Dengue Fever: Fastest Growing Vector Borne Disease?

WorldNomads.com‘s roving medical expert Dr. Erik McLaughlin MD discusses Dengue Fever, its symptoms and the preventative measures travelers can take when visiting at risk areas.

What is Dengue Fever?

A recent article on Medical News Today discussed Dengue Fever as the fastest growing vector borne disease in the world.  Dengue is a viral illness that is spread by the bite of infected Aedes mosquitoes.  This illness, once confined to SE Asia has now become more common in Latin America, Asia, Africa, North America and even Australia.  Dengue, nicknamed “breakbone fever” due to the wracking muscle cramping it causes, has no specific treatment and carries a case fatality rate of 40-50% if left untreated and progresses to the dreaded Dengue Hemorrhagic Fever (DHF).

Dengue fever is a flavavirus that is classified into 4 different strains, named Dengue 1, 2, 3 and 4.  All four different strains can be present in the same geographic area, at the same time.  Once a person is infected with a specific strain of Dengue, they are believed to be immune to that strain for life.  The problem occurs when a person who has been previously infected with one strain acquires a second and different strain.  This infection by a second strain increases the likelihood that a person will acquire Dengue Hemorrhagic Fever (DHF) characterized by uncontrolled bleeding from the gums, intestinal tract, skin rash and fevers.  The increased risk of progression to DHF with each subsequent infection is exactly one of the reasons why producing a successful vaccine has been so difficult.

What are the symptoms?

Symptoms of Dengue fever can be as mild as a slight fever, head and muscle aches, rash and nausea/vomiting.  Often times, the first case of Dengue gets undiagnosed by a person who believes they simply have a “bad cold” and then go on to make a full recovery.

This has now made their body a candidate for DHF should they become infected a second or even third time.

Who is at risk?

The World Health Organization estimates that there are roughly 50 million Dengue infections per year and 2.5 billion people live in areas at risk for Dengue infection.  This is 2/5 of the world’s population.  In 1970 there were only 9 countries with Dengue fever and at present there are 100 countries that contain Dengue.  With the Aedes Mosquito acting as the vector or carrying agent for Dengue, one can clearly see the explosive growth the mosquito species has had, as well.

Researchers are attempting to link increased global temperatures and rainfall with the increased Dengue activity.  The idea that warmer weather leads to increased mosquitoes and mosquito breeding grounds is nothing new, especially combined with standing water which allows the mosquitoes to have an ideal breeding ground.

How can I prevent Dengue Fever?

Prevention of Dengue fever by travelers centers around several key points.   First, knowledge that one is traveling in a potential Dengue area should raise alert and prompt the traveler to be cautious.  Second, prevention of mosquito bites should become a way of life.  Using DEET sprays, permethrin treated clothing, bed nets and long sleeves and pants are vital steps to help keep mosquitoes away from your skin.  Lastly, be cautious of areas with standing water such as upturned canisters, flower pots, tires that may contain water and lakes or large puddles.  Public Health campaigns center on the destruction of these standing water breeding grounds, trying to eliminate of at least decrease the Aedes mosquito population.

Travelers headed to areas with Dengue activity should travel prepared to do what they can to prevent mosquito bites.  Caution should also be used when looking at the time of year traveling occurs, especially during rainy seasons.  Dengue should not be going away any time soon and savvy travelers need to be aware of it and start getting used to taking proper precautions.

Read more stories from WorldNomads.com to help keep you travelling safely. WorldNomads.com – an essential part of every adventurous traveller’s journey.

Travel Scams 2.0: The Evolution of Deceit

You’ve most likely been warned about pickpockets, drink spiking, and conniving tuk-tuk drivers. However, new and increasingly more creative scams seem to keep popping up on the backpacker trails everywhere. We’ve highlighted some of the latest scammer tricks and trends, and how to handle them safely while they are happening.

The Bogus Doctor Scam

Relatives of overseas travellers are being contacted by bogus doctors and hospital staff claiming their family member has been injured and asking for money to be sent for medical treatment. In this new scam, relatives are contacted by phone, email or SMS text messages and given contact details of where to send the money that will pay for the treatment of their supposedly injured loved one. In reality, no one is in hospital, the details are their personal accounts – and if you panic and act on their request, you will be out a large sum of money.

How to avoid this scam – You should share your insurance policy details with friends or family before leaving. If they can’t get through to you, then at least they can get through to the emergency assistance number and they can contact the person who is claiming someone is injured.

How to stay safe when it’s happening – If you are the friend or relative of a traveler and receive such a call, it’s advised to hang up and call the hospital or doctor back – but only through a publicly advertised number such as the yellow pages or other reputable directories. Do not use the contact details the potential scammer has sent you or the organization’s contact details given by the person requesting the information. Again, contact your travel insurance emergency assistance team to help, that’s why they’re there !

The Gems Scam

Gem scams are the most prolific and website forums are littered with stories of travellers who thought they were buying rare, ‘illegally smuggled’ Burmese gems at a fraction of the cost. Soon they find out that their polished gems are polished glass and worthless and the shop they bought from, was not an official government gem store and is no longer there. Worst still are those travellers that choose to pay up front on the belief that the ‘precious gems’ will be sent home, but alas nothing arrives in the mail. This is particularly prevalent in Thailand.

How to avoid this scam – As a rule of thumb, if the price appears to be too good to be true, it probably is! Thai people may sometimes be poor by Western standards but they are not stupid (that goes for market traders everywhere). You’ll be interested to know that there are no jewelery or gem shops that are owned, operated, or sponsored by the government in Thailand.

How to stay safe when it’s happening – As with the tailor scam, you’re unlikely to be at risk from a personal safety viewpoint. Golden rule, do not, under any circumstance agree to follow a street vendor to a gem store that’s ‘just around the corner’, you may well end up being mugged in a back alley!

The Gambling Scam

A traveller is approached on the street by a friendly local who invites you for a drink at their house. After a nice meal a friend or relative arrives and lets them know of a card game happening later that day with some inside tips on how they can cheat and make some easy cash. The ‘mark’ turns up for the game, is allowed to win a few hands but then starts losing and is bankrolled by that friendly person they met on the street, who cooked them such a lovely meal. You see where this is going?

Suddenly the new-found friend is not so friendly and wants that money back and now. Generally under the threat of violence, the ‘mark’ ends up cashing their travellers cheques or clearing out their ATM.

How to avoid this scam – Just be cautious when accepting the warm hospitality that locals may display that you’re not being coerced into something other than a terrific meal. Trust your instincts if you’re not comfortable. Better to risk offending than your personal safety.

How to stay safe when it’s happening – of all of the scams this is the one that has the most amounts of reported threats of violence. If you do find yourself stuck in this situation, and I hope not after reading this, comply with your attacker. If you’re essentially being robbed at knifepoint, the safest course of action is to hand over the money. Personal safety has to come first.

The Tailor Scam

A classic scam involving promises of the finest Kashmir suits, made to perfectly fit, paid in advance. Two days later your clothes arrive at your hotel and low and behold the material does not seem to be the finest Kashmir and the fit is suitable for an 8-year old. Not to worry, the tailor comes to your hotel to measure for adjustments and tells you the dodgy material is just being used to get the fit right. Promises of delivery are made, ensuring that you’ll have them before your flight leaves. Sure enough 30 minutes before you have to get on a plane, they arrive. The same ill-fitting, poor material rags you saw the day before. Too late to chase them down, home you go with what’s now a pretty worthless outfit.

How to avoid this scam – This is a tough scam to avoid, given the relatively hit & miss results travellers have experienced when getting tailored suits, particularly throughout Asia. One suggestion is to bring your own material and research online for those tailors who are well regarded by other travellers.

How to stay safe when it’s happening – You’re generally not going to be at risk from a personal safety viewpoint when it comes to this scam, aside from the rogue tailors pin when measuring up. Our advice to best avoid this particular problem is to only use a tailor who has a shop or factory and to arrange fittings there.

For more information and tips on popular scams check out:

Travel Scams 101

Scams – the advanced course

Read more stories from WorldNomads.com to help keep you travelling safely. WorldNomads.com provides travel insurance and travel safety services to residents over 150 countries. Find out why WorldNomads.com is an essential part of every adventurous traveler’s journey.

If Travelers Are Where Disaster Strikes: Survival Tips from WorldNomads.com

Immediately following the tragedy in Haiti, WorldNomads.com, the travel services company that’s helping travelers stay safe and stress-free on the road, posted information on their Travel Safety Hub on how travelers can safeguard their own health and safety in an earthquake / disaster affected area.

If you have access to a working phone or the internet:

- Make contact with family, friends & your local embassy and let them know that you’re safe.

If you are injured or become ill

- Contact your travel insurance 24-hour medical assistance service as soon as possible, they’ll guide you through what to do next. Follow their advice to the letter.

- If you’re not covered under a travel insurance policy, seek attention at the nearest medical clinic or ask for directions to your nearest embassy.

Beware of the environment:

- Avoid downed power lines and disaster-caused hazards. Use battery-powered flashlights and lanterns, rather than candles, gas lanterns or torches. Following a disaster there may be rapidly moving water that can also carry infections. Disasters resulting in massive structural damage can also result in exposure to chemical or biologic contaminants (i.e asbestos).

- Do not return to your hotel / accommodations, or any building, if they are in any way damaged as aftershocks could cause a collapse.

- Move to the nearest open area (oval, park) away from damaged buildings, trees or roads where powerlines may have fallen.

Keeping Safe:

- Disease can spread very quickly post disaster, so ensure you protect against injuries and infections by wearing sturdy footwear. Tetanus is a potential health threat for cuts and grazes.

- Frequent hand washing helps keep germs at bay. (If a traveler becomes unwell within six weeks of returning home and has fever, rash, respiratory illness or any other unusual symptoms, advise a physician of having just returned from a disaster-affected region.)

- Drink only bottled, boiled or disinfected water. For more information refer to the CDC website (http://www.cdc.gov/).

- In the event of diarrhea, replace lost fluids with clean drinking water or oral rehydration solutions.

- Keep close tabs on personal belongings, passport and money.

Getting out:

- Follow all advice from either your medical assistance service and/or local emergency service team and authorities to move to safe zones or transport to take you to the airport for evacuation.

Chris Noble, General Manager of WorldNomads.com says “Being caught in the middle of a natural disaster is both terrifying and confronting, but it’s also the one situation where you need to remain as calm as possible. Help those around you if able, take every pre-caution to avoid placing yourself at further risk and follow all directions from emergency services”.

WorldNomads.com products and services include global travel insurance protecting residents from over 150 countries with high value medical and evacuation coverage, 24-hour emergency assistance and coverage for a large range of adventure activities; language guides and travel blogs plus a stream of travel safety information to ensure all World Nomads stay informed, educated and safe when traveling.

WorldNomads.com clients may also donate to a range of community development projects when purchasing travel insurance through the company’s Footprints Charity program http://footprints.worldnomads.com/.

Collectively, The Footprints Network has raised over $800,000, from over 310,000 donations, which has funded 53 projects across the globe through partner organizations such as Oxfam, Save the Children and Water Aid.

Read more stories from WorldNomads.com to help keep you travelling safely. WorldNomads.com provides travel insurance and travel safety services to residents over 150 countries. Find out why WorldNomads.com is an essential part of every adventurous traveler’s journey.

5 Things I Wish I Knew Before Going to Mexico

Ay, Caramba! You’ve gone on that long awaited vacation to Mexico and all of sudden you 1. Are sick 2. Had your money stolen or 3. Are stuck alone on a roadside! At World Nomads we’re lucky to have lots of friends in the travel industry, we polled them to give you the very best tips staying safe in Mexico.

1. Learn the Lingo.
A little bit of Spanish goes a long way! Try your hardest with the locals and it will get you a lot further than simply trying to get them to understand English.

Daniel Radcliffe,  Volunteer HQ

2. Drink responsibly.
The variety of tequila is simply overwhelming, so was the hangover! Drink responsibly and test new alcohols cautiously and with friends that can watch out for you. No matter what your friends say don’t eat the worm in the Tequila bottle!!

Mat Lewis, i-to-i
3. Stay alert!
If you get far off the beaten path (for example, deep in the Copper Canyon) and see fancy late-model pickups and gated driveways, know that you’re in a drug growing and trafficking area and get the hell out of there.

Josh Steinitz, Nile Guide
4. Check the water.
Don’t drink the water also means don’t drink the ice! Check with your hotel or restaurant if the ice is made with purified water, same goes for anything that would be washed in water during preparation like salads.

Christina Tunnah, World Nomads
5. Get directions.
Rural roads can be bad. Very, very bad. Make sure your vehicle can handle them. The last thing you want is your rental to break down, your cell phone doesn’t work and no one speaks English. Check with the locals on which routes are the safest to take.

Kathy Dragon, Travel Dragon

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It always helps to know a little bit of the local language, so have a quick study of the below:

¡Hola! = Hello
Buenos Dias = Good Day
Buenas Noches = Good Night
Gracias = Thank You
De Nada = You’re Welcome
¿Cuanto Cuesta? = How Much?
¿A Que Hora? = At What Time?
¿Donde esta el baño? = Where is the bathroom?
¡Emergencia! = Emergency!
¡Ayudame por favor! = Help me please!

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Keen to learn more?

If you want to learn more Spanish in prep for your trip, check out our FREE Spanish Language Guides. If you’re determined to nail more than just the basics, check out our latest Spanish Language Guide PLUS iPhone app with over 500 phrases!

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Read more stories from WorldNomads.com to help keep you travelling safely. WorldNomads.com provides travel insurance and travel safety services to residents over 150 countries. Find out why WorldNomads.com is an essential part of every adventurous traveler’s journey.

When bears attack! Practical tips for staying safe in the wilderness

One of my favorite quotes from Hunter S. Thompson is “Civilization ends at the waterline. Beyond that, we all enter the food chain, and not always right at the top.” I feel the same can be said for those who venture into the wilderness.

WorldNomads.com‘s roving medical and adventure expert Dr. Erik McLaughlin MD shares these practical tips to help you enjoy the North American wilderness from the top of the food chain.

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Adventurers who enjoy hiking, tramping, cycling, climbing and outdoor pursuits should always be prepared for conditions they cannot control.  You can run into stronger, nastier and faster animals than yourselves… and it’s vital to know what to do.

Perhaps the most frightening animal to outdoor adventurers is the bear.  I have a very healthy respect for bears of all types.  Common sense should be used by those traveling through bear country and all bears should be considered dangerous.

Bear safety when you are camping:

• Avoid camping in known bear feeding areas or movement routes
• Keep garbage away from your campsite and do not camp in areas with garbage
• Sleep in a tent and keep a flashlight inside
• Keep sleeping bags partially unzipped for a quick get-away
• Strongly consider carrying pepper spray or if properly trained, carry a firearm
• Store food properly and keep it in bear-proof containers or hung in a tree, away from you
• Cook and store food  at a site away from your sleeping area
• Try to change clothes after cooking and leave them with your food, away from your sleep area
• Do not keep food, trail mix or energy bars in your tent or pockets when you sleep

When you are hiking or traveling:

• Make lots of noise while moving so a bear is aware you are approaching
• Do not rely on bear bells alone to produce adequate noise
• Be aware of wind direction; an “upwind” bear cannot smell you
• Heavy forested areas, rushing water, rain or fog can all act to decrease sound transmission.  In these places be extra loud
• Do not approach bears or any wild animal too close, especially not for a photograph or “better view”
• If you observe signs of bears in the area (tracks, droppings or fresh prey carcasses) consider them to be close by
• Avoid berry patches, elk grounds or streams with spawning fish because bears like to eat there

If you see a bear:

• Allow the bear to see you are there. As a human, you are not one of their favorite meals
• Avoid sudden movements or yelling
• Do not climb a tree or attempt to run
• Do not stare at the bear or make eye contact; look to one side or the other
• Do not attempt to hide
• Avoid standing next to objects such as tree stumps, bushes or things which will cause the bear to think you are anything but “human shaped”
• Speak to the bear in a clear, calm voice to allow the bear to identify you as human

If attacked:

• Do not run, climb trees, fight back or scream
• Do not hold out an arm to ward of an attack
• Drop to the ground and cover your head, in a fetal position
• Curl into the smallest ball you can make yourself
• Interlock your hands behind your head, covering your ears and use your elbows to protect your face
• After you think the bear has left, try to move as little as possible while looking around
• Try to see which way the bear went and travel in the opposite direction

If you are attempting to carry either a firearm or pepper spray, ensure you are properly trained to use these items.  Fatal accidents can result from improper use or inadequate training.

Tips for avoiding other animal attacks

• Avoid sudden movements around animals
• Never pet an unknown dog
• Never pet or kiss an animal, avoid petting them on the head
• Do not reach into animal cages
• After preparing food, wash your hands before touching an animal
• Never leave children alone with animals
• Do not try to take food or toys from an animal
• Do not try to separate fighting animals

Perhaps the greatest danger from an animal attack or bite comes from the initial trauma of the bites or scratches.  After the initial blood loss has been controlled and first aid has been rendered, there should be concern for infection.  Often times, antibiotics are indicated following an animal bite, especially wild animals.

Rabies is always a concern and victims of animal attacks should speak with their health professional immediately about treatment or prevention following a bite.  Frequently, stitching or tightly closing an animal bite will only serve to trap dangerous bacteria in the wound.

Finally, after being bitten, do not forget to check the status of your last tetanus shot.

Bear scare gadgets

Before hitting the trails in North America, you might like to whack these into your hiking pack…

Bear pepper spray

Bear bells
Further reading about

Travel Safety

Bear attacks

Surviving a mountain lion attack

Read more stories from WorldNomads.com to help keep you travelling safely. WorldNomads.com provides travel insurance and travel safety services to residents over 150 countries. Find out why WorldNomads.com is an essential part of every adventurous traveler’s journey.

Sun Safety: How to Beat the Burn this Holiday

A lot of European beach-goers have heard of Croatia.  Warm water, beautiful beaches and great food make Croatia one of the “Dream holiday” destinations.  A little bit of precaution can help that perfect beach holiday from turning into a sunburned and uncomfortable week of redness.WorldNomads.com‘s roving medical expert Dr. Erik McLaughlin MD talks through sun safety, skin protection and burn treatment you’ll need for a painless trip to sunny Croatia.

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Sunburns

The main cause of sunburns is not the sun itself but the ultraviolet energy.  Just to complicate matters, there are three main types of ultraviolet (UV) energy, designated A, B and C.  Erythema is what your skin gets after a day in the sun, which is redness, some slight swelling and pain.  Doses of UV energy and its effect on the skin are measured in units called minimal erythema doses (MED).  This MED represents the smallest does of UV energy to cause that “sunburn” appearance.

Beachgoers are typically exposed to 15 MEDs of UVB and 4-5 MEDs of UVA.  Almost all of UVC is absorbed by the Earth’s atmosphere.  There is increasing evidence that shows both UVA and UVB can be harmful to human skin and both can cause skin cancers.

UVA rays penetrate the skin more deeply and are largely the cause of aged skin and wrinkles.  UVB is generally responsible for most “sunburn” effects and has traditionally been thought of as the cause of most skin cancers.  Ideally, persons in the sun should be protecting themselves with a sunscreen that blocks both UVA and UVB.

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Sunscreens

Sun protection factor (SPF) is the ability of a sunscreen to protect skin from ultraviolet induced erythemas (sunburn).  This SPF number is calculated based on the length of time it takes to cause one MED in protected versus non-protected skin.  Basically, SPF is the amount of time it takes to causes a sunburn in someone with sunscreen protection versus someone who is unprotected.  At present, most sunscreens protect largely against UVB only, although there are some products that are beginning to protect against both UVA and UVB.

SPF:                 % UVB absorption

2                                  50.0

4                                  75.0

8                                  87.5

15                                93.3

30                                96.7

50                                98.0

Chart from “A field guide to wilderness medicine” by Paul Auerbach, pg. 69

Clearly, one can see that UVB protection increases with the higher SPF and use of SPF 30 is becoming more and more advised.

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How to Apply Sunscreen

• Apply liberally to all areas of exposed skin including backs of hands,  ears, nose and tops of feet

• Apply 15-30 minutes before swimming or water exposure

• Reapply immediately after exiting the water

• Using sunscreen and DEET based insect repellent will reduce the effectiveness of sunscreen by approx. 35%

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What is in the sunscreen?

The ideal sunscreen spread onto your skin easy, does not cause allergy, pimples and does not stain clothing.  PABA (para-aminobenzoic acid) is the most common cause of sunscreen dermatitis and effects 4% of people.  Creams and lotions spread on the skin well.  Oils spread very easily but may cause pimples.  For extreme conditions a wax or ointment will help resist skin chapping.  Aerosols are often wasteful and leave parts of the skin over coated and others under protected due to difficulty in ensuring even spray.

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Sun protective clothing

Clothing that has been tested and proven to block the UV energy is designated by the term Ultraviolet protection factor (UPF) which is identical to SPF for sunscreen.

The tightness of the fabric’s weave is most important in determining how effective it will be in blocking UV energy.  A good example of this is Lycra which can block nearly 100% of UVR when relaxed but only 2% when stretched tight.  A typical white cotton tshirt has a UPF of about 5-9.

Wide brimmed hats are especially good for protecting the face, head and ears.  Sunglasses should be labeled to protect against UV energy and side shields do work in decreasing the amount of UV absorbed by the eyes.

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Treating a Sunburn

Sunburns are largely self-limiting and will typically resolve on their own.  Treatment is largely centered on relieving symptoms.  Skin moisturizers and cool compress or cool water baths may help decrease the pain.  There is little evidence to suggest tradition treatments such as baking soda, aloe and oatmeal are effective pain relief but there is also a lack of decent studies.  Oral pain control can be achieved with either aspirin, acetaminophen or ibuprofen.  After a day in the sun, dehydration is also a factor and adequate water intake should also be assured.

Read more stories from WorldNomads.com to help keep you travelling safely. WorldNomads.com provides travel insurance and travel safety services to residents over 150 countries. Find out why WorldNomads.com is an essential part of every adventurous traveler’s journey.

WorldNomads.com free iPhone and iPod Touch Language Guides

The WorldNomads.com free iPhone and iPod Touch language guides have been a HUGE hit with travelers all over the world, with over 610,000 downloads from iTunes in the 9 months since launch! Now the media loves them too. This week the language guides were voted ŒBest Freebie¹ by MSNBC!

Available in 22 languages including Spanish, French, Italian, Mandarin, Thai and Turkish (see Worldnomads.com for a full list and details) each guide includes a few dozen basic travel phrases organized by category (such as ‘transport’, ‘food & eating’ and ‘directions’). Tap a category, select a phrase and a native speaker pronounces the phrase. As the MSNBC reviews says “a high-end feature we’re surprised to find in a free app.” For the full review see: http://www.msnbc.msn.com/id/32464923/ns/travel-tips/

World Nomads has always taken a different approach to travel insurance by providing not just great insurance coverage and travel safety services, but also other tools to keep you traveling safely. This includes free online travel journals, travel scholarships, competitions, and a monthly e-newsletter with safety articles, safety advice and tips, and destination of the month spotlights (for this month’s newsletter http://tinyurl.com/lhj7bx).

To learn more about WorldNomads.com visit: http://worldnomads.com

For more on World Nomads Language Guides, visit: http://journals.worldnomads.com/language-guides/

Hiking holiday? Here’s what to bring… just in case!

WorldNomads.com’s roving medical expert and afficionado of Adventure Travel Health, Dr. Erik McLaughlin MD helps you prepare for a hiking excursion.

Hiking holidays are a great way to spend your time off.  These trips are often done at new trails and areas you’ve never been before and that is part of the excitement.  Often, people do a bit of hiking while they are packing their trip with other activities and do not specifically plan for their outdoor adventure.  Shore excursions from cruise ships are a prime examples of this.

The factors of an unfamiliar area, being unprepared and often in a hurry can stack up against someone, quickly.  When adventuring outdoors, you want as many things in your favor as possible.  Here’s what to prepare for your hiking excursion on your trip!

Signaling Device

• Phone/mobile/sat phone
• Mirror
• Whistle

Being able to contact someone for help is probably the most important thing in an outdoor emergency.  Popularity of mobile phones has helped adventurers be rescued in a timely manner.  Make sure your device from home works in your new location and be prepared that you may not have a signal when outdoors.  Consider renting a local phone, for use during your trip.  Satellite phones can also be rented and provide connectivity, even in remote locations.

Mirrors and whistles serve to attract attention and are very reliable.  They do not run out of battery or lose signal.  Mirrors can reflect light to passing planes or other people, and whistles work well to draw attention, too!  Both are very lightweight and portable.

Extra Food

• Enough for 1-2 days
• Energy bars
• Comfort food

Most day hikes are just that, hikes that are over in one day.  Spending the night outside only happens if there is a problem, but you should be prepared for it.  Healthy people can generally go several weeks without food, but why try it!?  Carrying some extra food, in case you have to sleep out, can make a big difference for comfort and morale.  I am not saying to carry a full buffet, but a few energy bars are lightweight and can make you more comfy waiting for help or while your figure your plan out.

Extra Water

• Carry extra supply
• Purification method (potable aqua tablets, filter, boiling)

Humans may be able to go a week or two without food, but drinkable water is needed much more often.  Death from dehydration can occur in several days.  Carrying extra water is a vital survival tool and should not be taken lightly.  Anticipate your water needs, per person, for your adventure and plan ahead.  This can be carrying extra water or carrying a method to purify water found in the area.  Plan to spend a night outside and consider that you’ll need to drink water during this time.

Fire starter

• Lighter
• Flint and striker
• Matches

The ability to make fire is something anybody who leaves a paved road needs to have.  Fire can be a great signal, especially at night.  Smoke from a fire can be a daytime signal, as well.  Not only does fire provide warmth, but it serves as a tremendous moral booster and makes the difference between an uncomfortable night outside and a potentially life threatening event.  Fuel can be found in the area or brought in your pack.  A few cotton balls or some tissue make perfect fuel sources to help get wood burning and take up a minimal amount of space.

Multi-tool / Knife

• Leatherman
• Swiss knife

A good knife is an incredibly valuable tool.  Multi-tools contain screwdrivers, files and many other accessories that can all have application if you find yourself needing to wait for a rescue or have to spend an unexpected night outside.  A good knife can help with first aid, shelter construction, food preparation and countless other chores that help improve your situation.

Itinerary left with responsible person

• Where you are going
• Which route you are planning
• When you will be home
• Who to call if you are not back by a pre-set date/time

Letting somebody you trust know where you are going and when you are due back should be second nature to outdoor adventurers.  The person you discuss your plans with doesn’t even have to be in the same country, as long as they know the details of your trip.  Make sure they know where you are going and when you are due back.  If you have not let them know that you’ve safely made it back, they should begin looking for you or arranging for help to find you.  Hotel employees, local ranger stations or friends/family back home are all good resources.  Ensure they have some contact information for your area and police stations are often good places to start.  Finally, when you do get back form your adventure, make sure to let them know so they don’t activate a search party!

Extra warmth layer

• Fleece jacket
• Hat
• Gloves

Even in the hottest climates, one should be prepared for a drop in temperature, especially at night.  Changes in weather can come quickly and having an extra layer of warmth can help fight off hypothermia as well as make you a bit more comfortable.  A large amount of body heat is lost through the head and simply wearing a hat can help keep warm.  A fleece jacket and hat take little extra space but can make a night outside a lot more tolerable.

Navigation aid

• Map and compass
• GPS
• Know how to use them

Getting lost is a common occurrence and I am frequently “lost” even at my home trails.  Relying on memory is difficult and next to impossible in an area you’ve never been before.  Carrying a map and compass or GPS is a good idea and may help you find your way back to safety.  However, simply carrying them does no good, unless you know how to use them.  Basic info on how to use a GPS can be found here.  A map and compass do not run out of batteries and never have “no signal”.  A compass requires a different skill than GPS and you can get the basics on compass navigation here.  Practice your navigation skills at home, before you get to the trails!

Basic first aid kit

• Ibuprofen/pain reliever
• Antihistamine
• Antiseptic towlettes
• Bandages/gauze
• Space blanket
• Personal medication

Every person going on an adventure should carry a first aid kit.  What you choose to carry in your kit is another matter, but everybody should carry a first aid kit, of some sort.  A basic kit should include the above items.  Many commercial kits are available, at most outdoor stores.  Also, the kit does no good if you leave it at home!

Portable shelter

• Space blanket
• Tarp
• Plastic trash bag

Carrying some basic equipment that can be fashioned into a shelter is an easy way to minimize discomfort and risk outdoors.  Being prepared to stay overnight, even if you are only being out a few hours is a good way to help survive an emergency on the trails.  Several items, listed above, can be fashioned into an emergency shelter, if the need arises.  Shelter can keep you dry, keep you warm and even help signal for help.  Taking a few extra minutes to drop one of these items in your pack is a great idea.

Even those going off on a “day hike” should be prepared to spend the night outdoors, in the event of an unforeseen emergency.  Carrying a few extra items in your pack can make this night outside more comfortable and lessen the risk of serious injury or death.  These items can help you find your way back home, signal for help and let you take care of yourself and others, should the need arise.  I hope you never have to use any of them, but at least you’ll be prepared if you do have an unplanned emergency outdoors.

Share your hiking stories

Have you ever been caught out unprepared? Or ever so grateful that you packed your favourite gadget? What happened, how did you survive?  Please leave a comment and share your hiking stories with us.

11 tips for overseas hospital treatment

You could have sworn that sushi smelt funny.  Unfortunately that thought is two hours too late and now you’re curled up in the toilet inventing a new guttural language.

And then a new fear strikes you.  You’re in a foreign country, alone, and you really should go to hospital. Or should you? What do you need to know? What should you look out for?

Dr Sneh Khemka, Bupa International’s Medical Director, tells you what to look out for if you need hospitalisation overseas.

Being admitted to hospital

1. Choose the best option

If you’re being admitted as an emergency or taken by ambulance, you often won’t have much choice in where you go.  However, if you can exercise choice, it’s important to select the best hospital for you – does it have the right services (eg a CT scanner), is it clean, can the staff speak your language etc?

2. Let your insurer know

Once there, you should let your insurer know you have been admitted as soon as possible so you can ensure you are covered for all treatments that you receive.  If you can let them know before you attend, they may even be able to point you to the best facility in town.

3. Ask questions

Don’t be afraid to ask questions that may seem difficult – it is important that you know what is happening to you, and instead of being offended, medical staff have a duty of care to ensure you are kept up to speed with what’s going on.

4. Provide the right information

You will be asked for your demographic details (age, sex, next of kin etc) and your medical history.  It is a good idea to carry with you a list of previous operations and treatments you may have had, along with a list of medications and allergies.

You will also be asked about how you are going to pay for treatment.  Without insurance, it can be frighteningly expensive, so you’re best to be covered and you can give them the contact details for your company who should then be able to settle your bills.

What to look out for?

5. Location is important

Hospitals do not have the same standards of care everywhere. Depending on which country you are in, and whether you are in a big city or the rural countryside, hospitals can differ greatly.  Many developed countries will have a government regulation committee that will inspect all hospitals to make sure there is a minimum standard of care.  However, in other areas it is completely unregulated.

Generally speaking, hospitals in developing countries have less regulation and lower standards than those in developed nations.  Sub-saharan Africa is notorious for its underfunded and understaffed institutions and parts of South America have poor legacies for the state of healthcare.  However, South East Asia and the Indian subcontinent have some of the best hospitals in the world.  It’s all a matter of choosing the right place.

6. Cleanliness is next to…

As a general rule of thumb, cleanliness is a good indicator of the level of safety in a hospital.  Word of mouth is also a good way of gauging a hospital’s reputation.  However, if you are insured with someone like Bupa International, you will more reliably be able to find out which are the good and bad places, as we have experience and check hospitals around the world for quality.

7. Consider benefits of private vs. public hospitals

Private hospitals are generally as good as public hospitals and in many places often better.  Private hospitals tend to have better funding and can therefore afford better equipment and facilities.

However, public hospitals may offer a range of services that private ones cannot, including intensive care units, emergency cardiac interventions and a wider range of staff for paramedical services such as physiotherapy and radiology.

What role does my insurer play?

8. Returning home is not necessarily the best option

It is not always the best option to medivac you home, Bupa International runs a full medivac servicec called WMA (Worldwide Medical Assistance).  WMA get calls from all over the world, and because we know the local services and hospitals, we can often find you excellent treatment without having to fly you back home, meaning you can carry on your trip after treatment.  We may need to send you to a nearby country, but if you need urgent attention, having you in an aeroplane for an extended period is not the best idea.

In determining whether or not to medivac a patient home, we look at all the medical details of the customer, what medical services they are likely to need, and the level of cover that they have purchased.  We also take into account the personal preferences of the customer, and often will pay for a family member to travel with them should there be the need.

Then we look at where will be the best place to send them so they can get the best and quickest access to the treatment they need.

9. Understand the hospital fees and charges

There is an emerging problem amongst certain hospitals that, if incentivised in the wrong way, they are more likely to intervene with a procedure or test which may not be entirely necessary.  This is the case with not only foreign visitors, but local patients as well.

We encourage our customers to let us know in advance of any planned treatment so we can talk through the options with both the patient and the doctor, and ensure that they are acting in a medically sound manner, and not just doing things for the sake of a few extra bucks.

For hospital out-patients, you will need to pay the bill when you are discharged and make a claim from your insurer later.  For more serious problems or hospital in-patient admissions, your insurer will liase with the hospital directly about the bill.

Avoiding hospital in the first place

10. Take your own first aid kit

An emergency medical kit always comes in handy, but what you can do with one is limited.  Kits should ideally contain basic painkillers, antiseptic, anti-diarrhoea and rehydration preparations, bandages and plasters.  Customs and prescription laws restrict the amount you can carry around with you.

For any worrying conditions, it is always best to seek expert medical advice – things can be picked up before they develop into major problems and sometimes you need a doctor to give you medications you cannot otherwise access.

If you take any medications, eg insulin, it is essential to keep an adequate supply, and to keep stores in two separate bags in case one is lost. Also, if you are anaphylactic, don’t forget to take adrenaline with you (and give your travelling companion instructions on how to use it).

11.  Use your common sense

The biggest single problem that the traveller will face is dehydration (from diarrheoa and vomiting).  Access to a plentiful supply of rehydration salts and clean drinking water is paramount.

And making sure you’re adequately insured so that not only will your bills be paid, but you’ll have a ‘friend’ that can help you through particularly troublesome times.

Been to hospital whilst travelling?  Share your stories (by leaving a comment) below to help others stay safe on the road.

Travel Safety Tips for Women Travelers

So you’ve packed your common sense and are all ready to go out and explore the world, but remember that old Boy Scout motto? ‘always be prepared!’ By taking some basic security precautions both prior to departure and while away, women travelers can greatly reduce the travel risks they might otherwise face. We searched the web for a experts on travel safety for women and here is what we’ve come up with.

What the Detectives Have to Say:

Jade, an Australian police detective, recommends the following for women traveling alone:

“My number one tip is when going out to remember to get the business card of where you are staying before you head out to show to the cab driver/tuk tuk driver/donkey to get home again.

I make sure now that someone knows where I am and when they are next likely to hear from me again just in case something goes wrong in between. I take a mobile with me for emergencies when I’m on my own too.

It’s just about trying to maintain a balance between having a great time and keeping myself safe.”

What the Experts Suggest:

We found some great safety tips for women over at KevinCoffee.com, such as:

• Study a map before going out; once on the street, use a pocket-size guidebook to avoid looking like a tourist. Your hotel’s concierge or a female employee can mark any dangerous areas on your map.

• Avoid jewelry–even a chain that’s fake gold can be ripped off your neck. Do consider wearing a wedding ring.

• Talk to female passengers and flight attendants on the plane about the safety of your destination.

• In public rest rooms, use the corner stall.

• Stand near the elevator buttons with your back to the wall; if threatened, push all the buttons at once with your back.

• Request one near the elevators and away from any renovation work. Have your key out when you leave the elevator.

To see the full list of tips have a look over at KevinCoffee.com

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