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Here's a quick guide to some key health issues for journalists working abroad. The Fleet Street Clinic is happy to advise if you have a problem that is not covered here, and links to additional resources are listed below. Most people are surprised to discover that the average news industry professional is often worse off, in terms of health protection, than the typical package tourist. The reason is obvious: package tourists have months to plan ahead for that special trip, but journalists covering a breaking news story simply don't have the time. Years of last-minute assignments, and of putting “the story” ahead of personal health preparation and planning, mean that vaccine courses are rarely completed, if they have been initiated at all. The latest advice on malaria, and on prevention and treatment of other travel-related health problems, is seldom sought or updated. The Fleet Street Clinic in London looks after hundreds of working journalists and other news industry professionals from around the world, and this is a common theme. Our approach to this problem is simple: the time for preparation is when you get the job , not when you get the assignment. Here's another basic principle: many of the health risks of travelling and working abroad are preventable, or under a high degree of individual control – so the preventable risks need to be tackled to the fullest extent possible. VACCINES
It takes 4-6 weeks – sometimes longer – to complete a course of vaccination against the major vaccine-preventable diseases. For travel to the yellow fever zones of Africa and South America, a yellow fever certificate takes 10 days from receipt of the vaccine to become effective. So we try to identify people whose work involves the possibility of rapid deployment, and prepare them “offline.” Here are some of the vaccines journalists commonly need: Tetanus/Diphtheria: Risk arises from injury (and with diphtheria, close contact with local people). Needs updating every 10 years. Polio: Still a risk in parts of Africa & Asia, though eradication programmes have been effective. Food/water-borne virus infection. Needs updating every 10 years. Typhoid: Highest risk is in Indian subcontinent, but also wherever hygiene is poor and infrastructure breaks down. Food/water-borne virus infection. Needs updating every 3 years. Hepatitis A: Can cause serious illness – this is the commonest vaccine preventable disease, apart from flu. Food/water-borne virus infection. 2-dose course protects for over 10 years. Hepatitis B: Serious liver infection. Blood-borne virus infection, transmitted via body fluids and contaminated medical instruments. Risk associated with accidents and injuries involving emergency treatment. Needs updating every 5-10 years. Yellow fever: Mosquito-transmitted virus, now becoming more of a problem. Occurs in Africa and South America. Main issue for journalists is Certificate requirement for destinations within YF zones, and for onward travel from the YF zones to other countries. Certificate valid for 10 years, from 10 th day after vaccination. Rabies: Lethal virus infection transmitted via animal bites, licks and scratches. 3-dose course protects for 3 years. Correct treatment following a bite may be extremely difficult to obtain, especially in remote places or where local infrastructure has broken down. Meningitis: Infection transmitted by inhaled droplets, from close personal contact. Major risk is across sub-Saharan Africa, and possibly parts of Asia; also Middle East (Saudi Arabia). Vaccine protects for 3 years. Cholera/ETEC: A new oral vaccine is available for protection from cholera and the main cause of travellers' diarrhoea. Vaccine protects for 2 years. Vaccine strategy We consider it vital to give travellers in the news industry a baseline level of protection, tailored to their likely needs. We also think it's important to ensure continuing protection, with an automated reminder system to warn everyone when there vaccine protection is about to need updating. When there's a new assignment, fine-tuning should be all that's required. MALARIA PROTECTION There have been several recent “near misses” – with journalists narrowly escaping severe illness in parts of the world such as West and Central Africa, and Afghanistan. The global malaria situation changes over time, and so does the latest advice on prevention. It is vital to seek up-to-date advice for every trip. If you have a good relationship with your doctor or travel clinic, this should be possible even at the last minute, over the phone. There is now a wider choice of malarial medication for prevention, treatment, and emergency self-use, appropriate for every situation. In particular, there are good options that can be used even at the last minute prior to departure. A breaking news story should be no excuse for ever missing out on malaria protection. Staff on long term postings are surrounded by – and sometimes influenced by – local people who do not need to take malaria medication. They are especially likely to miss out on expert advice and protection. Every news media employer with staff permanently based or travelling to malarial regions should have a formal, written malaria prevention policy. OTHER HEALTH PRECAUTIONS A spot of travellers' diarrhoea might be a modest inconvenience for the holidaymaker relaxing by the beach; at the wrong moment in a war zone, it could become a distraction of more than trivial proportions. There's no substitute for a detailed briefing on the commonest travel-related health problems, and the best ways of combating them. The variety of issues is vast, from infectious and parasitic diseases to insect bites, animal bites and DVT. You can't be an expert in everything, and many useful precautions come simply from experience. Seminars, formal briefings, books, and individual consultations can be vital aids for delivering and updating knowledge of the latest thinking on prevention and treatment. TRAUMA KITS, MEDICINES AND MEDICAL SUPPLIES Depending on circumstances, you may need a small, lightweight, personal supply of medicines to keep at base; a personal trauma kit, light enough to be carried with you at all times; a large team kit to be carried in a vehicle or kept at base; a reserve stash of supplies to replenish individual kits; and sometimes all of the above. Give careful thought to your exact requirements whilst away. Key supplies include:
The most popular medicines we send abroad turn out to be the kind of things most people keep in their bathroom cabinet: painkillers, antacids, remedies for coughs, colds and flu. Medical kits should include prescription medicines that you can take under appropriate instruction from a doctor: for example, a choice of antibiotics to be used on the basis of telephone advice, depending on your symptoms. Remote medical support is increasingly an option, especially since journalists often have easy access to technology for sending home digital photographs of injuries, lumps, bumps and rashes. POST-ASSIGNMENT CARE AND SUPPORT The medical equivalent of a debriefing session is an important component of ongoing healthcare for working journalists following an assignment abroad, especially if it has been long, risky or stressful. There's an opportunity to screen for infectious diseases that may have been picked up, or to document a clean bill of health; to complete any vaccination courses that may have been started; to discuss problems arising from stress, personal problems, depression or PTSD, in a confidential setting with the possibility of onward referral to experts. USEFUL LINKS Malaria Reference Laboratory, UK:www.malaria-reference.co.uk/
Official UK Guidelines on Malaria prophylaxis for long-term travellers
Official UK Guidelines on malaria prevention in travellers
Centers for Disease Control & Prevention, USA:
World Health Organization:
Fleet Street Clinic, London: |