This section is designed to give to general advice, when travel ing abroad. PLEASE READ IT ! The
information wil help you to stay healthy on your trip. However, it is not an alternative substitute to seeing
Diseases can be caught from drinking contaminated water, or swimming in it. Unless you know the water supply
is safe where you are staying, only use (in order of preference) 3. Water treated by a sterilising agent. This includes ice cubes in drinks and water for cleaning your teeth.
It is safer to swim in water that is wel chlorinated. If you are travel ing to Africa, South America or some parts of the Caribbean, avoid swimming in fresh water lakes and streams. You can catch a parasitic disease cal ed schistosomiasis from such places. This disease is also known as bilharzia. It is wise never to go barefoot, but to wear protective footwear when out, even on the beach. Other diseases can be caught from sand and soil, particularly wet soil.
Contaminated food is the commonest source of many diseases abroad. You can help prevent it by fol owing
Avoid buying food from street vendor’s stal s Two phrases to help you remember 1. Cook It, Peel It, Or Leave It!
Personal hygiene
Many diseases are transmitted by what is known as the ‘faecal-oral’ route. To help prevent this, always wash your hands with soap and clean water after going to the toilet, before eating and before handling food.
Travellers’ diarrhoea
This the most common illness that you wil be exposed to abroad and there is no vaccine against it !
Travel ers’ diarrhoea is caused by eating and/or drinking food and water contaminated by bacteria, viruses or
parasites. Risk of illness is higher in some countries than others. You can certainly help prevent travel ers’ diarrhoea in the way you behave - make sure you fol ow the food, water and personal hygiene guidelines already given. Travel ers’ diarrhoea is 4 or more loose stools in a 24 hour period often accompanied by stomach pain, cramps and vomiting. It usual y lasts 2-4 days and whilst it is not a life threatening il ness, it can disrupt your trip for several days. The main danger if the il ness is dehydration, and this, if very severe, can kil if it is not treated. Treatment is therefore rehydration. In severe cases and particularly in young children and the elderly, commercial y prepared rehydration solution is extremely useful. This can be bought in tablet or sachet form at a chemist shop e.g. DIORALYTE or ELECTROLADE. Prepare according to instructions. Anti diarrhoeal tablets can be used for adults but should never be used in children under 4 years of age, and only on prescription for children aged 4 to 12 years. Commonly used tablets are IMODIUM and LOMOTIL. None of these tablets should ever be used if the person has a temperature or blood in the stool. Do contact medical help if the affected person has:- Diarrhoea for more than 48 hours (or 24 hours in children) In very special circumstances, antibiotics are used for diarrhoea, but this decision should only be made by a doctor.
Hepatitis B and HIV infection
These diseases can be transmitted by 1. Blood transfusion 2. Medical procedures with non sterile equipment 3. Sharing of needles (e.g. tattooing, body piercing, acupuncture and drug abuse) 4. Sexual contact. Sexual y transmitted diseases are also transmitted by no. 4) Only accept a blood transfusion when essential If travel ing to a developing country, take a sterile medical kit Avoid procedures e.g. ear, body piercing, tattooing and acupuncture Avoid casual sex, especial y without using condoms
Insect bites

Mosquitoes, certain types of flies, ticks and bugs can cause many different diseases. e.g. malaria, dengue fever, yel ow fever. Some bite at night, but some during daytime. Covering up skin as much as possible if going out at night, (mosquitoes that transmit malaria bite from dusk until dawn). Wear light coloured clothes, long sleeves, trousers or long skirts. Use insect repel ents on exposed skin. (Choose those containing DEET or eucalyptus oil base. A content of approximately 35% DEET is recommended for tropical destinations.) Clothes can be sprayed with repel ents too. Impregnated wrist and ankle bands are also available. Check suitability for children on the individual products. If room is not air conditioned, but screened, close shutters early evening and spray room with knockdown insecticide spray. In malarious regions, if camping, or sleeping in unprotected accommodation, always sleep under a mosquito net (impregnated with permethrin). Avoid camping near areas of stagnant water, these are common breeding areas for mosquitoes etc. Electric insecticide vaporisers are very effective as long as there are no power failures! Electric buzzers, garlic and vitamin B are ineffective.
If you are travel ing to a malarious country, please refer to
You will have to pay for medication for this.
Animal bites
Rabies is present in many parts of the world. If a person develops rabies, death is 100% certain. There are 3 RULES REGARDING RABIES 1. Do not touch any animal, even dogs and cats 2. If you are licked on broken skin or bitten in a country which has rabies, wash the wound thoroughly with 3. Seek medical advice IMMEDIATELY, even if you have been previously immunised.
Major leading causes of death in travel ers are due to swimming and traffic accidents. You can help prevent
Never dive into water where the depth is uncertain Only swim in safe water, check currents, sharks, jel yfish etc. Avoid alcohol when driving, especial y at night If hiring a car, rent a large one if possible, ensure the tyres, brakes and seat belts are in good condition Use reliable taxi firms, know where emergency facilities are.
Air travel
It is sensible on any long haul flight to

Exercise your legs, feet and toes while sitting every half an hour or so and take short walks whenever feasible. Upper body and breathing exercises can further improve circulation Drink plenty of water and be sensible about alcohol intake which in excess leads to dehydration 2 working days notice. Alternatively, you may post your request including a self addressed stamped envelope. Whenever possible, incoming telephone cal s wil be answered within 1 minute. At the busiest times (between 9.15 and 10.30am) al lines may be engaged and patients are requested to leave non-urgent cal s until later. Patients seeking advice between 6:30pm and 8:00am wil receive a clinical y appropriate response from Camidoc. Remember that this is an emergency service for conditions that are too serious to wait until the next working


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MaxorPlus National Tiered Drug Formulary A Tiered Drug Formulary is a list of medications to be used as a guideline for physicians when prescribing medications and is designed to help keep your prescription drug benefit affordable. It also informs you of the availability of generic or less-expensive drugs, which often can reduce your out-of-pocket costs. First (1st)-tier drugs are gen

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THE JOURNEY TO COMPASSIONATE CARE In 1991, I helped create one of the fi rst woman-centred, harm-reduction programs for women from the Downtown Eastside of Vancouver.1 The grassroots program was named Drug and Alcohol Meeting Support for Women (DAMS) by women who met weekly. DAMS emerged as a response to concerns about harms associated with drug use, poverty, isolation, HIV/AIDS, and parenting.

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