Archive for the ‘Yeppoon’ Category

Travel to India

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Towards the end of my second semester of university at the University of Queensland, I expressed to a friend the desire to “one day” do voluntary work somewhere/anywhere overseas.  To which her reply was “Well, I’ve actually just started helping Lattitude do interviews for a volunteer placement starting next February. I can send you a link on Facebook, if you want.”

Fast forward three months, and I was deferred from University and on a plane to New Delhi, nervous and excited for the upcoming months.  As part of Young People without Borders, a new initiative for the Foundation of Young Australians, I was off to teach at a school for underprivileged in Dehradun, a city at the base of the Himalayas.

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Israel Holiday

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‘Boker Tov’, good morning!

Our tour of Israel lasted for twelve days, and every day was packed with visits to historical sites; many recorded in the Bible. It was thrilling to stand in historical places which are so well documented, and to see many towns and cities thriving due to the influx of immigrants seeking a better life style.  As an example, over one million Russian Jews have settled in Israel since the Union of Soviet Socialist Republics (USSR) was disbanded in 1991 under President Michael Gorbachev’s time in office. The present day population of Israel is close to 8,002,300 people.

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Meningococcal B vaccine

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Dr Julie Burke – Yeppoon

BEXSERO , the first broadly effective Meningococcal B vaccine is indicated for immunisation of infants (from 2 months of age), toddlers, children, adolescents and adults against Meningococcal serogroup B (MenB) disease.  It’s  availability to travellers will be particularly useful for infants and exchange students, students studying overseas especially in  residential colleges, people without a functioning spleen, or those with other conditions that impair their immunity.

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Elephantiasis – Sri Lanka

… Prepared by TMA Member Yeppoon, Qld: Megan Young (medical student)

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)

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Immunisation – Children and Travel

… Prepared by TMA Member Yeppoon, Qld: Dr Julie Burke

Travelling with children can be very rewarding. People of all ages and cultures are drawn especially towards children, often making the family travel experience especially fulfilling.

Travelling with children does, however, pose some extra challenges. Ensuring optimum preventative care with pre travel vaccinations can eliminate some of these extra stressors.

Routine Schedule of Vaccinations

All travelling children should be immunised in accordance with the Australian National Immunisation Programme. If you can not find documentation of your child’s vaccinations; this can easily be retrieved from the Australian Childhood Immunisation Register. Travel doctors will tend to adopt the policy of “no documentation means not immunised” and vaccination will be recommended; as evidence shows the risk of adverse events if a child is inadvertently revaccinated far outweighs the risk of the disease.

Routine schedules are designed to vaccinate children at the earliest age when they respond with optimal, long-term protection. Little ones are more susceptible to disease but usually have little chance of exposure in Australia. However, travelling to developing countries, the risk of exposure may greatly increase. Almost all of the routine vaccines can be given early and more frequently than the schedule suggests.

Measles, for example; is an exotic disease in Australia, but is regularly re-introduced by young travellers, especially from regions where there is no national programme to eliminate it. The Measles/Mumps/Rubella vaccination can be given as young as 9 months of age but with a booster 3 months later.

Since late 2008, an Australia-wide whooping cough epidemic has seen an increase in hospitalisations of infants with life-threatening whooping cough. It is highly infectious; making little travellers highly vulnerable in crowded airports/aeroplanes/countries.

Polio has been eradicated from most of the world but still circulates in many developing countries, particularly Africa and the Indian sub-continent and, to a lesser degree, Indonesia and the Arabian Peninsula.

The routine whooping cough/diphtheria/tetanus/hepatitis B/polio vaccination given at at 2, 4 and 6 months can be given at 6 weeks; 10 weeks; and 18 weeks without affecting the booster immunity. The 3rd dosage may even be given as early as 14 weeks if the child at high risk; but an extra booster to cover for the hepatitis B component of the vaccination would be necessary.

Rotavirus; the predominant cause of severe dehydrating gastroenteritis in infants and young children in both developed and developing countries; can also be prevented through an accelerated schedule; the first dose of this can be given as young as 6 weeks with interval between dose between 1st, 2nd, and 3rd dose at 4 weeks minimum.

Meningococcal disease is both sporadic and epidemic throughout the world. with meningococcal C associated with small clusters in schools and child care centres. On the schedule; the protection against group C meningococcus is a single dosage of vaccine at 12 months; but this can also be given early 2-3 doses (dependant on the specific vaccine) starting at 6-8 weeks of age.

Travel-specific Vaccinations

Vaccinations such as Hepatitis A, Typhoid, Rabies, TB Japanese Encephalitis, and Influenza may be recommended to your child for country-specific disease cover and accelerated schedules may also be possible for these vaccinations.

Influenza, for example is one of the most common travel-acquired vaccine-preventable illnesses and vaccination should be considered in all children travelling overseas.

All persons aged up to 6 months should be vaccinated against influenza. The 2010 suspension of 2 influenza vaccines (Panvax and Fluvax) in Australia has been fully investigated; and the Australian Technical Advisory Group on Immunisation (ATAGI) has now recommended the use of 2 vaccines; InfluvacReg and VaxigripReg in children between 6 months to less than 10 years. Two doses one month apart are needed if under 10 and receiving influenza vaccine for the first time.

Such accelerated schedules are highly recommended for any families taking infants overseas for several months in their first year of life.

Travelling With Children Tip

Tired and hungry children do not do well with vaccinations! Well rested and fed children who have had Emla cream/patch applied to the area of vaccination area can make a huge difference to the pleasantness of a pre-travel consultation.

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A Year in South America

Brian and Debbie don their back-packs and pretend they are young – a year in South America.

Intrepid travellers from way back, my husband and I, at 53 years old, found ourselves rattling around in our huge empty nest, encumbered by possessions, job security, and misguided ideas that our adult children still needed us. We were feeling a tiny bit ‘old and achy’.
It had been a long journey since we’d first bumped back-packs in Europe in 1980. Four children and 30 years later, we had lost our ‘Mojo’ so, we took a year off from our teaching jobs and armed with our freshly gleaned Lonely Planet Guide, fledgling Spanish, overly-heavy back-packs, and traveller’s medical kit (thanks Dr. Julie Bourke); we landed in Buenos Aires just after Christmas 2009.

And thus began the adventure of our mid-lifetime! We had scribbled a loop clockwise around the continent, including all 13 countries with side trips to Antarctica, Easter Island, Galapagos and Cuba allowing roughly a month in each of the big countries and highlighting a few “must-sees” like Macho Picchu and Iguaçu Falls.

For us all the fun of travelling has always been, getting down and dirty and mixing it with the locals in their everyday lives – catching local transport, sleeping in hostels and cheap hotels, and eating in the local food-stalls.
This kind of rough travelling is not for every ‘oldie’. It was tough and not without its dangers!

At first it was hard to sleep in public – in strange beds. I’m not sure if modern unisex dormitories and bathrooms represent progress?

Sleeping soon became a non-issue as we toughened up. Pounding the pavements for hours every day, trekking up and down mountains, cycling and horse-riding made us so tired, we could sleep on a stone!

Wherever possible we caught local transport, from the world-class buses of Argentina and Brazil with airline-like service – to the bone-rattlers of Bolivia and Ecuador, jam packed with people, produce and peddlers- selling everything from hot food to God (evangelists), as the drivers careened down the mountains, at break-neck speed with one hand on the wheel, the other on their mobile phones.

Dealing with endless dysfunctional and often dirty toilets, or simply trying to find one at all was a daily challenge!

We learned to eat all manner of meat/ chicken and potatoes. Apart from the excellent ‘barbeque bife’ in Argentina and the odd spicy local delicacy like empanadas the food is … well … boring. People are poor and eat basic fare.Probably the biggest disappointment in a continent that produces some of the world’s best coffee is that incredibly, they mostly drink instant Nescafe!Life at the rough end of the travel spectrum, involves hassles at border crossings, and inevitably being robbed. Not many people can survive a year in South America without being relieved of some of their goods! We both lost our mini back-packs on separate occasions, cried with outrage …  and got over it. No one can be vigilant 24/7.

But life at the rough end is where all the fun is! We work on the premise, that people are basically good and that a smile goes a long way.

The only regret I have about being Australian is how dumb we are with other languages. Listening to Europeans slip in and out of 5 lingos in a conversation has always filled me with shame and envy.Fumbling along in our basic Spanish, we decided to home-stay in Sucre, Bolivia and attend language school for 2 weeks. After that, we ‘upped the ante’ and persevered till our heads ached.

Then one magic day, we realized we had passed through a barrier and could understand a great deal of what was being said around us. I can not explain what a thrill that was! Speaking the lingo takes the ‘tourist’ stigma away and opens so many doors to experience the hospitality and kindness of the wonderful local people.
Although border crossings and late night bus travel can be scary, we were rarely frightened, except when we were caught in 2 natural disasters.
Firstly the earthquake in Chile, ‘shook us to the bone’. We were in a cheap and rickety old hotel in Valparaiso, asleep, when the whole building began to shake….. then rock….. and then belt the furniture from one side to the other! The plaster ceiling showered down on us and the walls cracked from top to bottom. We eventually made a run for it down the swaying cracking stair-cases to the square outside. The after-shocks went on for days. Towns went into lock-down and looters and armed guards controlled the streets. Brian had his day pack stolen. Scary stuff!

We now have a new understanding as we watch news coverage of those kinds of events.The 2nd time we thought our number was up was when we were trekking to ‘the lost city’ in the Columbian jungle. A huge mudslide engulfed the dodgy-built bunk-house, where we were resting after lunch. I swear I broke the world land- speed record as I leapt up over boulders and up the ridge as the whole mountain came down! I couldn’t find Brian! He had run the other way!The local guides frantically started digging in case someone was trapped underneath. Miraculously everyone had escaped! Many in our group lost everything. It was a long muddy 3-day trek back to civilization in shared clothes and various improvised footwear held on by gaffer tape! We still keep in contact with the 17 magnificent people on that trek (from 14 countries). We developed a wonderful camaraderie and respect through that shared hardship. Humour abounded as we hugged each other in the nightly soggy giant ‘spoon’ to keep warm.

As for illness, we picked up a couple of tummy bugs, suffered from mild altitude sickness several times and Brian had the horror of discovering a hook worm winding its way under the skin on his little toes! Teach him to walk around bare-footed!

South America has it all:- trekking in the awesome Andes; battling the wild winds of Patagonia; marching Incan trails to Machu Picchu; discovering Columbia’s lost city; sweating it out in the Amazonian jungles of 5 countries; catching and eating piranha (before they eat you!); chugging up the Mighty Amazon itself in Brazil on a supply boat; the seductive music and rhythm of the Latino Salsa and Tango; the enduring Catholicism, cathedrals and cobble stones of the great Spanish Conquistadores; the ingenuity of the Incas; the white wonderland that is Antarctica; the quirky culture of Cuba (a society cut off from the real world); the amazing animals of Galapagos; enigmatic Easter Island; the boisterous Bolivian markets; the surrealism of the high altitude salt plains of the Atacama Desert; the sexy culture of iconic Ipanema Beach in Rio de Janero … I could go on and on …

We left old and achy feeling like the best years of our lives were over and returned, a year later, feeling young and invincible! We can do anything!

Next stop – Africa!

… Prepared by Debbie Mann Yeppoon State High School, Queensland

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