Ask yourself: 1. MEDICAL HISTORY:  Have you had any serious illnesses that could recur or cause problems during an expedition? Can these be self-managed? How far in advance would you recognise the signs and symptoms of a recurrence?  What if you are several days away from professional medical help? 2. PRE-EXISTING CONDITIONS: Do you currently have any medical condition(s) that could be adversely affected by expedition conditions (heat, cold, humidity, altitude), including asthma? Are you currently taking any medication for a specific condition? Will you be able to obtain sufficient supply to last the duration you are away from home, including unexpected delays?  Will all medications still be in date during that period? 3.ALLERGIES:  Do you have any food intolerances or allergies, or allergic reactions to any medication (eg penicillin)?  Do you carry / wear medical alert information regarding your allergies?  Anyone you are travelling with should be aware of allergies to medication in case of unconsciousness, and you may want to consider a Medical Alert tag or bracelet. 4. MENTAL & EMOTIONAL HEALTH:  Do you have a history of mental health problems or problems with addictions (as these may be exacerbated under stress or by certain medications)?  Have you ever suffered from irrational fears, including panic attacks, or phobias (heights, insects, dark etc)? 5. FITNESS:  What is your overall level of fitness in relation to what will be required of you on your trip?  Whilst in many situations you can expect your fitness levels to increase during adventure travel, it is important you are also able to keep up with a group during the initial period. 5. WOMENS’ HEALTH:  Are you likely to be pregnant or experience gynaecological problems (including problems with managing period control and menopausal symptoms)?  In many remote rural areas, modern sanitary items such as tampons can be unavailable. 6. UNDIAGNOSED MEDICAL SYMPTOMS:  Have you experienced any unresolved medical concerns that you have not discussed with your GP (pain, coughs, etc)?  In most undeveloped countries, outside of major cities, medical care is of a lower standard, and facilities less well equipped, than you are likely to be used to in your home country. 7. VACCINATIONS:  What vaccinations have you had or will you need? This will depend largely on your work and what exposure you have previously experienced, as well as which countries you will be visiting.  If you are joining an organised expedition you should be provided with information regarding recommended vaccinations.  Note, not all vaccinations are required in all parts of the world, and in some cases only at certain times of year (eg, Yellow Fever vaccination is required in Saudi Arabia in November due to the massive increase in the number of international pilgrims arriving then).  Allow plenty of time for full courses of vaccinations to be completed before departure. 8. MALARIA:  Are you able to take anti-malarial prophylactics, which will be recommended for use in at least the Central and South Americas, Asian and African countries?  For extended stays in remote areas with a Malaria risk, consider carrying malaria a diagnosis kit and medical first response treatment options.

In a modern society where we can pick up the phone and have a doctor or ambulance at the house in a matter of minutes, it can be easy to forget that in order for travel to be adventurous we are likely to find ourselves days away from the arrival of a doctor or air ambulance.  Being sick or injured in these situations may mean relying on local help in a different culture, with different expectations of medical standards, and a language you don’t understand.  Group guides may have some medical training but there will be a limit to how much medical intervention they can provide in the field.  The more adventurous, the more remote and inaccessible your adventure location, the longer it will take for medical help to reach you, and could easily be several days.  You could be in for a long and uncomfortable wait if you fall ill or are injured.Ask yourself …The first stage of travel health preparation is to sit and honestly answer some questions about your own personal health; some examples of these questions are listed in the box on the right.If you are planning on being a member of an organised expedition you are likely to be sent a questionnaire by the organisers that will cover all these points, and more.  Although it is sometimes tempting to omit pre-existing conditions over worries about being excluded, or perhaps to imply that you are fitter than you really are, it is important to answer honestly so that the expedition organisers can discuss your needs with you.  They know the terrain, the facilities, the risks and their ability to respond to your needs in those particular circumstances.  In remote environments such as those frequently visited during adventure travel, it is entirely possible that one person’s accident or illness, including yours, jeopardises the safety of the whole group.Independent TravelIf you are planning on travelling independently or as part of a small self-organised group, you may be able to more easily adjust the pace at which you travel or tackle difficult situations.  However, it will also mean there will be times when you will be more isolated in the event of needing medical help, and your trip preparation will benefit from including some kind of wilderness medical training.  Depending on the course you undertake this can include procedures such as suturing wounds, setting up drips in cases of severe dehydration, and administering prescription medication, for use when professional medical treatment is too far away and life is at risk, as well as advanced first aid in the event of a serious accident. Beware the little problems that get bigger Major falls, animal attacks in remote areas, to car accidents in cities – these are the big events that make the news and raise fear levels.  However, it is the mundane that is most likely to strike the unwary traveller.  Minor injuries, such as cuts and bruises, can easily lead to infections that become more serious due to poor hygiene or insufficient treatment; travellers’ diarrhoea can lead to severe dehydration, loss of weight and weakness; feet need particular care and attention in very humid or extreme cold environments to prevent conditions such as trench foot or frostbite; unfamiliar surroundings and lack of awareness increases the risk of insect and animal bites; insect bites can become infected and need antibiotic treatment.  Simply flying into some adventure travel locations and enthusiastically getting straight into action can produce altitude sickness, so remember to allow time early in your schedule for acclimatisation.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Real life case studies   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Life, Death & Insurance

Many travel health insurances are only available for up to a year of travel and cannot be renewed once the trip is underway.  If your trip is likely to last for longer than 12 months, check these conditions with your insurance provider well in advance.  Some specialist insurers will increase the policy period for trips lasting more than a year, but these are rarely ‘off the shelf’ policies.  If necessary consider whether or not you should set up your insurance to start at a point when you are at greater risk rather than at the very start of your trip.

When setting up your own trip or expedition consider the need for a Personal Locator Beacon (PLB) or an Emergency Position Indicator Rescue Beacon (EPIRB), such as the examples shown here, which can be used to initiate a rescue in the event of a life or death situation in remote areas.  They generally cost little or nothing to set up but rescue and medical costs can mount up if they are used.  If you carry a beacon to use in emergencies, make sure your insurance includes cover for remote area rescue, or you may find yourself saddled with a life changing bill, or at worst, being denied rescue if you cannot prove you have the funds to finance it. 

The bottom line

Ultimately, it should go without saying that your health is your responsibility.  Be honest with yourself and anyone else you are travelling with about any issues that might arise.  Pay rigorous attention to your own hygiene and, if necessary, encourage others to do the same.  Get minor ailments treated before they become a problem.  If in doubt, drink bottled water, peel fruits and do not eat food that is uncooked or not hot when it should be.  Accept that sooner or later the odds are you will suffer from something or other but don’t let it stop you from enjoying your trip.