Estimating the risk of illness for international travel depends on how and where you travel. Are you staying in the Hilton Hotel or are you the adventurous backpacker staying in the villages with the locals? Are you going to be a long term resident living in air-conditioned housing or a Peace Corps volunteer? You should understand the hazards of international travel and find a doctor who is willing to spend the time providing you with information on how to treat medical problems that might occur during your journey. Remember, you want to experience the charms of a country, not its medical facilities.

Prior to departure, visit your doctor to determine if any limitations apply to your travel overseas. Arrange for any prescriptions or staff-assisted medications you will require. Bring a doctor's statement with you describing your medical problem, a generic prescription for drugs you may require for its treatment, and a very clear explanation about any drugs or medical paraphernalia that you are carrying with you. Bring copies of any relevant records: X-rays, EKG's etc. If you have a health condition which requires routine attention, prepare to deal with the condition overseas. The Health Guide for International Travel (Passport Books) suggests the following steps:

Ask your doctor which vaccinations are necessary prior to departure to your destination. Are there particular health problems? Phone the U.S. State Department Overseas Citizen Emergency Center http://travel.state.gov/travel/tips/emergencies/emergencies_1187.html at (888) 407-4747 between 8:15 am and 10 PM. EST on weekdays for information on current health conditions worldwide. The Center for Disease Control and Prevention (www.cdc.gov) provides up to date information on immunizations, current health risks, travel advisories, and embassy information for any country. The phone number is (404) 639-3311.

The Centers for Disease and Control publishes "Health Information for International Travelers", a yearly update on health vaccinations and other health issues (Washington, DC 20402, (877) FYI-TRIP) www.cdc.gov/travel/yby/8b/.

Everyone's body reacts differently to new foods and eating habits, as well as to new environments. Some people gain weight, others lose it. Some get a little sick from trying new foods, others can eat anything and not get sick. It may take a few weeks for your body to adjust to the new ingredients you will be eating. But don't let your fears get in the way of tasting new foods; that is half the fun of learning the new culture. Pepto Bismol or other medications usually do the trick when you are sick. You may want to take your favorite over-the-counter medicines (i.e. aspirin, Tums, etc.) for the first few weeks until you are comfortable with the surroundings and language. If you are ill the first few days, it may be too stressful to try to find the items you need while attempting to negotiate your way in a new country.

Inoculations
Some vaccinations may be required to enter certain countries. Other vaccinations may not be required, but suggested. Check with your local county health department and/or your family physician for suggested and required vaccinations to enter countries where you may be traveling. Visit the Inoculations and Malaria Prevention page for further details.

Medications
If you are currently taking medication, be sure to take enough for the duration of your stay. You may not be able to find the same medication overseas. For customs purposes, it is advisable to leave all prescriptions in their original labeled containers. Also, keep an original copy of the doctor's prescription with your passport. These measures should assist your processing through customs and insure that you won't break any laws of the country you are entering. If the medication you are taking contains narcotic substances, you may want to consult the consulate of the country where you will be studying to see if it's legal.

English-speaking doctors
Learn how to find a doctor overseas. If you are with a program, your director should be able to tell you who is reliable. If you are traveling by yourself, you might contact a Western-style hotel to ask which doctor they refer their guests to. You might go to a University Hospital, or contact a U.S. consulate for a list of doctors. IAMAT, the International Association for Medical Assistance to Travelers (417 Center St. Lewiston, NY 14092, phone (716)754-4883) - www.iamat.org, provides a list of English-speaking doctors all over the world. There is no fee, but donations to this non-profit worldwide organization are welcomed.
Write to:
AMAT
417 Center Street
Lewistown, NY 14092
(716) 754-4883

Prevention of sexually transmitted diseases
Students studying abroad should be aware of condom quality, HIV antibody testing, clean blood supplies, sterile needles, and medical facilities in the target country. Each of these topics is address below:

• Condom caution
  Condoms can be difficult to acquire in parts of the world. In addition, the ones you do find may be of lesser quality than you are accustomed. Take responsibility for yourself. The best prevention is abstinence. However, you may want to bring condoms with you, even if you are not planning on being sexually active while abroad.
  
• HIV Antibody testing requirements
  Some countries screen incoming travelers (especially those on extended visits and students) and prohibit entry of those with AIDS and those who have tested positive with HIV. Any country may reserve the right to require HIV testing from any visitor. Make sure you are aware of each country's policy to which you will be traveling. This information is available from the consular officers of individual countries or by calling 202-647-1488, which is the U.S. State Dept. Office of Public Affairs.
  
• Clean Blood Supplies and Sterile Needles
  In the U.S., Australia, Canada, Japan and Western European countries, the risk of infection with HIV through a blood transfusion is greatly reduced through mandatory testing of all donated blood for the presence of antibodies to HIV. In some countries, especially less-developed nations, there may not be a formal program for testing blood or biological products for antibodies to HIV. See the above mentioned website for how to deal with this situation. Diabetics and other persons who require routine or frequent injections should carry their own supply of syringes and needles sufficient to last their entire stay
• If You Think You May Have Been Infected With HIV
  Knowing your status will help you in planning your trip. While pre- and post -counseling are required for persons being tested in the U.S., this is not true of many countries. Therefore, you may consider being tested before leaving the country. Special medical facilities may be needed and this is information you should seek out before you begin the program. Your program director can help you locate the medical facilities you need. Free, confidential testing is available at the Allegheny County Health Center on Forbes Avenue. The Student Health Center here at Pitt also performs HIV/AIDS testing and counseling as part of your Student Health Fee.
• Additional Resources
  In addition to those already mentioned, the following hotlines are valuable sources of more detailed information: U.S. Department of Health and Human Services - (877) 696-6775 - www.os.dhhs.gov
  Center for Disease Control National AIDS Information - (800) 342-AIDS - www.cdc.gov/travel/index.htm
  

Additional tips for staying healthy

• Moderation is the key. Don't wear yourself out by trying to do too much at once.
• Sicknesses occur more frequently when you are tired and worn down.
• Eat well-balanced meals.
• Watch what you eat. If you are wary of the quality of the food and drink, make sure everything you eat is thoroughly cooked or boiled to kill any bacteria.
• Take measures to reduce the risk of STDs (sexually transmitted diseases).
• If you drink, consume alcolhol in moderation. Intoxication can lead to unsafe and potentially deadly situations.
• Be informed! Know where to get treatment. When you settle in, find out where health care facilities are located. Check with your on-site program director for the name of a doctor and hospital.
• Depending on the region, you may need water purification tablets, salt tablets and/or insect repellent.
• Women may want to pack feminine hygiene products if they are not sure of the type available where they are traveling, though familiar products are available in most foreign countries.
• It is advised that you take your own syringes if you require regular injections
• If you have a special medical condition, it is a good idea to buy a medical alert bracelet
• If you use any kind of specific, over-the-counter medications, ointments, acne cures, etc. (that you cannot live without), take enough to last your entire trip.

Pre-departure checklist of health-related items

Robert Kohls in his book Survival Kit for Overseas Living (International Press) recommends the following predeparture checklist:

• Make an appointment to see your doctor at least three months ahead of departure for a physical and required immunizations.
• Find out from your Public Health Service if gamma globulin shots, a preventative measure against hepatitis, are recommended for the country of region where you plan to travel. (www.achd.net/)
• Request copies of medical records that would be important to the treatment of problems you might encounter overseas: X-rays, a record of your blood type, prescriptions written in a generic form, dental records, and a letter describing any special health problems.
• Remember that U.S. prescriptions cannot be honored overseas. Take additional prescribed drugs with you and be sure that you have a doctor's letter with you describing, in generic terms, what these drugs are and how they are used. Sometimes, prescription drugs in the U.S. can be bought over the counter in other countries. Beware, however, of buying potent drugs over the counter. Always ask careful questions about what you're purchasing.
• Bring eyeglasses prescriptions and an extra pair of glasses or contact lenses. If you are using an electric cleaner for your contact lenses, make sure that you have the appropriate transformers or find other methods of cleaning. Bring extra dentures too, if you wear them.
  
• Bring a medical kit. Standard items, which may be useful abroad, include adhesive tape, cotton swabs, gauze, Band-Aids, sterile cleaners and anti-bacterial ointment. Depending upon the country, it might be useful to have water purification tablets, salt tablets, skin lotion and moisturizer, insect repellent, antihistamines and painkillers.
  
  

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