Health Information Sheets
Travel to areas of disasters and conflicts
Natural disasters, such as earthquakes, floods and tsunamis present significant challenges for travellers to affected regions. Many areas of the world also experience civil war or conflict, placing travellers and aid workers at risk of injury or violence.
Check the Foreign and Commonwealth Office (FCO) website for current security advice about your destination before you go. This will help you assess the safety of your plans and ensures you are aware of any travel restrictions and specific security issues. If you are travelling to disaster/conflict regions for work, ask your employer about safety and security advice, if they haven't provided it as part of your pre-travel briefing. You can also look at NaTHNaC's Country Information Pages for specific advice about vaccines, malaria prevention disease outbreaks.
Poor living conditions, damaged sewers, flooding and contaminated drinking water all increase your risk of diarrhoea and stomach upsets. Good personal hygiene, including frequent hand-washing, is essential.
Bottled water may not be available, so you must be able to purify water. Bringing water to a boil is the most reliable way of making water safe to drink, but this is not always practical. Chemical water purification tablets can protect against bacteria and viruses, but may not kill parasites like cryptosporidium and giardia. Combining chemical treatment with a water filter offers good protection against bacteria, viruses and parasites.
Take a supply of diarrhoea treatments, including oral rehydration powders (e.g. Dioralyte®) and a drug like loperamide, which can be taken for short periods to control symptoms. You can also ask your doctor to prescribe a short course of antibiotics (azithromycin or ciprofloxacin) as an emergency treatment for diarrhoea. However, if you have blood in your stools and/or a fever or your symptoms do not improve after a day of antibiotics, you must try to get medical help straight away.
Floods and stagnant water attract insects and can increase your risk of insect spread diseases like dengue fever, japanese encephalitis, leishmaniasis and malaria . You should follow insect bite avoidance advice carefully.
Snakes may have been disturbed after natural disasters and can be a particular hazard during floods. Try to avoid any contact and if you are bitten, get urgent medical attention.
See your GP, practice nurse or travel clinic as soon as you know you are travelling. You may need malaria tablets and vaccines - even last minute advice is valuable.
If malaria is a risk, it is essential you get the right tablets for your destination. Specific advice on malaria risk regions is available from NaTHNaC’s Country Information Pages. Remember the ABCD of malaria prevention - as no malaria tablet gives 100% protection.
If you have any malaria symptoms, such as fever and/or flu-like illness, either while away, or for up to a year after you return, get urgent medical help and tell your doctor that you have been to a malarial region.
Cholera, hepatitis A and typhoid - are spread by contaminated food and water. Vaccination is recommended for travellers to risk regions, especially those with limited access to safe water and whose activities put them at higher risk of exposure. Good food and water hygiene recommendations should always be followed, even if you have received these vaccines.
Hepatitis B is spread by direct contact with infected blood or body fluids. This could happen during emergency medical treatment, unprotected sex or through your work if you have contact with blood and body fluids. There is a safe, effective vaccine available to protect against Hepatitis B.
Tetanus bacteria is found in soil worldwide. Your risk increases during emergencies, as you are more likely to get a wound contaminated with dirt. A tetanus vaccine is recommended if you have not received one in the past 10 years. In the UK, when an adult needs a tetanus booster, a single injection combining tetanus, diphtheria and polio vaccines is given.
Rabies - there are likely to be large numbers of stray animals, especially dogs, in the aftermath of any disaster or during a conflict. This increases your risk of rabies - a fatal disease with no treatment. Emergency rabies vaccine products are often in short supply or completely unavailable, so consider having a rabies vaccine course before you go.
If an animal bites or scratches you, or licks a cut or any open skin, you must immediately wash the wound or exposed area thoroughly with soap and lots of water, apply disinfectant and get urgent medical attention, even if you have had the full pre-travel vaccine course.
Your risk of injury is high after a natural disaster. Dangers include: electrocution from broken power lines, injuries related to building damage, and accidents due to poor road surfaces.
Dust, toxic chemicals and dangerous waste can be released during disasters. Follow advice carefully and wear personal protective equipment, if necessary.
Living accommodation may be poor. Dangerously low body temperature (hypothermia) can be a hazard if you are sleeping outside. Hospitals and clinics may be damaged and there is likely to be a shortage of drugs, dressings and equipment. You should always carry a personal first aid kit, including basic medical items. Remember, toiletries are usually hard or impossible to obtain.
Be careful if you have to wade in flood waters. As well as risking drowning, cuts and grazes can get infected with bacteria in contaminated water. You should also be aware of the risk of leptospirosis in any water contaminated with animal urine. Wear protective clothing if you are in direct contact with animals, sewage or water. If you think you are likely to be exposed to leptospirosis, ask your doctor about taking antibiotics for protection.
Strong sunlight and high temperatures can cause heat exhaustion and sunburn. Drink plenty of non-alcoholic liquids, avoid direct sunlight as much as possible and take a supply of high factor sun screen.
Visiting an area after a natural disaster or humanitarian crisis, with the potential loss of many lives, involves facing very difficult situations. Witnessing suffering can generate feelings of anger and helplessness that may trigger mental health issues. These can include anxiety, depression and adjustment difficulties after returning home.
The physical dangers associated with dealing with dead bodies, such as the risk of infection, are low. However, it can be difficult to prepare adequately for the emotional and psychological impact. Many aid organisations offer psychological support, including pre-trip screening and post-trip debriefing.
If you want to help after an emergency, contact the appropriate aid agencies or charities for advice. If you are travelling with an aid organisation, check that they provide adequate medical assistance and insurance before you leave.
Going to a disaster area on your own, without proper support and training is dangerous and could put a strain on already overwhelmed local emergency and medical services. Unless you have the relevant skills and experience, the best way to help is to stay at home and become involved in supporting the relief efforts.
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