Archive for the ‘Brisbane’ Category

Working with Symbiosis in Bangladesh

Lipi’s Story

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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Uganda

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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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Chopsticks Lanterns and the Great Wall

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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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Are you involved in sending staff overseas for work?

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Travelling Staff – Employer Occupational Health and Safety Responsibilities

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.

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Mosquito Avoidance

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.

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Splitting tablets?

Dr Deb – TMA member in Brisbane  

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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Wife White Knuckles – Hurning to Brisbane – in 5 hour hops

Julie Wright, Admin Staff, TMA Member Brisbane

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.

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Exploring the World’s Remotest Rivers

… Prepared by Kevin Casey (visitor to Brisbane TMA members clinic)

 

 

One of the very best things about exploring the least known and most pristine rivers on the planet is that I experience the earth in its most natural state. What I do as the Remote River Man is certainly unique – I venture into extremely remote places, normally alone for a month or more, usually with only what can be carried on my back, or in a kayak or pack raft. I have filmed bears in Canada, been leech-bait in Borneo, trekked and paddled the most isolated parts of the Kimberley, got lost (on purpose) in an Argentinean swamp and shared meals with African pygmies. I plan these journeys, conduct them, film the adventures with lightweight video gear, and edit it all when I get home. I have no script, no film crew and no support team. The trips are expensive, so I can’t afford to get sick or have a careless accident while I’m enjoying myself out in the middle of nowhere. It’s not unusual for me to go a whole month in the wild without seeing another human, or be 400 kilometres away from the nearest one.

So how do I go medically with these far-flung journeys? So far pretty well, in over a quarter century of remote river exploration. I did get malaria once in New Guinea, and have had a few stomach complaints in various countries, and suffered the odd blister, cut or bruise, but the dangers of wild places are grossly exaggerated. I like to say (only half joking) that the most dangerous part of my remote river explorations is the car trip to and from the airport.

The real dangers in wilderness are the mundane ones – a sharp branch at eye level, loose rock on downhill slopes, a bad infection, drinking bad water or eating contaminated food, pushing too hard in the heat, etc. The insects make life interesting, too.

When it comes to food, I’ve eaten all sorts – donkey stew, lizard, wood grubs, roasted grasshoppers, raw queen fish (30 seconds after it came out of the ocean), stewed antelope, termite soup and a range of plant foods, from waterlily seed damper and hibiscus buds to palm heart and boab nut pulp. A lot of natural foods are actually more nutritious than the more adulterated stuff you buy in the shop. Generally the rivers I explore have no human habitation upstream which is always a help, but there are still plenty of microbes just waiting patiently for the ill prepared.

Insects are never to be taken lightly. I soak all my clothes in a permethrin solution before I go away, and carry a good repellent. 25-30% DEET is more than enough, unless you want to chemically burn holes in your nylon tarp, or melt the plastic case of your camera or sunnies. I like the Repel roll-on myself. I always sleep in either a mozzie-proof tent or in my trusty netted Clark Jungle Hammock. If I’m headed for a tropical country where I suspect bedbugs, fleas or other surprises might be joining me in my hotel bed, I’ll carry a very lightweight one-man Bug Bivy (Outdoor Research makes a nice one) and actually set that up right on top of the hotel bed, so nothing can get at me during the night. You can’t always assume a third-world hotel is going to provide a mozzie net, or if it does, that it won’t be full of well-hidden holes.

A comprehensive first aid kit is a must, and it’s always a struggle to balance keeping it lightweight and ‘covering all the bases’.

Getting into Dr. Deb’s Travel Medicine Clinic is something I always do at least 3-4 months before I head off overseas on a remote river exploration. Sooner is better than later for sorting out what’s needed, and since some of my destinations are exotic and seldom visited by tourists, it’s especially important for me to have up-to-date expertise, so I can then get down to the challenging business of exploring my chosen river, getting some amazing footage, and returning home safely so I can start editing all those Remote River Man DVDs!. Checkout Kevin’s website www.remoteriverman.com.

 

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RUM Project … Spot Quiz

What you are supposed to do with old or expired drugs that may be laying around your house?

A) flush them down the toilet
B) put them in the household rubbish
C) thrown them in a fire
D) give them to the RUM Project
E) use them anyway – waste is bad

The correct answer is D 
It is not safe or environmentally friendly to put expired medication in the household rubbish, and especially do not flush them down the toilet. Medicines can contaminate the environment when discarded via landfill sites and sewerage facilities. Many medications are supplied packaged in blister plastic made of PVC, which, when incinerated, produce dioxin (usually found in Agent Orange).

RUM in this circumstance is not what we mix with coca cola, RUM stands for Return Unused Medicines. It is a free service, funded by our taxes. Your local Pharmacy has special yellow bins to receive the medicines, which are then sent for high tech disposal in Victoria. RUM guidelines advise it is best to remove cardboard outer packaging (and place in the household recycling paper bin). Then, take the meds to shops next time you go, and deliver the used tablets, bottles and blister packs… to your local pharmacy. Many TMA member clinics will collect expired drugs when restocking kits, and drop them at the pharmacy for you. More info.

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Travelling Children

Travelling Children
Some recent studies have documented the likelihood of illness in children travellers. They reported roughly one in 3 children who travel abroad, will acquire a travel-related illness. Diarrhoea, feverish illness, skin conditions, and respiratory problems were the most common. Infected insect bites and sunburn also rated a special mention. Risk varied by age groups and destinations (greatest for African destinations). Young children visiting friends and relatives in Africa or Asia were at greatest risk; they visit places less frequently visited by tourists, and so are exposed to more of the local diseases.In the U.K., imported diseases account for 2% of pediatric hospitalizations. In one group of child travellers with fever; 59% had specific diagnoses, mainly malaria, glandular fever (highest in age group 15-19 years), and dengue fever. There were also cases of typhoid and paratyphoid ( from Asia); meningococcal meningitis, tuberculosis, visceral leishmaniasis, and hepatitis A simvastatin 10 mg.

One study also highlighted high rates of fatigue, itching, nausea, and sunburn while children were abroad; symptoms of which were not common in adults. Interestingly, one study found children received four times more insect bites than their in parents. Adolescents (aged 15-19 years) behaved more independently, undertook more adventure travel and backpacking, and were more likely to acquire glandular fever, sexually transmitted diseases, and suffer trauma.

 

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Travel Health Information

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