Pack medications in their original, clearly labelled, containers. A signed and dated letter from your physician describing your medicalconditions and medications, including generic names, is also a good idea. If carrying syringes or needles, be sure to have a physician's letter documenting their medical necessity. If you have a heart condition bring a copy of your ECG taken just prior to travelling. If you happen to take any regular medication bring double your needs in case of loss or theft. In most Southeast Asian countries you can buy many medications over the counter without a doctor's prescription, but it can be difficult to find some of the newer drugs, particularly the latest antidepressant drugs, blood pressure medications and contraceptive pills.
HEALTH ADVISORIES
It's usually a good idea to consult your government's travel-health website before departure, if one is available:
Australia (www.dfat.gov.au/travel)
Canada (www.travelhealth.gc.ca)
New Zealand (www.mfat.govt.nz/travel)
INSURANCE
Even if you are fit and healthy, don't travel without health insurance - accidents do happen. Declare any existing medical conditions you have - the insurance company will check if your problem is pre-existing and will not cover you if it is undeclared. You may re quire extra cover for adventure activities such as rock climbing. If your health insurance doesn't cover you for medical expenses abroad, consider getting extra insurance If you're uninsured, emergency evacuation is expensive; bills of over US$100,000 are not uncommon. You should find out in advance if your insurance plan will make payments directly to providers or if they reimburse you later for overseas health expenditures, (Note that in many countries doctors expect payment in cash.) Some policies offer lower and higher medical expense options; the higher ones are chiefly tor countries that have extremely high medical costs, such as the USA, You may prefer a policies that pays doctors or hospitals directly rather than you having to pay on the spot and claim later. If you have to claim later, make sure you keep all documentation. Some policies ask you to call back (reverse charges) to a centre in your home country where an immediate assessment of your problem is made.
Even if you are fit and healthy, don't travel without health insurance - accidents do happen. Declare any existing medical conditions you have - the insurance company will check if your problem is pre-existing and will not cover you if it is undeclared. You may re quire extra cover for adventure activities such as rock climbing. If your health insurance doesn't cover you for medical expenses abroad, consider getting extra insurance If you're uninsured, emergency evacuation is expensive; bills of over US$100,000 are not uncommon. You should find out in advance if your insurance plan will make payments directly to providers or if they reimburse you later for overseas health expenditures, (Note that in many countries doctors expect payment in cash.) Some policies offer lower and higher medical expense options; the higher ones are chiefly tor countries that have extremely high medical costs, such as the USA, You may prefer a policies that pays doctors or hospitals directly rather than you having to pay on the spot and claim later. If you have to claim later, make sure you keep all documentation. Some policies ask you to call back (reverse charges) to a centre in your home country where an immediate assessment of your problem is made.
VACCINATIONS
The only vaccine required by international regulations is yellow fever. Proof of vaccination will only be required if you have visited a country in the yellow-fever zone within the six days prior to entering Vietnam. If you are travelling to Vietnam from Africa or South America you should check to see if you require proof of vaccination. Specialised travel-medicine clinics are your best source of information; they stock all available vaccines and will be able to give specific recommendations for you and your trip. The doctors will take into account factors such as past vaccination history, the length of your trip, activities you may be undertaking, and under lying medical conditions, such as pregnancy. Most vaccines don't produce immunity until at least two weeks after they're given, so visit a doctor four to eight weeks before departure. Ask your doctor for an International Certificate of Vaccination (otherwise known as the yellow booklet), which will list all the vaccinations you've received. In the US, the yellow booklet is no longer issued, but it is highly unlikely the Vietnam authorities will ask for proof of vaccinations (unless you have recently been in a yellow-fever affected country).
For info on current immunisation recommendations for Vietnam, contact the inter national team of doctors at the Family Medical Practice (www.donorkot.com) in Hanoi and HCMC . They can provide the latest information on vaccinations, malaria and dengue-fever status, and offer general medical advice regarding Vietnam. See the boxed text for possible vac cinations you may require.
MEDICAL CHECKLIST
Recommended items for a personal medi cal kit:
antibacierial cream, eg Muciprocin ;
antibiotics for skin infections, eg Amoxi-cillin/Clavulanate or Cephalexin
antibiotics for diarrhoea, eg Norfloxacin or Ciprofloxacin; Azithromycin for bacterial diarrhoea; and Tinidzode for giardiasis or amoebic dysentery
antifungal cream, eg Clotrimazole
antihistamines for allergies, eg Cetrizine for daytime and Promethazine for night anti-inflammatories, eg Ibuprofen antinausea medication, eg Prochlorperazine
antiseptic for cuts and scrapes, eg Betadine
antispasmodic for stomach cramps, eg Buscopa
contraceptives
decongestant for colds and flus, eg Pseu-doephedrine
DEET based insect repellent
diarrhoea 'stopper', eg Loperamide first-aid items such as scissors, planters (Band Aids), bandages, gauze, thermom-eter (electronic, not mercury), sterile needles and syringes, safety pins and tweezers
indigestion medication, eg Quick Eze or Mylanta
iodine tablets (unless you are pregnant or have a thyroid problem) to purify water laxatives, eg Coloxyl
migraine medication (your persons brand), if a migraine sufferer
oral-rehydration solution for diarrhoea ,eg Gastrolyte
paracetamol for pain
permethrin (to impregnate clothing and mosquito nets) for repelling insects steroid cream for allergic/itchy rashes, eg 1% to 2% hydrocortisone
sunscreen and hat
throat lozenges
thrush (vaginal yeast infection) treatment, eg Clotrimazole pessaries or Diflucan tablet
urine alkalisation agent, eg Ural, if you're prone to urinary tract infections.
INTERNET RESOURCES
There is a wealth of travel health advice on the Internet. . The World Health Organization (WHO;www.who.int/ith/) publishes a superb book called International Travel & Health, which is revised annually and is available free on line. Another website of general interest is MD Travel Health (www.mdtravelhealth.com), which pro-vides complete travel health recommenda
tions for every country and is updated daily. The Centers for Disease Control and Prevention (CDC.www.cdc.gov) website also has good general information.
FURTHER READING
Vietnam Travel Guide's Healthy Travel - Asia & India is a handy pocket-size book that is packedwith useful information including pretripplanning, emergency first aid, immunisation and disease information and what to do if youget sick on the road. Other good recommended references in- wood as well as Travelling Well by Dr Deborah Mills - check out the website (www.travellingwell.com.au).
RECOMMENDED VACCINATIONS
The World Health Organization (WHO) recommends the following vaccinations for travellers to Southeast Asia; Adult diphtheria and tetanus - single booster recommended if you've had none in the previous 10 years. Side effects include a sore arm and fever. Hepatitis A - provides almost 100% protection for up to a year; a booster after 12 months provides at least another 20 years' protection. Mild side effects such as headache and a sore arm occur for between 5% and 10% of people. Hepatitis B - now considered routine for most travellers. Given as three sho:s over six months. A rapid schedule is also available, as is a combined vaccination with Hepatitis A.
Side effects are mild and uncommon, usually a headache and sore arm. Lifetime protection occurs in 95% of people. Measles, mumps and rubella - two doses of MMR required unless you have had the diseases. Occasionally a rash and flulike illness can develop a week after receiving the vaccine. Many young adults require a booster. Polio - in 2002, no countries in Southeast Asia reported a single case of polio. Only one booster is required as an adult for lifetime protection. Inactivated polio vaccine is safe during pregnancy. Typhoid - recommended unless your trip is less than a week and only to developed cities.
The vaccine offers around 70% protection, lasts for two or three years and comes as a single shot. Tablets are also available; however, the injection is usually recommended as it has fewer side effects. Sore arm and fever may occur, Varicella - if you haven't had chickenpox, discuss this vaccination with your doctor. Long-term Travellers: These vaccinations are recommended for people travelling more than one month, or those at special risk-Japanese B Encephalitis - three injections in all. A booster is recommended after two years. A sore arm and headache are the most common side effects reported. Rarely, an allergic reaction comprising hives and swelling can occur up to 10 days after any of the three doses. Meningitis - single injection.
There are two types of vaccination: the quadrivalent vaccine gives two to three years protection; meningitis group C vaccine gives around 10 years protection. Recommended for long-term travellers aged under 25. Rabies - three injections in all. A booster after one year will provide 10 years of protection. Side effects are rare - occasionally a headache and sore arm. Tuberculosis - adult long-term travellers are usually recommended to have a TB skin test before and after travel, rather than vaccination. Note that only one vaccine is given in a lifetime.
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