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Many holidaymakers are showing solidarity with communities affected by
Southeast Asia's Boxing Day tsunami by voting with their feet: going ahead
with travel plans, visiting resorts in the region to support the tourist
industry on which the local economy so heavily depends. But is it safe to
go?
Be guided by practicalities rather than fear of disease. Begin by seeking
advice from your tour operator, who will have plenty of local knowledge
about conditions in resorts. What is the state of accommodation? How easy
will it be to get around, and to have a good time? What facilities are
unaffected? While the worst hit areas will undoubtedly be off limits, many
resorts in the region are entirely intact. Consult the Foreign Office
website for its latest assessment of physical safety and the general state
of the infrastructure in the country you plan to visit.
If you choose to go, it makes sense to take more careful health precautions
than usual. Follow vaccine recommendations carefully, and try to allow at
least 2 weeks for them to reach full effect. For most countries, vaccination
against hepatitis A, typhoid, tetanus, diphtheria and polio, would be
essential. Vaccination against cholera (with Dukoral, a drinkable vaccine
that also offers some protection from one of the commonest types of
travellersą diarrhoea) and flu might also be considered; there are some
additional options for longer term travellers as well, such as rabies,
hepatitis B and Japanese encephalitis.
All of these diseases are present in the region anyway, at a low level;
there have been no outbreaks as yet, but the general damage to the
infrastructure makes the prospect more likely, and it is sensible to be
protected.
Take careful advice on malaria prevention: flooding, followed by further
heavy rain, has created conditions in which mosquitoes could easily thrive.
Control measures are being stepped up but it is highly likely that numbers
of cases of malaria, and also of dengue fever (a virus infection spread by
mosquitoes) will rise.
The most likely disease risks are those spread by food and water, ranging
from travellersą diarrhoea, to dysentery, cholera, giardia and parasitic
infestations. Careful food and water hygiene precautions are essential. It
makes sense to travel with water purification drops or tablets, rehydration
solution, medication to control diarrhoea symptoms, and a course of
antibiotics.
Aim to be entirely self-sufficient take all the medicines and supplies you
might need (and leave them behind at the end of your trip). In some places,
it will be harder than usual to find basic medical supplies, or skilled
emergency care, and it would be wrong to divert essential local services
from the enormous task in hand.
Above all, put safety awareness and common sense first. We' ve had three
patients in Southeast Asia who have needed medical care in the week since
the crisis began: an asthmatic who left his inhaler at home; an air
traveller who broke a rib when hit by luggage from an overhead locker, and a
back-seat passenger, badly bruised in a car accident, who was not wearing
his seatbelt.
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