By Dr Eddy Bajrovic*
These days, finding uncrowded breaks in overseas destinations like Indonesia, the Maldives, Mexico or the Pacific islands means exploring ever more remote locations.
Unless you can afford a five-star option, that often means living like the locals with very basic sanitation and dodging disease-carrying insects far from reliable medical help.
Illness or injury can not only put an end to your surfing odyssey, but may mean not-always-safe local medical treatment, or very costly evacuation and repatriation, followed by weeks – or months – out of the water.
Keeping the dream afloat means getting yourself and your kit prepared well before departure.
Before you go, get your shots
For typical short stays in a developing region it’s advisable to get a few vaccinations: some routine boosters, plus some recommended for developing countries where sanitation and hygiene may be wanting. Routine childhood vaccinations such as measles, mumps, rubella (MMR), polio, and tetanus should be renewed, if necessary. Vaccination for food and water-borne diseases such as hepatitis A and typhoid are typically recommended for travel to developing regions. Typically, high rates of these common food and water-borne diseases are present among the local population in developing countries and they’re easily passed on through contaminated food and water. Vaccination for hepatitis B, which is transmitted via blood and body fluids, is highly recommended for young adults, although most under the age of 30 will have undergone vaccination as infants or in school. It is especially important if a coral cut or injury required stitching at a local medical facility. (If you need a shot or stitch get the doctor or nurse to use the equipment in your first-aid kit – more on this important item later.) Rabies vaccination is generally not recommended for short stays, but it is important that you avoid contact with dogs, monkeys or other small mammals including bats. Vaccinated or not, seek urgent medical help if you get bitten. If you are planning to stay for months rather than a couple of weeks, rabies vaccination will almost certainly be recommended. Left untreated, rabies is always fatal once symptoms appear.
Even a few last-minute vaccinations will provide basic protection – it’s better than doing nothing!
Get travel insurance
Not just for luggage or lost or damaged boards. You’ll be surfing in places you are not used to and as experienced as you might be, accidents can happen in and out of the water. If you get a serious injury or illness and need medical attention, it’s not likely to be available locally and that might mean medical evacuation, which can be very costly.
Pack a surfers’ first-aid kit
You’ll be surprised how often you use it. Get one that can deal with a range of problems and is equipped with waterproof coverings and bandages for the (inevitable) cuts from coral and rocks. Include first-aid cream and a broad-spectrum antibiotic, especially if you’ll be off the beaten track. If you get seasick, take some medication like dramamine or kwells for longer boat rides to breaks. Travelvax has supplementary packs for surfers to add to first-aid kits.
Beware of dodgy food or water
Contaminated food and beverages are often the biggest health risk in developing countries. At the milder end of the scale and usually short-lived is traveller’s diarrhoea (TD). At least half the people visiting a developing country for two weeks will experience TD (aka Bali Belly, Montezuma’s Revenge – every country has a different name for it!).
Hepatitis A, typhoid are also common in developing countries – especially in more remote communities off the beaten track. Medication to treat TD should be part of your first-aid kit – talk to your travel doctor about what’s right for the region you’re visiting. Remember, rule number one: NEVER trust the local water without first boiling it or treating it. Even if the water is relatively safe for the locals, it may contain bacteria and organisms that could make you very sick. With food, go for food that’s well cooked and avoid dairy, and raw or leafy salads or vegetables. Check out the dos and don’ts of food and beverages.
Foreign mozzies pack a punch
In the tropics, mosquitoes can carry diseases like malaria, Japanese encephalitis, dengue, chikungunya, and Zika. If you’re lucky enough to be staying in an up-market resort with air-conditioned rooms and pristine bed nets, or on a surf yacht more than a kilometre offshore, malaria will not be as much of a risk as if you stay in a beach hut or camp.
If there is a significant risk of malaria you’ll be advised to take preventative medication and this is something you need to get expert medical advice on. First up, call Travelvax’s travel health advice line (1300 360 164) to make an appointment at your nearest Travelvax clinic. We’ll work out (a) if there is a risk and (b) if you need to take the pills and (c) if so, which anti-malaria medication is right for you. There’s an effective vaccine for Japanese encephalitis (although it is relatively rare in travellers) but minimising bites is the only way to avoid the far more common dengue, chikungunya and Zika, which are all found extensively in urban areas throughout the tropical world.
The danger times are dusk and dawn
The malaria-carrying Anopheles mosquitoes are night feeders and are active from dusk till dawn. However, the banded Aedes species that spread dengue, chikungunya and Zika, mainly bite during the day (but may also feed at night in brightly lit areas). They are urban critters and breed in and around huts and gardens – basically anywhere people live – which makes getting bitten very hard to avoid because humans are at the top of their menu.
The Travelvax web site has lots of advice on protecting yourself against mosquitoes.
We advise taking along a knockdown spray as well as a bed net treated with a contact insecticide like permethrin – especially if you’re staying outdoors or in budget accommodation. You can get a pre-treated net or buy a DIY solution and use a second one to treat your clothing, too. Everything helps.
Most important, take a few tubes of a personal insect repellent that contains a long-lasting active ingredient such as DEET (30-40%), Picaridin, IR3535, or oil of lemon eucalyptus. It should be applied to all exposed skin when you’re outdoors. Remember, it will wash off in the water, so get into the habit of whacking it on after each surf.
• Don’t forget plenty of sunscreen: the sun’s a lot stronger in the tropics.
• If you are prone to seasickness, pack dramamine or kwells in your first-aid kit.
• Don’t surf near sewage outlets and creek entrances – that’s asking for trouble.
• Pack plenty of wax and condoms (the only thing you want to catch are the waves!).
* Dr Bajrovic is the Medical Director of Travelvax Australia.
For more advice and information go to Travelvax.com.au or call our free travel health hotline on 1300 360 164.