Travelling Well - Excerpts
The following are actual text excerpts from Travelling Well, and as well as being useful snippets of information in their own right, also show the level of detail that has gone into the preparation of this extremely useful handbook.
The Table Of Contents of Travelling Well is also available.
Excerpt From 'Before You Go'
Pre-Travel Dental Checkups
A dental checkup before departure is essential if you are visiting countries where dental services are poor.
- Visit the Dentist: If you have not had a check up in the last six months, go now. You should mention to your dentist where you are going and for how long.
- Three Months Before: Aim to visit well before departure, so there is time for necessary dental work to be done. Your dentist may suggest x-rays if you will be away for more than six months. This will detect problems in the early stages. e.g. a loose filling may cause considerable pain if you fly in an unpressurised aircraft or scuba dive. You should avoid air travel for three days after extensive dental work.
- Dentures: Carry a spare set in case dentures get damaged or lost.
- Fluoride: Children on fluoride supplements should not stop them when they are overseas.
- Toothbrush Container: While you are away, avoid placing your toothbrush on bathroom counters, or unclean surfaces. Germs can be picked up in this way, and quickly transferred to your mouth.
Excerpt From 'A Few Details'
Hepatitis means infection of the liver. There are many types of hepatitis: A, B, C, D, E, F and G at last count. Hepatitis may also occur as part of another illness e.g. Glandular Fever, or as a side effect from a drug.
Vaccines are only currently available against Hepatitis A (contracted from food), and Hepatitis B (contracted from blood products). Hepatitis C is transmitted via blood transfusions. Hepatitis D can only occur with Hepatitis B. Hepatitis E is caught from food and water, like Hepatitis A, and is particularly serious in pregnant women.
Three to four weeks after contact with infected food or water, the sufferer develops a fever. This is accompanied by loss of appetite, stomach discomfort and yellowing of the whites of the eyes and skin. The urine becomes dark and the stools become pale. On average, the sufferer loses a month off work, and alcohol may not allowed for up to one year. In adults, Hepatitis A can cause tiredness for months afterwards. The disease is seldom fatal, though it is more likely to be fatal in persons over 40 years of age.
This disease is common in third world countries because sanitation is poor. In developing countries most locals contract the disease in childhood. Once someone has had Hepatitis A they cannot catch it again. Hepatitis A is also known as 'Yellow Jaundice' (This type is quite different to baby jaundice. Baby jaundice is caused by immaturity of the liver and develops in the first few days of life.)
Adult travellers to developing countries should be vaccinated against Hepatitis A. Backpackers are more prone to Hepatitis A ( about one case per 50 backpackers per month of stay). Travellers staying in five star hotels are not always safe however. Hepatitis A is usually extremely mild in young children, and if they contract the disease they are immune for life. For this reason, vaccination is not recommended for children under 2 years of age.
Protection against Hepatitis A can be given as either:
- Vaqta/Havrix: These excellent vaccines give long term protection with few side effects, but are more expensive.
- Gamma Globulin: (Also known as Immune Globulin) This is a blood product. It has been used safely for 50 years. It has been carefully investigated and shown not to transmit AIDS or Hepatitis B, but cannot be proven 100% safe from diseases as yet undiscovered. It is less effective than the 'real vacines' - there have been cases of persons developing severe Hepatitis A disease, despite recent Gamma Globulin. Protection lasts a shorter time. The only advantage over Vaqta and Havrix is that it is cheaper.
The disease Hepatitis B causes symptoms of tiredness, nausea, loss of appetite, rash, muscle and joint pains. Symptoms develop two to six months after exposure to the virus. The skin and eyes turn yellow, the urine may become tea coloured and the bowel motions turn whitish. The acute illness lasts several weeks. 1.4% of sufferers will die during the acute attack. 6-10% of adult sufferers remain chronically infected or infectious to others, and one fifth of those chronically infected will die from the infection. Chronic Hepatitis B carriers are 94 times more likely than average to develop a primary liver cancer.
Hepatitis B virus is fragile and cannot survive long outside the body. It must travel from person to person through blood or other body fluids, i.e. transfusions, sharing contaminated needles or sexual contact (similar to AIDS). Acupuncture, tattoos, dental procedures can also transmit the disease. It is present all over the world, including Australia, but is more prevalent in developing countries.
Travellers anticipating sexual contacts overseas should be vaccinated. Vaccination is also recommended for long term travellers to developing countries (greater than 3 months), and for those working with blood or blood products.
Children may be at risk if they play with infected children. Minor injuries are common and the virus could pass from one to the other via broken skin. The National Health and Medical Research Council of Australia now recommends Hepatitis B vaccination should be included with all the other 'standard' childhood vaccines.
Note that the Hepatitis B virus and the Hepatitis A virus are very different. Vaccination against one does not protect you from infection with the other, however there is now a combined vaccine which does give protection from both.
Excerpt From 'While You're Away'
What is Culture Shock?
"Culture Shock" is the temporary inability to cope with a different culture. "Culture Shock" can be felt with varying degrees of severity. When symptoms are mild, it may be described as "Culture Fatigue". "Reverse Culture Shock" can also develop on return to one's home country after an extended stay away.
Who is most at risk?
"Culture Shock" is most common in people going to live and work overseas for several years, even to English-speaking countries.
Long term, budget travellers, visiting multiple countries may also experience it to varying degrees. Those travelling by themselves and/or in countries where they do not speak the language, are particularly at risk. When couples move overseas, the non-working partner often suffers culture shock more intensely. They do not have a familiar work environment, and work mates to cushion the impact. They also tend to be the one out in the 'thick of it' while trying to do the shopping, work out the transport system etc.
What causes Culture shock?
Culture shock is due to an excess of novelty.
Many of the rules you learned in childhood about how things work and how people behave suddenly change. In a different country there are many new things to get used to and worry about e.g. time zone shifts, differences in weather, food, language, money, tipping, taxes. Worries about avoiding illness, mugging, being ripped off, leaving things behind. Bus, train and air timetables take some figuring out. You often have to worry about where to stay, what to see, how much money this is all costing, and how important it is to have a good time. There are new people to meet, and new cultures and customs to understand. Each of the changes by themselves is a small challenge and part of the adventure of travel. If they occur simultaneously, it is possible to become overloaded - which leads to stress.
Furthermore, all this change and stress occurs in the absence of the usual social support system of family and friends.
Preparation for departure is usually a major undertaking and involves leaving your job, perhaps training your replacement, selling the car and/or house, putting possessions into storage, organising finances, passports, visas, saying goodbye to all the relatives and friends etc. Often you arrive in the new country feeling exhausted and in need of a holiday; but instead you are called on to deal with a dazzling array of new things.
Three stages of adaptation to a new culture
Note that different members of a family may go through the stages at different times.
1. Excitement: Initially there is great excitement at being away, out of the rut, seeing the world, meeting new people.
2. Disappointment: After the initial excitement of being away from home has settled, it is not unusual to feel lonely. You may also feel extremely disappointed that the experience is 'not what it was cracked up to be'. Other symptoms commonly described are feeling anxious, depressed, tired, lacking in enthusiasm, bored, sleepy, homesick, or emotionally on the edge. You may get cravings for 'normal' food or 'normal' behaviour. "Culture Shock" may lead to unexplained crying. You may even decide you want to go home, and start fantasising about arriving home, explaining your behaviour to your friends etc. This is all fairly normal. Culture shock can even make you sick. Stress can weaken your immune system and increase your susceptibility to diseases such as diarrhoea or the flu. If it is very severe, "Culture Shock" can make you pack your bags and head home.
3. Adjustment:During this stage, the excess of novelty is under control. You can enjoy the new challenges and the new culture. There is excitement of a different sort.
So how do you make the transition from Disappointment to Adjustment? It takes time and patience. Some ways to assist the process are listed in the following section. (Incidentally, if you are returning home after a long time overseas, it can take quite some time to adjust back; this is known as 'Reverse Culture Shock' and the hints to follow are relevant for those symptoms as well.)
Seven Ways to deal with Culture Shock
- Be aware of it: Awareness and acceptance is the first and most important step. It is normal to feel overwhelmed in such circumstances.
- Get used to things gradually: Don't expect to see too much or do too much all at once. Give yourself time e.g. months to get used to the many changes. Be patient.
- Find yourself someone who knows the system: Other expatriates are a valuable source of information and moral support. They will help guide you through 'the system' most efficiently. They will be able to give you advice on where to shop, who gives a good haircut etc.
- Have a disaster plan: It is comforting to know where to find reliable help if you need medical advice urgently. Do a test run of the emergency procedures. Ring the insurance or assistance company. Know where to go, and if necessary, drive the road you would take. If possible introduce yourself to the doctor, and let them know of any important medical history you may have such as allergies, medication etc. Find out the doctor's hours, alternative arrangements if you get sick in the middle of the night, or injured on the weekend, find out how they charge. While you are there, you might want to arrange medical checkups for any employees you have (e.g. for Tuberculosis) - the healthier they are, the better it is for you and them.
- Take care of yourself.
- Get plenty of rest.
- Eat as well as you can.
- Stay fit.
- Resist the temptation to drink a lot of alcohol
- Plan fun activities or even little holidays, so you can have a laugh and keep your sense of humour. In some postings shore leave is a necessity - not a luxury.
- Keep in touch with friends / support network: 'Phone Home', write letters, or email.
- Try not to withdraw: Avoidance is a natural first response to the unknown. It is scary to learn new things, and painful to make mistakes. The normal tendency is to try and avoid this pain. If you do the thing you are afraid of, (within reason) you often find it is not as bad as you thought. If you learn some of the language you can interact more the locals, and discover the great aspects of their culture.