Advice for Volunteers and those going on Expeditions
Travel in areas remote from reliable medical facilities involves an additional element of risk and expeditioners and volunteers are more likely to be exposed to infection, accident and injury than other types of traveller. In the event of serious injury or illness it could be many hours or even days before evacuation is possible. It is wise to consider the characteristics of the environment you will be in, such as altitude, extremes of temperature and weather, distance from outside help, and how these factors may affect the ease of rescue in the event of an emergency.
Depending on whether travel is with a commercial trek, a youth expedition, independently or in some other group, the provision for medical support can vary enormously. Some groups always have a doctor with them, others may have a nurse, paramedic or first aider. Find out about what medical support is available to you and to carry a first aid kit appropriate to your circumstances. Preferably everyone on the trip should have a basic knowledge of what to do in an emergency. Some first aid training in advance of departure is advisable; courses are available which are aimed specifically at those travelling in remote areas or through challenging terrain and conditions. It is worth taking a small personal first aid kit in addition to the main expedition kit.
Pre Travel Assessment
The best way to deal with medical problems is to prevent them happening in the first place. This is even more important if going to an area where medical support is hard to obtain. A medical assessment pre departure is wise and sufficient supplies of ongoing medications for the trip should be obtained.
A dental check up is especially important, and should be done at least three months before departure to give time for any necessary work to be completed. Having small dental problems dealt with earlier rather than later may help avoid potential complications in the middle of your trip.
For those who usually wear contact lenses, give consideration as to whether they can be kept in a sterile condition when away. Often in an expedition environment this is not possible, and it may be wise to use spectacles instead. Contact lenses can also be a problem in a dusty environment, such as a desert.
Physical and Mental Fitness
Most expeditions are likely to involve a considerable amount of physical exertion. It is worth preparing for this with a regular aerobic exercise programme, for several weeks or months before departure.
Some people may find it difficult adapting mentally to an expedition or volunteering environment. This can be due to multiple factors including lack of privacy, being away from family and friends, isolation, unusual food, religious and cultural differences, language barriers, coming to terms with poverty, begging, adjusting to changes in climate and different living standards. If you have a history of any psychological problems, including alcoholism or drug dependency, it is important to make sure that these are well under control before putting yourself into an unfamiliar environment. The extent of difficulties will vary between individuals, but being open to new and different cultures and being patient, rather than critical, will help adaptation to new and challenging adventures. For further information see the mental health and travel page.
Adequate travel health insurance to cover medical treatment is essential. It is important to consider repatriation particularly when visiting areas with inadequate medical facilities.
Vaccination schedules should be arranged with care. Leave plenty of time to prepare for courses of travel vaccinations which take time to become effective.
- Consult with your GP, practice nurse or travel health provider as soon as possible but ideally 6-8 weeks before departure.
- British schedule vaccines. This includes tetanus, polio and diphtheria, and measles, mumps and rubella vaccines. For countries where these diseases are still common it is important that the routine British schedule of vaccinations plus any relevant boosters are up to date.
- Rabies vaccine. A pre-exposure course of rabies vaccine is recommended for those travelling to remote areas of rabies endemic countries and who will be more than 24 hours away from a reliable source of rabies immunoglobulin and vaccine.
- Hepatitis B vaccine should be considered for those with underlying medical conditions or undertaking potentially risky activities, consider hepatitis B vaccination as medical facilities may not be available or be poor.
- Meningococcal Meningitis ACWY vaccine is advised for those visiting risk areas in sub-Saharan Africa if mixing closely with the local population.
- Hepatitis A and Typhoid vaccines. Important for individuals who are not able to take adequate care with food and water hygiene in risk areas, as is often the case with the more adventurous expedition and volunteer traveller.
- Yellow fever vaccine. Yellow fever is a mosquito borne disease and occurs in Africa and South America, most commonly in rural and jungle areas. A yellow fever vaccination certificate may be necessary for entry or for crossing borders in parts of Africa and South America and also if returning from these areas to some other countries not in infected areas.
- Japanese encephalitis vaccine. This disease is spread by mosquitoes and vaccination is sometimes advised for those spending longer periods in higher risk, rural areas of South East Asia.
Malaria and Mosquito Bite Prevention
Volunteers and expeditioners are more likely to be exposed to malaria and other insect borne diseases than other travellers, for example package tourists or business travellers.The relevant country pages should be consulted for current malaria risks and chemoprophylaxis advice.
Malaria prevention requires careful mosquito Bite Avoidance measures in addition to taking antimalarial chemoprophylaxis.
Standby emergency treatment can be prescribed and carried for travel in remote, malaria endemic areas. This must be discussed with a healthcare professional to ensure that you fully understand the signs to look for and how/when to use the medication.
Non-Vaccine Preventable Diseases
The relevant country pages should be consulted for current non-vaccine preventable disease risks and their prevention.
Depending on whether food is provided by the expedition organisers, or bought locally, the risks of infection will vary. If local cooks are employed check that they use hygienic methods to avoid contamination. Drinking water must be treated by boiling, chemical means and/or filtration. Treated water should also be used for cleaning teeth and for washing dishes and cutlery. All expeditions should have an environmentally aware policy about the disposal of kitchen and human waste, which should be kept totally separate from cooking areas and water sources. Ensure you wash your hands with water containing a disinfectant, before eating or handling food and always after using the toilet. For further information please see the advice page on food and water precautions.
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