KEEPING HEALTHY WHEN ABROAD
AIR TRAVEL
To reduce the risk of Deep Vein Thrombosis it is sensible on any long haul flight to:
- Be comfortable in your seat.
- Exercise your legs, feet and toes while sitting every half an hour or so and take short walks whenever feasible. Upper body and breathing exercises can further improve circulation.
- Drink plenty of water and be sensible about alcohol intake which in excess leads to dehydration.
DRINKING WATER
Diseases can be caught from drinking contaminated water (or swimming in it). Unless you KNOW the water supply is safe where you are staying, only use:
This advice applies to ice cubes in drinks and water for cleaning your teeth.
FOOD SAFETY

Contaminated food is the commonest source of many diseases abroad. You can help prevent it by following these guidelines:
- Only eat well cooked fresh food
- Avoid leftovers and reheated foods
- Ensure meat is thoroughly cooked
- Eat cooked vegetables, avoid salads
- Only eat fruit you can peel
- Never drink unpasteurised milk
- Avoid ice-cream and shellfish
- Avoid buying food from street vendor's stalls unless it is thoroughly cooked in front of you
- Alcohol! If you drink to excess, alcohol could lead you to become carefree and ignore these precautions
HYGIENE 
Many diseases are transmitted by what is known as the 'faecal-oral' route. To help prevent this, always wash your hands with soap and clean water after going to the toilet, before eating and before handling food.
DIARRHOEA AND VOMITING
This is the most common illness that you will be exposed to abroad and there is no vaccine against it! Travellers' diarrhoea is caused by eating or drinking food and liquids contaminated by bacteria, viruses or parasites. Risk of illness is higher in some countries than others:
- High risk areas include North Africa, sub-Saharan Africa, the Indian Subcontinent, South East Asia, South America, Mexico and the Middle East.
- Medium risk areas include the northern Mediterranean, Canary Islands and the Caribbean Islands.
- Low risk areas include North America, Western Europe and Australia.
You can certainly help prevent travellers' diarrhoea in the way you behave - make sure you follow the food, water and personal hygiene guidelines already given. Travellers' diarrhoea is 4 or more loose stools in a 24 hour period often accompanied by stomach pain, cramps and vomiting. It usually lasts 2 to 4 days and whilst it is not a life threatening illness, it can disrupt your trip for several days.
The main danger if the illness is dehydration, and this if very severe can kill if it is not treated. Treatment is therefore re-hydration. In severe cases and particularly in young children and the elderly, commercially prepared re-hydration solution is extremely useful. This can be bought in tablet or sachet form at a chemist shop e.g. DIORALYTE; or ELECTROLADE. (Dioralyte Relief is a new formula containing rice powder which also helps to relieve the diarrhoea, particularly useful in children). Prepare according to instructions. Anti Diarrhoeal Tablets can be used for short term relief for adults (eg for a bus or train journey or flight) but should never be used in children under 4 years of age, and only on prescription for children aged 4 to 12 years. Commonly used tablets are IMODIUM and LOMOTIL. None of these tablets should ever be used if the person has a temperature or blood in the stool. Do seek medical help if the affected person has:
- A temperature
- Blood in the diarrhoea
- Diarrhoea for more than 48 hours (or 24 hours in children)
- Becomes confused
In very special circumstances, antibiotics are used for diarrhoea, but this decision should only be made by a doctor (a woman taking the oral contraceptive pill may not have full contraceptive protection if she has had diarrhoea and vomiting. Extra precautions must be used - refer to your 'pill' information leaflet. If using condoms, use products with the British Kite Mark).
SUN SENSE
Sunburn and heat-stroke cause serious problems in travellers. Both are preventable - to avoid, use the following precautionary guidelines:
- Increase sun exposure gradually, 20 minutes limit initially.
- Use sun blocks of adequate Sun Protection Factor strength (SPF 15 minimum). Reapply often and always after swimming and washing. Read manufacturer's instructions.
- Wear protective clothing - sun hats etc.
- Avoid going out between 11am - 3pm, when the sun's rays are strongest.
- Take special care of CHILDREN and those with pale skin/red hair.
- Drink extra fluids in a hot climate.
- Be aware that alcohol can make you dehydrated.
Why factor 15?
The reason experts recommend factor 15, is that this represents the best balance between protection and price. You will get over 90 per cent protection from UVB rays with SPF 15. But no sunscreen, no matter how high the factor, can offer 100 per cent protection.
When Buying sunscreen:
- Choose one with an SPF of 15 or above - this will give you over 90% protection.
- Make sure it is labelled 'broad spectrum' - to protect against UVA and UVB.
- Choose water resistant - it is less likely to wash or be sweated off.
- Check the 'use by' date - most sunscreens have a shelf life of 2-3 years.
- You don't have to pay for expensive brands. All types are tested and the cheaper brands are just as effective if used properly - just remember factor 15+.

Tips for using sunscreen properly:
- Try to apply it 15-30 minutes before going out in the sun.
- Apply to clean, dry skin and rub in only lightly.
- Use generous amounts.
- Re-apply once outside to ensure even coverage.
- Then re-apply every 2 hours or more frequently if washed, rubbed or sweated off.
- Put on before make-up, moisturiser, insect repellant, and so on.
- Never use it to spend longer in the sun - this will put you at risk of sun damage that could lead to skin cancer.
- In hotter climates and hotter days in the UK avoid direct sun exposure between 11am and 3pm.
- Take special care of children and those with pale skin / red hair.
- Use SPF 60 on any areas of recent scarring / skin damage.
- You can get severe sunburn in the UK.
- Do not store sunscreens in very hot places as extreme heat can ruin their protective chemicals.
PERSONAL SAFETY
Leading causes of death in travellers are due to drowning and traffic accidents. You can help prevent them by following these precautionary guidelines:
- Avoid alcohol and food 1 hour before swimming.
- Never dive into water where the depth is uncertain.
- Only swim in safe water, check currents, sharks, jellyfish etc.
- Avoid alcohol when driving, especially at night.
- Avoid hiring motorcycles and mopeds.
- If hiring a car, rent a large one if possible, ensure the tyres, brakes and seat belts are in good condition.
- Use reliable taxi firms.
- Know where emergency facilities are.
SEXUAL HEALTH
Remember that unprotected sex can result in anything from Chlamydia to HIV. The Sun newspaper reported in July 2005 that a Syphilis outbreak in Manchester was quickly replicated in Amsterdam, Dublin, and Paris as a result of people jetting from place to place and having unprotected sex - everyone going on holiday should take condoms, don't leave it to chance, it's not worth the risk
PSYCHOLOGICAL SUPPORT
Medical Students - On your elective you may have many new and sometimes distressing experiences including helplessness and frustration witnessing preventable deaths. You may experience significant culture shock and have difficulty adjusting on your return to the UK. It is important to prepare for this and also to ask for help from peers, colleagues, counselling services or doctor if needed.
FIRST AID KIT 
If you are travelling to remote areas where access to medical care is limited we strongly advise you to carry a medical kit appropriate to the nature of your trip.