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repatriation home. Citizens from other countries should find out if there is a reciprocal arrangement for free medical care between their country and Germany. If you do need health insurance, make sure you get a policy that covers you for the worst possible case, such as an accident requiring an emergency flight home. Find out in advance if your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures.

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RECOMMENDED VACCINATIONS

No jabs are required to travel to Germany. The World Health Organization (WHO), however, recommends that all travellers should be covered for diphtheria, tetanus, measles, mumps, rubella and polio, regardless of their destination.

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IN TRANSIT

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DEEP VEIN THROMBOSIS (DVT)

Blood clots may form in the legs during plane flights, chiefly because of prolonged immobility. The longer the flight, the greater the risk. The chief symptom of DVT is swelling or pain of the foot, ankle or calf, usually but not always on just one side. When a blood clot travels to the lungs, it may cause chest pain and difficulty breathing. Travellers with any of these symptoms should immediately seek medical attention.

To prevent the development of DVT on long flights you should walk about the cabin, contract the leg muscles while sitting, drink plenty of fluids and avoid alcohol and tobacco.

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JET LAG & MOTION SICKNESS

To avoid jet lag (common when crossing more than five time zones) try drinking plenty of non-alcoholic fluids and eating light meals. Upon arrival, get exposure to natural sunlight and readjust your schedule (for meals, sleep etc) as soon as possible.

Antihistamines such as dimenhydrinate (Dramamine) and meclizine (Antivert, Bonine) are usually the first choice for treating motion sickness. A herbal alternative is ginger.

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IN GERMANY

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AVAILABILITY & COST OF HEALTH CARE

Excellent health care is readily available but rather expensive. For minor illnesses, pharmacists are able to dispense valuable advice and over-the-counter medication. They can also advise when more specialised help is required and point you in the right direction.

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MEDICAL CHECKLIST

All of the following are readily available in Germany. If you are hiking out of town, these items may come in handy.

antibiotics

antidiarrhoeal drugs (eg loperamide)

acetaminophen (Tylenol) or aspirin

anti-inflammatory drugs (eg ibuprofen)

antihistamines (for hay fever and allergic reactions)

antibacterial ointment (eg Bactroban; for cuts and abrasions)

steroid cream or cortisone (for poison ivy and other allergic rashes)

bandages, gauze, gauze rolls

adhesive or paper tape

scissors, safety pins, tweezers

thermometer

pocket knife

DEET-containing insect repellent for the skin

pyrethrin-containing insect spray for clothing, tents and bed nets

sun block

oral rehydration salts

acetazolamide (Diamox; for altitude sickness)

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TRAVELLERS’ DIARRHOEA

If you develop diarrhoea, drink plenty of fluids, preferably in the form of an oral rehydration solution such as Dioralyte. If diarrhoea is bloody, persists for more than 72 hours or is accompanied by fever, shaking, chills or severe abdominal pain, seek medical attention.

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ENVIRONMENTAL HAZARDS

Heat Illness

Heat exhaustion occurs following excessive fluid loss with inadequate replacement of fluids and salt. Symptoms include headache, dizziness and tiredness. Dehydration is already happening by the time you feel thirsty – aim to drink sufficient water to produce pale, diluted urine. To treat heat exhaustion drink water and/or fruit juice, and cool the body with cold water and fans.

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Cold Illness

Hypothermia occurs when the body loses heat faster than it can produce it. As ever, proper preparation will reduce the risks of getting it. Even on a hot day in the mountains, the weather