Category Archives: Medical

Let’s Get Medical

Bee Says: When you make the decision to jet off to tropical climes, your brain is instantly filled with a flickbook of tropical islands, gushing waterfalls, exotic creatures and (in my case) all the rum cocktails I have lying ahead of me. The last thing that enters your head is those boring niggles such as insurance, vaccinations and medical preparation. Who wants to bore themselves with that when all you want to do is daydream about pina coladas?! Well, it doesn’t need to put a kink in your pre-travel haze, if you plan far enough in advance.

As a total travel rookie, when my (ex-doctor) dad sent me a list of “have you sorted out…” followed by what seemed like a never-ending list of potential ailments and medical concerns around South & Central America, I was absolutely overwhelmed. I felt like I’d already been ousted as a travel-failure, as I didn’t have a single answer to his sensible questions. My experience is specific to our itinerary (link) but hopefully the advice would be useful to anyone taking a trip to far-flung locations, as even a two-week honeymoon to Asia or quick business trip to Africa has similar implications.

photo 4 (7)

Vaccinations
Give yourself at least THREE months to sort your vaccinations, and actually six months would be ideal. This sounds like a ridiculously long amount of time, but with many of the vaccines you actually need numerous injections over the course of weeks to provide inoculation. With some vaccines, each booster has to be on a very specific day (e.g.  day 1, day 14, day 21 of a month) so clear your diary. Also, in my case I needed an MMR and Yellow Fever. These are both “live” vaccines, and need a clear month between jabs. Therefore if I hadn’t given myself so long to prepare, I wouldn’t have had anywhere near enough time to fit in the necessary vaccinations.

Most importantly; you don’t need to take on the battle of researching what vaccines you need yourself! There is plenty of support and help out there to make sure you are covered. My first port of call was the nurse at my GPs. Book an extra-long/double-slot appointment, and together you can go through your itinerary and work out what you need. Only limited vaccines are available on the NHS (and as with most health-things,  it seems to be a postcode lottery as Nick’s GP had a wider range available than mine) so your second trip will need to be to one of the fantastic Nomad Travel Clinics  or MASTA clinics. If you can’t find either of these in your area; there is a search engine for your closest clinic here or Nomad/MASTA will happily recommend a reputable local resource.

Being in London I had the pick of places, so opted for Nomad – as they have an affiliation with Sta Travel. I had booked my flights and insurance via Sta, and this bagged me a whopping 10% discount off all my kit purchased at Nomad AND crucially, the pricey vaccines. I was pin-cusioned at the Victoria branch of Nomad, and treated by a lovely nurse named Beverly who instantly won me over a) by looked like Zooey Deschanel but b) being instantly reassuring and a clear expert in travel vaccines. On the first session we worked out my schedule of appointments, my options and everything was explained clearly, calmly and with no medical jargon. Every session has been a delight (despite the pain factor) as Beverly always has taken time to check how I reacted to previous injections, fill out my vaccine card and explain clearly any potential side-effects and symptoms.

For South & Central America you need the following:

NHS Provided (Free!)

  • Hepatitis A
  • Tetanus, Polio & Diphtheria
  • MMR (recommended)

Nomad Provided (Paid for)

  • Hepatitis B (£90, £30 per dose)
  • Typhoid (£30)
    There is a national shortage of this vaccination, therefore I had this orally which involved shenanigans with a cool bag and frozen peas as I travelled around, as the tablets can’t be kept in anything other than fridge-like conditions and need to be taken over the course of six days. So, be sure to give plenty of advance notice if you need this as it can’t be obtained instantly, there is a waiting list. I’m not sure how long the national shortage will last, but if there wasn’t a shortage it would be available on the NHS for free and lasts for 3 years.
  • Yellow Fever (£50)
    This is a legal requirement for entering most countries we are visiting as it is endemic in many regions. For this reason you are provided with a yellow fever certificate to prove you are inoculated before entering. Don’t think you might be able to wing-it, as if you can’t provide a vaccination certificate you will be expected to pay sometimes up to £100 to be vaccinated before crossing the border, so it’s safest and easiest in the long run to just suck up the cost and do it here. You must be vaccinated 7 days pre-travel to be covered.

Optional

  • Rabies (£150, £50 per dose)
    This is entirely at your discretion, and most travellers don’t get vaccinated. However for peace of mind both Nick and I have forked out and got the rabies protection as we are travelling to so many areas with feral and wild animals, and we like petting things. This combination just means we would rather be safe than sorry. Even with the vaccine, you would need a booster if you were bitten, but if you are going to be in the wilderness then it buys you the precious time to travel to a clinic or hospital. Once we return to the UK, we have one booster and then are protected for 5 years, so for regular travellers like us then splitting the cost over 5 years makes it a smarter investment

photo (19)

The two questions on everyone’s lips I’m sure are…
Did they hurt? None of the vaccines were more than your standard short, sharp scratch that you can barely feel and is over before you notice it hurting. The one tricky customer was Hep B, as the vaccine is a syrup-y consistency so just a little bit more stubborn going in, but it didn’t hurt at all. So none of these injections are anything to worry about AT ALL and it helps that you can gaze at maps on the walls of the amazing locations you are getting them in order to visit.

Did you have any gross side effects? I was fortunate enough not to have any side effects, except lead-heavy sore arms on the days I had multiple jabs in one arm. Nick had a reaction to Typhoid, which is very common, but that was a night of queasiness and then he was right as rain in the morning.

How much does it all cost? As you can see the financial hit is far worse than the physical pain and these were with discount. I can’t stress enough to start factoring in your vaccine costs at the earliest possible stage. They can’t be avoided and whilst they seem pricey; they aren’t HALF as costly as your medical bills / flight home would be if you skip out on getting them and then get sick. Leading me nicely on to…

Insurance
Two words: Get it! There’s a hideous statistic out there about 75%+ travellers not taking out insurance which give me chills. There are plenty of online price comparison sites out there, for those without pre-existing medical conditions, such as lucky Nick! He got his insurance via Columbia for £150. If you havea pre-existing medical condition then you will need to get special cover, as your condition invalidates any cover if it’s not declared. I recommend Sta Travel, firstly for the sweet nomad discount, but secondly because of the easy process to insure your existing condition. It’s just a swift 5 minute phone interview, where you are quoted then and there. My insurance is the more costly £300 but this is due to my asthma and the fact I had surgery less than a year ago. Having feared I wouldn’t even GET insurance, this feels reasonable. One BIG pearl of wisdom, that we are literally paying for our own mistake on, plan your flights carefully. Our flight home takes us ONE DAY over 6-months, which means we have to pay for 7-months of cover. Bah! Also, you can’t lie and say you fly home a day early because any claims will need the flight details of your homeward leg of the journey so you’ll be busted and invalidated and sad.

No one wants to focus on illnesses, accidents and unexpected emergencies… but you don’t have to if you’re prepared and that’s why I’m relieved we’ve done it properly so we can be spontaneous souls once we are where it counts most – on our trip!

Nick says… 

photo 2 (20)

Medication
So after you’ve spent more on vaccinations than you’ll spend on actually going back-packing, it’s time to worry about all the medication you’ll have to lug with you. What do you really need to take? Travel books will recommend a whole heap of stuff I’d never heard of (such as lidocaine cream) and on my previous trip I dutifully took everything. And then didn’t use half of it. So… take what you’d generally use in everyday life. Inhalers etc. if you suffer from asthma. This also means painkillers for those nights you’ve enjoyed a bit too much of the local hospitality or for those days where you’ve been on a punishing trek/ran away from bandits. I would also recommend an antiseptic of some sort – I swore by little bottles of iodine last time I went, but sadly you can no longer get them. But you’re bound to need wounds cleaning up at some point in time when you’re away. That’s not me being super gory, it’s just a fact. In my previous trips I’ve managed to cut up feet, shins, hands, and also had to take someone’s stitches out. You need something to clean it all up with. A spray based one is a good bet as that stops you prodding and wiping any cuts with your grubby little fingers. Although not strictly medical, I wouldn’t go anywhere without tiger balm. It’s basically magic in a tiny jar. Good for headaches, muscle pain, and even bites – the tingling removes the itching! You can pick this up from Boots for about £4. If you don’t know where it is in the store, just ask – it’s usually near the rescue remedy.

However, that’s not to say you shouldn’t take all the bells and whistles if you’re worried. It’s just that you probably won’t need them. Unless you’re off on a lot of solo hikes, a standard medical kit should be just fine (you can buy them from Nomad or other travel shops for around £30, or you can make up your own and put it in an ice cream box or something). For anything that gets a bit more serious, such as badly infected bites, you’ll most likely be able to find doctors that can help you out. Medical care does exist all over the world.

For those travelling to tropical climes, mozzies are going to be a big problem. You will get bitten, but you can take measures to discourage these pesky things. The most obvious is getting yourself a Deet based bug spray. Then liberally douse yourself. It stinks and tastes horrible, but it does work. Spray your ankles and wrists especially as these seem to be hotspots. Mozzie coils to burn at night are also a good idea. Again, most places you stay will probably already own them so just get a lighter out and get them going.

photo 1 (20)

But what about anti-malarials?
Oh yes, the great anti-malarial debate… Again, it’s totally up to you if you take them or not. If you’re headed somewhere that’s known as a malarial region then I would probably take them. It’s an extra-insurance against quite a nasty disease. I once knew a guy who got bitten only a few times in India and ended up having to have a blood transfusion over there after he fell ill. But then again, people spending a lot of time in malarial regions often don’t bother due to their side-effects. I’ve previously experienced photo-sensitivity, but nothing like night terrors you hear about.  Again, each person is different.

If you do decide to go with taking anti-malarials, there are a few things to know. Do your research on which ones you’ll need. There are several different types. Your travel nurse will be able to help you with this. Some cannot be taken with other meds or pre-existing conditions. Some don’t work in various regions – the mozzies have developed immunities. If you get them pre-trip, they’re going to be expensive. If you get them while you’re away, they’ll be a lot cheaper. When I went to South-East Asia (Laos is a malaria area) I bought mine in a pharmacy in Thailand, saving me about £50. This time I’ve bought them pre-trip, costing me about £75. Why the change? Well last time I wasn’t getting to Laos until about 7 months into my trip, I just didn’t need to carry them around for that long and only needed one specific type of tablet for a month long period. This time I’m going to be in tropical malarial regions within a week of landing, and needed a mix of anti-malarials. Doxycycline for South America and Chloroquine for Central America. I wanted to talk through with my nurse what to do about swapping over and when was the best time to do it. It felt right to sort it all out before, even if it was more expensive! To save costs, you can also go through online pharmacies. Your nurse can recommend legitimate, reputable ones to go to – Bee bought her Malarone and Proguanil from Travel Pharm and it was half the cost that Boots quoted. Bear in mind you will still need a private prescription from either your doctors or travel clinic to use these sites.

Things do go wrong on the road, but unless you’re very unlucky then it’s nothing you won’t be able to sort out yourself. By being insured, vaccinated, and aware of the possible diseases in the areas you’re going to, you’ll be much more likely to avoid anything nasty. However, please do plan into your budget how expensive it all is to get ready to go away. I had most of my vaccinations in date from previous trips, and I still forked over a couple of hundred quid to be stuck with needles. Bah!