General Recommendations before Travelling
Before travelling abroad, mainly to tropic and sub-tropic areas, each traveller should visit his/her doctor 3 months before the departure – ideally a doctor specialised in travelling medicine. The term of 3 months before departure is recommended due to the fact that it allows assessment of health conditions, healing of some diseases and possibly performance of some necessary examinations. In case of chronic diseases it is necessary to revise and adjust treatment, to set efficient vaccination and to set the intervals between them. It is necessary to be instructed on health protection from infectious diseases, imprudent sunbathing, climatic influences and risks connected with bathing in the sea and in surface water, to recommend suitable literature on health problems in countries that the traveller is going to visit.
Before specifying the individual vaccinations, the vaccinating doctor will take into consideration the term of the stay, the country, time or country stay locations, appropriate medical regulations for vaccination, age and health conditions of the traveller, previous symptoms of allergy and chronic diseases that could be negatively affected by vaccination, data on previous vaccinations and undesirable effects of their application. And finally, the doctor will consider a suitable method of malaria chemo-prophylaxis, sometimes even prophylaxis in relation to some other tropic diseases. He will check compatibility of medicaments against malaria – usually by starting their administration 2 weeks before departure or even earlier. The doctor will also suggest suitable equipment of the travel first aid kit.
Travel first aid kit
The equipment of the travel first aid kit depends on the term of stay, health conditions and areas that the traveller is going to visit. It is also necessary to take into consideration the supposed availability of medical care in given location. More, it is necessary to warn travellers of the fact that quality of medicaments in some countries is doubtful, as medicaments that have not underwent any control may be sometimes sold. In some locations it is difficult to buy wide-spectrum antibiotics or anti-diabetics. When buying a medicament, you always have to check the expiration date (the date by which the medicament is to be used). In case of unsuitable storage, the efficiency of medicaments decreases faster than in case o mild climate. That is why medicaments are not used in mountain climate a few weeks before expiration.
As a standard, the travel first aid kit is equipped for short trips to tropic and sub-tropic regions with suitable bandage material (hydrophilous roller bandage, elastic bandage, mull, sticking plasters of various sizes, alcohol tampons, triangular bandage, rubber bandage), disinfection for treatment of small injuries, freely available analgesics and antipyretics, medicaments against plane, car and possible ship disease, gel with antihistaminics contents against itching rash, bites of arthropods, stinging by sea animals and plants. It is also important to have medicaments against diarrhoea. In case of strong diarrhoea and vomiting it is necessary to add liquids and salts (electrolytes) – that is why the travel first aid kit should contain a mixture for re-hydration solution preparation. Eye drops with disinfection effects are used after removal of foreign objects, in case of conjunctivitis or after an injury up to the moment of medical treatment. An integral part of the travel first aid kit is the anti-mycotic powder or ointment to be applied between the toes after bath and thorough drying so as to avoid frequent mycotic infections in hot climate (the skin between toes becomes white and desquamates). The first aid kit should also include syrettes for individual use and needles, tweezers, scissors and forehead thermometer.
At least one member of the team travelling to climatically and epidemically risky areas must be instructed in detail and he should also take a first aid course. First aid kits are setup for expeditions depending on the number of participants and the areas of their stay.
Those suffering from some chronic disease should visit the specialised doctor before their departure – e.g. diabetologist, alergologist, gynaecologist, dermatologist or internal medicine doctor and ask him for recommendation of medicaments for possible health condition deterioration. Each medicament is completed with an information leaflet, describing use of the medicament, dosing and contraindications. You can find the expiration date on the package of the medicament – it is not allowed to use the medicament after that date.
The travellers leaving for locations with supposedly difficult availability of unavailability of medical care should include even antibiotics to the first aid kit (for example doxycycline or ciprofloxacin), respectively sulphonamides (for example sulphametoxazol-trimetoprim). The traveller should be informed about indications for antibiotic treatment and undesirable effects of antibiotics (photo toxicity – sulfonamides, chinolons and tetracyclines). It is recommended for the traveller to consult – if possible the local doctor before administrating the antibiotics respectively to visit him immediately after unavoidable administration of antibiotics.
It is also recommended to give to the luggage even insecticides for possible necessary use after your arrival. Preparations containing pyretrins and pyretroids have even repellent characteristics. The insecticides are used in the form of aerosol, fumigator and evaporators.
In case of a stay in malarial areas, the first aid is completed with antimalarial drugs according to recommendation of a doctor from the travel medicine centre. The antimalarial drugs serve for chemo prophylaxis, respectively for so called emergency self-treatment.
Sometimes it is difficult to boil water. In such cases it is possible to filter water (it is possible to buy many different types of water filters that are suitable for longer stays) or it is possible to disinfect it in a reliable way by using some suitable preparation being sold. The preparations for chemical treatment of water can be used for washing fruits and vegetables. The first aid kits should also include a preparation for potable water preparation. It is also possible to use potash solution for washing the fruits and vegetables.
Even though it is possible to buy repellents in all the countries, it is recommended to take at least some small quantity along. The most efficient are the means on the basis of N,N-diethyl-m-toluamide (DEET). Preparations in the form of creams are more favourable, as they provide much longer protection compared to liquid preparations.
Never forget of high-factor sunscreen. High protective factor is recommended to individuals sensitive to sunshine effects, blond people and in case of prophylactic administration of doxycycline against malaria. Do not forget to take your sunglasses.
A traveller may encounter problems with customs clearance of medicaments. Import of some medicaments is prohibited to some countries – respectively the custom officers require their customs clearance. The traveller may ask the institution engaged in travel medicine to issue a certificate for the carried medicaments to be designed exclusively for treatment and prevention of traveller´s diseases respectively that they are of life importance.
Health insurance
The traveller mustn´t forget about travel health insurance. It is necessary to study in advance the insurance conditions and to ask the insurance company about details. Some insurance companies refuse to compensate injuries suffered during alpine tourism, diving, skateboarding and treatment of acute attacks of chronic diseases. There is usually compensated elimination of teeth pains, but no fillings.
The insured person should contact the assistance service as soon as possible – they are in nonstop operation and they will provide information on the nearest contractual insurance company doctor to be addressed. Some doctors require excessive sums, which the insured may refuse to pay. It is always necessary to carry the insurance company card along. In case of rips organized by travel agencies, the health insurance is included in the price, but it is necessary to get information about its extent. Sometimes it applies to injuries only.
Other equipment, practical advices
Preparation of luggage
Do not leave preparation of your luggage to the very last day. Carefully consider which luggage to take for your stay and which to an adventure trip. Always put the most important accessories for your trip to your hand luggage / carryon as it is rarely lost.
Selection of clothes
When selecting your clothes and underwear prefer cotton or mixture of cotton with some other suitable material. Your underwear should be washable, the material should allow hot ironing so as to destroy all the microorganisms. The most suitable colour for tropic areas is khaki. Recommended tissues for hot and wet climate are sparsely woven of strong threads, so as the insulation effects are as minimal as possible. You must take along shorts as well as long trousers for your stay in nature. Together with shirts with short sleeve you should also take vests and long-sleeve shirts, partially protecting you from arthropoda, tree leeches, stinging plants and injuries. The clothes should be free, not to cause scratches on macerated skin.
Shoes selection
Your shoes should be light, airy and in approximately 1/2 – 1 size bigger than the shoes that you wear at home, the shoes mustn´t cause galls. The shoes should always be closed so s to provide better protection against parasites, bacteria, chignon fleas and mycoses. When bathing in warm seas it is necessary to use bathing shoes or trainers, protecting you from injuries caused by sea animals and your should wear them also in the beach so as to be protected against migrating larvae.