General recommendations before travelling
Before travelling abroad, especially to the tropics and subtropics, every traveller should see a doctor, preferably one who specialises in travel medicine, 3 months before departure. The 3 month pre-departure period is recommended because it will allow to assess the health condition, cure some diseases, or. to carry out the necessary examinations. For chronic diseases, treatment needs to be reviewed and adjusted, effective vaccinations need to be established and intervals between vaccinations need to be determined. Conduct a briefing on health protection against infectious diseases, unwise sunbathing, climatic influences and risks of swimming in sea and surface waters, recommend appropriate literature on health problems in the countries the traveller intends to visit.
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Before determining individual vaccinations, the vaccinating physician shall take into account the length of stay, the country, urban and rural locations, the relevant medical regulations for vaccination, the age and health status of the traveller, previous allergy manifestations and chronic diseases that could be adversely affected by the vaccination, data on previous vaccinations and adverse reactions after their administration. Finally, the physician will consider the appropriate method of chemoprophylaxis for malaria, and exceptionally for some other tropical diseases. They check the tolerability of antimalarial drugs by starting them usually 2 weeks before departure, or earlier if necessary. The doctor will also suggest the equipment of a suitable travel first aid kit.
Travel first aid kit
The contents of the travel first aid kit depend on the length of stay, the state of health and the areas the traveller intends to visit. The expected availability of medical care at the place of stay must also be taken into account. It is also necessary to warn travellers that the quality of medicines in some countries is questionable, sometimes medicines are sold that have not passed any inspection. In some places it is difficult to buy broad-spectrum antibiotics or antidiabetic drugs. You should always check the expiry date (the date by which the medicine should be used up) for any medicine you buy. If stored improperly, the effectiveness of medicines declines faster than in temperate climates. Therefore, in mountain climates, it is preferable not to use medicines a few weeks before expiration.
A standard travel first aid kit equipped for short trips to the tropics and subtropics should contain suitable dressing material (hydrophilic knitted bandage, elastic bandage, gauze, plasters of various sizes, alcohol swabs, triple-loop scarf, rubber tourniquet), disinfectant for treatment of minor injuries, over-the-counter analgesic and antipyretic, medicines against airplane, car, or other airplane accidents. boat diseases, gel containing antihistamine against itchy rashes, arthropod stings, stings by marine animals and plants. The remedy for diarrhoeal diseases is also important. In case of severe diarrhoea and vomiting, body fluids and salts (electrolytes) must be replenished immediately, so a mixture for preparing a rehydration solution is included in the travel first aid kit. Eye drops with a disinfectant effect are used for dripping after the removal of foreign bodies, for conjunctivitis or after an accident until a doctor can be reached. An indispensable part of a travel first aid kit is an antifungal pack or ointment, which is applied between the toes after bathing and drying thoroughly against a common mycotic disease in hot climates (the skin between the toes turns white and peels off in cuts). The first aid kit should also include disposable syringes and needles, tweezers, scissors and a forehead thermometer.
At least one member of the expedition going to climatically and epidemiologically risky areas needs to be briefed in detail and it is also advisable that he/she has attended a first aid course. For expeditions, handheld first aid kits are compiled according to the number of participants and the areas of stay.
If you suffer from a chronic illness, you should see a specialist before departure, e.g. a diabetologist, allergist, gynaecologist, dermatologist or internist and ask them to recommend any medications that might be considered if the condition worsens. Each medicine is accompanied by a leaflet describing its use, dosage and contraindications. There is also an expiry date on the packaging, after which the medicine cannot be used.
For travellers going to places where medical care is expected to be difficult or even unavailable, antibiotics (e.g. doxycycline or ciprofloxacin) should also be included in the travel first aid kit. sulfonamides (e.g. sulfamethoxazole-trimethoprim). The traveller should be familiar with the indications for administration and side effects of antibiotics (phototoxicity – sulfonamides, quinolones and tetracyclines). It is recommended that, if possible, the traveller should consult a local doctor before using antibiotics, if possible. to see him after the inevitable antibiotic treatment.
It is recommended to put insecticides in your luggage for any necessary use upon arrival. Preparations containing pyrethrins and pyrethroids also have repellent properties. Insecticides are used in aerosol, fumigant and vaporizer forms.
In the case of a stay in malarial areas, the travel first aid kit should be replenished with antimalarials according to the advice of the doctor at the travel medicine centre. Malarika is used for chemoprophylaxis, or. to the so-called. emergency self-medication.
Sometimes it is difficult to boil the water. In such cases, the water can either be filtered (a number of types of suitable filters can be purchased, which are more suitable for longer stays) or reliably disinfected with a suitable preparation that is on sale. Chemical water treatment products can also be used to rinse fruits and vegetables. A suitable part of the first aid kit is therefore a preparation for drinking water. A hypermanganese solution can also be used to rinse fruits and vegetables.
Although repellents can be purchased in all countries, it is advisable to take at least a small amount with you. N,N-diethyl-m-toluamide (DEET) based products are the most effective. Cream formulations are preferable because they provide much longer protection than liquid formulations.
Never forget to wear sunscreen. A high SPF is recommended for individuals hypersensitive to the effects of sunlight, for blondes and in the case of prophylactic administration of doxycycline against malaria. Bring sunglasses with you.
The traveller may have problems with customs clearance of medicines. Importation of certain medicines is banned in some countries, or. customs officials are demanding that they be cleared. The traveller may request confirmation from the travel medicine service that the medicines carried are intended solely for the treatment and prevention of the traveller’s illnesses or that they are vital.
Health insurance
The traveller must not forget to take out travel health insurance. You should study the terms and conditions of the insurance beforehand and ask the insurance company for details. Some insurance companies refuse to pay compensation for injuries sustained while hiking, diving, skateboarding, and treating acute flare-ups of chronic illnesses. Usually only tooth pain relief is reimbursed, but not fillings.
The insured person should first contact the assistance service, which works around the clock and will advise him/her where to contact the nearest insurance company’s contracted doctor. Some doctors demand an exorbitant amount that the insured may refuse to pay. You must carry your insurance card with you at all times. For tours organised by travel agencies, health insurance is usually included in the price, but you should check the extent of the insurance. Sometimes it only applies to an injury.
Other equipment, practical advice
Luggage preparation
Don’t leave luggage preparation until the last day. You need to think carefully about what luggage you take on a holiday trip and what luggage you take on a sightseeing trip. Always put your most important travel essentials in your hand luggage, which rarely gets lost.
Choice of clothing
When choosing clothing and underwear, prefer cotton or a mixture of cotton and other suitable materials. The laundry should be washable and the material should allow ironing with a hot iron to destroy microorganisms. The most suitable colour for the tropics is khaki. Suitable fabrics for hot and humid climates are sparsely woven from strong fibres to minimise their insulating effect. In addition to short trousers, you must also bring long trousers for the outdoors. In addition to short-sleeved shirts, it is necessary to bring tank tops and long-sleeved shirts, which protect partly against arthropods, tree leeches, plant stings and against injury. Clothing should be loose so as not to cause abrasions in the macerated skin.
Choice of footwear
Shoes should be light, airy and about 1/2 – 1 size larger than you wear at home, not causing blisters. Footwear should always be closed to provide better protection against parasites, bacteria, sand fleas and mycoses. For swimming in warm seas, it is necessary to have bathing shoes or sneakers to prevent injury by marine animals and to wear them on the beach against skin migrating larvae.
In hotels in tropical and subtropical areas, mosquito nets are usually installed, or mosquito nets can be installed. the staff will stretch them on request. It is recommended to purchase a mosquito net when travelling where sleeping under a mosquito net is not guaranteed. According to the World Health Organization, mosquito nets should be impregnated with the insecticide permethrin, or. deltamethrin. In the case of departure to areas where phlebotomized diseases occur, a mosquito net with a mesh size of 0.5 mm should be selected. It is also necessary to check the nets in the tents and look for openings through which arthropods could enter. For personal protection in the open air, a permethrin-impregnated net is recommended, which can be thrown over the head and shoulders while walking, or alternatively. all the way up through the upper body to the arms.
Other useful tips:
- It is advisable to get internal lighting for the tent, if necessary. lighting that allows reading in the evening under a mosquito net.
- Every traveler should have a handheld flashlight, which is indispensable when walking outdoors after sunset.
- For expeditions to high altitudes (above 6000 m), a portable hyperbaric chamber with a foot pump is recommended, which can save lives in the event of brain or lung oedema.
- If the traveller wants to equip himself for diving, a consultation with a professional company is recommended.
- New guidebooks and maps should also be purchased for travel in the tropics and subtropics.
- Dictionaries are useful.