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Many travellers needlessly overmedicated Add to ...

It is the sorry lot of a health correspondent to bear tidings of misery, death and disaster most of the time. True, we tell of the occasional miracle breakthrough but the greater part of our days is spent alerting the world to ominous increases in infectious diseases and unpleasant new viruses.

So perhaps it is our fault. Maybe we are responsible for the rise of the anxious-traveller syndrome and the whole new industry that has built up on the back of the health worries of travellers abroad: the telephone hotlines to comforting, English-speaking nurses who will tell you whether to take an aspirin or find a doctor, pronto; the soaring sales of totally unnecessary anti-snake serum and dubious herbal remedies; the obsession with security; the proliferation of Web sites listing all the things that could go wrong.

Now, I used to think -- and still want to think -- that travel is fun. Part of the attraction is the unknown, which inevitably means risk. The only real way to be rid of the risk is to cocoon yourself in a cultural enclave. But the real abroad -- with its different food, interesting hygiene and varying road safety standards -- is not, fundamentally, safe.

I would not for a minute advocate that you should always leave your malaria tablets at home, and a basic first-aid kit is obviously sensible even for holidays near where you live. But before getting anxious and packing half a tonne of remedies and potions and spending your entire holiday boiling water, it is worth looking at the real risks.

Dr. Peter Barrett, senior medical adviser in London to the highly respected Medical Advisory Services for Travellers Abroad, believes there is "over-emphasis on certain aspects of risk."

He cites a study in the World Health Organization publication International Travel and Health, which found that some 50 per cent of travellers staying for a month in the developing world are likely to suffer from something, which could range from a common cold to a fatal car crash. But only about 8 per cent will be sick enough to feel that they want to see a doctor. About 5 per cent will at some point be confined to bed. Three in 1,000 will be hospitalized during or after their trip, and one in 2,000 will have to be air-evacuated. One in 100,000 is likely to die.

But what do travellers mostly die of? Malaria? Dysentery? No -- cardiovascular disease. They are felled by a heart attack, just as they could have been at home. Maybe the stress or excitement of the trip brought it on; possibly they might have stood a slightly better chance of recovery at home. But, nonetheless, the chief cause of death is pre-existing ill health, not some vicious disease picked up abroad.

The next highest cause of mortality is accidents. Those who die are likely to be doing something reckless, but not necessarily taking risks with other cultures. They are much less likely to be stabbed in a street fight than to drown in the hotel swimming pool with a bellyful of beer in the early hours. Or they will be racing round an island's gravel roads on a substandard motorbike without a helmet.

We don't read about stories like these because they occur too often. Instead, we hear of the young man torn to pieces by lions on safari, because he left his tent flap open, or the young woman climber who died of altitude sickness.

In fact, information about the place you are going to is far more likely to keep you in good health than a suitcase of medicines.

"It is at least as important to give sound advice to people as stick needles in them," Barrett said. His organization runs the British Airways travel clinics, whose staff try to make sure people understand the basic precautions needed -- what to eat and drink to avoid getting traveller's diarrhea, how to protect against insect bites and sunburn, and the folly of casual sex in some parts of the world.

Immunization is important, of course, but not blanket immunization. You can still come across ancient, out-of-date charts recommending malaria prophylaxis for Thailand. "Yes, there is malaria, but the risk to travellers is practically non-existent," Barrett says. "Given that some people react badly to one anti-malarial drug, it is not sensible to hand tablets out when they are not needed."

All right, if you are genuinely going on an expedition to the back of beyond, living rough and eating whatever you can find, it may be worth taking specialist advice and packing the antibiotics -- if you know how to use them. For the rest of us, the more ordinary things in life, such as plasters, bandages, aspirins and insect repellent will probably do.

 

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