Travellers are swamped with so much travel advice that they tend to forget the advice that could save their lives, writes CLAIRE O'CONNELL
WHAT ARE the best pieces of advice to pack when travelling to a different part of the world? Forget brushing your teeth with bottled water, the keys to having a healthy holiday are to stay off motorbikes, swim between the flags, use condoms and, above all, plug in your common sense.
That’s according to Prof Lars Rombo from the Karolinska Institute in Sweden, who addressed a recent meeting in Lucan of the Irish Society of Travel Medicine.
“Information is heavy, you can only carry small packages,” says Rombo, who contends that would-be travellers are often swamped with too much travel advice, much of it negative and some of it misleading.
“I think the present system is harmful; we give too much advice,” he says. “And by providing too many pieces of advice we lose the confidence of the traveller, who will miss out on the important bits of information.”
Rombo is dismayed by the amount of negative advice on offer that warns of dire tummy bugs, parasites and other nasties that are invisible until it’s too late.
“The idea isn’t to scare away people, the idea is to tell them the really important things,” he explains, noting that people sometimes get distracted from the more pertinent risks. “If I could prevent riding on motorcycles and drowning, that is more effective than any immunisation that you can get.”
He believes medical professionals should streamline their advice to the risks that are markedly different from home territory, stick to scientifically validated findings and refer to the traveller’s common sense. And, as a rule of thumb, he recommends that doctors should only offer advice that they would follow themselves.
In particular, he reckons that overcaution about food can reduce the traveller’s enjoyment of a holiday. “Eating and drinking is an important part of the travel and I don’t want to walk around scared stiff when I am on holiday. It’s much better to really have an experience of the local foods,” he says, suggesting that travellers be guided by their own noses. “Eat and drink only what looks, smells and tastes nice, and try to eat what other people are eating and where they are eating.”
As for water, Rombo suggests that brushing your teeth with the bottled variety is probably not necessary, and could be distracting from other, more risky behaviours. “My opinion is that compared to other things, it’s so troublesome to use mineral water to brush your teeth,” he says. “And also it turns the awareness of risk away from the motorcycle to this. Or maybe the person will ignore having a safety belt in the car because they brush their teeth with bottled water.”
He also recommends not travelling with small children (who are at greater risk of illness from food-borne bugs), having any animal bites seen to immediately, using insect repellant in malarial regions and mentioning any travel to malaria zones to your doctor if you fall ill within several months of returning.
And he wants to see travellers advised to protect themselves if having sexual contact with a new partner. “It doesn’t work to tell people to refrain from casual sex,” he says. “So advise them to use a condom.”
In Ireland, travel advice tends to emphasise the need to be proactive and assess risks, says Prof Sam McConkey, head of the Department of International Health and Tropical Medicine at the Royal College of Surgeons in Ireland, which runs courses in travel medicine for about 50 doctors and nurses each year.
“We feel the broader aspects of preventative healthcare should be part of pre-travel information and it’s not all about vaccines, malaria, weird pathogens – a lot of it is about risk management,” says McConkey. “It’s enabling people to put risks into context. So swine flu is really unlikely to be a major risk but sadly getting killed in a car accident is a substantial risk.”
He echoes the need for travellers to exercise judgment about vehicles. “If you are abroad in a poor African country, if the transport you are getting on – be it a car or a boat or a plane, helicopter, train – looks unsafe to you, then it probably is unsafe.
There’s no nanny state embracing you in cotton wool and looking after you. There are almost no health and safety regulations so people have to look after themselves and they are not used to doing that.”
However, he counters Rombo’s suggestion that too much non-specific advice is doled out, at least in Ireland. “Here people tailor it not only to the country you are going to but also the type of holiday. If you are hiking in rural Nigeria that’s one thing, whereas if you are going to stay in a five-star hotel for a business meeting that’s different.”
And for immunisations against polio and rabies when travelling to affected areas, he warns that the risk of getting the disease may be small but the price of being unlucky is high, so it’s best to be protected.
“Even though polio and rabies are quite rare to get, the consequences of getting them are so horrendously bad, that’s why it influences you towards doing something to prevent it.”