Middle East - Anthony Ham [559]
oral-rehydration salts
pocket knife
scissors, safety pins, tweezers
steroid cream or cortisone (for allergic rashes)
sunscreen
syringes and sterile needles (if travelling to remote areas)
thermometer
INTERNET RESOURCES
There is a wealth of travel health advice on the internet. For further information, lonelyplanet.com is a good place to start. The WHO (www.who.int/ith/en) publishes a good book, International Travel and Health, which is revised annually and available online at no cost. Another website of general interest is MD Travel Health (www.mdtravelhealth.com), which provides complete travel health recommendations for every country, updated daily, also at no cost. The website of the Centers for Disease Control & Prevention (www.cdc.gov) is a very useful source of traveller health information.
FURTHER READING
Recommended references include Traveller’s Health by Dr Richard Dawood (Oxford University Press), International Travel Health Guide by Stuart R Rose, MD (Travel Medicine Inc), and The Travellers’ Good Health Guide by Ted Lankester (Sheldon Press), an especially useful health guide for volunteers and long-term expatriates working in the Middle East.
IN TRANSIT
Deep Vein Thrombosis (DVT)
Deep vein thrombosis occurs when blood clots form in the legs during plane flights, chiefly due to prolonged immobility. The longer the flight, the greater the risk. Most blood clots are reabsorbed uneventfully, but some may break off and travel through the blood vessels to the lungs, where they may cause life-threatening complications.
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 help prevent the development of DVT on long flights you should walk about the cabin, perform isometric compressions of the leg muscles (ie contract the leg muscles while sitting), drink plenty of fluids, and avoid alcohol and tobacco.
JET LAG & MOTION SICKNESS
Jet lag is common when crossing more than five time zones, and results in insomnia, fatigue, malaise or nausea. To avoid jet lag try drinking plenty of fluids (nonalcoholic) and eating light meals. Upon arrival, seek 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. Their main side-effect is drowsiness. A herbal alternative is ginger, which works like a charm for some people.
IN THE MIDDLE EAST
AVAILABILITY & COST OF HEALTH CARE
The health care systems in the Middle East are varied. Medical care can be excellent in Israel, with well-trained doctors and nurses, but can be patchier elsewhere. Reciprocal health arrangements with countries rarely exist and you should be prepared to pay for all medical and dental treatment.
Medical care is not always readily available outside major cities. Medicine, and even sterile dressings or intravenous fluids, may need to be bought from a local pharmacy. Nursing care may be limited or rudimentary as this is something families and friends are expected to provide. The travel assistance provided by your insurance may be able to locate the nearest source of medical help, otherwise ask at your hotel. In an emergency, contact your embassy or consulate. Also see Medical Services in the Information section of the capital city in each country chapter.
Standards of dental care are variable and there is an increased risk of hepatitis B and HIV transmission via poorly sterilised equipment. Keep in mind that your travel insurance will not usually cover you for anything other than emergency dental treatment.
For minor illnesses such as diarrhoea, pharmacists can often provide valuable advice and sell over-the-counter medication. They can also advise when more specialised help is needed.
INFECTIOUS DISEASES
Diphtheria