Archive for the ‘Country’ Category

Typhoon Haiyan travel advice

Prepared by TMA member Narre Warren

It is now over a month since Typhoon Haiyan (called Yolanda in the Phillipines) struck the Philippines on 8/11/13. The worst hit provinces were Leyte and Eastern Samar, which experienced sustained winds of 270 kph, gusts of up to 312 kph, and a storm surge in coastal areas as high as 7 metres. Not all travel is for pleasure. Typhoon Haiyan travel advice is be prepared and be informed.

The official death toll from the Phillipines Government is approaching 6000, the injury toll 27000, and 1800 people as of mid December 2013 are still listed as missing. These figures are considered by most to be conservative.

Enormous international aid efforts are underway. Significant infrastructure damage has caused problems with sanitation, food supply, electricity, transportation, shelter, communications, security, and medical care.

This all has implications for people who are considering travelling with aid organisations, or in those visiting relatives and friends to help them. 

The following advice applies to both groups of travellers:

1                Take a kit with you from your travel medicine clinic to treat diarrhoea; diarrhoeal illnesses are likely to be more common after a disaster where serious flooding has occurred. Follow the usual safe food and water precautions advised by your travel clinic

2                Use mosquito repellents with more than 30% DEET to prevent mosquito borne illnesses such as Dengue Fever and Chikungunya. Mosquitos will breed in greater numbers around flooded areas. The areas worst affected by Typhoon Haiyan are the islands of Leyte, Samar and Cebu; they are not affected by malaria so malaria tablets are not required for these islands.

3                Be vaccinated for Hepatitis A and Typhoid; update your tetanus injections as debris clearing will often result in injury. Have a flu injection, and speak to your travel Doctor about other vaccines you may need.

4                Avoid injury—most deaths after a natural disaster are due to blunt trauma, crush-related injuries, and drowning. Use caution around damaged or down power lines, 

water-affected electrical outlets, and interrupted gas lines.

5                 Avoid stray or frightened animals. Seek medical help immediately if you are bitten or scratched by an animal and wash out the wound. Consider rabies vaccination before you go, or seek rabies vaccination within 48 hours of any animal bites.



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Sri Lanka

Sri Lanka

by Dr Jonathan Barrell, TMA Member Daylesford, Victoria

The Democratic Socialist Republic of Sri Lanka, is an island country in the northern Indian Ocean off the southern coast of the Indian subcontinent in South Asia; known until 1972 as Ceylon. Sri Lanka has maritime borders with India to the northwest and the Maldives to the southwest.

Sri Lanka has a documented history that spans over 3000 years. Its geographic location and deep harbours made it of great strategic importance from the time of the ancient Silk Road through to World War II. Sri Lanka is a diverse country home to many religions, ethnicities and languages. It is the land of the Sinhalese, Sri Lankan Tamils, Moors, Indian Tamils, Burghers, Malays, Kaffirs and the aboriginal Vedda. Sri Lanka has a rich Buddhist heritage, and the first known Buddhist writings were composed on the island. The country’s recent history has been marred by a thirty-year civil war which decisively but controversially ended in a military victory in 2009.

We visited central and southern Sri Lanka in 2011 for 4 weeks. The people and cuisine and seaside villas such as near Galle and near Tangalle are fabulous.
Highlights included the tiny tea country mountain village of Ella, the very slow train to Nuwara Eliya,, and climbing the rock at Sigiriya just north of Kandy.In Colombo I would recommend  and, the latter being a fabulous venue for wedding party photo shoots that last for days.Travellers to Sri Lanka do need to seek medical advice about their trip as diseases such as hepatitis A, typhoid, rabies and dengue do occur and are largely preventable click here to find your nearest TMA clinic

Springs Medical Centre

You can give us a call on (03) 5348 2227 or visit our clinic website click here

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Europe – Tick Encephalitis


Recently a US family have been awarded $41.7 million in compensation for their daughter catching Tick Encephalitis on a school trip to China. More info.

The disease is quite rare in China but is not uncommon in Europe. Most Australians have never heard of this disease! Tick Borne Encephalitis is a serious disease carried by tick bites in Europe. 1-10% of ticks in affected areas may harbour the virus, and whilst many sufferers have no effect, the disease can cause brain damage and death.

If you are travelling to Europe in the summer (risk season is April to October) and spending a month or more in the forests, vaccination may be recommended. The vaccine is not readily available in Australia, but in Europe the vaccine against TBE is the largest selling private vaccine. There have been 35 million doses prescribed since 1980. Austria has a national program for routine vaccination. Consult your local TMA clinic for more information. More info.

Areas with TE
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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.

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Working as an Educator in Tanzania

… Prepared by Travel Medicine Alliance Member, St Kilda Road, Melbourne

Jacinta Bongiorno has worked as a practice nurse at St Kilda Rd Travel Medicine for 18 months. Prior to commencing her position at St Kilda Rd, Jacinta worked as an educator in Tanzania, which she found extremely rewarding. Although she enjoyed her time working for the practice, she was extremely passionate about assisting disadvantaged communities. Thus, in early 2012, she decided to again leave Melbourne to work for a non-profit aid organisation, foodwatershelter, in Tanzania.

Tanzania is a major tourist destination, with approximately 1 million visitors entering the country per year. There are a range of incredible attractions, including Mount Kiliminjaro, the Serengeti National Park and the Norrongo Conservation Area.

However, Tanzania is also one of the poorest nations in the world. Shockingly, 50% of all Tanzanians live below the poverty line, and approximately one-third live in abject poverty. Infant and maternal mortality rates remain amongst the highest in the world, and more than one third of all children under the age of 5 are malnourished. Literacy rates are also extremely low. The country is battling with major health problems, particularly infectious diseases, including malaria, HIV, TB and numerous others. As a consequence, life expectancy is around 53 years of age, and twelve percent of children are orphans.Foodwatershelter is an Australian not-for-profit that was established in 2005 by 5 Australian women. It has subsequently grown, and is now run by 50 volunteers from Australia, the USA and abroad. Their goal is to build and manage environmentally friendly villages in underprivileged areas, and provide onsite education, health and social facilities for vulnerable women, children and orphans in the local community. Their first project is Kesho Leo Children’s Village in Tanzania. Kesho Leo is run by a Tanzanian staff, supported by a team of volunteers. It is home to seven women who head households of their own children and other child orphans.

Jacinta undertook the role of Health Manager at Kesho Leo, where she was able to develop and coordinate a range of health services and strategies, and provide invaluable health education to the local women. Her role proved to be very challenging, and on numerous occasions, she was involved in the care of life threatening conditions, such as HIV, Malaria and TB. Whilst caring for sick patients, she was forced to battle with the poor health care available in the country; many hospitals had 2 patients in one bed. Additionally, there was limited access to a range of services we take for granted in Australia, such as a simple plain x-ray machine, which would frequently break down. Jacinta also questioned the accuracy of the pathology tests – many patients with extremely different symptoms would somehow end up with the same diagnosis and treatment, which concerned her immensely. Due to the lack of education and literacy within the country, it was a constant struggle to deal with the many dangerous myths circulating about health. For instance, many men believed the myth that HIV could be cured by sleeping with a virgin or an albino.

In some instances, the important health aids that were handed out were instead used for other purposes. Mosquito nets designed to reduce the risk of malaria were instead used for food storage.

Whilst these issues created a hurdle, Jacinta still loved the work, and felt privileged to be involved, “the most rewarding part of this sort of work is seeing people get health information and advice that they otherwise wouldn’t have got. Like on community health day, where we saw 170 people in 4 hours. They all had HIV testing and then … we checked their blood pressure and discussed any health concerns they had“, Jacinta remarked of her experience.

Jacinta and her partner, Josh, also developed very close relationships with many of the families. One of the mothers named one of her children Jacinta, and another mother named her son Josh. Overall, she found the locals to be very friendly and welcoming, and responded to the work very openly. They were keen to listen to any advice and treatment that could be provided. This made the experience all the more rewarding.

Jacinta and Josh have returned to Australia, but they plan to continue to work with disadvantaged communities. Jacinta is studying for her Master of Public Health, a qualification which will enhance her skills in working within disadvantaged communities.

And incidentally, they did also get to manage to visit some of the spectacular tourist attractions in Tanzania. Most importantly, Jacinta ensured she had all of the recommended travel vaccinations, and used her knowledge of travel medicine to ensure they both stayed healthy.


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