To properly prepare for medical emergencies in advance of an extended cruise, sailors should consider taking a basic first aid course. Programs typically cover the symptoms and treatment of allergic shock, animal bites, bleeding, burns, concussion, drowning, sprains and fractures, choking, heart attack and cardiopulmonary resuscitation, poisoning and overdose, seizures and shock. Most courses available come with well-illustrated texts that can be kept aboard as valuable resources later on.
Medications Every cruising couple or family setting out on an extended voyage should first analyse their medical history and anticipate the demands on their medical chest so they’ll know to stock up on the necessary items wherever they’re available. You can also consult your local travel clinic as well as physician before leaving to obtain prescription medication, but don't go overboard in stocking up for every conceivable eventuality. Not only are medications expensive, they generally have an expiration date. Although it is wise to carry antihistamines and antibiotics, specific medications can be purchased locally when needed and often cost considerably less in developing countries.
We recommend that you carry a variety of medical books, oriented both for general family health and travel. It is in the tropics that you will most likely have problems. It's worth taking time when choosing these resources to ensure that they address your particular destination and lifestyle. Also find out about any radio resources that offer emergency medical advice.
Immunizations When you travel outside Western and Central Europe, the US, Canada, Australia, New Zealand, and Japan, certain immunizations may be needed. As several diseases are on the rise it is important to have current information. Obtaining this and the necessary vaccinations can require careful advance planning. Fortunately, due to the dramatic increase in travel, especially adventure holidays, travel clinics are now common in the major cities in most first world countries. Visit a clinic at least six weeks before you leave for infected areas. Updates and advice on immunizations and high-risk areas for malaria are provided by organizations such as the World Health Organization and IAMAT (International Association for Medical Assistance to Travellers 716 754-4883). In addition IAMAT has listings of English-speaking doctors and health institutions worldwide.
|"Don't be in too much of a rush to go cruising after you have immunizations in case you have an allergic or adverse reaction."|
For worldwide cruising, you’ll also want to make sure you have prepared for diseases transmitted through food and water such as:
Hepatitis A (also called infectious Hepatitis)—This is a viral infection of the liver which is found worldwide, and it can be transmitted in food and drink or by ingesting contaminated water during swimming. Vaccines come in a two-dose series, 100 percent one-year coverage with the first. A second, one year later, boosts protection for 20 years. (See note after Hepatitis B for vaccination for both A and B.)
Cholera—This is an acute intestinal infection caused by bacterium transported in contaminated food or water. Although the risk is low, check where cases have been reported (e.g. Africa, Central and South America, SE Asia and India). Vaccine now gives good immunity for six months, injection or oral capsule. Also be cautious about swimming in freshwater. In most tropical regions there is a risk of Bilharzia (schistosomiasis), with an estimated 80 percent of cases in Africa. This infection is acquired through a parasite that may enter the skin during contact in slow-moving freshwater.
Of course there are some insect-borne diseases that sailors need to be wary of. Avoiding insect bites by wearing long-sleeved clothing, staying inside when mosquitoes are biting (generally dawn, dusk or evening), and using repellent are the best initial defences. Also, having screens fitted on all ports and hatches works.
Yellow fever—This is viral infection of the liver and other tissues transmitted by mosquitoes in the tropical areas of Africa and South America. One injection protects you almost 100 percent for 10 years.
|"Malaria is found in virtually all tropical countries. Unfortunately, there's no vaccine is available to prevent it."|
Of course there are other diseases that cruising sailors need to be aware of. These include:
Hepatitis B—An infection of the liver caused by a virus, which ranges from mild to life threatening. It is spread through poor personal hygiene and exposure to contaminated blood, through poorly sterilized medical equipment, sharing needles including tattoo, ear piercing or acupuncture needles, having a blood transfusion (particularly in a tropical country) and sexual activity. The vaccine gives 90% protection and is generally given in three injections over 6 months. Immunity lasts from three to five years. (In many places it is now cheaper to have the Twinrix vaccine for both Hepatitis A and B than either of the vaccines for A or B on their own. Requires a three-series injection over 12 months)
Rabies—This is an acute viral infection of the nervous system spread through the bite of an infected animal and it is usually fatal if not treated promptly. It is more common in tropical countries. Avoid contact with animals and do not feed or pet cats, dogs or monkeys. Given as a course, protection lasts for tow to three years.
As we travelled the world, it was rare that there weren't adequate medical facilities in the most populated centers we visited. The buildings may not have been in good repair, with paint peeling off the walls, but the medical care was generally excellent. Many developing countries have good medical schools. They also send students for training overseas and receive supplies and personnel from Europe and North America.
You’ll also want to know the following things about your policy:
For those sailors cruising for shorter periods, cheaper rates may be obtained buying regular travel insurance sold at travel agencies, automobile associations, or through the bank or your credit card company. Be aware that when using regular travel insurance that there is often a strict vacation time limit and that the company's policy is generally to ship people home as quickly as possible, so that they will be covered by their home-based plan.
Besides having details of your insurance on the boat, give copies to your business manager or family member back home. And always get a detailed invoice from the doctor or hospital. Trying to get copies of the paperwork after you have left, particularly if in a different language, can be frustrating.
In all of our travels we have not found taking medical precautions a burden, but we do have some interesting anecdotes to tell. We first took malaria pills in Venezuela. While Andy and I took our quinine in sundowner gin and tonics, I gave the quinine to the children in strawberry jam. They have never eaten strawberry jam again! It wasn't until the Indian Ocean that we had to have immunizations against yellow fever, Hepatitis A, typhoid, and cholera. Those of you who have read Still Cruising may remember our son Colin's reticence about having his shots after watching 30 boat loads of adults coming out of a clinic in Darwin moaning in pain!
Just the Basics
Here are three examples of insurance companies that offer overseas medical coverage:
SailNet Store Section: First Aid and Medical Supplies
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