Travel Right, Travel Light

… Provided by Dr Joan Chamberlain, TMA member Rockhampton

 

Often people put a lot of time into their itinerary and flights but forget about pre travel advice and preparation. Also forgotten at times is consideration to your luggage and packing.

Consideration should be given to your destination, activities, length of flight and luggage requirements.

1. Choosing Luggage

Although each traveller will have different needs some principles remain the same. Choose a good quality bag. You will get what you pay for and you want to get your best mileage out of it. If for under the plane, light weight, two sets of handles, and preferably with wheels and pull out handle. You will not always have trolleys or assistance at your destination. If back pack for under plane, ensure you bag does not have straps or portions that can get caught or torn on automated conveyers or transport belts. Be careful not to have baggage tags that can also be caught. Find another way to ID you luggage. Also ensure that zippers do up well and are unlikely to undo with handling. You do not want to own the bag on the carousel with the under pants taped to the outside.

Put your contact details inside the bag or ensure it is well covered. You don’t need to advertise your details. E.g. If you have a bag with a name place, put your card with details towards the inside.

Watch your luggage. Never leave it. More luggage is stolen from the ground than lost from transportation.

2. On flight bag…what to carry

You and your under plane luggage can be parted. Your onboard luggage and your handbag are easier to keep tabs on. Make sure the bag complies with the airlines limits. They can refuse to carry, charge hold fees etc if not compliant. Name everything. Ensure your bag is well labelled. Enclose eye wear, tooth brush and paste, hair brush or comb, moisturiser and a change of underwear. Lost luggage and arrival clothes are not fun for 2 days waiting for lost luggage. A fresh set of under clothes is vital. Ensure medications, travel letters and a copy of documentation is also kept on board. Valuables should not be stored in the hold, take them on board. Phone, camera, jewellery, passports, money, travel checks etc should be carried in your hand bag or in a body belt. Pack a book or activity for in flight.

3. Carry what you know you need, not the spares

Most people just carry too much. You really only need a minimal number of underpants, not one for every day. Most times you can rinse or wash. The same with day clothes, evening wear, rationalize. Spare toiletries? Try buying them. What about the accessories. Do you want to carry these everywhere just in case? Get a seasoned travel friend to revise your bag and show you how to pack it, or read a book on it.

4. Travel with expectancy, good attitude and flexibility

I am yet to have a travel experience where all goes well and according to plan.

Take your attitude and flexibility pill before you go, especially with lost luggage. Handle schedule changes gracefully and ask for assistance with ongoing flights etc as needed.

Don’t harass the ones trying to assist you. You may be surprised to know that when the customer’s attitude is aggressive, accusing and harassing to the ground crew at the arrival destination, where they had nothing to do with the luggage becoming lost, some luggage will JUST never be found. A pleasant and polite attitude asking for their assistance without accusation will do more to track down your luggage than anything else. Always report lost luggage early and with good attitude.

Trauma with time becomes humour and a good story at the next party!

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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

 

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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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A Dental Experience In Thailand

 

Surrey Hills Senior Clinic Receptionist

I decided to research dental treatment in Thailand after being quoted on a (costly) treatment plan by my Australian dentist.

A colleague who had previously had dental treatment in Thailand, and my brother-in-law who lives part of the year there, encouraged me and reassured me that the high end Thai dental clinics were safe and offered a full range of dental services.

I contacted the clinic recommended to me, firstly by email and promptly received a reply from the dentist assigned to me, requesting the medical and dental history and x-rays etc. that she required to plan and quote.

Meanwhile, I sought travel medicine advice, with particular regard to ensuring I was up to date with Hep A and B immunisations. I also took a course of antibiotics with me to take at the first sign of any infection (which fortunately wasn’t necessary).

The dentist continued email contact with me, with an excellent command of English and reassuring manner. Closer to the time she phoned me a few times confirming how best to book my trip around treatment. It was to start in Bangkok the day I arrived in Thailand, then I would travel to Phuket for a beach holiday and the work would be completed there, including removing the temporary crowns applied in Bangkok, and replacing them with my new ones. Finally Zoom whitening of my remaining teeth was to be done. An unexpected complication was, upon examining me the dentist was unhappy with the integrity of pre-existing root canal treatment of a tooth done in Australia. She arranged a car to take me to an endodontic specialist in Patong that day. I felt momentarily anxious because I hadn’t researched this new place. Anyway, I proceeded and the tooth was retreated to ensure I didn’t encounter trouble beneath the new crown in coming years. Fortunately, the professionalism, equipment and clinical environment at the endodontic clinic also appeared faultless.

In the end I returned to Australia with a complete dental makeover, completed in 2 weeks costing between 30 and 50% of what I would have paid at home. The group of clinics have a very informative website, but didn’t mention, and which I discovered to my delight, that most of the treatment was done in an elevated room with panoramic views over a beautiful beach, and any discomfort I may have experienced was counted by the attentive dental assistants massaging my feet and hands. Perhaps it’s unremarkable there, but what a treat for us Aussies.

I was farewelled with a mouthguard to use at night and a Zoom maintenance treatment to use after 12 months. I had an issue with a tooth a year later and emailed the dentist for advice. By the end of the day she had replied, advising it was not a tooth treated in Thailand, but she gave good and detailed advice and emailed me a week later to ensure that I had seen a dentist here.

Cheaper treatment is available but may come with an increased risk. My overall experience was very positive and extremely cost effective.

 

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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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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. 

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Hangover Cures – Do They Work?

Dr Deb Mills – Brisbane TMA Member

In about 4000BC, agriculture started, some say to make Beer as well as food.

They don’t call it inTOXicated for nothing … those enjoyable drinks also contain cell poisons that can affect all body systems for up to 72 hours. 

Even after your alcohol has fallen to zero, there are still some measurable effects on manual dexterity, memory, reaction time, visual-spatial skills, and attention.

We also recommend that persons avoid alcohol for 48 hours before or after vaccinations to get the best result from vaccines.

There are a host of interesting hangover cures that have been proposed over the years

BEFORE DRINKING

  • Lemon in armpits before drinking (!)

AFTER DRINKING

  • LIQUIDS – cucumber/ tomato /cabbage/ banana peels/ buffalo milk/ coffee / tea with
  • ADDED: tripe/ raw eggs/ dried bullock penis/ sheep eyes/ rabbit droppings
  • FLAVOURINGS: pepper / salt / garlic/ Worcestershire sauce
  • FOODS: pickled herring, pickled plum, cod, deep fried canaries!
    or even …
  • PUNISH THE BOOZE: place 13 black pins in the cork of the bottle
    or
  • MORE BOOZE: ‘Hair of the dog’

Do they work? Or does consuming all these unpleasant things just take your mind off the bad headache?

Needless to say, the above cures do not have much of an evidence base to support them.

A recent study in the BMJ found NO compelling evidence exists to suggest that any conventional or complementary intervention is effective for preventing or treating alcohol hangover. The most effective way to avoid the symptoms of alcohol induced hangover is to practise abstinence or moderation.

Alcohol seems to increases the likelihood of sexually transmitted disease and unintentional injury in travellers. (more info)

Even locally, the figures show that an Australian who consumes more than 8 standard drinks a day is twice as likely to die from injury than chronic disease.

As with many things, alcoholic drinks should be consumed in moderation.

These are Australian Guidelines

  • For healthy men and women, drinking no more than two standard drinks on any day reduces your risk of harm from alcohol-related disease or injury over a lifetime.
  • Drinking no more than four standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion.

Ideally these guidelines should be followed on holidays as well!

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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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A Fun And Festive Thai Shopping Adventure

GoldCoast TMA Member

Frontline at Travel Health Doctors, Southport, Senior Receptionist Ilana Capan, recently embarked on a 7 day girls shopping, relaxing and more shopping trip to Phuket and Koh Samui in Thailand.

Travelling with her sister and friend, Ilana was keen to soak up some culture and also visit Maya Island – backdrop to movie, The Beach, starring Leonardo Di Caprio.

Her first trip to Thailand, Ilana stepped off the plane in Phuket and immersed herself in the hive of activity which is synonymous with the tourist hotspot.

Struck by the friendliness of the Thai people Ilana and the girls laughed as each Thai greeted them with a welcoming “Oh I remember you!!”

Being a short trip, the girls were keen to hunt out some bargains. They didn’t have to look far. Patong is a tapestry of multi dimensional modes of shopping including high end shopping malls and boutiques, selling the highest quality Thai silks, furniture etc. However the hub remains the Beach Road Markets – a vibrant and eclectic mix of local stalls stretching along the entire beachfront and through the numerous lanes and alleyways cris-crossing the area. The area particularly comes alive at night where the sense of chaos and festive atmosphere is pumping. Enthralled by the range and choice, Ilana said many of the items are counterfeit ranging from fake Cartia watches through to Jimmy Choo shoes and Samsonite luggage.

 

“It’s a unique shopping experience as you walk up to a small roadside stall front and then the owners persuade you to walk behind this into air conditioned rooms stocked floor to ceiling with merchandise…quite a surprise” she said.

Despite the revenue generated for the local Thais from these stores, officially, selling counterfeit items is against the law in the area and at any time the police and/or military can move in, shut the stores and fine the owners.

A storeowner with heart

This situation was witnessed by Ilana and the girls. After happily purchasing hundreds of dollars worth of Samsonite bags, their storeowner offered to mind them while the girls went for a bite to eat. By the time they returned, it was raining solidly and the entire lanes and roadways of stalls were completely shut up as the police had arrived. Thinking there was no hope of finding the Thai storeowner again, frustrated; the girls gave up their search and left for their hotel. On their way back however they were incredulous to see their Thai storeowner by the side of the road, standing on his own in the downpour, with the Samonsite bags beside him. He was so happy to see them… and they him!

Maya Bay

With shopping behind her and despite stormy weather, Ilana was keen to see Maya Bay. With the large boats taking three hours to take tourists to the island, Ilana instead found a man with a smaller boat willing to take ten passengers. Half an hour into the trip though lost in the sea’s crashing waves, all ten on board were seriously sea sick and there was no choice but to turn the boat back to shore. Maya Bay will have to wait till Ilana’s next trip. “I can see why people take the slow boats – the sea is so choppy – don’t risk a dinghy!” she said.

After elephant trekking, the girls concluded their trip with a night out at Fanta Sea – an entertainment experience which included a performance similar to Circ De Solae. It left a lasting impression from their trip as it reflected the simplicity and beauty which is so intrinsically central to the fabric of Thai culture.
In Thailand they sell gasoline on the street everywhere and a tuk tuk has no seat belts!

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Handwashing

Frequent careful handwashing is the simplest, most effective tool for decreasing the risk of many infectious diseases…

Scientists have recently reported that handwashing with soap could reduce the risk of lower respiratory tract infections such as pneumonia by 23%.

Who is Semmelweis?

In the mid-nineteenth century, Hungarian Ignaz Semmelweis postulated that doctors’ hands spread disease to the women in the childbirth wards. Septicemia after childbirth was common in mid-19th-century hospitals and was often fatal, with death rate of 10%-35%.

Despite various publications of results where hand-washing reduced mortality to below 1%, Semmelweis’s observations conflicted with the established scientific and medical opinions of the time and his ideas were rejected by the medical community.

In 1865, Semmelweis was committed to an asylum, where he died at age 47 after being beaten by the guards, only 14 days after he was committed. More info.

Travellers cannot afford to overlook such a simple and cost effective method of protecting their health.

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