Tips to avoid travel trauma
One of the more interesting jobs I have had is being an international repatriation doctor.
Just like in Thunderbirds, if you end up in an overseas hospital through illness or injury we are sent to rescue you and bring you home.
Many Kiwis in overseas hospitals who need someone like me to escort them home have had near-death experiences. Some think they may never see the long white clouds, gorgeous beaches, stunning mountains and the friends and family of Aotearoa again. They also think they may never get home as they languish, waiting for the paperwork to be completed and to be stable enough to be medically escorted home.
While it’s probably a bit cheesy, my opening line of ‘‘Hi, I’m Dr Tom and I’m here to rescue you and take you home’’ has the desired effect of putting a smile on these patients’ faces – you can see that sense of relief wash over them.
So how does one’s dream holiday turn into the nightmare of ending up in a foreign hospital? For those 25 per cent of people who still choose to travel without insurance, it can become an expensive nightmare. Trauma can be caused by doing things you wouldn’t normally do at home – like riding a scooter in a busy city without a helmet or footwear. Just because the locals do it doesn’t mean it’s safe. They end up in hospital, too.
Alcohol also takes its toll. What might seem a reasonable intake at home may not be on a cruise ship on a rough ocean. I have had to suture a few people as they have bounced off the decks and nervously wondered if the abdominal pain was a leaking spleen or broken ribs, or both, while in remote locations.
Not getting vaccinated can also be a recipe for disaster as diseases like typhoid and now even cholera are making a comeback.
So much planning goes into creating the holiday of a lifetime, while health issues are often left to the last minute, or just left out. It is not uncommon for people to front up to their doctor or a travel clinic and say they want to be vaccinated – only for the doctor to find out the date of departure is today or tomorrow.
Vaccination is like insurance and while strategies such as ‘‘cook it, peel it, boil it or avoid it’’ can provide some protection, having antibodies patrolling your blood stream and taking out unwanted viruses and bacteria is another great line of defence.
Simple strategies like using hand sanitiser can also reduce the risk of nasty gastroenteritis.
I can recall having to rescue someone who had spent a month in hospital, including in a coma, after severe diarrhoea and vomiting.
A good website I use is worldwise.co.nz for up-to-date risks and advice. Like most things, prevention is better than cure. Avoiding being bitten by mosquitoes is the best defence against malaria but if you’re in a high-risk area then taking antimalarials can save your life and reduce plenty of suffering.
Taking your regular medications and a few carefully selected other ones may also mean you don’t have to engage the local health services.
I love travelling and much 123RF prefer to escort people on trips rather than bring them home.
Remember, some common sense and proper planning can help ensure your dream holiday doesn’t become your worst nightmare. ● Dr Tom Mulholland is an Emergency Department doctor and GP with more than 25 years’ experience in New Zealand. He’s currently on a mission, tackling health missions around the world.