Overseas Challenge

Vaccinations - Bilharzia

Bilharzia (schistosomiasis)

Bilharzia is present in fresh water lakes and rivers. It is a small parasite which is capable of penetrating unbroken skin. It generally will not cause serious illness unless you receive a heavy exposure over a long period of time. Avoid swimming and paddling in fresh water. Swimming pools which are well-chlorinated and maintained are safe.

Vaccinations - Rabies

Rabies

Britain is very fortunate in having largely avoided rabies.  We have mentioned before in this dossier the importance of avoiding unnecessary contact with animals and we will reiterate it here.  The easiest way to avoid rabies is not to come into contact with a carrying animal.  We recommend that you have a rabies vaccination before departure, but you should seek further medical advice from your GP or a Travel Clinic.

Vaccinations - HIV/AIDS

HIV/AIDS:

The statistics for HIV/AIDS world wide are well documented. Therefore any exposure to blood, blood products or bodily fluids, as well as unprotected sexual intercourse, may put individuals at risk. The World Health Organisation has an extensive programme of blood screening. However, the reality of this in smaller hospitals in remote areas is questionable.  If, in the event of any need to attend hospital, the project co-ordinator will monitor your care.

In the context of health advice we feel comfortable saying this: you should not be planning to have sex while in Tanzania – HIV/AIDS stays with you for life and whilst modern drugs are working well at keeping the disease controlled there are no cures.

Vaccinations - Malaria

Malaria

Malaria remains rife throughout much of the tropics and causes a huge burden in terms of illness and death for the indigenous population.  Awareness of the very real hazard and the importance of gaining accurate pre-travel advice is vital for travellers to the tropics.  It is not something that you need be afraid of as long as you take the right precautions – it is though something to be respected and dealt with.

Malaria is a parasitic blood infection transmitted by the bite of the female anopheline mosquito. There are 4 types of malaria: Plasmodium falciparum, Plasmodium ovale, Plasmodium vivax and Plasmodium malariae.

The incubation period after a mosquito bite varies from a minimum of 8 days up to several years. Most people infected with falciparum malaria develop symptoms within a couple of months. Early symptoms are similar to flu or gastroenteritis – fever, headaches, aches and pains with some diarrhoea and vomiting. Later stages of falciparum malaria are high fevers, coma and ultimately death. Approximately 5-10 people die of malaria infection in the UK every year, generally due to delay in seeking medical advice.

In-Flight Problems - Poor Circulation

Poor circulation

Sitting still for long periods in the inevitably cramped positions in aircraft frequently leads to swollen ankles and sometimes muscle cramps. Venous thrombosis in the legs and occasionally pulmonary emboli can occur but this is not unique to air travel and can occur whenever people are immobile for prolonged periods. Regular stretching and mobility exercises are the answer -  walk around the cabin whenever practicable. 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 doctors. Possible advice may include the use of graded compression stockings or a small dose of aspirin for its anti-adhesive effect on blood platelets. Similar advice is appropriate for travellers by bus or train who spend many hours immobile in cramped conditions.

In-Flight Issues - Dehydration

Dehydration

Oh look, we are going to talk about water again.  The circulating air in aircraft cabins is kept dry to protect equipment and this can mean passengers may become significantly dehydrated. Alcohol can make this problem worse. Drinking adequate fluids (sufficient to keep the urine pale) is necessary.  Orange juice, coffee and tea are not the answer and actually exacerbate the problem.  Skin moisturisers can help prevent or cure dry skin.

Health Issues - Heat Stroke

Health Related Problems - Heatstroke 

Heat stroke occurs when the body’s heat-regulating mechanism breaks down. It is associated with a very high body temperature and an absence of sweating. Other symptoms include aggressive behaviour, lack of co-ordination and lethargy.  Heat stroke is very dangerous, however it will not become an issue if you follow the advice in this dossier and listen to your leader in country.

Health Issues - Heat Exhaustion

Health Related Problems - Heat Exhaustion

Dehydration or salt deficiency can cause heat exhaustion. It is essential that you can recognise the symptoms in yourself and others. It is characterised by fatigue, lethargy, headaches, faintness and muscle cramps. To prevent heat exhaustion it is essential that you drink enough fluids. Do not wait until you are thirsty to drink – that’s too late.

Dark urine or not needing to urinate frequently are also indicators that you are dehydrated.

If you think we are becoming repetitive about water it is only because it is immensely important.  You will have a better expedition if you are properly hydrated.

Health Issues - Sunburn

Heat Related  Problems - Sunburn

Sunburn can range from a mild irritation to severe burns, which can cause further complications. The effects of excessive sun are well documented and most people are aware of the long-term effects of increased exposure to the sun’s rays. Protection from sunburn should be through both clothing and high factor sun creams, as well as effective head protection.  It is no good just having the sun cream in your bag – use it. 

Food Issues

Food

Milk is often unpasteurised and should be boiled if you are unsure. Powdered or tinned milk is available and is advised, but make sure that it is reconstituted with pure water. Avoid dairy products which are likely to have been made from unboiled milk. Only eat well-cooked meat and fish, preferably served hot.  Pork, salad and mayonnaise may carry increased risk.  Vegetables should be cooked and fruit peeled.  Despite these warnings do not become paranoid and therefore miss out on an experience by not trying the local dishes; generally, if an establishment looks clean and well frequented by locals or tourists it will be fine.  Your leader will be advising you all the time and making sure that the group’s provisions are suitable.