Sarah Boseley, health correspondent 

Worried sick

All travelling entails risk, but are we spoiling our holidays by overestimating the dangers?
  
  


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 - and usually get slammed by scientists for calling it a 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 holidaymakers abroad: the telephone hotlines, such as NHS Direct, 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 websites 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, as indeed you can on a Mark Warner or Club Med site. 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 in the UK. But before getting anxious and packing half a ton 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 to the highly respected Masta (Medical Advisory Services for Travellers Abroad), believes there is 'overemphasis on certain aspects of risk'.

He cites a study in the World Health Organisation publication International Travel and Health, which found that some 50% 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% will be sick enough to feel that they want to see a doctor. About 5% will at some point be confined to bed. Three in 1,000 will be hospitalised 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 UK travellers most often die of? Malaria? Dysentery? No - cardiovascular disease. They are felled by a heart attack, just as they could have been in the UK. Maybe the stress or excitement of the trip brought it on; possibly they might have stood a slightly better chance of recovery here 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 lager 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,' said Dr Barrett. Masta 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 diarrhoea, how to protect against insect bites and sunburn, and the folly of casual sex in some parts of the world.

Immunisation is important, of course, but not blanket immunisation. 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,' says Dr Barrett. '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, insect repellent and Calpol for the kids, will probably do.

For all you need to know on staying healthy and safe while travelling, visit the Safe Travel 2000 area of Independent Traveller's World at the London Arena, Docklands, January 28-30 and the Assembly Rooms, Edinburgh, February 5-6. There will be talks and demonstrations on everything from purifying water to choosing the best insurance, and on-the-spot vaccinations at the Nomad health clinic. On Saturday January 29, you can 'ask the experts' at a Travel Safety Panel in Talk Room 4. Entry to ITW is pounds 6 and all talks are free on the day, or you can book a place in advance at pounds 5 per talk. Guardian readers can get a special advance discount of pounds 2 by pre-booking on 0800 328 0888 (quoting GUITW), or you can obtain a pounds 1 discount on the day by presenting a copy of this newspaper when buying a ticket. Check out the website at www.itwshow.com

 

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