Member Login
1300 42 11 42

Archive for the ‘Brisbane’ Category

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.

 
Read More »

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.

Read More »

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.

 

Read More »

South Pacific – Leptospirosis

Dr Colleen Lau

Leptospirosis is a bacterial infection that is often misdiagnosed as dengue because symptoms can be very similar. The bacteria are carried by animals (including rodents, pets, livestock, and wildlife), and excreted in their urine. Humans can become infected by direct contact with animals, or contact with water and soil that has been contaminated by animal urine. The risk of infection is especially high after flooding, because floodwaters can spread the bacteria, and wash them into rivers and streams. During flooding, people often have to wade in water and therefore have cuts, wounds, and waterlogged skin, all of which increase the risk of infection. In the Pacific Islands, recent outbreaks have occurred after cyclones and flooding on some islands including Fiji and New Caledonia. People participating in outdoor activities are also at risk because of contact with fresh water and soil. The risk of infection can be reduced by wearing protective clothing and boots, cleaning and covering wounds, and avoiding swimming in freshwater streams and rivers after heavy rainfall. The bacteria do not survive in seawater, so there is no risk of leptospirosis from swimming in the ocean.

Leptospirosis research team at work in American Samoa. Left: Unloading fieldwork gear on the remote Manu’a Islands in the far east of American Samoa. Right: Collecting blood samples and questionnaire data. Our study collected data from over 800 people from 5 islands in American Samoa, and found that about 15% of people have had previous leptospirosis infections. The study investigated environmental factors that increased the risk of leptospirosis transmission, produced maps to predict high-risk areas, and provided information to improve public health interventions.

Read More »

Island Hopping in the South Pacific

Dr Colleen Lau is one of the founding travel doctors of the TMA Perth Clinic, and also works at the TMA Brisbane Clinic. Over the past 3 years, she has travelled around the South Pacific for tropical medicine research projects and consultancies, and has just completed a PhD in infectious disease epidemiology at the University of Queensland. In this article, Colleen provides us with information on health hazards in the South Pacific, and some snapshots from her research trips in American Samoa, Vanuatu, and the Solomon Islands.

Travel Health Precautions for the South Pacific

If you expect to find remote islands, underwater adventures, friendly smiling faces, flower garlands, tropical sunsets, coconut trees, and cocktails in the South Pacific, you will not be disappointed. On a world map, the islands look like tiny dots in the vast ocean. Close up, they are home to incredible diversity in culture, history, language, landscape, economy, and wealth. Consequently, sanitation, hygiene, and the quality and availability of health care also vary dramatically between the island nations. Although the Pacific Islands conjure images of tropical paradise, most of them are developing nations, and there are health issues that travellers should be aware of. Prevention is always better than cure, and the risk of many of the health hazards can be significantly reduced by simple precautions.

Rainmaker Mountain, American Samoa. After a 2-hour uphill hike, the view from the top of Mount Alava is breathtaking. Everything is lush and green, because American Samoa is one of the wettest inhabited places in the world, with an annual rainfall of over 3000mm. For my leptospirosis research project, I spent 3 months there during the ‘dry’ season, and it rained every single day!
Mosquito-borne Diseases
  • Dengue occurs throughout the South Pacific. In most tropical areas around the world including the Pacific, the frequency and size of dengue outbreaks have increased in recent years due to a combination of demographic, environmental and climatic factors. In one of my studies from American Samoa, about 95% of adults had antibodies to dengue viruses, indicating that they had been infected some time in the past. Dengue can cause fevers, a rash, sore bones/joints/muscles, headache, and a flu-like illness. A very promising dengue vaccine is currently being tested, and will hopefully be available in a few years’ time.
  • Malaria is found in Vanuatu and the Solomon Islands, but there is no risk in Fiji, Samoa, American Samoa, Tonga, French Polynesia, Cook Islands, or the Micronesian Islands. In Vanuatu, malaria is found in virtually the whole country, but is low risk in Port Vila and Tafea Province (including Tanna Island, where the famous active volcano Mt Yasur is located). Malaria is also found throughout the Solomon Islands, but is low risk in Temotu Province in the far south. In Tanna and Temotu, an AusAID-funded Malaria Elimination Program has significantly reduced the number of malaria cases. If travelling to Vanuatu and the Solomon Islands, you should speak to your travel doctor about antimalarial medications. Malaria is a potentially fatal infection, but is treatable if diagnosed early. If you develop any fevers during or after travelling to the tropics, see a doctor as soon as possible.
  • Chikungunya virus has spread over the past few years from East Africa to the Indian Ocean Islands and Asia, and local transmission was recently identified in New Caledonia and Papua New Guinea. There is therefore a risk that the virus will continue to spread to surrounding countries including Australia and the Pacific Islands. The infection can cause quite disabling symptoms including fever, rash, joint pain and stiffness, and severe tiredness. A large Ross River virus outbreak swept through the Pacific Islands in 1979/1980, but there have been few reports of infection since then.

    When travelling in the South Pacific, it is therefore very important to take precautions against mosquito bites by using DEET-containing repellents, wearing protective clothing, and using mosquito nets or screened accommodation. Perfumes can attract mosquitoes and should be avoided.

Village health post (left) and Tanna Hospital (right), Tanna Island, Vanuatu. Health care and medical supplies are limited, especially in the more remote islands. It is always best to carry a few basic supplies, and the most common items that travellers need are medications for diarrhoea, colds and flus, and pain-killers, and simple dressings for minor wounds and injuries.

Read More »

Melatonin And Jet Lag

Melatonin is the hormone of darkness – a hormone from the pineal gland in the brain which controls the body’s internal clock. Melatonin levels increase when it is dark outside and this causes you to feel sleepy. A great deal of research is being undertaken on melatonin to clarify its role in treatment of jetlag.

In the United States, melatonin is available without a script and outsells vitamin C. In Australia, some melatonin is available on a script. In Dec 2002, a literature review found that 5mg of melatonin, taken at the target bedtime at the destination (10pm-midnight), for 2-5 days after arrival, decreased jetlag resulting from flights crossing five or more time zones. It seemed to work best in persons who were travelling eastward.

Melatonin is not recommended if you have epilepsy or take the drug warfarin. Science News 2008 published information about a food related ‘clock’ in the brain, that overrides the light based ‘clock’. A period of fasting for about 16 hours (e.g. no eating during the flight) and then eating as soon after landing seems to help travellers adjust to the new time zone more quickly than they would otherwise do.

… From “Travelling Well”. Available here for your kindle from Amazon

 
Read More »

Volubilis, Morocco

Prepared by Dr Deb Mills – TMA member Brisbane

Volubilis is a partly excavated Roman ruin in northern Morocco. Built in a fertile agricultural area, it was developed from the 3rd century BC onwards as a Phoenician/Carthaginian settlement. It grew rapidly under Roman rule from the 1st century AD onwards and expanded to cover an area of about 40 hectares (100 acres) with a 2.6 km (1.6 mi) circuit of walls. The city gained a number of major public buildings in the 2nd century, including a basilica, temple and triumphal arch. Its prosperity, which was derived principally from olive growing, prompted the construction of many fine town-houses with large mosaic floors. More info.
I am a fan of ancient ruins, and this site was one of the highlight of my trip to Morocco. It is a short trip from Fez or Meknes, either by private car or bus. Morocco is a country for mosaics but this site has some rather well preserved mosaics from roman times. The ruins are substantial enough to give a very vivid picture of the locals who lived in the city at that time. The rich Romans seemed to have built a very comfortable life for themselves. The ruins are still surrounded by farmlands which makes a most picturesque setting. There are no signs or maps on any of the structures when I was there, so it helps to have a guide to get the best stories and make the most of your visit.

 

TIP: Arrive as early in the morning as you can (7am) before the bulk of tourists … as we were leaving … 5 large tourist buses arrived!

 

You may be interested in Dr Deb’s one minute video: Why travellers seem to be complacent about their health. It was filmed in Volubilis. Watch it here.
Read More »

Egypt – Hot air balloon disaster

We are all saddened by the tragic story of the 19 tourists killed in Egypt after their balloon flight went horribly wrong.WHO reports Tourists are 10 times more likely to die as the result of an injury than from an infectious disease

; injuries cause 23% of tourist deaths compared with only 2% caused by infectious diseases. Contributing to the injury toll while traveling are exposure to unfamiliar and perhaps risky environments, differences in language and communications, less stringent product safety and vehicle standards, unfamiliar rules and regulations, a carefree holiday or vacation spirit leading to more risk-taking behaviour, and overreliance on travel and tour operators to protect one’s safety and security.

Safety in the air takes major attention to every tiny detail, obsessional training of pilots and maintenance crew, tightly enforced government regulations, expensive and well maintained equipment and so on. This article in Sydney Morning Herald on the balloon disaster in Egypt is worth reading for anyone planning balloon flights.
Read More »
  1. Pages:
  3. 1
  4. 2

Travel Health Information

Creative Commons License
This work by Dr Deb The Travel Doctor Pty Ltd (ABN 75 624 360 247) is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Permissions beyond the scope of this license may be available at http://www.thetraveldoctor.com.au/website_terms_conditions.htm.

Website Terms and Conditions | Governing policy | Sitemap| Privacy Policy

Website Developed by Big Blue Creative