A hospital visit was always going to be ‘on the cards’ for me. I wanted to go and see what facilities there were there, and also to see what (if anything) we could do to help. It’s easy, I know, to say that ‘we are keen to help’ from the rather exalted position that we are in – in Kiwi Base – because we have everything we can possibly need and on top of this there is always the capability of being able to ‘call in’ an aircraft to transport a really unwell case to the American Hospital at Bagram Air Force Base. Here, the local population do no have this facility and so we at KB are keen to provide whatever we can to assist the local medical and health services. As it is now getting extremely cold, with the temperature today at minus 15 degrees, this would appear to be an ideal time to visit and take some of the many bags of woollen gear and toys that folk from NZ have sent over here to present to the local patients and their, usually, mothers. Who better to visit the hospital with than the Padre,

Steve Clarke (Chief petty Officer) and Allan Kelly (administration Officer here at the camp). The three of us have been involved in a lot of visits to various schools and health clinics around this region and so it was with pleasure that we visited the Bamyan General Hospital. Having said that these three guys have been all very tolerant of my energies in wanting to dash off and see things. I have this sort of ‘places to go – people to see’ and ‘not here to foxtrot with spiders’ mentality. In the wagon and off we go to the hospital. Through the gates, part the vehicle and we walk to the director’s office. Well, Padre and Allan and I walked, but Steve is a navy man and he walked like he was on a shop in a storm, swirling from side to side in the corridors. A quick meeting with the Hospital Director, Sarjo Kanji (who is from The Gambia in Western Africa), and then it is ‘off’ to the paediatric wards to see the kids.

Son, Father, Padre, Doc, alan, Steve, Hospital Manager

Up the stairs we go – there are shoes lining the entry door as we go in. The management do not require us to take off our shoes, but I am rather embarrassed about this as the locals do and so, I feel, we should but Sarjo says ‘no need’ so we don’t. Through and under a rug hanging over the door, it is starting to get quite cold outside during the day now and the barriers to the weather are gradually going up in the community. The smell of the halls, as we go into the wards, is of smoke from the coal- fired heaters in all the rooms and wards. In to the ‘acute baby room’.

One of the nurses in the ward

Mothers are with their kiddies, and immediately they turn away – as is their custom when men walk into a room. We give dolls and knitted woollen booties out to the babies, wherever possible, or their mothers. Long time since I did this for my children so I struggle a bit to undo the bow around ‘the feet’ part of the booties – much mirth amongst my compatriots. The mothers accept the gifts in silence. Occasionally one or two smile and say ‘tashikor’ (thank you), but mainly they respond with an expressionless face and take the clothes or dolls and put them by their babies or children. Some cover up their faces and turn away from us. We expect this, as this is what happened the first day that I came into the hospital a few months ago. For all this, however, we realise that our gifts are indeed needed and valued.

'How do I put these on?'

In to the next ward and the same thing happens – we walk around the beds – 15, of which none are empt. A doctor is doing a ward round. He speaks English and does not mind us bustling through. I stop to chat with him. He was educated in Kabul, and he stops to tell me a little of the illnesses as we pause over a kiddie who has pneumonia, and malnutrition. The doc says that the main diseases are these two conditions, plus diarrhoea – the latter in summer and the former two in winter. Logical really. He is OK with us going around giving the children toys.

Mothers and their babies

 

Interpreter Baby whose mother died and Grandmother

I stop by the bed of a woman who has her face partially covered. I ask the doc what is wrong and why is the child in the ward. He says that the child’s mother died in childbirth (in Afghanistan the maternal mortality rate approximates 25%) from haemorrhage, and that the woman with the child in his  grandmother. The woman lives at Yakawlang which is a long way away – 4-6 hours due East by vehicle. She is so far away that there was no chance of preventing any calamity and this is obviously what occurred. Fortunately the child is a boy, says the doc, as girl children do not get much of a ‘look in’. I look at the child again, and he is very pale – probably he has anaemia due to his mother bleeding to death.

Ra giving a doll

Meeting the Paediatric Staff

We finish giving our gifts and feel the better for it. The ward-manager says to us how happy he is because of what we have done, so perhaps we did something good today. Whilst toys are rather a ‘little thing’ to give … I think that they meant something to us, also, in giving them on behalf of our country-folk back home in NZ.

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You’re travelling on a 13 hour train trip across India.

You’ve just boarded and managed to get a seat. You’ve got your book or your ipod and you’re sorted. Then… oh NO!…. your bowels have become loose!
There are minimal station stops and the toilet consists of a hole in the floor of the carriage – the train tracks zooming past underneath you… and no toilet paper.
I don’t need to paint the picture any more than that suffice to say that it will probably remain the worst train trip of your life.

Travellers Diarrhoea – one of the most common health problems for travellers.

Some 30% of sufferers are confined to bed, and a further 40% are forced to change their travel plans.

Symptoms – Travellers Diarrhoea is defined as greater than or equal to 3 loose bowel motions (stools) within 8 hours or greater than or equal to 4 within 24 hours…plus 1 of:
· Nausea
· Vomiting
· Abdominal cramps
· Mild fever

How is it spread?
The disease is caused by micro-organisms (bacteria, viruses and parasites) that damage the gut.
It is spread by consuming contaminated food and water.
By touching food with unclean hands.

When eating and drinking, WORLDWISE apply the adage:

“COOK IT, PEEL IT, BOIL IT OR AVOID IT”

Be sensible with your eating and drinking whilst travelling to at risk areas.

· Drink bottled, filtered, purified and carbonated water. If buying bottled water, make sure that
the bottle is properly sealed. Remember to wash you teeth with this safe drinking water
· Choose raw fruit and vegetables that you can peel yourself
· Wash your hands with soap or hand sanitizer before eating
· Foods should be thoroughly cooked and served piping hot

UNSAFE FOODS:
· Those cooked early in the day and served at room temperature
· Salads, raw vegetables, cold buffets
· Tap water, ice cubes, ice blocks
· Poorly or uncooked seafood and meat
· Food prepared with unpasteurized milk eg: ice cream

WORLDWISE stock a variety of travel medical kits, including the ‘Gastro Pack’ that includes appropriate prophylactic antibiotics– Designed to treat Traveller’s Diarrhoea.
We also stock a range of water purification products.
Please contact us if you would like more information on these products.

Check out our Facebook photo album dedicated to ‘Food and Water encounters’ whilst travelling

Avoid ice cubes in your drinks – you never know where it has come from and how it’s been handled

July 21, 2010

WORLDWISE 2010 TRAVEL MEDICINE CONFERENCE PROVES SUCCESSFUL!

WORLDWISE Travellers Health Centres, NZ,  recently held a successful Travel Medicine Conference for Health Professionals in Christchurch.

These educational events have been presented annually by WORLDWISE, for the last 12 years and are the longest ongoing regular open travel health meetings in Australasia. More than 70 Health Professionals from around New Zealand attended this year’s conference to update and gain knowledge of safe practice in the delivery of health care to intending travellers.

Key Speakers included: Prof Peter Leggat, Dr Deborah Mills from Australia, Dr Michael Moreton from Thailand and Assoc Prof Marc Shaw from New Zealand.

Doctor Deborah Mills, Medical Director for The Travel Doctor – Brisbane, contributed a wealth of information on ‘Women and Children travellers’, Risk assessmentof travellers, advice on travel health and vaccinations travelling to Bhutan, an update on the Australian prep, and pep guidelines for Rabies, and finally on Mosquito borne diseases in the north of Australia.

Professor Peter Leggat, Head of School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, applied his considerable expertise and research knowledge to the current Travel Medicine, Mosquito prevention measures, gastro problems for travellers and Anti-malarial management.

Dr Michael Moreton from Bangkok Hospital in Thailand added an interesting expatriate perspective and experiences of working in Asia, dealing with expatriates, and essentials of travel for health tourism.

Assoc Prof Marc Shaw, WORLDWISE Travellers Health Centres NZ infused his personal experiences and research into his presentations on The terrors of Travel, the safety and security of travellers, a Cholera vaccine update,  First Aid travel medical kits, Malaria, and Rabies epidemiology in New Zealand.

Other Speakers included: Hemi Morete – QSI Solutions, David Hammer – Microbiology, Edward Coughlin – Sexual Health Department,Iain Bell/Sue Chambers-Ross/Lincoln Nicholls – NZDF, Dr Mark Taylor / Dr Janine Rasmussen ‘ Lisa Scotland – WORLDWISE, Dr Debbie Walkden –The Travel Doctor NZ.

A variety of other topics were covered including the management of risk for groups and corporates / Safety and Security / Dengue Fever / Acute Mountain sickness / Kiwi Family holidays to in the pacific / Post Tsunami outbreaks / Life style issues of travellers / Travellers Diarrhoea / Insects and critters /New Zealand Defence Force perspectives on deployment travels to Samoa during the Tsunami experiences, and the Afghanistan.

WORLDWISE received fantastic feedback for the two days of education and would like to thank all the speakers who presented.

Planning is well ahead for the next conference in 2011 and those who wish to receive upcoming information are invited to write to online@worldwise.co.nz

WORLDWISE would also like to thank Glaxo Smith Kline for their unique contributions towards such a successful event.

Travel and Tropical Medicine is a growing  specialization. With around 2 million kiwis travelling overseas per year, Travel Health Professionals need to be regularly updated in global travel health information.

The WORLDWISE ONLINE Seminars have been annually presented for the last 12 years, and are the longest ongoing regular ‘open’ travel health meetings in Australasia.

This year’s WORLDWISE ONLINE conference offers Health Professionals a solid platform on which to learn and up-skill knowledge in this exciting specialization. It is aimed at all Primary Health Care Practitioners (General Practitioners, Public Health Physicians, Infectious Disease Specialists, Military medical Staff,  Pharmacists) with an interest in travel medicine. Primary Healthcare Nurses who have attended previous WORLDWISE ONLINE Level 1 courses are also invited to attend this annual meeting.

This year, the primary focus of the Conference will be on Corporate travellers and families travelling to the Asia – Pacific region. Special focus will be on

i) ‘rabies in our region’

ii) the safety of travel

iii) how to develop a risk analysis of a travel itinerary

iv) Women and children travellers

There are to be special sections on ‘country based   requirements’ for travel to South East Asia and Oceania.

The conference will be hosted at Hotel So in Central Christchurch. A hotel which implements sustainable business practices that reduce its ecological footprint.

LEARNING OBJECTIVES

  • To understand safe practice in the delivery of health care to intending travellers, particularly to those travelling to the Asian and Pacific region
  • To update knowledge on current pertinent travel health issues and its relevance to current medical practice
  • To understand and develop knowledge base in Travel and Geographical Medicine  practice
  • To identify when it is vital to refer patients/travellers to specialty services
  • To understand the advice that corporate travellers need to keep them well on overseas  deployment
  • To understand what responses are needed in global emergency

PROGRAMME AT A GLANCE

  • Travelling groups and corporates      – Risk assessment
  • Life style issues of Travellers – Sex and STI’s
  • Medical Tourism – The Thailand Experience
  • Update on Dengue Fever – Current thinking and into the future
  • Food and Water borne issues – The family holiday, outbreaks
  • Woman and children travellers     – management, the pregnant traveller
  • Mosquito borne diseases
  • Wilderness weather extremes and travel – Creepy Crawlies , the essence of management
  • Region specific destinations – Asia, Pacific
  • Post natural disaster outbreaks – Thailand and Samoa experiences
  • Update on Malaria – Future developments
  • Rabies – devising a management plan, the Bali experience

WORLDWISE Post Graduate Conference Advanced Level – The New Zealand Advanced course in Travel, Tropical and Geographical Medicine for Travel and Primary Health Care Practitioners – has been endorsed by The Royal New Zealand College of General Practitioners (RNZCGP) and has been approved for up to 13.25 Hours CME for General Practice Educational Programme Stage 2 (GPEP2) and Maintenance of Professional Standards (MOPS) purposes.

For more information, full programme details or registration, please contact Clare at online@worldwise.co.nz or 09 520 5830

We look forward to seeing you there!