An introduction to expedition Healthcare with Nomad Travel Health Clinic
Travelling to new climates and exposing yourself to extreme exertion and high altitudes can really takes its toll on you so it is important to make sure your health is up to scratch. The purpose of these notes is to encourage you to prepare yourself well for your Charity Challenge. The potential problems listed below make up an alarming list but you are most unlikely to encounter any of the problems if you start your journey well prepared and if you act sensibly throughout your challenge.
Charity Challenge have teamed up with travel health experts Nomad to deliver releveant health advice and answer some of your most commonly asked questions .
Most commonly asked Questions:
Question 1: What can I do to make sure I stay healthy on my challenge?
"One of the most underestimated health issues – and so easy to avoid and put right - is dehydration. Follow these simple guide lines to give yourself a head start in completing your challenge:
- Ensure you drink enough water throughout the day. This helps combat all of the following: heat exhaustion, muscle fatigue, dehydration and low energy levels
- During a normal slow exercise day you need 3 litres per day. In hot climates this should be 4 litres and at high altitude this should increase to 6 litres.
- Drink plenty of water in the morning.
- Isotonic drinks can improve your general hydration"
Question 2: What are the main vaccinations I need before I set out?
"You need to visit either your GP or a specialist travel clinic to get a definitive answer. A specialist clinic will take into account detail such as seasonal diseases, activities involved in your itinerary and your general state of health. Allow at least six weeks for this process, eight weeks is even better."
Question 3: Are there any (medical) products that you recommend will be really useful for me to take out?
"The minimum you should take is a kit that covers basic first aid. You should also include a sterile equipment kit for travel to countries with limited medical services or supplies, or where HIV and Hepatitis B are prevalent. Remember – being able to prevent health problems and having the correct treatment if you do succumb could keep you out of hospital and save your whole trip."
Challenge health advice - pre-challenge
It is a good idea to have a dental check-up before you go, as, in many of the countries we travel to, facilities can be very expensive and may not be of the same standard you are used to.
Charity Challenge provides guidelines on the vaccinations and malaria protection needed for all the countries we operate our challenges in; see the Fact File for each country. These however are broad outlines and you should consult your GP or travel health clinic at least two months prior to departure for further advice. Some vaccinations cannot be given at the same time and some take time to be effective. For example, immunisation against Hepatitis B, can take six months to give full protection. See your doctor even if you are going at short notice, as some protection may be better than none. Some immunisations are free under the NHS. For others, there may be a charge.
If you need anti-malaria medication, your doctor will advise on which is most appropriate. Some anti-malaria tablets are available from pharmacists without a prescription.
Charity Challenge provides comprehensive medical kits to our staff on all of the challenges, however we also recommend you taking your own. Pack your medical kit in your main luggage except any medication you may need during your journey. Nomad Travel Store & Clinics supplies medical kits suitable for our challenges. For further information, please contact them on 0845 310 4470. or click on http://www.nomadtravel.co.uk Emergency medical travel kits should carry sufficient identification to ensure their acceptance by Customs Officials but the contents should not be opened until needed. It is also unwise to carry loose syringes or needles unless you have a doctor's letter explaining their purpose, for example, if you are a diabetic. For more information contact:
For further information:
- http://www.bashh.org (Sexual health support)
If you want to take any sort of medicine with you - either prescribed or bought from a pharmacist - find out if there are any restrictions on taking it in and out of the UK or the country you are visiting. Ask the relevant Embassy or High Commission or the Home Office Drugs Branch. Always carry medicines in a correctly labelled container, as issued by the pharmacist. Otherwise take a letter from your doctor or a personal health record card giving details of the drug prescribed in case you need it to get you through Customs. Remember, some medicines available over the counter in the UK may be controlled in other countries, and vice versa. Keep a written record on your person of any medical condition affecting you, such as angina pectoris, diabetes and haemophilia, and the proper names - not just the trade names - of any medication you are taking.
Challenge health advice - on the challenge
deep vein thrombosis
Sitting still for long periods in the inevitably cramped positions of an aircraft frequently leads to swollen ankles and sometimes muscle cramps in the legs can occur, but this is not unique to air travel and can occur whenever people are immobile for prolonged periods. Try not to sit down for too long. Rotate your ankles at regular intervals to help avoid swelling. Wear loose fitting, clothing and have something warm to wear, as the air-conditioning on the plane can be very cold. When it is convenient, get out of your seat and move around the cabin, to avoid travellers' thrombosis. Those with risk factors such as a history of deep vein thrombosis, hormone treatment, presence of malignancy, recent leg surgery, or any major surgery, should discuss additional protective measures with their doctor. If you are concerned in any way about DVT, please consult your GP. Whilst on the flight, if you have a headache it is probably due to dehydration, so drink plenty of non-alcoholic fluids.
set your watch
Set you watch to your destination time as soon as possible before take-off and mentally try to do the things at the right time. On arrival, try your hardest to fit in with the new time and resist the temptation of going to sleep too early or getting up too early.
other in-flight advice
It is recommended for women to take sanitary protection with them. Even if you think you shouldn't need it, it is a good idea to have something just in case, as long-haul flights can often confuse the menstrual cycle. Also pack any regularly used medication in your hand luggage as you may need it during your journey or if your luggage is delayed.
A major element to culture shock lies in becoming familiar and to some extent taking part in the local way of life rather than trying to maintain your usual lifestyle and expectations. Keep reminding yourself that people and ways are different everywhere in the world. If you feel strongly enough about negative things that you see try not to interfere there and then, but on return get involved in charities that are positively active. Use relaxation breathing (with your eyes shut) to overpower panicky feelings - this is particularly useful on very overcrowded buses, trains, etc.
diarrhoea (food & drink/water)
Travellers' diarrhoea is very common, especially in hot countries. Diarrhoea, as well as diseases such as cholera, typhoid and hepatitis, can all be caught from contaminated food and water, wherever you are in the world, be careful what you eat and drink. All of these diseases can be avoided by taking simple precautions:
- Always wash your hands thoroughly after going to the lavatory, before handling food and before eating.
- Carry wet wipes with you for cleaning your hands before eating or wipe your hands with a no water hand sanitizer.
- Clean water plays a big part in staying healthy while travelling (that includes the water in swimming pools, lakes, rivers and the sea, so try not to swallow water when you are bathing or swimming). If you have any doubts about the water available for drinking, washing food or cleaning teeth; use bottled water, sterilise it with disinfectant tablets or boil it.
- When buying bottled water, check that the seal is unbroken, the sell-by date, and that there are no algae growing inside the bottle.
- You can buy water purification tablets from most chemists and they are easy to use, although make the water taste a little chlorinated.
- Avoid ice unless you are sure it is made from treated and chlorinated water. This includes ice used to keep food cool as well as ice in drinks.
- It is usually safe to drink tea or coffee, wine, beer, carbonated water and soft drinks and packaged or bottled fruit juices.
- Eat freshly cooked food and ensure it is piping hot, avoid food, which has been kept warm.
- Avoid uncooked food, unless you can peel or shell it yourself.
- Avoid food likely to have been exposed to flies.
- Avoid ice cream from kiosks or traders.
- Fish and shellfish can be suspect in some countries, so be careful.
Visitors to the tropics are prone to dehydration and heat related conditions. This is particularly so in the first few days of travel, and more so if the traveller is exerting him/herself, e.g. trekking. It takes our bodies at up to 3 weeks to adjust to the heat. In this time, we sweat more than we should and lose a lot of salt. Drink at least 3-4 litres of water per day to limit the effects of dehydration. This does not include tea, coffee or alcoholic beverages, which can contribute to dehydration (your urine should be light in colour, if it is dark you are not drinking enough).
Although we provide clean drinking water during your challenge, you may want to bring extra purification methods. We strongly recommend the Aqua Pure Traveller Water Purification System. An easy-to-carry, convenient bottle, it ensures you have safe, pure water wherever you go. The outer iodine sleeve kills all waterborne viruses and bacteria, such as Ecoli, Typhoid, Cholera, Hepatitis A and Polio. Officially endorsed by the Hospital for Tropical Diseases, the Aqua Pure Traveller is a partner of the Foreign and Commonwealth Office's Know Before You Go campaign (advice for British nationals on safe overseas travel). For more information, please contact Aqua Pure on 08705 820 000 and mention Charity Challenge.
Add extra salt to your food in this period, about two extra teaspoons of salt per person per day. Use electrolyte solutions if you are dehydrated. Trekking uses up a lot of energy and fluid and you will be sweating even in cold environments. Even if you are not in the sun or heat, it is still very easy to dehydrate to a dangerous level. As for tropical conditions, keep drinking, drinking, drinking. Avoid exhaustion, which very easily leads to carelessness, lack of concentration and accidents.
sunburn / sun damage
Sunburn is a major cause of distress to travellers and can have long-term effects, including skin cancer and premature skin ageing. Sunburn is more likely when the light is also 'reflected' from water (swimming pools or the sea), white sand or snow. Sunscreens absorb ultraviolet B (UVB) and to a lesser extent ultraviolet A (UVA). The Sun Protection Factor (SPF) refers to the protection against UVB. (e.g. 'SPF 8' allows approximately 8 times longer sun exposure without burning than with no protection). Wear a hat in the sun. Use30+ sun protection cream. Cover up in lightweight cotton clothing. We also recommend you wear 100% ultra violet glasses. Ensure your sunscreen protects you from UVA’s & UVB’s.
sore feet, cuts and grazes
Any soreness of the feet should be treated immediately with 'second skins' or other dressings. Treating sores early will help avoid crippling problems developing later & feeling uncomfortable throughout the challenge. It is better to hold up the group for a few moments to apply an initial dressing rather than to handicap the challenge with serious lameness caused by untreated sores, they will thank you for it in the long run!
Treat even small wounds and scratches promptly & let your tour leader know of any serious wounds or cuts. Abrasions in the tropics are most likely to become infected. Clean the wound and dress it. Change the dressing regularly. Take a simple, purpose-built medical kit & if you don't have the relevant first aid items necessary, please use the Charity Challenge kit.
Animal bites can start infections, which can be serious and sometimes fatal. Be wary of even apparently tame animals as rabies occurs in Europe and North America as well as in less developed countries. You can contract the disease if an infected animal bites you, so be careful not to touch any animal, whether it is wild, stray or tame. If you are bitten, post exposure treatment - if given early enough - usually prevents the disease developing. You can get the rabies vaccine before you leave, but it is only necessary for those who are undertaking long journeys in remote areas where medical treatment may not be immediately available. (Please see our list on recommended vaccinations for your destination in the Fact File.) Please see Nomad's most up to date infomation on Rabies here
insect borne diseases
Biting insects spread a wide range of tropical diseases; the most dangerous to the traveller is malaria. If possible, avoid mosquito bites as they carry any number of infections and can be very irritating. There are various anti-bug sprays available. Try to get one, which contains DEET (Diethyltoluamide). At dusk and in wet weather, keep your arms and legs covered as that is prime time for mosquitoes. If you need anti-malaria medication for your challenge, your doctor will advise you on which is most appropriate, or refer to our notes on Vaccinations & Health in the Fact File for your chosen challenge. When you return home, if you are feeling particularly unwell it may be worth going to your GP to ensure you have not picked up an infection or parasite, which can cause symptoms such as anaemia and lack of energy. Remember that it may be a while before you readjust to a faster pace of life.
participants with diabetes
If you are a diabetic, it is a good idea to take some food with you on your flight in case there is a problem with the meal you ordered, or there is a delay in the meal service. If your diabetes is treated with insulin or sulphonylurea tablets, physical activity increases the risk of hypoglycaemia. Ask your doctor or diabetes nurse about adjusting your diet and medication to help prevent hypos when exercising on your challenge. It is also important to discover how activity affects your diabetes control. In general terms, activity will bring blood glucose levels down because your muscles are using up extra glucose for energy. People who treat their diabetes with insulin or sulphonylurea tablets need to be prepared by carrying hypo treatments such as glucose tablets or sweet drinks. Regular blood glucose testing before, during and after activity will help you to discover how a particular activity affects you, so that you can adjust your routine, including your eating habits and/or your diabetes tablets or insulin as necessary. As everyone is different, this will involve a certain amount of trial and error but your diabetes team will be able to advise you. These notes were provided by Diabetes UK.