Remaining healthy while travelling is an essential element in successful study abroad. Travelling to a foreign country poses numerous health risks and it is important to know how to prevent or handle these so that they don't become dangerous or life threatening. Maintain a positive attitude to begin with. The best way to handle potential health problems is to try and avoid them. This section will serve as a general introduction to some of the major health issues facing travellers, and suggest precautions you can take to decrease your chances of becoming ill. In addition to consulting a physician, look in "Resources" for more information related to travel health.

You should contact a health care provider to discuss certain health issues and recommended immunizations for your specific area of travel. This may be your family physician, campus health care service or the traveller's clinic at your local Public Health Unit. If you will be studying in or travelling to a tropical destination your regular doctor may request you book an appointment with a tropical health clinic in your area.

Here are some general Travel health related Websites:

Health Canada - http://www.hc-sc.gc.ca/pphb-dgspsp/tmp-pmv/pub_e.html
Centre for Disease Control - http://www.cdc.gov/travel/
Medical College of Wisconsin Physicians and Clinics - http://healthlink.mcw.edu/travel-medicine/
International Society of Travel Medicine (ISTM) - http://www.istm.org/

What you need to know
Activity: Health Questions about your Destination
Before you visit your physician or travel clinic you should check the Centre for Disease Control website http://www.cdc.gov/travel/destinat.htm and answer the following questions for your desination:

• What are the major health concerns where you are going?
• What is the safety of food and water supplies?
• What vaccinations will I require?
• Print off the information for your destination and take it and the Health checklist with you when you visit your physician or traveller's clinic.

Locating Medical Help Overseas
The International Association for Medical Assistance for Travellers (IAMAT) will provide climate charts, current information on diseases specific to the region to which you will be travelling, and a list of doctors worldwide. IAMAT doctors speak English and are trained in the specific health needs of travellers. This non?profit foundation exists solely on donations from its users. If you use IAMAT, please give a donation!
Check the IAMAT website for information on locating medical assistance in your host country.

"I Feel Like a Pin Cushion!" Immunizations and Vaccinations
Immunizations and vaccinations will help to prevent infection from numerous viruses and diseases, including cholera, rabies, yellow fever, typhoid, meningitis, Japanese encephalitis, hepatitis and malaria. Vaccinations may come in the form of an injection or a pill. Make sure that your routine immunizations are up to date as well. If you weren't exposed to certain diseases as a child, or weren't immunized, you could be at an increased risk of acquiring diseases such as tetanus, diphtheria, polio, measles, mumps or rubella.

If you will be in an area with endemic rabies or if you will be working with animals, you should get a rabies vaccination before you leave. The rabies immunization involves a series of shots - give yourself sufficient time for this. Be cautious around dogs-in many parts of the world dogs are used for security, not as cuddly family pets.

Some vaccinations and immunizations are required for entry to, or return from, certain countries. These change periodically, so check on their current status at the country's nearest mission and/or IAMAT .

Avoid injections in foreign countries, unless necessary. Some countries re-use disposable equipment or do not sterilize materials properly. If injections are required, make sure that the needles and syringes come straight from a package or have been sterilized with chemicals or by boiling for twenty minutes. Ask to see how the equipment was sterilized. In some cases you may be able to purchase needles and syringes and take them to the hospital for your own use. Caution regarding instrument sterilization applies to all treatments that pierce the skin, including tattooing, acupuncture, ear or body piercing and dental work.

Diabetics and other people who require routine or frequent injections should carry a supply of syringes and needles sufficient to last their stay abroad. However, carrying needles and syringes without a prescription may be illegal in some countries. Take a note from your doctor explaining that you require the syringes for medical reasons.

Immunizations and vaccinations should be researched early in your pre-departure preparation. Some shots have to be administered months before departure in order to be effective and many require multiple doses, weeks apart. Do not leave this to the last week. Some people have short-term reactions to certain immunizations, so allow some time. Ask your doctor about immunizations and vaccinations as soon as possible.

Due to specific health concerns and conditions in various countries, you may need to show proof that you've received certain immunizations. The record is usually asked for when you enter the country. Ask your health care provider for an official record of your vaccinations.

Keep in mind that many travel immunizations are not covered by your provincial health insurance plan so ask about costs so you can budget appropriately.

For more information on vaccinations see:
Trip Prep - http://www.tripprep.com
Health Canada Travel Information - http://www.hc-sc.gc.ca/pphb-dgspsp/tmp-pmv/pub_e.html
Centre for Diesease Control - http://www.cdc.gov/travel/vaccinat.htm
National Vaccine Information Centre (U.S.- alternative Information regarding vaccines) - http://www.909shot.com/

Prescription Drugs
If you require regular medication or injections (including birth control pills), be sure to check with your physician for any recommendations concerning your welfare while abroad. Take an adequate supply of any needed medication, keep it cool and dry and carry a copy of your prescription with you. Prescription medicines should be submitted to a pharmacist with a letter from your physician detailing the problem, the chemical make up of the prescription drug and the generic name of the medicine. Do not buy medications over the counter unless you are familiar with the product.

If you have diabetes, allergies or any other condition that may require emergency attention carry identification (a tag, bracelet or card), on your person at all times. This should indicate the specific nature of the problem and what measures should be taken if you are unable to communicate this information yourself. MedicAlert offers a bracelet service. Call 1-888-633-4928 or visit http://www.medicalert.com for membership information.

If you are required to take a medicine containing habit-forming or narcotic drugs you should carry a doctor's certificate attesting to that fact. Keep all medicines in their original containers. To avoid potential problems, consult the embassies of the countries you will visit before departing to ask about any laws or restrictions regarding your particular drugs.

If you wear eyeglasses or contact lenses, carry an extra pair as well as a copy of their prescription. In some cases, you may need to take contact lens solutions with you.

Sex and Sexually Transmitted Diseases (STDs)
The wide range of beliefs and values in the host country can complicate any sexual relationships that you may develop abroad. Consider differences in language, culture and experience before getting involved. Ensure that you are acting appropriately and acceptably and you are sensitive to community standards.

Sometimes seeking physical intimacy is just a way of reaching out to fill an emotional void. It might be less complicated to fill this void through a platonic friendship rather than a romantic relationship.

Unless you abstain from sexual activity altogether, you are putting yourself at risk. Incurable sexually transmitted diseases are present everywhere in the world. Know how to decrease the risk and be responsible. If you choose to have sexual contact, you may reduce the risk by using protection (i.e. latex condom or dental dam) during penetration or oral sex. Take a supply with you, as the quality and supply may be questionable elsewhere. If you are on the pill, ensure that you carry enough of your prescription for the duration of the trip as you may have difficulty obtaining the same drug elsewhere. Birth control pills are not legal in some countries and may not always be available.

Everything you already know about HIV and how it is contracted is as true overseas as it is at home. Act responsibly and refrain from unprotected sex, needle sharing, the medical use of blood or blood components, and other behaviours that carry the risk of infection. AIDS is not spread by daily and routine activities such as sitting next to someone, shaking hands or working with people. It is not spread by insect bites, swimming pools, public transportation, food, cups, glasses, plates, toilets, water, air, touching or hugging, coughing or sneezing. For more information on HIV and travel go to http://www.cdc.gov/travel/hivtrav.htm

Some countries now require incoming foreigners to take HIV tests. An unofficial list of these countries is available at http://www.travel.state.gov/HIVtestingreqs.html.

You may need a doctor's certificate showing the results of the test. Allow yourself two weeks for the testing process and consider getting tested twice; once anonymously, to allow you the privacy to decide what to do in the event of a positive result and then again for a doctor's certificate, if needed. Ask your physician if antibody tests are required for your destination.

While many countries have mandatory screening of donated blood for HIV, you should find out about safe sources of blood overseas from the Red Cross, medical clinic, or Canadian embassy. If uncertain, consider avoiding or postponing any blood transfusion while abroad if you are injured or ill unless it is absolutely necessary. If you do need blood, try to ensure that screened blood is used.

Living overseas in certain areas may present greater risks to those who test positive for the HIV virus or other diseases. Some overseas locations have limited medical facilities that cannot monitor the progress of such infections. Know your HIV status before you go.
For other results of unprotected sex see the section on Women's Health.

Women's Health
Women have special needs when it comes to health and travelling. Prepare yourself by reading about health issues that concern you. Her Own Way - Advice for the Woman Traveller is a free publication from the Department of Foreign Affairs and International Trade website: http://www.voyage.gc.ca/Consular-e/Publications/her_own_way-e.htm

Other excellent resources include the book Gutsy Women Travellers, and Gutsy Mama Travellers and the Journey Woman magazine.

Have a pre-departure medical exam, including a Pap smear to detect cervical cancer, pregnancy test (if you have been sexually active) and have a breast examination. Learn how to examine your breasts and do this regularly.

Menstruation may become much less frequent when travelling or even stop altogether. Pre-menstrual symptoms may also change. This is not uncommon and is usually caused by a new diet and environment. Even if your periods stop, you are still ovulating and could still become pregnant. You should fall into a regular menstruation again after a few months when your mind and body have acclimatized. If you are having heavier and more frequent periods, eat plenty of foods rich in iron and folic acid such as green leafy vegetables, red meat, dried apricots or figs. Using iron cooking pots will increase the iron content of the food you cook. There may be local customs regarding menstruation. For example, in some Hindu cultures menstruating women are not allowed to enter temples. Ask local women if there are any customs you should observe.

Yeast infections can proliferate in warm and humid climates. For prevention, wear cotton underwear and loose-fitting skirts or slacks. Don't use any pre-packaged vaginal douches and don't sit around in a wet bathing suit. If anti-fungal vaginal suppositories or creams are not available to treat an infection, apply plain yogurt externally to soothe the itching or sit in a shallow tub of lukewarm water with four tablespoons of baking soda.

If you are pregnant, ensure that there are facilities present in your host community or school to handle this. Ensure that you have insurance that will cover health complications, which arise due to pregnancy. Be aware that abortions are illegal in many countries. In those countries where abortions are legal, the procedures may still be dangerous. Take any contraceptive supplies you may need with you or plan to have them sent. Keep condoms, diaphragms and dental dams in closed containers, stored in a cool dark place.

Many cultures have pre-conceived notions about the values and behaviour of Western women. To avoid being approached or harassed, women should dress and act conservatively and follow local customs.

Special Needs Travellers
It is possible for people with special needs (such as mobility, hearing, vision, medical, or learning disabilities) to travel in most countries of the world. Unfortunately, it may not be feasible to study at each institution with which your university has a study abroad agreement. Consider your alternatives. While it may not be possible for you to attend university in Guyana, it may be possible for you to study in Finland or Sweden. Mobility International is an American organization specializing in educational travel for students with disabilities. Visit the website at http://www.miusa.org.

Some Things to Consider:

• You may face discrimination directed at your physical or mental disability.
• Will there be transportation, accommodations, restaurants, markets, stores, medical facilities, etc., to meet your needs?
• Will you need to take any special supplies or medications from home? Will you be able to buy any there?
• If necessary, will you be travelling with someone who can help you get through your daily routine?

Warm Climates
It is in warm places that Canadians have the most climate related health problems. Protecting yourself from the sun is of utmost importance. Skin cancer and retinal damage rates are increasing worldwide. Wear sunscreen, hats and sunglasses to reduce the risk of sunstroke and UV damage. In hot climates, be wary of dehydration and heat stroke. Drink plenty of water or fruit juice (caffeine, pop and alcohol dehydrate you) and stay in the shade whenever possible. In some moist and warm conditions, fungal infections, such as athlete's foot, can be a problem. Air out clothing and belongings daily and try to keep your feet as dry as possible.

Northern Climates
If you are in a northern climate (Sweden, Finland even England) remember that you may experience fewer hours of sunlight than you are accustomed to. This could often lead to mood swings or feelings of lethargy. It is important that you spend time outdoors and maintain physical activity to combat the lack of motivation or slight depression that is sometimes attributed to shorter daylight hours.

Mosquitos and Other Insects
Shots or pills do not exist for all diseases and many are not very effective. Disease-carrying mosquitoes and other insects have developed resistance to many forms of vaccination. If you will be in an area where insects are known to carry disease, you need to take precautions.

• Use insect repellent.
• Sleep under mosquito netting, well tucked-in and closed.
• Have a fan blowing over your body.
• Plan your daily activities to avoid periods when insect activity is greatest, usually at dawn and dusk.
• Wear adequate clothing, such as long sleeved shirts, long pants tucked into socks and shoes (not sandals).
• It is often found that large biting flies are more attracted to dark colors.

Most diseases carried by insects are transmitted seasonally. It might be possible to make arrangements and travel plans prior to departure that will greatly reduce the risk of acquiring these diseases. Again, consult your physician.

First Aid Kit
If travelling to a more remote area, you should prepare a first-kit to carry with you wherever you go. Many of the following items are available overseas, though it may be preferable to buy them before leaving Canada. Pack them in a sturdy, accessible container, such as a hip pouch or plastic food storage box.

Activity: First-Aid Kit Checklist
Click on the link above to print the First-Aid Checklist.