Hopefully while in the process of making your travel plans and after you've made a decision on a travel destination, appropriate
vaccination and prophylactic medicine should be obtained. Many of these vaccines are on scheduled time intervals for
administration, so planning far in advance is a wise and prudent choice. You can use the services of a travel clinic. I have used a
travel clinic associated with the University of Missouri - Columbia and I have also made several referrals to Travel Connection.
The main thing that Travel Connections and other clinics offer is convenience and they follow the CDC recommendations for
specific vaccinations and meds. and usually have these in stock, this is very helpful since some of the
medications might be difficult to obtain and most are not used inside the United States. They can also
be helpful with questions that might have a grey area, for instance: Which antimalarial med is best for
you individually or is the rabies vaccine really necessary? Last year on the edge of a primitive
Zambian grass hut village I drew the attention of a mangy, snapping, and barking mad dog, I did not
get bitten, however next time I travel to Africa, which will be soon, I will carry rabies vaccine or will have
the rabies vaccination. I highly recommend Travel Connections, or similar clinics, because of their
convenience in getting the proper vaccination for your specific travel destination. They can also
supply you with an updated shot record and an official documentation of your shot record, which I believe is a good thing to carry
on your person when abroad. I've never been asked when passing through customs for my shot record, however I have heard
stories in which people have been asked for their specific vaccine history and/or shot record. The shot record and travel
medicines are better to have and not need than to need and not have, especially if your travel destination includes traveling into
and/or third world areas.
However, for a safe and successful travel, especially adventure travel, requires much more prior planning and preparation than
just a simple trip to the local Travel Clinic.
Basic Travel:
Basic Travel to me would include going on a cruise, traveling abroad, sight-seeing, tours, sun and fun resort type activities.
My specific recommendations for basic travel would be research your travel destination and resort activities as thorough as
possible and give yourself plenty of time. The more you plan and the more you research the more likely you will have a safe and
successful trip. It also negates some of the potential pitfalls, risks and problems. Prior research and planning is the key. Along with
this comes a good mental attitude and giving your best to have fun. Try to be patient, take a deep
breathe, and throw your shoulders back before entering the airport. Air travel can be extremely
frustrating, tiring and difficult. Trying to maintain a good mental attitude will help any given
circumstance and will help you enjoy your vacation and that's what this is all about anyway.
Use a travel clinic similar to Travel Connections or check the CDC for specific recommendations of
vaccinations, which you can obtain and administer through your own office or through the use of a
travel clinic. Research of malaria prophylactic is required to ensure that there is no malaria drug
resistance and try to determine which antimalarial is best for you personally. With mefloquine or malarone
it is necessary to begin taking these meds. one week before departure and continuing for four weeks after returning from epidemic
area. Prophylactics require starting the medicine days or weeks before departure, this is another reason why planning in advance
is essential. Other online resources are available from CDC (www.cdc.gov/travel) and Global Infectious
Disease and Epidemiology Network (www.GIDEONonline.com). I would also recommend physicians and non-physicians to take a
medic bag, a basic medic bag for non-physicians travelers would include Cipro for travelers diarrhea, other anti-diarrheals such
as Pepto-Bismol and Imodium, and of course their usual medications, which should be in that persons carry-on or possession at
all times. or the physician traveler, I would recommend a more extensive medical bag. For Basic Travel the need for an extensive
medic bag is not that great, but for Adventure Travel, where no professional medical help is available, I would definitely have a
well stocked and well thought out medic bag. I have included a list of the contents of my medic bag for this lecture. Physician
travelers who do set up their own medic bag should have a full and complete inventory list in the bag on the physicians office
letterhead. Doing these simple things will help ensure no problems when going through customs with your supplies and medicine.
There is some debate on the usefulness of benzo-diazepine or hypnotic agents to allow to you sleep on very long flights. An 18-
hour flight from Atlanta to Johannesburg can be very long and being able to sleep certainly makes
the trip seem shorter and helps you feel well rested upon arrival. On the other hand, being in a stupor may put you at risk for
making bad decisions. I have heard of accounts or travelers being pick-pocketed or victimized while
being semi-stu porous from drugs or alcohol during travel. Being prudent would be the best course
while looking out for yourself and/or your travel companion, which is a must. I also recommend trying
to pack smart and planning ahead based on your travel destination. Good quality layered clothing
with a gortex outer shell, where you can adjust your clothing depending on the wind, rain and other
weather conditions, sunscreen and wide-brimmed hats. In areas where there are insect born illnesses
I would recommend a deet containing bug spray, lotion and a mosquito net if necessary, as the best way to avoid being bitten in
the first place. Long sleeves and pants, along with keeping your head covered is an excellent way to prevent mosquito or tick born
illnesses along with doing routine tick and bug checks in front of the mirror. So if possible, keep clothing and personal items in
zipped bags or stored in areas where insects and scorpions can be prevented from getting inside. Always shake your boots before
putting them on. Having military style or camouflage clothing may draw unwanted attention and is probably not a good idea. Always
try to plan ahead and avoid situations that might put you at risk, sometimes these situations are more easily identified than others,
however having situational awareness and knowing what is going around you is always a good idea. Avoiding potential conflicts is
very important. Alcohol often increases the possibility of a problem situation and I believe it is best while doing foreign travel to
avoid certain circumstances that would expose you to this. I would also recommend the med jet even for basic travel. Commercial
airlines usually will not allow sick and injured passengers to travel. Because of liability, traveling back home with someone with an
injury or medical condition is and may become very expensive to return home. The med jet service is an inexpensive insurance in
case something bad happens while abroad. I will discuss the med jet assistance program more extensively later in the lecture.
Something as simple as a broken ankle in Mexico can turn into a nightmare if you are trying to get home. The airlines are not set
up to handle sick and injured people and often refuse to do so because of liability and other reasons.
Outdoor Adventure Travel:
Going beyond basic travel is what I would like to call Adventure Travel or Action Adventure Travel which includes travel to far-
flung places and third world countries doing activities which could incur some potential risks, such activities would include
mountain climbing, hiking through wilderness areas, hunting, fishing, diving, and lots of other sports not included on this list.
Action Adventure Travel is my passion or obsession, my wife probably has a few other adjectives to
describe it, however it takes a great deal of preparation to plan one of these experiences. Some people
just don't have the desire to do things, however I believe there are several that do, some people just
talk about Action Adventure Travel and some act. If there is something that you would like to do, there's
no time like the present to start planning. The key issues must be addressed to successfully complete
the adventure of a lifetime. Prior planning and research to find out as much possible about your
destination is extremely helpful. Its not uncommon for major expeditions to be planned as much as two
years in advance. Experienced advice from someone who has done the activity or has been to the
destination tat your have in mind is best. Someone who has completed their travel to this area could be a wealth of information
and could be difficult to find someone locally who has "been there and done that". There are also chat rooms, internet references,
and clubs, but do your homework that is the key. After doing your homework and selecting a potential destination, it is now time to
do a realistic evaluation of your level of physical fitness, how much time can you spend, what financial resources, what levels of
potential discomfort and risk are your willing to incur? These questions may seem basic, but they are the foundation for which the
rest of your planning will be based. All travel has a certain level of risk, some are higher levels, such as mountain climbing,
hunting dangerous game, different types of diving and repelling. Know the different types of risks and your comfort level with each
type. Along with the realistic evaluation will be the evaluation of your fighting spirit. How much energy
and passion do you have for the specific action adventure activity being undertaken? Realistic
evaluation depends on how much discomfort and effort is within your acceptable zone. There will be
huge potential of being wet and cold or hot and tired, and if wet and cold is something that you can't
tolerate, then there will be certain activities that should not consider undertaking. Your ability to deal
with the unexpected and uncertainties, being able to adapt and overcome is critical for adventure
travel. There are many variables and possibilities of things that can go wrong, such as weather,
airplanes, mechanical breakdowns, unexpected problems, which is to be expected in remote and third
world countries. Things often do not go as planned and your ability to deal with that will be essential. Following The Realistic
Evaluation: How to select a guide or outfitter with a specific travel adventure in mind, after thorough research and homework is
done, and hopefully advise from an experienced and non-biased person is obtained, it is time to talk to a guide or booking agent.
The more you know about the activity the better you are able to deal with the outfitters or booking agents, which helps translate
into a better and safer adventure and often a better deal. It is very important to use references, the internet and different clubs are
available for this when booking a guide or booking agent. Nearly all action outdoor activities have clubs associated with them and
with the internet the amount of information has exploded and it is far easier and more accurate to get. Adventure travel is less hit
and miss in the age of the internet unlike in the past, on your chances of having a less than optional experience is decreased. The
action adventure information I like the most is hunting and fishing report. These are a wealth of information and when someone is
un-repeatable, doesn't keep their word, or is dangerous, the word spreads soon throughout the safari
club and/or hunting and fishing reports. The word soon gets out if an outfitter is undependable, but
also why you must do your homework. Personal references are good, however very few guides or
outfitters would list dissatisfied or unsuccessful adventures on their reference list. Now that you've
booked your adventure get the specifics from your outfitters, such as what clothing, equipment, gear
and specific items are necessary for your adventure. Any good outfitter will have a complete list of
necessary items, if they do not have a list of all items needed, I would reconsider your choice of
outfitter. Also try to get a specific level of fitness needed, and length of activity that will be required to try
and train to that level or a higher level of fitness to make your activity more enjoyable. Travel Companions: Having a travel
companion to share adventure and travel with greatly increases the enjoyment of your travel. However, the wrong travel partner
can lead to disaster. It is necessary to have someone with similar abilities physically, financially, and time-wise and as well as ability
to adapt and overcome uncertainties with things, that don't go as planned is essential. I'm very lucky and thankful that I have travel
companions and friends that are dependable and have similar interests, abilities, and resources to travel with. Sharing the
experiences and memories of a big adventure is wonderful, however I would much rather travel an adventure alone, than
undertake that big adventure with someone who could not meet the basic requirements of adventure travel such as time, fitness,
bright mental outlook, financial resources, etc. Another important part of having a good hunting or adventure partner is being one
yourself. Being dependable, safe and planning ahead and looking out for your partner is part of being of a good travel partner. If
you have an interest in adventure travel, have talked about it, thought about it, but have never done it, now would be a great time
to start planning. It takes a lot of time, effort and planning for a successful adventure, but it can be highly rewarding. For me
personally, not only does it charge my batteries, but I feel like it enriches my life, adds purpose and having that outlook makes my
daily life and daily responsibilities seem easier to cope with. Knowing I have plans for action adventure, makes working everyday
more enjoyable.
Air Evacuation:
Air Evacuation is essential for the adventure traveler, especially in remote areas where they already have the contacts and
resources in place prior to an illness or injury. When delays can be life or limb threatening, trying to make emergency travel
arrangements in remote places may be impossible. In nearly all circumstances prompt evacuation would be impossible.
Evacuation from a remote area after illness or injury is not only difficult, but the cost if absolutely
astronomical. I know of an incident when a gentleman was seriously injured while hunting a leopard in
Zimbabwe last year, the cost for getting him home from Zimbabwe after suffering a significant injury
was well over $125, 000 and he had to have monies up front before travel plans could be made.
Several hundred dollars spent for air evacuation insurance is a small price to pay after you take into
consideration the true cost, if arrangements and insurance are not taken care of prior to travel.
Evacuation from common travel destinations with a sick or injured person is very difficult to arrange
and extremely expensive, even from common and well known travel destinations. Airlines are not set up or equipped to handle sick
or injured travelers and issues of liability have a great deal to do with this, most are unwilling to transport sick or injured travelers.
Travelers and adventurer's should always expect the unexpected. Proper prior planning can overt potential disasters to you or
your family. I highly recommend Med jet Assistance Corporations. My family and myself are members, however I've never had to
use the service. They provide a unique service and a certain piece of mind, especially when doing adventure and remote travel. I
would not do an adventure without a current Med jet Assistance Card and phone number in my pocket, which is Med jet Assist
(800) 963-3538 or (205) 421-4552; email: www.medjetassist.com. Membership rates for annual programs are $205 per individual
and $325 per family, which I believe is pretty cheap insurance and well worth it for piece of mind and certainly worth it if the
unexpected should happen.
Building A Medic Bag:
Areas traveled, remoteness of areas and activities being undertaken are the key considerations when deciding what contents to
place in a travel medic bag. Level of remoteness is the most important issue when preparing your medic bag. Level of remoteness
is the most important issue when preparing your medic bag. The reason why well prepared medic bags are important is that you
may have to take care of yourself and your travel companions for an extended length of time. Also any
specific health needs or issues for yourself or your party should also be considered when choosing
the contents of your bag. A collapsible nylon fishing tackle type bag with a shoulder strap makes an
ideal travel medic bag. They come with transparent boxes for storage allowing you to see all your
items and stores them safely in lightweight waterproof containers. These are very functional and
useful. I keep a copy of my medical license and detailed list of all contents of my medic bag on my
office letterhead. Doing this should prevent any problems while passing through customs. Further
information on this topic, what specific items to pack in a travel medic bag, along with practice guidelines
are available at the Wilderness Medical Society at www.wms.org. The contents of my bag have mostly routine items and some
specific things based on travel destination. I often add different items when traveling with children. The travel medical kit should
also include an adequate supply of prescription medication and a list of their pharmacologic names. Things to include are
analgesics or antipyretics (ibuprofen or acetaminophen), antihistamines or antipruritics, (diphenhydramine), DEET based repellent
with permethrin, diaper rash ointment, disinfectant solution such as iodine or chlorhexidine. Elastic dressings, oral re-hydration salt
recipe for making oral re-hydration solution. Prophylactic medications for motion sickness, altitude sickness, malaria and travelers
diarrhea. Sunscreen with greater than fifteen SPF and protects against UVA and UVB light. Tweezers and scissors should be
included in the travel medic bag when traveling with children. Other specific recommendations for traveling with children include
advising families to boil water or use chemically decontaminated water if bottled water is not available.
Consume only good that has been peeled or cooked. Parasites associated with swimming is common
throughout the world. In general fresh non-clorinated water should be avoided. To avoid ground
dwelling parasites I advise parents to make sure children wear protective footwear and avoid direct
contact with the ground. Air travel is not recommend for infants younger than two weeks, or with ear
infections or effusion. Children traveling with chronic diseases should keep medications in original
containers in their carry on luggage to ensure that parents have an adequate supply of medications
for administering. Prevention is far better than having to use the medic bag that you have prepared.
Prior planning and research is the key to avoid many pitfalls while traveling, however, some are unforeseen and not all are
avoidable. Preventing the bug bite or the exposure to other risks if possible, having situational awareness, or always being aware
of your surroundings, trying to think ahead and use good judgment to look out for your travel companions are good travel policies.
Disclaimer:
Stories, Smart Talk, Pictures and My Opinion, are only coming from an expert
These stories are opinion ONLY!!! And not the substitute for professional medical advise! Reading my Smart Talk NO WAY
INFERS a doctor patient relationship!!
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