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Risk Management

This advice was
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MDAV

The risks of leaving your comfort zone

Some of us choose a holiday that involves lying on the beach while some of us choose to do voluntary work in a developing country.

Equally you could do a short-term elective in a city-based hospital or broaden your experiences by going to a place that is not even listed in a trendy travel guide.

Take your preference. Whatever you do will have inherent risks because every day living can be risky, especially for a medical practitioner. But leaving behind your comfortable home, job, family and friends for the unknown (or lesser known!) can be easier with a bit of advice from those who have been there before you.

Basically the risks can be broken down into:

The basic rules for personal and physical risks

  1. Talk to friends and colleagues who have undertaken similar work or have been to this country or similar countries before you.
  2. Make sure you are fit and healthy.
  3. Get your teeth checked.
  4. Get advice from your own GP or travel medicine doctor about vaccinations and medication as soon as you have made the decision to travel.
  5. Use commonsense with food and water.
  6. Research and read as much as you can about the places you are going to.
  7. Check the local weather conditions for the time you will be there and prepare for the worst!
  8. Take appropriate clothes, toiletries and plenty of your preferred form of entertainment - books, radio, personal music system, notebooks and drawing equipment.
  9. Take a personal first aid kit (suggested range):
    • Personal prescription medications (copies of all prescriptions, including the generic names for medications, and a note from the prescribing physician on letterhead stationary for controlled substances and injectable medications should be carried)
    • Antimalarial medications, if applicable
    • Antidiarrheal medication
    • Antibiotic for self-treatment of moderate to severe diarrhea
    • Antihistamine
    • Decongestant, alone or in combination with antihistamine
    • Anti-motion sickness medication
    • Medication for pain or fever
    • Mild laxative
    • Cough suppressant/expectorant
    • Throat lozenges
    • Antacid
    • Antifungal and antibacterial ointments or creams
    • 1% hydrocortisone cream
    • Epinephrine auto-injector especially if history of severe allergic reaction. Also available in smaller-dose package for children.
    Other Important Items
    • Insect repellent containing DEET (up to 50%)
    • Sunscreen (preferably SPF 15 or greater)
    • Sunburn cream
    • Digital thermometer
    • Oral rehydration solution packets
    • Basic first-aid items (adhesive bandages, gauze, ace wrap, antiseptic, tweezers, scissors, and cotton-tipped applicators)
    • Antibacterial hand wipes or alcohol-based hand sanitizer
    • Moleskin for blisters
    • Lubricating eye drops
    Other items that may be useful in certain circumstances
    • Mild sedative or other sleep aid
    • Anti-anxiety medication
    • High-altitude preventive medication
    • Water purification tablets
    • Commercial suture/syringe kits
    • Latex condoms
  10. Travel guides and websites are a good source of general information, but will not tell you the specific information you might need as a medical practitioner!
  11. Be aware of the electricity situation, what type of adaptors are required and take plenty of batteries
  12. Australian Volunteers International, AusAID and other organisations are generous with their training, advice and information.
  13. Research websites such as CDC Traveler's Health

Clinical and legal risks:

  1. Talk to your MDO in the planning stages. Ask if they have any experience in that country. Can they give you any specific advise or refer you to an a clinician who has?
  2. Keep up to date with your medical indemnity requirements http://www.mdav.org/content
  3. Keep up to date on clinical risk management information, education and support at http://www.mdav.org/clinicalrisk
  4. Ensure that you are covered for volunteer work and for working overseas in the country/ies you are planning to work in (http://www.mdav.org)
  5. Don't be scared, by the risk of litigation, from being a Good Samaritan but check your Good Samaritan cover to make sure it is available worldwide. See MDAV's Good Samaritan & Gratuitous
    Services Policy
  6. Research and keep up to date the current political situation in your country and surrounding countries. (DFAT and www.smartraveller.gov.au/)
  7. Be culturally sensitive and aware of local practices and customs
  8. Are there cultural issues and sensitivities you need to be aware of?
  9. Are people happy to receive medical assistance from a person of the opposite sex?

The Top 10 Travel Tips from the Australian Government

From www.smartraveller.gov.au/

  1. Check the latest travel advice for your destination and subscribe to receive instant e-mail notification each time the travel advice for your destination is updated.
  2. Take out appropriate travel insurance to cover hospital treatment, medical evacuation and any activities, including adventure sports, in which you plan to participate.
  3. Before travelling overseas register your details online or, when overseas, register in-person at any Australian embassy, high commission or consulate.
  4. Check to see if you require visas for the country or countries you are visiting or transiting. Be aware that a visa does not guarantee entry.
  5. Make copies of your passport details, insurance policy, travellers cheques, visas and credit card numbers. Carry one copy in a separate place to the originals and leave a copy with someone at home.
  6. Check with health professionals for information on recommended vaccinations or other precautions and find out about overseas laws on travelling with medicines.
  7. Make sure your passport has at least six months validity and carry additional copies of your passport photo with you in case you need a replacement passport while overseas.
  8. Leave a copy of your travel itinerary with someone at home and keep in regular contact with friends and relatives while overseas.
  9. Before departing Australia check whether you are regarded as a national of the country you intend to visit. Research whether holding dual nationality has any implications for your travel.
  10. Obey the law. Consular assistance cannot override local laws, even where local laws appear harsh or unjust by Australian standards.