Continental Shift

Medical issues for your move overseas II March 10, 2010

We’re continuing the discussion of steps to take to ensure your health is protected.

Medical kit
The travel doctor you attend for your vaccinations will also be able to supply you with a travel medical kit. While you may already have a household medical kit, the travel medical kit differs in that it is designed to deal with some of the ‘Bali belly’ troubles you might encounter in your first few months (or, just as a wild example, on the plane on the way over there. Yes, I am speaking from experience, more’s the pity).

It will contain various prescription and general medicines, antibiotics and creams that will treat:

• Diarrhoea, both mild and severe
• Nausea and vomiting
• Giardia
• Bacterial dysentery (diarrhoea with blood and mucus in it) and amoebic dysentery
• Constipation
• Respiratory infections
• Pain and fever
• Skin problems such as tinea, infections and allergic rashes
• Thrush
• Eye and ear infections
• Jetlag
• Altitude sickness
• Malaria.

The kit should come with an instruction booklet which will help you diagnose the problem and the best medication to use. However, in all except the mildest of cases, you would only resort to using the kit if you couldn’t easily see a doctor (for example, because of distance, language difficulties or trouble getting an appointment).

You may also wish to obtain a more general first aid kit; if you purchase this from your first aid training provider, you will often be given a discount. Depending on the first aid kit you decide to buy (e.g. compact, car, household etc), it may contain the following items in varying quantities:

• Adhesive strips and tape
• Wound dressings and bandages
• Scissors and forceps
• Antiseptic or saline solutions
• Eye pads
• Pain relief
• Safety pins
• Disposable gloves
• Emergency shock blanket
• Gauze, alcohol and iodine swabs
• Pain-relief gel for insect bites and rashes
• Disposable splinter probes.

As with the wide variety of first aid training courses, if the many options for first aid kits leave you unsure about the best for your situation, ask the first aid kit provider or your doctor for advice.

Other medical/health supplies
In addition to a first aid kit, you may also wish to bring with you over-the-counter medicines and health supplies that you commonly use. Even if you think or know such things are easily available in your new country, it’s good to have them on hand in case you need them while you’re still settling in. It’s easier to go to your stock of pre-planned supplies than to find a pharmacy and try to mime what you need while fighting off symptoms (here, my partner speaks from experience).

Common useful health items include:

• Antihistamine tablets and cream (for hayfever and insect bites respectively)
• Suncream UV30+
• Antiseptic cream or spray
• Bandaids or other plasters
• Pain killers like Panadol or Nurofen
• Cold and flu medicine like Codral
• Multivitamins
• Antibacterial handwash
• Insect repellent like Aerogard
• Dental supplies (floss, mouth rinse).

You should also carry with you a good supply of any prescription medicine you need, with a letter from your doctor which specifies that you are carrying a prescribed medicine for your own use – this may be needed at the airport or border check to prove you are not a drug-runner just because you’re carrying large quantities of drugs.

Depending on the availability of your prescription medicine in the new country and its expiry range, you might even wish to carry a supply that will last you until the next time you visit home or another location you can get re-stocked – in this case it is absolutely vital that you have that letter from your doctor, as otherwise the large quantity may make it appear as if you are exporting medicine and/or importing it for re-sale, which is usually illegal.

Another option for dealing with prescriptions, particularly where the medicine has a short expiry time and so can’t be stockpiled, is to use online pharmacy sites. You will need your prescription script and an address in your home country (it can be sent there and then forwarded on to you). The mail system of your new country must be relatively quick, reliable and free of tampering for this to be a viable option. Also check that the pharmacy you are using is not some discount site selling expired or near-expired medicines (it does happen). You will eventually need to visit a doctor to get a replacement script, but it is a good stopgap measure.

You should check with the embassy or consulate of your new country to ensure that the over-the-counter and prescription medicines you plan to bring with you are actually legal there. With this knowledge, you can make your own decision about what you will risk carrying or whether the inability to take a particular medicine with you affects your plan to move to the new country (illegal birth control strikes me as a deal-breaker, for example).

You may also wish to carry spares of things like glasses or contact lenses, dental guards, hearing aids, and other health paraphernalia that could be difficult or inconvenient to replace.

Health insurance
Take out health insurance, insuring for medical, hospital and medical evacuation needs. You do not necessarily need to arrange this in your new country – some insurance companies have specialist expatriate policies which will cover you in your old and new countries and when travelling between them; you should check to see which one suits your needs best. You should also check that you are covered when travelling on holiday. Remember to cancel your old policy if you do end up taking out a new policy.

If you’re an Australian citizen, be aware Australia has reciprocal health care agreements with Finland, the Republic of Ireland, Italy, Malta, the Netherlands, New Zealand, Sweden and the United Kingdom which allows you emergency treatment within their public health system. However, this does not cover all medical or hospital expenses, so you should still have health insurance.

Also for Australians – if you’ve lived outside Australia for less than five years, you still retain your entitlement to Medicare (cheap health care). After five years, you’re no longer eligible.

Safe sex
This should, by the 21st century, be self-evident and automatic, but I am going to repeat it again: when overseas, when at home, wherever you are: practice safe sex. Never assume your partner is not HIV-positive or not carrying some other sexually-transmitted disease, even if they tell you they are not.

As embarrassing as it may be to have to mime and phrase-book your insistence on a condom in the middle of a hot and heavy session with your newly-met partner, the discomfit level is far less than having to deal with herpes, gonorrheae, or HIV. If your partner resists, think about whether someone happy to risk your health and theirs is the sort of person you want to be getting naked with.

You might wish to carry your own condoms and water-based lubricant, as condoms may be hard to find or of poor quality (and a condom with a hole in it is as useful as no condom at all).

CASE STUDY
For our trip to Libya, we undertook medical and dental check-ups and received the full complement of vaccinations appropriate to that region of the world. I could not receive the final shots of Hepatitis A and B vaccinations, as they needed to be administered 6-12 months after the initial course, and by then we would be in Libya. I had to make sure I went either to the local clinic in Tripoli, or to my original travel doctor in Perth next time I visited home, to ensure I completed my course of vaccinations and was fully protected.

We each had a travel kit, and I also carried with us a good supply of our usual medications, both prescription and over-the-counter, as well as general healthcare products. My partner’s company provided us with first aid training, health insurance meant to replace both Medicare and private health insurance, and a home medical kit. The company also arranged access to the local GP clinic and gave clear instructions on how to obtain emergency care.

ACTIVITY
Start making appointments – GP, dentist, travel doctor, first aid training and so on. Think about your regular health needs and stock up on what you need to take with you.

That’s it for this week; next time, I’ll discuss about a general list of other preparations you should make. See past topics and what’s coming up next at the table of contents. Subscribe or check back for more content soon.

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