Travel Medical Issues

Transportation Strikes
Transportation Strikes 700 394 Greg Ellifritz

If you travel in the developing world, you’ll know that taxi and transportation strikes are stunningly common.  Have you prepared for one?  These travelers had to walk more than two miles from the airport to a location that wasn’t blockaded by striking taxi drivers in order to get to their hotels.  Can you carry your bags that far?  If not, you overpacked.

 

When I travel, I carry the Osprey Sojourner as my luggage.  It has very sturdy wheels as well as a set of hidden backpack straps and a hip belt in the event I am on rough terrain where the wheels won’t roll.

 

It’s not cheap, but it’s bulletproof and I can hike with it if necessary.

Brazilian tourist dies in taxi drivers’ blockade of Chilean airport

Medical Management of Frostbite
Medical Management of Frostbite 300 42 Greg Ellifritz

If your adventure travels take you to cold places, you’ll want to review this complete guide for treating frostbite in the field.

A New Proposal for Management of Severe Frostbite in the Austere Environment

Covid-19 Testing
Covid-19 Testing 600 383 Greg Ellifritz

As the world starts to open up, more and more places are requiring negative Covid tests from all travelers.  The USA also requires all citizens returning from an international destination by air to have a negative Covid-19 test within three days of their flight.

I recently had to take three different Covid tests in a two week period (coming home from Mexico, entering the Dominican Republic (random passengers get tested on arrival.  I was lucky enough to be chosen) and returning from the D.R.

I absolutely despise anything in my nose.  I have some damaged cartilage from boxing and sparring and the Q-tip up the nose Covid test is agony for me.

You’ll definitely want to be an informed consumer in this arena.  I found the following article to be exceptionally useful at explaining all the testing issues.

https://internationalman.com/articles/covid-tests-gone-wild-an-epidemic-of-covid-positive-tests/

The bottom line according to the article is:

Summary:

  1. We have an epidemic of COVID-positive tests that is substantially larger than the epidemic of identified Relevant Infectious COVID Disease. In contrast, people with actual, mild cases of COVID-disease aren’t all getting tested. So the data, on which lockdowns are supposedly justified, are lousy.
  2. The data on COVID hospitalizations and deaths in the US are exaggerated by a government subsidization scheme that incentivizes the improper use of tests in people without particular risk of the disease.
  3. Avoid getting tested for COVID unless you are symptomatic yourself, have had exposure to someone who was both symptomatic and tested positive for COVID, or have some other personal reason that makes sense.
  4. Know that getting tested before traveling abroad puts you at a modest risk of getting a false-positive test result, which will assuredly screw up your trip. It’s a new political risk of travel.
  5. There is a lot more to this viral testing game, and there are a lot of weird incentives. There are gray areas and room for debate.
  6. Yes, the COVID disease can kill people. But a positive test won’t kill anybody. Sadly, every COVID-positive test empowers those politicians and bureaucrats who have a natural bent to control people—the sociopaths and their ilk.

 

 

 

Imodium for Travel
Imodium for Travel 259 478 Greg Ellifritz

Read a little about Loperamide.

 

Imodium’s Survival Applications: What It Is & Why Carry It Everywhere

 

Imodium (or generic Loperamide) is an essential drug to stockpile for both travel and survival purposes.  In addition to the reasons mentioned in the article, in any survival situation the chance of consuming bad food and water increases.  You don’t want to be disabled from the resulting diarrhea.

 

One caution…

 

There are a couple of cases where you SHOULD NOT use Imodium to control your diarrhea.  If you have bloody diarrhea or diarrhea with fever, it’s best to let it run its course.  You can make your illness worse by “stopping things up” under these conditions.

 

One more interesting point….

 

Besides controlling diarrhea, Modicum can help people suffering withdrawal symptoms from opiate drugs.  A lot of people in this country are hooked on narcotic pain meds.  The withdrawal symptoms from not taking those meds in a survival situation would be horrible.  Although Imodium doesn’t cross the blood brain barrier (and get you high), it does have a weak effect at the opiate receptors and might reduce some of the physical symptoms of opiate withdrawal.  This article explains some of the details.

Travel Motion Sickness?
Travel Motion Sickness? 460 650 Greg Ellifritz

Nausea and vomiting are medical conditions I see more often than anything else in my third world travels.

 

My go-to treatment has always been Ondansetron, but it’s prescription only here in the States.

 

There may be a quicker option than anti-nausea meds that doesn’t require any prescription.  Who knew about this alternate use for the simple alcohol prep pad?  A very neat trick for those interested in austere medical issues.

 

Trick of the Trade: Isopropyl Alcohol Vapor Inhalation for Nausea and Vomiting

 

 

Unhappy News
Unhappy News 1280 855 Greg Ellifritz

The US government announced yesterday that all air travelers arriving in the USA after January 26, must have evidence of a negative Covid-19 test within three days of their travel.  It will be a horrible blow to the travel economy and will limit a lot of Americans’ travel plans.

 

U.S. Will Require All International Arriving Passengers To Have A Covid-19 Test

 

 

This is a really poor public policy. The USA has the worst rate of infection of any country on the planet. Who are we “protecting” at home when we bar someone from entry when he is coming from a nation that has a lower infection rate than the USA?
Countries in the developing world do not have the same capacity for testing that the US has. Travelers simply may not even be able to get tests.
I’m in Mexico right now. Currently, without a testing requirement, the labs down here are scheduling PCR tests 7-10 days out. Mexico doesn’t have the infrastructure in place to do them any faster. As soon as the USA implements this requirement on the 26th, there will be massive new demands for testing and no ability to satisfy those demands.
People estimate down here that it may take two to three weeks to get tested after the new requirement is in place.
And keep in mind that I am in a very developed part of Mexico looking at a long wait for a test. How are you going to get tested in rural Uganda or the Peruvian jungle?  I had plans to travel to both of those locations in 2021.  This ruling will either prohibit me from traveling there or force me to stay an extra three days in a big city in one of those countries waiting for my test results to come in.
The requirement will effectively stop any “long weekend” international travel.  It will also make larger families stop traveling internationally.  With the tests costing $100-$150 each way, it gets really expensive to take your spouse and three kids on an international getaway.
What I also find curious is that you will be able to fly with a negative test or proof that you’ve already recovered from a past case of Covid-19.  Having taken both doses of the vaccine isn’t good enough.  What does that say about the government’s true opinion of the efficacy of the vaccination?
The only thing this restriction will do is to further destroy the travel industry and create a huge market for forged testing results.
It’s a good thing I got a six-month travel visa here in Mexico.   I may be stuck for awhile.  That might not be a bad thing.  Overall, people in Mexico seem to be far more sensible about effective precautions than the politicians in the USA.

Health Care in Mexico
Health Care in Mexico 748 420 Greg Ellifritz

Mexico is a prime destination for American expats.

 

My favorite Mexican ex-pat blogger recently posted an incredible resource for people living in or visiting Mexico.

 

Great Site to Find Doctors in Mexico, Check Reviews, Compare Prices and Schedule Appointments

 

This will make finding and booking good medical care much easier for those of you spending time in Mexico.

Environmental Medicine
Environmental Medicine 200 181 Greg Ellifritz

Interested in a summary of the best practices for practicing environmental medicine? Those skills are important when you are spending time outside in austere environments.

Here’s a link to papers covering best practice medical treatments for heat injuries, hypothermia, and altitude illness.  This is really good knowledge to have.

 

AIR Series: Environmental Module

Long Term Travel Insurance Policies
Long Term Travel Insurance Policies 780 520 Greg Ellifritz

I’ve written about travel insurance policies in the past.  Many of the short term trip insurance policies become very expensive if you are staying long term or actually living in a foreign country.

 

Check out the link below to find some less expensive plans for long term travelers.

 

5 BEST Digital Nomad Health Insurance Plans for Long-Term Travel (2020)

Mammalian Bite Wounds
Mammalian Bite Wounds 184 37 Greg Ellifritz

When you travel in the developing world, your risk of getting bitten by stray cats, dogs, and feral rats increases significantly.  One of the most important skills you should have is to know how to handle animal bite wounds.

 

The article linked below covers the basics for treating a bite wound.  You’ll note that the most commonly prescribed antibiotic for animal bite wounds is Augmentin.  I always carry some of it in my travel medical kit.  If your personal doc won’t prescribe a dose for you to take on your trip, you can generally buy it without a prescription in most developing world pharmacies.

 

Mammalian Bites: ED presentations, evaluation, and management