the successful inaugural trip in 2018.
The noises of the slum continue well into the wee hours of the morning. As Lipi and her husband stepped gingerly yet resolutely across the moonlit dry river bed, the muffled sound came again. Now they were closer to the source. Somehow the stillness of the night brought a clarity that added to the terror of the cry as it hung palpably in the air almost seeming to urge them forward. Reaching the large island of sand now in the centre of the old river, Lipi looked up at the group of huts just visible at the edge of the sand cliff in front of her. In her torch light she could just make out the sandbags set into the sloping cliff of sand, marking the well-worn pathway up. Almost crawling to keep from slipping at the final step, Lipi was grateful again for her husband’s strong hands on the small of her back easing her onto the flat path ahead. Looking down the four metres or so below, she wondered how they would go with the return journey.
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Dr Lisa Chapman, Stafford
Known also as The Pearl of Africa, it is a country of spectacular natural beauty. Not only does it have the largest lake in Africa (Lake Victoria), the world’s longest river (Nile River), the tallest mountain range in Africa (Rwenzori Mountains), and one of the world’s most powerful waterfalls (Murchison Falls). Uganda also lies on the equator, has open savannah, dense rainforest, deep crater lakes, lush green hills, intensely red earth, abundant birdlife, diverse wildlife, and is home to half of the world’s remaining mountain gorillas.
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Dr Lisa Chapman, Stafford
Dragons, firecrackers, red lanterns, awe-inspiring ancient structures, impressive modern architecture, advanced technology, bamboo scaffolding, tradition, friendly locals, orphanages, multitudes of silent electric scooters, loud market place haggling, cups of tea, fiery chilli and bottomless bowls of rice. Eclectic images greeted my family as we journeyed in China for a month.
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A poll at a recent webinar of over 100 members of the Chamber of Commerce revealed most business did not have a current Travel Health policy. Very few systems were in place to protect either the travelling staff, or those who are sending them overseas. This is scary.
Read More »Dr Deb Mills
Moisture, warmth, carbon dioxide and odour all attract ‘mozzies’, and some unlucky people seem to be genetically more delicious to mosquitoes.
Cover up – long sleeved, light coloured clothes
Try and avoid being outside when they are biting. If you are outside between dusk and dawn, wear treated, long sleeved shirts, long pants, and long socks. Light coloured clothes are best. Dark colours attract mosquitoes. Strong scents also attract them, so avoid perfumes etc.
30% DEET is the best
‘DEET’ (Diethyl toluamide) is clinically proven to be the most effective mosquito repellent to apply on your skin e.g. Repel™ or Rid™. Repellents work by blocking the receptors on the mosquitoes antennae. A concentration of 30% DEET is recommended for adults under conditions of intense mosquito exposure. Concentrations greater than 50% DEET are usually not recommended. In field trials, DEET products on the skin have been found to be more effective than coils, ‘mozzie plants’, citronella candles, sonic repellers, and UV light lures. DEET can damage plastics, synthetic fabrics, leather and painted or varnished materials so be careful with eye glasses, cameras etc. DEET has no effect on cotton, wool or nylon or skin(!) DEET has been on the market for 45 years and side effects are rare if used properly.
Apply regularly
Apply regularly as per instructions on the bottle (for 30% DEET usually every 4-5 hours). Don’t forget your neck and ankles. Use just enough repellent to lightly cover your skin. You do not need to saturate your skin. Never use repellent over cuts, wounds or inflamed skin. After application, wipe or wash the repellent off your palms to avoid inadvertent contact with your eyes, mouth and other sensitive areas. Don’t apply repellent to children’s hands if they are likely to put their hands in their mouth. Ideally, wash off the repellent when you no longer need it.
Sleeping precautions
Sleeping in air-conditioned or well-screened rooms is the ideal. Use a ‘knock down spray’ if necessary to remove stray mosquitoes. The next best plan is to sleep under a permethrin-treated mosquito net. Check there are no holes in the net, and tuck the edges under the mattress. If mosquitoes are already inside the net, spray them with insecticide before you go to bed. As a last resort burn mosquito coils, cover exposed skin in insect repellent, and sleep next to a fan.
Did you know … mixing sunscreen and repellent?
When sunscreen is required, apply sunscreen first, wait 20 minutes and then apply repellent. Combination products are not as effective.
Read More »A recent study looking at the accuracy of tablet splitting, found large variations in dose in some of the splits. Some tablets are easier to split than others, and some drugs are more dangerous than others if you get the dose slightly wrong.
The major finding of the study was this “Based on our results, we recommend use of a splitting device when splitting cannot be avoided, for example when the prescribed dose is not commercially available or where there is no alternative formulation, such as a liquid.”
Tablet splitters can be purchased from most pharmacies. More info.
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After 10 years of dreaming, and 8 months of planning, my husband and I embarked on the adventure of a lifetime in August of 2006. (Six weeks prior to departing Brisbane, we of course consulted with Dr Deb Mills to ensure our health was optimal! ) We shared the small cockpit of a single engine Beechcraft Bonanza F33A at 10,000 feet, across half the world. Our fuel tank only allowed a 5 hour flight range, so we had to make 29 stops in 31 days. Our flight path took us – Hurning (Denmark), Copenhagen, Baden Baden, Barcelona, Corsica, Amalfi, Athens, Santorini, Istanbul, Adana, Tabriz, Esfahan, Dubai, Muscat, Karachi, Ahmedabad, Nagpur, Colcutta, Chiang Mai, Bangkok, Phuket, Singapore, Jakarta, Bali, Kupang into Darwin and on to Archerfield airport, Brisbane. To experience the many different cultures in quick succession was a fascinating experience. However, despite our careful preparation, the different terrain, along with language barriers, and unforeseen weather conditions presented both mental and physical challenges. We became known as the “Crazy Aussies” by many air traffic controllers. Sometimes we were met with an incredulous “You’re flying to Australia in that?” from commercial pilots on the ground. We planned the route with a German company that organises flight paths and permissions for cargo aircraft around the world. They successfully applied for our permissions, even organizing us to transit through Iran where we made stops for fuel in Tabriz and Esfahan. To smooth our dealings with Army and security on the tarmac at various terminals, they suggested we wear a uniform, so from Istanbul to Darwin, my husband and I wore collared white shirts with epilates and navy pants. We were seen as flight crew. We were to need it sooner than we thought.
On one occasion we had some problems that resulted in our passport stamped with the words Illegal Aliens… Our aircraft was only rated to fly in good visibility. In Esfahan, Iran, our refueling and paperwork took so long, that it was well into the afternoon before it was finalised. Problem. We had no visa to stay in Iran, only permission to transit. We were marched inside the airport under army guard. We sat for six hours in a tiny room with a young fully armed guard right beside us. We overheard the head of the police and the government officials yelling into their phones, trying to sort out what to do with us. We phoned our contacts, they called the Australian consulate. This went on and on.
At midnight we were taken from the airport, thankfully to a hotel, still under police guard – at least the guard stayed outside the room! How could we sleep with visions of being trapped in Iran forever running through our heads. The next morning, we were returned to the airport. Yet another official met with me. This time, thankfully, he had a big grin. I think he was as happy as we were, that a solution had been found. Our passports had been blessed overnight with a 7 day visa. In fact the now smiling official even warmly welcomed us to stay a few days in Iran! We made all the proper polite comments and hurried to our aircraft. As we were waiting on the tarmac, running through our flight checks, we heard a huge roar from the runway. A mick fighter took off and flew vertically at great speed in front of us. What a sight! I looked over at the Iranian police, unsure why the tower had put the mick fighter up in the air before our take off. The officials were all smiling, pointing to the fighter in the air and hands on their hearts yelling, “Ours, ours!” with much pride. Now it was our turn, my husband and I sat waiting for the radio signal from the tower that would giving permission to take off. Silence…. We watched the fighter land and be towed off the runway. Only then, were we given permission to take off. As we looked over at the smiling Iranians, we realised that we had been honoured with a display and fighter ‘send off’.
I earned the nick name ‘wife white knuckles’ after episodes like that, along with sand storms in Tabriz, dust storms in Dubai and a raging torrential storm over Singapore. The realization of our dream would not have been possible without an extraordinary team of many helpers from across the world. In 2006, we, “the Crazy Aussies”, were the 187th in the world to fly this particular route in a small single engine aircraft.
Read More »Travel Health Information
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