Mark Sweet TMA member Surrey Hills VIC
International travel has been severely curtailed as a result of Covid19. But there are still many reasons that you may want to consult a travel clinic. The TMA doctors are experts in immunisation and some of the TMA clinics are involved in pre-employment / pre-deployment medical assessments.
Immunisations when you are not travelling? – Yes!
Ayubowan Readers! “Ayubowan” is the word used in Sri Lanka to greet someone
Sri Lanka is a small Island off the south east tip of the Indian subcontinent. Measuring a total area of 65 610km, it is home to 20.5 million people (2013). Until 1972 the island was known as Ceylon, however still goes by many other names such as “The pearl of the Indian Ocean” and “The teardrop of India”. Colombo is the nation’s commercial and capital city.
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Here I am sitting poolside somewhere between overheated and hot just from the exertion of walking from the hotel room up through the reception and dining room of this magic old English colonial hotel with a romantic story to keep you on the edge of your seat. I will have to leave you there for another time.
As I look across the inviting pool of Mt Lavinia Hotel to the rolling surf where the Arabian sea meets the Indian Ocean, to the skyline of a bustling city, I give away my location as being in Sri Lanka. With almost three weeks behind me in this land of contrasts I am reluctantly packing to catch the early morning flight to Singapore.
Ones first impressions are that at least 2 things are missing here …
We started and ended our time in five star luxury that thrills the wallet, but spent 15 days on an Intrepid tour that covered all the major historic places. These included Anuradhapura, Polonnaruwa, Kandy, Colombo and Dambulla, each with their fascinating mix of ancient kingdoms, Portuguese, Dutch and English influence. Most of the lodgings were 2 star but clean and acceptable. Cheap tasty meals made up for reduced aesthetics and lack of fluffy white towels.
Just when almost “Templed” out our guide took us trekking through beautiful cool mountain tracks to the tea plantations and cascading waterfalls to stay in an original Managers Bungalow. We were entertained by our guides with local music (one of those special moments in the life of a traveller).
We visited spice gardens; saw a turtle rehabilitation centre; climbed 200m to a citadel in Sigariya; and then spent 2 days at a beach in pounding surf. We learnt to eat without knife and fork and not to roll our eyes when rice and curry where being suggested yet again. I wonder if my new found skill will go down well at home.
Another special occasion was when our guide, and now friend Bruno, took us to a family friend’s home and we all helped to cook a lively meal and learn the differences in curries, and how to make coconut cream and milk. His wife also joined in – we were family now.
Considering some of the off beat places we ate at and the prevalence of many stray mangy dogs and monkeys we were grateful for good advice from our travel doctor before our departure.
So now the thoughts of home and work are fast becoming a reality, we say goodbye. There is still much to explore here and while peace prevails here we promise to return.
Read More »Travelling to third world countries as part of a medical attachment can be a life changing event with life long learned skills and memorable experiences. This 64 year old gent was happy to share his story with Megan Young, our final year medical student, presently attached to a hospital in Sri Lanka. He has suffered this condition for 22 years. The risk to visiting travellers is quite low.
Lymphatic filariasis, also known as Elephantiasis, is a parasitic nematode infection spread me mosquitoes, in which the worms obstruct the lymphatic system, causing severe chronic lymphoedema. It may result in deformity and cause disability and is associated with social stigma. (WHO)
Aetiology:
Wucheria bancrofti is responsible for around 90% of lymphatic filariasis infections, but Brugia malayi and B. timori may also be the cause. Infection occurs when mosquitoes (Culex, Anopheles and Aedes species) carrying the larvae of filaria bite a human, transferring larvae into the blood. The larvae enter the lymphatic system, where they mature into adult worms, where they form ‘nests’ which obstruct the lymphatic system causing lymphoedema, and, in more severe cases, elephantiasis (where the skin and tissues thicken). This occurs over a period of several years. Lymphoedema may occur in the limbs, genital and breasts. (WHO)
Epidemiology:
Lymphatic filariasis occurs in 83 countries in the tropics of Asia, Africa, and the Pacific and in certain regions of the Caribbean and South America.
Risk for Travellers:
Risk for travellers to endemic areas is low; however, lymphatic filariasis can occur in travellers who stay for extended periods in endemic areas.
Prevention:
There is no vaccination or prophylactic medication for lymphatic filariasis. It must be prevented throughprevention of mosquito bites.
Treatment:
Treatment of lymphatic filariasis is through mass drug administration (MDA) of albendazole 400mg with either ivermectin (150 – 200 mcg/kg) diethelcarbamazine citrate (6mg/kg). Treatment also aims to reduce lymphoedema and prevent secondary infections in the affected limb. (WHO)
Travel Health Information
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