Archive for the ‘Other’ Category

Family travel

Dr Matthew Cardone – Doctor from Tweed Heads  

My family and I travel regularly to an island in South West Fiji called Tavarua. It’s a magic island, shaped like a love heart. Tavarua is primarily set up for surfers. It is close to not one but two world-class reef breaks nearby – drawing surfers from around the world. The most famous surf break “Cloudbreak” is home to the Fiji leg of the World Surfing Tour. The island is a fantastic destination for families, with idyllic white sand beaches, great for snorkelling, the coral is astounding. The reef fish are beautiful. The water is warm. The dolphins are friendly and the fishing is fantastic. The only thing better than the place is the people. Never have I experienced a happier, warmer and kinder culture.

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The Kokoda Track

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The Kokoda Track

Ann-Maree Smith ( traveller/ patient of the Maitland Clinic )

When an email crossed my desktop early in 2014 and my 37-year-old nephew came on board, it was on. With four months left to departure, we made good use of training in local forests and national parks. Steep hills became loved, like never before. Our favourite climb was 153m, up and down five times, with 12kg in our backpacks. We also went to the gym, using weights to improve strength.

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Typhoon Haiyan travel advice

Prepared by TMA member Narre Warren

It is now over a month since Typhoon Haiyan (called Yolanda in the Phillipines) struck the Philippines on 8/11/13. The worst hit provinces were Leyte and Eastern Samar, which experienced sustained winds of 270 kph, gusts of up to 312 kph, and a storm surge in coastal areas as high as 7 metres. Not all travel is for pleasure. Typhoon Haiyan travel advice is be prepared and be informed.

The official death toll from the Phillipines Government is approaching 6000, the injury toll 27000, and 1800 people as of mid December 2013 are still listed as missing. These figures are considered by most to be conservative.

Enormous international aid efforts are underway. Significant infrastructure damage has caused problems with sanitation, food supply, electricity, transportation, shelter, communications, security, and medical care.

This all has implications for people who are considering travelling with aid organisations, or in those visiting relatives and friends to help them. 

The following advice applies to both groups of travellers:

1                Take a kit with you from your travel medicine clinic to treat diarrhoea; diarrhoeal illnesses are likely to be more common after a disaster where serious flooding has occurred. Follow the usual safe food and water precautions advised by your travel clinic

2                Use mosquito repellents with more than 30% DEET to prevent mosquito borne illnesses such as Dengue Fever and Chikungunya. Mosquitos will breed in greater numbers around flooded areas. The areas worst affected by Typhoon Haiyan are the islands of Leyte, Samar and Cebu; they are not affected by malaria so malaria tablets are not required for these islands.

3                Be vaccinated for Hepatitis A and Typhoid; update your tetanus injections as debris clearing will often result in injury. Have a flu injection, and speak to your travel Doctor about other vaccines you may need.

4                Avoid injury—most deaths after a natural disaster are due to blunt trauma, crush-related injuries, and drowning. Use caution around damaged or down power lines, 

water-affected electrical outlets, and interrupted gas lines.

5                 Avoid stray or frightened animals. Seek medical help immediately if you are bitten or scratched by an animal and wash out the wound. Consider rabies vaccination before you go, or seek rabies vaccination within 48 hours of any animal bites.

 

 

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Traveling with Diabetes

While you’re having a great time on your holiday, if you have diabetes you need to continue your monitoring and care routine.

Having meals later or more irregularly than usual, time zone changes and the heat of tropical countries can all affect how well you manage your blood sugar levels. Before you hit the road, have a look at some of these suggestions click here for info.

The Heat of Summer or the Tropics

Heat can affect your blood glucose (sugar) levels and also increase the absorption of some fast-acting insulin, meaning you will need to test your blood glucose more often and perhaps adjust your intake of insulin, food and liquids.

  • Drink plenty of fluids, especially water (always bottled or boiled if in less developed countries!), to avoid dehydration. Avoid sugar-sweetened soft drinks and fruit juices.
  • Check the product information in your boxes of medications to learn when high temperatures can affect them.
  • If you’re traveling with insulin pens or vials, don’t store them in direct sunlight or in a hot vehicle. Keep it in a cooler if possible, but do not place it directly on ice or on a gel pack to avoid freezing it.
  • Check glucose meter and test strip packages for information on use during times of high heat and humidity. Do not leave them in a hot car, by a pool or on the beach.
  • Heat can damage insulin pumps and other equipment. Do not leave the disconnected pump or supplies in the direct sun.
  • Undertake physical activity in air-conditioned areas, or exercise outside early or late in the day, during cooler temperatures.
Don’t Forget Your Medication
  • Take more medication than you would expect to need, in case of travel delays or lost luggage.
  • Keep snacks, glucose gel, or tablets with you in case you have a ‘hypo’. If you use insulin, speak to your Doctor before you go about taking a glucagon kit; this is an injection that can e given in case of a more severe drop in blood sugar.
  • Carry medical identification that says you have diabetes.
  • Keep time zone changes in mind so you’ll know when to take medication.
  • Keep all insulin in the original pharmacy labeled packaging. Get a letter from your Doctor stating you need to take syringes or insulin pens with you.
  • Take copies of prescriptions with you.
In the Air
  • Place all diabetes supplies in carry-on luggage in case checked in luggage goes missing. Keep medications and snacks at your seat for easy access.
  • If a meal will be served during your flight, call ahead for a diabetic, low fat, or low cholesterol meal. Wait until your food is about to be served before you take your insulin.
  • Make sure to pack snacks in case of flight delays.
  • Reduce your risk for blood clots by moving around every hour or two.
  • More Info on using insulin pumps during flight here.
Staying Healthy
  • Changes in what you eat, activity levels and time zones can affect your blood glucose. Check levels often. Stick with your exercise routine. Make sure to get at least 150 minutes of physical activity each week.
  • Protect your feet. Be especially careful of hot pavement by pools. Wet or sweaty feet are more prone to tinea as well; consider taking an anti fungal cream such as Lamisil with you.
  • Make sure you have all the vaccinations you need for your destination.
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South Pacific – Other precautions

Dr Colleen Lau
Food and Water-borne Diseases

The same precautions with food and water for developing countries apply in the Pacific Islands: Cook it, peel it, boil it, or forget it! However, it is not always easy to follow these rules at all times during travel. Depending on your trip, your travel doctor might recommend vaccinations for Hepatitis A, typhoid, and travellers’ diarrhoea. It is always a good idea to have a simple medical kit with medications for treating traveller’s diarrhoea, and correct treatment could mean that you are better in a few hours rather than being sick for days or even weeks.

Kayaking in Pago Pago Harbour, American Samoa – Chosen by Lonely Planet as one of the top 15 experiences in the Pacific Islands!
Blood-borne and Sexually Transmitted Infections

Hepatitis B is common in the Pacific Islands, and an estimated 25 to 30% of the local population have chronic Hepatitis B infection. Travellers should consider Hepatitis B vaccination if they plan to live or work in the Pacific, or expect to have close contact with the local population. All Australian children are now routinely vaccinated for Hepatitis B. Sexually transmitted infections are common, and HIV is also becoming a problem.

Others

There is no risk of rabies on the Pacific Islands, but dog bites are common on some islands, and American Samoa has the unenviable reputation of having the highest incidence of dog bites in the world! Scuba diving is a popular activity, but there are few decompression chambers in the Pacific in case of mishaps. The Divers Alert Network provides information and insurance for scuba divers. Ciguatera fish poisoning is caused by marine microalgae in the tropics, and can cause nausea, vomiting, abdominal pain, diarrhoea, muscle cramps, paraesthesia, and a reversal of hot and cold sensation. It is riskier to eat large fish because they accumulate for toxin by eating smaller fish. As a general rule, if the fish fits onto a dinner plate, Ciguatera is unlikely to be a problem. It is best to avoid eating large reef fish such as barracuda and grouper. More information on ciguatera can be found in the June 2009 edition of the TMA Newsletter.

Natural hazards such as cyclones, earthquakes, and volcanic eruptions are part of everyday life, but serious disasters are relatively rare. Indeed, volcanic activity is responsible for creating many stunning and incredible landscapes throughout the Pacific, including extinct craters filled with rainforests and bats, tiny islands with sharp jagged peaks piercing the sky, abandoned villages half buried by old lava, and active volcanoes that are still erupting today.

Tinakula, Temotu Province, Solomon Islands. On a rest day from fieldwork, the local team on the Solomon Islands showed me their active volcano, which was about an hour’s boat ride from where we were working. Tinakula is only 3.5km wide, but rises 850m above the ocean, and has been uninhabited for decades because of eruptions. Even from a far distance, it is clear that Tinakula is highly active, with smoke pouring out from the top of its cone. But the true forces of nature could only be appreciated from up close, where rumblings from the volcano could also be heard and felt, and hot rocks seen spurting into the sky, and then tumbling down the hill into the ocean with a big steaming splash.

… Prepared by Dr Colleen Lau, TMA Perth and Brisbane

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Handwashing

Frequent careful handwashing is the simplest, most effective tool for decreasing the risk of many infectious diseases…

Scientists have recently reported that handwashing with soap could reduce the risk of lower respiratory tract infections such as pneumonia by 23%.

Who is Semmelweis?

In the mid-nineteenth century, Hungarian Ignaz Semmelweis postulated that doctors’ hands spread disease to the women in the childbirth wards. Septicemia after childbirth was common in mid-19th-century hospitals and was often fatal, with death rate of 10%-35%.

Despite various publications of results where hand-washing reduced mortality to below 1%, Semmelweis’s observations conflicted with the established scientific and medical opinions of the time and his ideas were rejected by the medical community.

In 1865, Semmelweis was committed to an asylum, where he died at age 47 after being beaten by the guards, only 14 days after he was committed. More info.

Travellers cannot afford to overlook such a simple and cost effective method of protecting their health.

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Travel Health Information

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