THE TRAVEL DOCTOR
----www.traveldoctor.co.uk
 
 

Do you know which medicines you should take with you on your travels?

By accessing the interactive part of this web site you can obtain a list of all the medicines necessary for your trip.

Whether you are going on a holiday to a beach resort or a full blown expedition to some remote location.

However long you will be away or however many people will be in your group, wherever you are going and whatever you are doing, you can obtain your own customised list.

To access this special service:-

 
Member of the
British Travel Health
Association

 
 
 
 
 
 

Do you know which medicines you should take with you on your travels?

By accessing the interactive part of this web site you can obtain a list of all the medicines necessary for your trip.

Whether you are going on a holiday to a beach resort or a full blown expedition to some remote location.

However long you will be away or however many people will be in your group, wherever you are going and whatever you are doing, you can obtain your own customised list.

To access this special service:-

 
Member of the
British Travel Health
Association

 
 
 

Do you know which medicines you should take with you on your travels?

By accessing the interactive part of this web site you can obtain a list of all the medicines necessary for your trip.

Whether you are going on a holiday to a beach resort or a full blown expedition to some remote location.

However long you will be away or however many people will be in your group, wherever you are going and whatever you are doing, you can obtain your own customised list.

To access this special service:-

 
Member of the
British Travel Health
Association

 
 
 

Do you know which medicines you should take with you on your travels?

By accessing the interactive part of this web site you can obtain a list of all the medicines necessary for your trip.

Whether you are going on a holiday to a beach resort or a full blown expedition to some remote location.

However long you will be away or however many people will be in your group, wherever you are going and whatever you are doing, you can obtain your own customised list.

To access this special service:-

 
Member of the
British Travel Health
Association

 
 
 

Do you know which medicines you should take with you on your travels?

By accessing the interactive part of this web site you can obtain a list of all the medicines necessary for your trip.

Whether you are going on a holiday to a beach resort or a full blown expedition to some remote location.

However long you will be away or however many people will be in your group, wherever you are going and whatever you are doing, you can obtain your own customised list.

To access this special service:-

 
Member of the
British Travel Health
Association

 
 
 

Do you know which medicines you should take with you on your travels?

By accessing the interactive part of this web site you can obtain a list of all the medicines necessary for your trip.

Whether you are going on a holiday to a beach resort or a full blown expedition to some remote location.

However long you will be away or however many people will be in your group, wherever you are going and whatever you are doing, you can obtain your own customised list.

To access this special service:-

 
Member of the
British Travel Health
Association

 
 
 

Do you know which medicines you should take with you on your travels?

By accessing the interactive part of this web site you can obtain a list of all the medicines necessary for your trip.

Whether you are going on a holiday to a beach resort or a full blown expedition to some remote location.

However long you will be away or however many people will be in your group, wherever you are going and whatever you are doing, you can obtain your own customised list.

To access this special service:-

 
Member of the
British Travel Health
Association

 
 
 

Do you know which medicines you should take with you on your travels?

By accessing the interactive part of this web site you can obtain a list of all the medicines necessary for your trip.

Whether you are going on a holiday to a beach resort or a full blown expedition to some remote location.

However long you will be away or however many people will be in your group, wherever you are going and whatever you are doing, you can obtain your own customised list.

To access this special service:-

 
Member of the
British Travel Health
Association

 
 
 

Do you know which medicines you should take with you on your travels?

By accessing the interactive part of this web site you can obtain a list of all the medicines necessary for your trip.

Whether you are going on a holiday to a beach resort or a full blown expedition to some remote location.

However long you will be away or however many people will be in your group, wherever you are going and whatever you are doing, you can obtain your own customised list.

To access this special service:-

 
Member of the
British Travel Health
Association

 
Home Introduction Information Main Page About Us Links
Types of Traveller
---
Holidaymakers Business Travellers
Adventure Travellers Expedition Members
Long Term Travellers Special Needs

Holidaymakers

These people will travel to a holiday destination for a typical resort holiday. Many travel to European resorts in Mediterranean countries like Spain, Italy or Greece in search of the sun or to France and Switzerland on skiing holidays.

Others may travel a bit further to Florida in the USA or a Caribbean resort and some of the more adventurous will even travel to more exotic locations such as Kenya in East Africa or Thailand in South East Asia. Some will even venture as far as Australia for their holidays. Others may visit some of the world's most famous resorts and hotels to wine and dine and play casino games and generally live the high life just like the rich and famous for a few days.

Because these travellers are going to a holiday resort with a hotel with all the comforts of home, they will usually have easy access to medical facilities should they be required, and therefore, they should be able to obtain any medicines they require from a local pharmacy or medical facility.

These travellers usually remain within easy reach of a doctor or a hospital whilst they are away which is a much better option than self medication for serious illnesses. They may also include children, the elderly, pregnant women and the disabled who should all seek medical assistance if they become ill.

However, a small medical kit for treating minor ailments should they arise will be of great value and convenience. The information supplied in this site will also prove valuable to these travellers and the interactive page can also provide a list of the medicines they should take with them.

Vaccinations take time. A doctor or nurse should be consulted as soon as possible, ideally at least four weeks before travelling. Late bookings can leave insufficient time for vaccinations to become fully effective.

Stomach upsets and diarrhoea are very common. Contaminated food and water is a major cause of illness and care is especially important when eating out and in countries where local hygiene is poor. More spices or oil in food as well as alcohol can also lead to stomach upsets.

Sunburn is preventable, so always use an appropriate sunscreen when going outside into the sun.
See the sunburn page for more details.

For an excellent range of quality discount luggage
with best prices and selection on all types of suitcases, carry-on luggage, briefcases, handbags, wallets, laptop cases, garment bags, sports bags, rucksacks and travel accessories, go to:-


Business Travellers

This group of travellers for the main part fall into the same category as the previous group in so far as they are never far from medical assistance when it is required. The main difference being that the majority will be travelling to cities rather than holiday resorts. A small group however, will occasionally travel to more remote areas in the course of their business. In this instance, a small medical kit for treating minor ailments will be of great value and convenience. The information supplied in this site will also prove valuable to these travellers.

Tiredness and jet lag may affect your business efficiency. Rest before and after travel is important. Persons with occupations which involve frequent travelling should consider vaccinating in anticipation of overseas assignments in order that the vaccinations achieve optimum protection, e.g. a first yellow fever vaccination certificate is not valid for 10 days.

Contaminated food and water is a major cause of illness in business travellers although less so if eating and drinking is confined to first class hotels. Avoiding unsafe food and water can sometimes be difficult, when being entertained by enthusiastic hosts, unless a strategy is planned in advance!

It may be wise to always carry an anti-diarrhoeal preparation to make sure that you are able to attend important business meetings or to help you make long journeys without having to make frequent and inconvenient use of the toilet.

Unfamiliar surroundings, especially when combined with excessive alcohol consumption can lead to uncharacteristic behaviour including sexual risk taking. "Unsafe" sex, particularly with commercial sex workers, may pose serious infections risks including HIV.


Backpackers & Adventure Travellers

Backpacking is a term that has historically been used to denote a form of low-cost, independent international travel. Terms such as independent travel and budget travel are often used.

The factors that traditionally differentiate backpacking from other forms of tourism include the use of a backpack or other luggage that is easily carried for long distances or long periods of time; the utilization of public transport as a means of travel; a preference for inexpensive lodging such as youth hostels; a longer duration to the trip when compared with conventional vacations; and an interest in meeting the locals as well as seeing the sights. It is typically associated with young adults, who generally have fewer obligations and thus more time to travel. They also have less money to spend on hotels or private vehicles.

The definition of a backpacker has evolved as travellers from different cultures and regions participate. They also display a common commitment to a non-institutionalised form of travel, which identifies them as backpackers. Backpacking as a lifestyle and as a business has grown considerably in the 2000s as a result of low-cost airlines and hostels or budget accommodations in many parts of the world. Digital communication and resources make planning, executing, and continuing a long-term backpacking trip easier than before.

Of importance in backpacking is a sense of authenticity. Backpacking is perceived as being more than a vacation, but a means of education. Backpackers want to experience the "real" destination rather than the packaged version often associated with mass tourism. There is also the cocept of witnessing real life with more involvement with local people.

However, even though one of the primary aims of backpacking is to seek the "authentic," the majority of backpackers tend to spend most of their time interacting with other backpackers, and interactions with locals are of secondary importance.

Some useful websites include:-

The Backpacking Site Backpacker
World Backpackers Travel Independent

Adventure travel can be defined as: a vacation or trip to a natural environment or remote location with the specific purpose of active physical participation and exploration of a new experience. Nowadays many specialist companies and organisations can design a personalized itinerary that suits your individual adventure travel desires.

We tend to equate “adventure” with doing something sporty possibly slightly dangerous, but travel companies are bending over backwards to create a holiday that involves a sense of adventure ( this doesn`t mean being hooked up to an anti malarial drip in India) but not to the point where one or both parties find the so called adventure bit a bit too much hard work, the sort of holiday you need another holiday to recover from the previous, action packed one.

Depending on your age, income and level of fitness the choices are many and varied. You can opt for a cycling holiday in Vermont, trekking in the Nepal Himalayas, a sailing adventure in Thailand, crossing the Grand Traverse in New Zealand, walking the Inca trail in South America, scuba diving on the Great Barrier Reef, a cultural visit to see the Terracotta Army and the Great Wall of China, or a safari holiday to Massai Mara Game reserve, in which you explore rather close up and not behind zoo cages the likes of wild lions, elephants, giraffes and cheetahs, except you don`t have to sleep in tents, but in lodges which cater to Western travellers.

Adventure tourism gains much of its excitement by allowing its participants to step outside of their comfort zone. This may be from experiencing culture shock or through the performance of acts, that require significant effort and involve some degree of risk (real or perceived) and/or physical danger. This may include activities such as mountaineering, trekking, bungee jumping, mountain biking, rafting, zip-lining and rock climbing. Some obscure forms of adventure travel include disaster and ghetto tourism. Other rising forms of adventure travel include social and jungle tourism.

Adventure travel is to intentionally go beyond one’s normal known area, seeking out experiences which are unfamilar. This form of travel can expose travellers to additional health risks and it is this group of travellers who will probably benefit the most from taking their own customised medical kit with them.

Adventure Travellers often travel alone or in small groups on self-organised trips or on small group organised excursions. They include; tourists, trekkers, mountaineers, climbers, bikers, canoeists, scuba divers, etc. etc. The list is endless. This type of excursion usually involves travelling on foot, by bicycle or public transport and staying in simple cheap accommodation.

The growth of adventure travel has been accompanied by an enormous variety and availability of adventure travel companies specialising in international travel and tourism. A few examples include:

Explore Worldwide Exodus
Intrepid Travel KE Adventure Travel
Kuoni Travelsphere

More links to Adventure Travel companies can be
found on our "Adventure Travel" links page:


Both these types of travellers are also likely to be exposed to infections and diseases due to the nature of the activity they are involved in and the locations to which they travel.

They should therefore be extra aware of measures to prevent illness from food and water, insects and animals and close personal contact with locals.

Vaccinations should be arranged with a GP's surgery or travel clinic in plenty of time, ideally at least six weeks before travelling. Check if malaria is endemic in the region to be visited. Adventure travellers and backpackers tend to visit those regions where vaccinations and malaria prphylaxis are essenrial.

Mosquito and other insect bites should be minimised through wearing suitable clothing, applying insect repellents and using mosquito nets etc.

There is also the risk of accidents occuring when taking part in risky activities or even when trekking or travelling on poor roads in badly maintained vehicles.

Backpackers and adventure travellers may find themselves alternately in major cities with access to medical facilities and then in remote areas far away from medical help.

They should therefore seriously consider taking a medical kit for the times when they will be far from help. A comprehensive first aid kit is important especially if going to areas remote from medical facilities.

Contamination of food and water is a major cause of illness in theese travellers. Unless certain of the purity of the local water supply, stick to boiled or bottled water and avoid ice in drinks.

Alternatively, water can be sterilised with iodine drops/tablets or with a quality filter. Dishes and cutlery should also be washed with sterilised water. Hot tea, coffee, beer and wine are usually safe. Ensure that milk has been pasteurised and that cheese, cream and ice cream are made from milk that has been pasteurised.

Peel all fruit, eat only cooked vegetables and avoid salads. Ensure that seafood, fish and meat are thoroughly cooked and eaten hot whenever possible. Avoid leftovers. Wash hands before eating or handling food and always after using the toilet.

A situation that is exciting and welcome to one person can be daunting to another. Possible problems include adjusting to a different climate, unusual food, religious and cultural differences, separation from family, changes in living standards, different social amenities, language differences, coming to terms with poverty, begging, and compulsory movement restrictions for safety or political reasons. Being open to new and different cultures and being patient, rather than critical, will help the traveller adapt to new and challenging adventures.

Adventurous trips are those travels that change you, enchant you and ensure memories for a lifetime. Some travellers go for the physical thrills and the opportunities that stretch a body's physical capabilities to the utmost degree. Other travelers would rather use their minds, eyes, hearing and cameras to enhance their experiences. Each person's definition of adventure travel is unique.

For all your outdoor equipment requirements including:
mountaineering, climbing, skiing, trekking, backpacking,
camping, canoeing, caving, etc.etc. go to:-

Up & Under Equipment specialists for Expeditions and Backpackers

Expedition Members

An expedition typically refers to a long journey or voyage undertaken for a specific purpose. Very often they involve travel to remote and/or mountainous regions of the planet and require a certain degree of physical fitness in order to carry out the various activities required.

Expeditions, by their very nature
are similar to adventure holidays so everything in the above section is also of use for this group. However, expeditions are usually much longer in duration than most adventure holidays, travel to even more remote locations and require certain skill levels and fitness.

If you are going on an expedition you are likely to be exposed to more diseases than other travellers due to the nature of the location and duration of stay. You will probably interact more with the local population than other travellers. Study, in advance, any necessary measures needed to prevent infection from contaminated food and water, insects and animals bites and close contact with locals.

You will probably be travelling to extremely remote areas where there is no or limited medical assistance available. A medical kit together with first aid and surgical equipment will therefore be essential.

If you are leading the expedition it will be your responsibility to ensure that adequate medical supplies are taken. Consider taking a course in expedition first aid and emergency procedures.

The medical supplies should be appropriate to the type of expedition and the region and should contain enough supplies to adequately cover the number of persons in the group for the duration of the expedition.

Along with the medical supplies, the expedition should ideally take an expedition doctor or someone qualified in the diagnosis of illness and the administration of medicines.

If this is not possible then a handbook with instructions on the use of medicines should be included but will be a poor substitute.

If mosquito and other insect bites are likely you should consider taking suitable clothing, insect repellents and mosquito nets.

Large, professionally organised expeditions are likely to have their own expedition doctor complete with a whole host of medical, surgical & first aid supplies. Members of expeditions are usually quite fit and in excellent medical condition and will therefore, respond well to medical treatment.

An excellent range of medical items on line such as first aid kits, sterile surgical kits, insect repellents, mosquito nets and water purification systems can be obtained from:-

   

Those who travel to remote areas on adventure holidays or expeditions should seriously consider becoming proficient in and obtaining a first aid qualification from a specialist organisation such as Adventure First Aid.

Please see www.adventurefirstaid.co.uk for details of expedition first aid courses. Having a single strategy to deal with any injury or illness is the key to dealing with immediate and stressfull incidents. Adventure First Aid offers Interactive - Dynamic - Contextual - Cost Effective training.


Long Term Travellers

This group includes embassy staff, voluntary workers, missionaries, etc. intending to stay several years in a country. Some people intend to emigrate permanently whilst others may only intend to visit relatives for an extended period. Sometimes backpackers fall into this category e.g. those who take a year out to backpack "round the world".

Preparation should not be rushed. Vaccinations, prevention of malaria (if appropriate), making enquiries about likely food and water hygiene problems and other disease risks are all-important. A brief visit to the proposed destination in advance can help reduce fear of the unknown.

If you are travelling with children, plan to become pregnant or have any existing health problems you should plan well in advance in consultation with your doctor. A dental and eye check-up prior to departure is wise.

Backpackers may find themselves alternately in major cities with access to medical facilities and then in remote areas far away from medical help. They should therefore seriously consider taking a medical kit for the times when they will be far from help.

First aid equipment may be important and consider what you might do in an emergency, particularly those going to areas remote from or with only basic medical facilities.

The British embassy or high commission may be able to give give helpful advice about English speaking doctors and you should keep in touch with the embassy especially in areas of political unrest.

Homesickness after the initial excitement is common when you realise the visit is not short-term. Going out of your way to make new friends and being sensitive to cultural differences rather than critical will help you adapt more quickly.

C
ulture shock can be very real. If you anticipate problems of this kind seek counselling before your plans are finalised. Phone calls and emergency visits home to see relatives are often easier to arrange than you might imagine.

Volunteer Work Thailand

Volunteers in the World


Travellers with Special Needs

These include:-

  • Children
  • Elderly Travellers
  • Pregnant Women
  • Disabled Travellers

1. Children

Parents should take special care when travelling with young children and being prepared in advance is important. Special seating arrangements in planes can often be arranged if advance notice is given. Prepare for possible travel sickness. Boredom during travel can be relieved by books or toys.

All children, regardless of their age will require a valid passport and a visa to enter most countries. Depending upon their country of origin, most travellers can do the appropriate paperwork on the plane as they fly out but it is always wise to check the visa requirements for the destination country prior to departure.


For 50 Top Tips
when Travelling with Kids

Most major or larger hotels are happy to accommodate families, and finding a good location to stay should not present any difficulties.Dining, however, may present challenges for families with younger children since the exotic foods may not appeal to their palettes.

Vaccinations are important and schedules can differ for children so seek advice from your doctor or nurse. Doses of malaria tablets are usually less than for adults.

If children are too young to safely or comfortably be immunized against disease, the family should postpone travel until everyone can be sure of effective health measures.

Remember to avoid contaminated food and water. If your child has vomiting or diarrhoea lost fluid and salts must be replaced. It may be helpful to take rehydration tablets or powders for reconstituting with boiled water. You can usually buy these at your local chemist. Dehydration develops quickly in children so offer frequent cool drinks when it is hot.

Infections such as tuberculosis and diphtheria, spread from close personal contact with those infected, can be more serious in young children.

Keep children well away from stray or sick animals and seek medical advice without delay if any illness persists.

Sun protection

Studies have found that sunburn during childhood can increase the risk of skin cancer later in life.

Childrens' skin burns easily in the sun. Take sensible clothing, high factor sun screens and avoid exposure to 'mid-day' sun.

Another consideration is the child’s, or children’s, abilities to deal with the climate of some hot countries. Travelling abroad with children may involve long periods in the sun with high humidity.

Use at least a factor 15 sunscreen and apply it to areas that cannot be protected by clothing, such as the face, ears, feet and backs of the hands. Choose sunscreens that are formulated for children and babies' skin:
  • Apply sunscreen before children go outdoors.
  • Sunscreen can easily be washed, rubbed or sweated off, so reapply it often throughout the day.
  • Keep babies in complete shade, such as under trees, umbrellas, canopies or indoors.
  • Protect a baby’s skin with loose-fitting clothes and a wide-brimmed hat that shades their face and neck.
  • Make sure children drink regularly.

Pool safety:

Between 2001 and 2007, 30 British children under 10 drowned in holiday swimming pools abroad. Children need to be watched constantly. Don’t depend on a lifeguard, who may not be trained to UK standards.

Swimming aids, such as armbands, are great for playing in the water but can easily slip off. Therefore, you still need to keep an eye on your child. Always supervise all young children near water. Even if a pool has a lifeguard, make sure you know where your children are and what they're doing in the water.

Travel Sickness:

Children often get motion sickness more than adults. It rarely affects children before the age of two, and those between the ages of three and twelve are the most likely to suffer. Early symptoms of motion sickness include hot flushes, dribbling and paleness.

Travel sickness is often worse on a boat or ship. Staying outside in the open air, rather than in a stuffy cabin, can assist in relieving your child’s symptoms. Try to stand in the middle of the ship on a low deck where there is least movement.

Long car journeys, especially along winding roads, can easily induce nausea. In this scenario, it is your responsibility to motivate your child to concentrate on the road ahead.

A number of travel sickness remedies are available to reduce or prevent symptoms of motion sickness.. All need to be taken before your journey begins. Don’t wait until the symptoms start making its presence felt.

You can buy them over the counter from pharmacies. Anti-sickness remedies containing hyoscine are the most effective medicines for motion sickness. There are several brands of medicines containing hyoscine and they come as a soluble form for children.

Keeping motion to a minimum may help. For example, sit over the wing of a plane or on deck in the middle of a boat. Avoid heavy meals before and during travelling including spicy or fatty food. If possible, on long journeys, it may help to have a break and get some fresh air, drink some cold water and take a short walk. Ginger can improve motion sickness in some people. It can be taken in ginger biscuits, sweets or as tablets before a journey.

2. Elderly Travellers

More and more elderly people are now travelling abroad for holidays and to visit relatives. Special holidays can be arranged but age does not give natural protection against disease.

A greater life expectancy, better health in old age and increasing affluence have given elderly people more time and opportunity to travel or visit friends and relatives abroad. But there are some issues that elderly travellers should consider when planning the journey of a lifetime or a world cruise.

Getting adequate travel insurance can be a problem, particularly for those over 75, and especially for those with long-term illnesses such as diabetes or heart disease. However, purchasing full insurance is vital.

Read the small print of your insurance policy which should include repatriation in case of illness and ensure there are no important exclusion clauses.

Immunisations and malaria prevention remain as important in the elderly as in people of any other age – if not more so.

A weakened immune system makes infections more likely.
Having had a disease previously, such as polio or diphtheria, does not always mean you are immune. If you are prescribed anti malaria tablets, be sure to mention if you are on any other medication.

If you suffer from any recurrent illness or are on regular medication check with your general practitioner. You may find a check-up helpful to ensure that you are fit to travel. A referral letter can be useful in case you you need treatment while abroad.

Take adequate personal medications. These must be clearly labelled and carried in hand luggage for easy access in case of delays or loss of luggage. While abroad store your medicines in a cool dry place. If you are crossing time zones, do not miss out doses especially if you are diabetic or have a heart condition.

Age affects the body’s function, which can increase the risks of travel generally.
Declining senses can cause accidents or failure to see or hear important announcements. Poor balance and slow reaction time can increase the risk of falls and seasickness, and make adventurous walking more perilous. Thinning bones from osteoporosis increase the risk of fractures through falls.

Decreased lung capacity means there will be less of a reserve to deal with reduced oxygen at altitude or during chest infections. Decreased heart capacity makes it harder to bear stresses on the heart, through dehydration, altitude or exertion.

Remember to take care to with food and water hygiene. Reduced stomach acid raises the risk of food poisioning or infections through contaminated food. Poorer kidney function raises the risk that dehydration will lead to kidney failure and makes it harder for the kidneys to cope with salt loss through diarrhoea.

Poorer circulation leads to slower healing of scratches, bites and injuries making it more
important to avoid insect and animal bites.

All this means that The elderly are more vulnerable to:

  • High temperatures and heatstroke.
  • Deep vein thrombosis.
  • Hypothermia.
  • The effects of low oxygen during air travel and at high altitude
  • Fatigue and exhaustion

It is often said that "old age does not come alone". Age often brings with it long-term illness. This can also lead to various problems which arise during foreign travel;

There are more tablets to remember or worry about forgetting. Diuretics for high blood pressure can increase the risks of dehydration. Drugs for Parkinson's disease and for high blood pressure can cause dizziness, fainting, unsteadiness and falls. There is a higher incidence of diabetes in older people which can be more difficult to control overseas. A loss of intellectual function may be exposed - causing someone to struggle to cope with their changed surroundings.

Some importat issues to consider if you are elderly and travelling or taking elderly people overseas:

  • Good insurance should be obtained.
  • Travel should be planned carefully.
  • A pre-travel consultation should be booked at the travel clinic.
  • Contingencies should be planned for.
  • Journeys should not be over-ambitious and there must be plenty of rest stops.
  • Choose destinations with western equivalent medical facilities and infrastructure.
  • Medication should be kept in hand luggage, with plenty of spare supplies.
  • Travellers should take their time to ease the risks and stresses of travel.


    Please note: Even after taking all the preceding information into account, elderly people still can and often do travel without encountering any serious problems.

    It is important to bear in mind that many elderly people enjoy foreign travel and should not be prevented from doing so if they feel up to it. Indeed, nowadays many people enjoy good health and reasonable fitness well into their 70s & 80s.

3. Travel During Pregnancy

Travelling during pregnancy is usually possible and with the proper precautions, and armed with information on when to travel, vaccinations and insurance, most women can travel safely well into their pregnancy.

Always undergo a medical check-up before planning your trip and again shortly before departure. It is important to get the 'all clear' from your own doctor or obstetrician before departure. It’s a good idea to take your medical records with you so you can give doctors the relevant information if necessary.

Wherever you go, find out what healthcare facilities are available at your destination in case you require urgent medical attention.

Ante-natal facilities vary greatly between countries and you should think carefully before travelling to a country with poor medical facilities or where there are major cultural and language differences from home. This could be important if you have health problems such as threatening to miscarry or going into early labour.

Make sure your travel insurance covers you for any eventuality, such as pregnancy-related medical care during labour, premature birth and the cost of changing the date of your return trip if you go into labour. Bear in mind that insurance policies are only as good as the facilities available.

Some women prefer not to travel in the first 12 weeks of pregnancy because of exhaustion and nausea during these early stages.

Whether you're travelling or not, the risk of miscarriage is higher in the first three months.

However, if you feel well there’s no reason why you can’t travel at this time. If you have any worries, discuss them with your midwife or doctor.

Travel during pregnancy can be a concern for many women, but if your pregnancy has no complications then there’s no reason why you can’t travel safely, as long as you take the right precautions.

Some airlines will not accept a pregnant traveller after 28 to 32 weeks gestation and long air flights in the later stages can be very uncomfortable. The most risky times for travel are during the first 12 to 15 weeks of pregnancy when miscarriage is more likely.

Flying is not harmful to you or your baby, but discuss any health issues or pregnancy complications with your midwife or doctor before you fly.

The likelihood of going into labour is naturally higher after 37 weeks (around 34 weeks if you're carrying twins), and some airlines will not let you fly towards the end of your pregnancy. Check with the airline for their policy on this.

After week 28 of pregnancy, the airline may ask for a letter from your doctor or midwife confirming your due date, and that you aren't at risk of complications.

Long-distance travel (longer than five hours) carries a small risk of blood clots (deep vein thrombosis, or DVT) in pregnant women. If you fly, drink plenty of water and move about regularly – every 30 minutes or so. You can buy a pair of support stockings in the pharmacy over the counter, which will reduce leg swelling.

Appropriate immunisation and malaria prevention is sometimes difficult during pregnancy so seek advice. Some vaccines are best avoided during pregnancy, for example live vaccines. However vaccination may be safer than travelling to some high risk areas without protection.

Vaccines are generally not recommended because of concerns that the virus or bacteria in the jab could harm the baby in the womb. You are advised to avoid travelling to countries where immunisation is required. Live vaccines should not be routinely administered to pregnant women because of possible risk to the unborn child.

However, if you must travel to areas requiring inoculation, you should get vaccinated because the risk of catching an infectious disease far outweighs the risk from vaccination. One example of this is yelow fever.

Travel to malarious zones during pregnancy should be avoided. However, if travel is unavoidable, effective prophylaxis should be used as malaria is more severe during pregnancy and the risk of malaria to mother and fetus is greater than the risk from any anti-malarial drugs. Some anti-malaria tablets aren't safe to take in pregnancy. You should consult your GP or pharmacist for advice.

Chloroquine and Proguanil may be taken in usual doses throughout pregnancy but pregnant women taking Proguanil should be supplemented with folic acid. Mefloquine is not licensed for use during pregnancy and should normally be avoided. Doxycycline is contra-indicated during pregnancy and the safety of Malarone during pregnancy has not been established. Therefore travel to areas where chloroquine resistance occurs is strongly discouraged.

Illness during pregnancy can be more severe so take special care to avoid contaminated food and water and insect and animal bites. Avoid partially cooked meat, unpasteurised milk products and soft cheeses.

In some countries infections such as tuberculosis or meningitis can be spread from close personal contact with locals and these can be serious during pregnancy both to yourself and your unborn child.

Take care to avoid contaminated food and water which could lead to conditions such as stomach upsets and travellers’ diarrhoea (TD). But even if you are suffering from diarrhoea and vomiting, it is very unlikely that your baby will be harmed by a short-lived tummy bug.

Some medicines for treating stomach upsets and TD such as Imodium aren’t suitable during pregnancy. However, it is safe to take oral rehydration salts. Drink as much water or clear fluids as you are able to tolerate. If you are finding it hard even to keep water down, take tiny sips through a straw.

Always drink bottled water where possible. If you get ill, keep well hydrated and continue eating for the health of your baby, even if you may not be hungry.

Road accidents are among the most common causes of injury in pregnant women. Avoid making long trips on your own and get your companion to drive if possible or at least share the driving.

4. Disabled Travellers

Travelling with a disability is now commonplace and there is no reason why this should pose serious problems if good preparations are made. The more you know about a place, the less likely you are to experience problems or obstacles, so before you travel, do your homework.

Adapting to unexpected situations is a part of the challenge of travelling but advance knowledge of facilities available, during travel and at your destination, can be very important. Some organisations and tour companies arrange trips for the disabled when mobility problems, for example, are taken into account.

The Disability Holidays Guide has been specifically created to bring a choice of holiday opportunities to those living with special needs and mobility difficulties.

People with a disability often experience problems when travelling. However, in many cases these problems are not directly related to their disability, but rather discrimination. Some of the most common forms of discrimination are; denied boarding, degrading treatment, poor assistance, additional charges to receive assistance and loss or damage to mobility equipment and assistive devices.

Airlines are usually helpful and provide assistance at airports and offer special facilities on aircraft if advised in advance. However this may not be the case with some airlines and at small airports especially in African, Asian and South American countries.

Most people will agree that getting on a flight is almost as easy as taking a train or a bus these days. However, it is still an adventure for many travellers with a disability, reduced mobility or visual and hearing impairments.

The whole process of check in, security etc. is much more difficult for disabled travellers who are often faced with problems from the very moment they arrive at the airport to leaving the airport at their destination.

It is also a good idea to arrive at the airport in good time so that you can find your way around and avoid any mishaps. It will also give you plenty of time to register and label your wheelchair so that it doesn’t get lost along the way….and to pick the best seat on the plane.

You should check in at least two hours before international flights and 90 minutes before domestic flights.

Most airports and airlines have special facilities and assistance for travellers using crutches, a guide dog or a wheelchair. However, there is always room for improvement.

Before you set off you should ring the airport or check its website to find out what facilities it has. Find out if it has disabled parking spaces, elevators, disabled toilets etc.

Some airports have special check-in desks for wheelchair users. You should check out the airport’s website to find out or ring in advance.

In 2008, the Disabled Air Passengers' Rights Regulation was put in force by the European Union in order to prevent these forms of discrimination.

Wheelchair users often have problems which most travellers who do not use a wheelchair are unaware of. Up until only recently some airlines charged wheelchair users to take their wheelchair from check-in to the aircraft. Other airlines refused some wheelchair users to fly as they claimed there were too many disabled travellers on the flight.

Thanks to the law, airlines can no longer make these excuses. In fact, most airlines offer very good services for disabled travellers and they are aware that wheelchair users need more space and an aisle seat aboard the aircraft, as well as ground and onboard assistance etc.

In other cases, blind travellers were unable to fly accompanied by their guide dog and were not entitled to any form of aid to get from check-in to the aircraft. Thankfully, this is no longer the case today.

These regulations have helped to make travelling a right for everyone. However, discrimination is something that will be difficult to eliminate completely. If you experience neglect and maltreatment at an airport you should make the relative authorities aware.

When selecting accommodation check good lifts are available, the condition of staircases and bathroom equipment. Ask in advance if special food requirements are necessary.

Make sure that you have comprehensive health insurance with no important exclusion clauses which affect disability and which includes repatriation if necessary.

Many travellers share their experiences online and so this also may be helpful for you. It is an excellent way of helping you decide which airline to choose and may give you more information about the help available for passengers with reduced mobility, a visual impairment or some other form of disability. All these comments are written by people who have tried and tested the services. They write based on their experiences and so all feedback and comments about the airport facilities or the airlines are unbiased.

Some useful web sites relating to disabled travel are:

Disabled Travel Advice

Disabled Travel Guide


     
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