Healthy Travel

in the South Pacific...

Travelling exposes you to health risks that you would not encounter if you had stayed at home. Many of these risks are avoidable with the right advice and preparation. This page will attempt to prepare you for your family holiday in the South Pacific. Of course all the preparation in the world may not stop you from getting sick. When (or if) this happens you need to know what you can do lessen the impact or even better, avoid getting sick in the first place.

While this page is not a substitute for professional medical health advice, it is designed to give you enough information to decide what steps you need to take to have a healthy and enjoyable holiday.



Before You Go

Wherever you are travelling in the world with your family you need to cover off on a few health issues before you go. There are 4 main things you need to take care of. (1) find out what immunisations you need. (2) Take malaria prevention if required. (3) make sure you have health insurance and (4) pack a medical kit.

For your immunisation requirements the best place to start is your family doctor who can advise you on what is required. There are some very good sites available on the Internet which publish information on what vaccinations are required for each country. Make sure you are up to date with your regular immunisations and extra immunisations for Hepatitis A & B, Typhoid, Japanese Encephalitis, Tuberculosis and Cholera. A lot is dependant on the length of your stay and the countries you are visiting.

Malaria is a serious health issue and potentially fatal disease that you need to take precautions against. Popular destinations with Malaria close to Australia include The Solomon Islands, Papua New Guinea, Vanuatu, Indonesia (not Bali or Ubud) and Thailand (rare in the main tourist spots). Visit your doctor at least a month before you plan to travel and he will decide which treatment is best for you. Take some time to read up on the disease, the symptoms and what you can do to avoid being bitten by the mosquitoes that carry the disease.

Health insurance is an important thing to remember when you are travelling. Check that your travel insurance includes a health component otherwise take out some separate health insurance.

And finally you need to pack a medical kit. These lists will cover off on most of the basic requirements. Remember to pack medicines that are suitable for children.

Lotions, pills etc.

  • prescription medicines (including malaria prevention drugs)
  • paracetamol or aspirin (consider a stronger painkiller or anti-inflammatory)
  • antidiarrhoeals
  • antacid
  • oral rehydration sachets
  • antihistamine tablets
  • sting relief spray
  • emergency bee sting kit
  • sunscreen and lip block
  • insect repellent (DEET or plant based)
  • anti-motion sickness tablets
  • water purifying tablets (depending on travel destination)
  • cystitis treatment
  • antifungal cream
  • calamine cream or aloe vera
First Aid Equipment
  • Thermometer
  • Scissors
  • Tweezers
  • Sticking plasters (band aids)
  • Gauze swabs and adhesive tape
  • Bandages and safety pins
  • Non adhesive dressings
  • Antiseptic (solution and wipes)
  • Wound closure strips
  • Needles, syringes, suture kit.
Prescription Medicines
  • Discuss options with your doctor but consider taking emergency treatment for malaria plus a malaria diagnosis kit
  • antibiotics for treating diarrhoea
  • a course of antibiotics for chest, ear skin infections, cystitis and treatment for thrush.


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Staying Healthy

Climate
Travelling from a cool climate to a tropical South Pacific climate can offer some health challenges for the tourist. You need to give your body time to adapt to the temperature changes so don't do anything too strenuous too quickly. Drink plenty of fluids to avoid dehydration. Also ensure you wear appropriate clothing. Children need particular attention because they can lose fluid through sweating very rapidly and are unlikely to be able to tell you how hot they are feeling. Consider doubling their usual fluid intake to avoid dehydration problems.

Footcare
The heat can affect your feet and ankles so it's wise to take precautions. Ensure you bring appropriate footwear with you, especially for hiking. Athletes foot is a common ailment in hot climates so precautions are required to avoid it. If possible wash your feet daily and dry them carefully.

Sun
The sun is one of the greatest hazards you'll encounter in a tropical location. Ensure you cover up, especially during the hottest part of the day and use plenty of sunscreen. Children are even more vulnerable to sunburn so ensure they are appropriately dressed.

Bites
Insect bites can be an annoyance and a health hazard so precautions need to be taken. Avoid mosquito bites (at all times of the day and night). Use a repellent, cover up your skin, sleep in a screened room, avoid shady conditions late afternoon, spray you room with an insect spray at night and consider mosquito coils or electric insecticides.

Food
You need to take some basic precautions to avoid contaminated food. If you are unsure about any food then it is safer to avoid it. Avoid food that is lukewarm or has been sitting around in the open. Avoid fruit and vegetables that are not cooked or can't be peeled. Make sure meat is well cooked and avoid raw food, especially seafood. Avoid cream filled cakes. Contamination can be caused by unwashed hands, dirty dishes, cutlery or utensils so try to avoid cheap eateries, try to pick busy, popular places that look clean.

Water
Always assume that water is unsafe to drink, unless you know otherwise. Some areas, like mainland Fiji have safe tap water, but try to drink bottled water when possible. Make sure you drink the popular brands of bottled water and ensure the cap is intact before you open it. It is common in some countries for bottled water containers to be refilled with local water so care needs to be taken. Avoid ice in drinks and vegetables and fruit that may have been washed in contaminated water.

Basic Family Health Rules
  • Make sure your children's hands are washed before they eat (carry wet wipes with you).
  • Clean teeth and wash toothbrushes with bottled (or purified water).
  • Don't eat raw fruit or vegetables unless that have been washed in safe water (or you peeled the fruit).
  • Avoid water and ice unless you know that it is safe. Assume that all water is unsafe unless proven otherwise.
  • For small children try to regularly sterilise the utensils they use. Use sterilising tabs or alcohol based wipes.


Health Issues

For a tropical region the South Pacific is generally a healthy place. It is pollution free, the water is clear and clean and the local food is fresh and healthy. There are some things that can cause health problems and these can usually be managed by combining some common sense with the help of the advice listed on this page.

Acclimatising
Travelling from cold winter weather into the tropics can take a toll. Rest both before and after the trip and dress appropriately for tropical weather. Give yourself a chance to get accustomed to the heat and don't over exert yourselves early in your trip. It's vital that you drink plenty of fluids to replace sweat. Avoid the hottest part of the day and dress in loose, light coloured clothing.

Sunburn
The Tahitian name for white people is papaa, which means 'sunburned skin'. Exposure to ultraviolet rays of the sun can cause the skin to burn which can cause a deal of pain and misery and contribute to the possibility of skin cancer. Avoid the sun between the high risk periods from 11am to 3pm. The Australian 'slip, slop, slap' slogan provides good advice for avoiding the sun. Slip one a shirt, slop on some sunscreen and slap on a hat.

Food
Contaminated food can be a problem in some countries. Food, not water, is the main source for gastro problems for travellers. You can get sick from food anywhere but is more common when you are travelling. Eating safely is about commonsense and applying a few basic rules. Avoid food that's been sitting around in the sun. Ensure meat is well cooked and that fruit and vegetables have been cleaned - it's better to stick to fruit that's been cooked or that can be peeled. Look for signs of poor hygiene like dirty dishes or cutlery. When eating out look for popular, well patronised establishments that look clean and choose freshly prepared dishes. Avoid street food.

Water
Contaminated water can cause diarrhoea and hepatitis A. Always assume that water is unsafe to drink, unless you know otherwise. Avoid ice in drinks and vegetables and fruit that may have been washed in contaminated water.

Malaria
Malaria is one of the most serious health issues you're likely to face if you are travelling to a tropical area. Close to Australia fortunately it's mainly limited to Papua New Guinea, The Solomon Islands and Vanuatu. Symptoms of Malaria include chills, aches and high fever. The symptoms may not begin until months after contracting the disease and can be sometimes difficult to diagnose because of the similarities to influenza. However once identified it can be cured.
Malaria is spread by the Anopheles mosquito which is most active from dusk to dawn. There are a number of ways to avoid being bitten including using repellent, wearing long shirts and pants and sleep in a screened room. The Anopheles mosquito don't hum (or buzz) like other mosquitoes.
Anti-malarial drugs are a must if you intend to travel to an infected area. See your doctor around one month prior to departure and he will prescribe you with most effective drug. No anti-malarial drug is 100% effective so care needs to be taken to ensure you don't get bitten.

Hepatitis A
Hepatitis A is a viral disease that causes liver inflammation. Symptoms include fever, jaundice, and debility and is particularly dangerous for the elderly. It is transmitted by contaminated food and water. The only cure is rest and a high fluid intake. Taking care of what you eat and drink will help avoid it.

Hepatitis B
Hepatitis B is spread through contact with infected blood or body fluids. It has similar symptoms to hepatitis A but can be much more severe and may lead to irreparable liver damage or cancer. There is no cure, only rest. However there is a vaccine available - see your doctor. Avoid exposure to hepatitis by practicing safe sex, avoiding unsterilised needles, having a shave or tattoo in local shops and any body piercing.

Dengue Fever
Spread by mosquitoes, Dengue fever causes fever, headaches, and severe joint and muscle pain followed by a rash that spreads over the body. There is no cure only rest and self-management of the symptoms. The mosquitoes that spread dengue fever are prevalent during the day especially at dawn and dusk.

Diarrhoea
A mild version can be caused by a change of food water or climate but a more serious version is caused by contaminated food or water. The symptoms usually pass and it is recommended that you keep up your fluids. For more severe cases or for diarrhoea in babies and infants medical help should be sought.

Avoiding Mosquito Bites
Always try to prevent mosquito bites for yourself and your children. Mosquitoes spread diseases like malaria and dengue fever as well as providing pain and discomfort from being bitten.
  • Where possible cover your body as much as possible with light clothing.
  • Wear light coloured clothing.
  • Use mosquito repellents containing DEET at all times bust especially at night time, dawn and dusk.
  • Avoid aftershaves and perfumes as they attract mosquitoes.
  • Use a mosquito net, especially in malaria infected areas.
  • Use permethrin on clothes
  • Spray rooms with insect repellent at night before retiring.

Medical Help (South Pacific)

The quality of health care in the South Pacific varies within each country. In Fiji, French Polynesia and America Samoa the quality can be considered as good. Health care is considered reasonable in the Cook Islands, New Caledonia, Samoa, Solomon Islands, Tonga and Vanuatu and basic in other countries.

All of the South Pacific countries are small with limited budgets so even those that are considered as having good health care would not come close to what you would expect in a well-developed country.

'Good' health service can be defined as having readily available doctors, standard hospital facilities and specialist doctors in a number of major fields. Private dentists, opticians and pharmacies are also available.

'Reasonable' health facilities have limited specialist facilities but have hospital facilities and private doctors, dentists and pharmacies.

'Basic' health facilities mean the presence of nurses and a few doctors, limited dental facilities and a poor standard of hospitals.

Remember that the further you get away from the main towns the more basic the services become, even in the countries that are considered having a good health service. For example on an island in Fiji you may have access to a doctor or nurse but the nearest hospital may be over an hour away by boat.

Private consultation is reasonably expensive, similar to what you would expect to pay in Australia. Nearly all will require direct payment including hospitals and except for major hospitals and practitioner's credit card payment may not be an option. It is wise to keep a few hundred dollars in traveller's cheques aside for any medical problems that may arise.

Most common medications are available in countries with good or reasonable health care. If you need a particular drug it is always wise to ensure you bring an adequate supply with you especially if you need a brand specific drug or the drug is not considered common.

Except in remote areas the standard of medical and dental care is good. The facilities, however, may not necessarily match that care.

The overall risk of illness in the South Pacific is low with diarrhoea, viral sore throats and ear and skin infections the most common. All of these can be treated with self-medication. For more serious symptoms a visit to a local clinic of practitioner may suffice in the first instance.

Travellers with specialist needs
  • Get medical advice before you leave
  • Take any medical documentation you require
  • Make sure you have travel insurance
  • Take a good supply of your prescription medicines with you
  • If you need to be near specialised treatment stick to the main towns
  • Flying - let the airline know about any special requirements
  • Wear bracelets or tags engraved with your specific condition

When You Get Back

Even when you get back from your South Pacific holiday there may still be some health issues you need to address. Sometimes illnesses will not appear immediately. It can happen after you return from your holiday. And an illness that may have started while you were away may get worse when you get back or may persist for some time.

Illnesses that you suffer when you get back may not necessarily relate to your holiday but a checkup with your doctor may be required if:
  • You are concerned
  • Your symptoms won't go away
  • You have spent time in a rural area
  • You were ill while you were on holidays
  • You may have put yourself in a situation to contract hepatitis B
There are doctors that specialise in tropical medicine and these doctors will be more experienced in tropical diseases if you think you need specialist help or require a second opinion. Otherwise see your local doctor. Make sure you tell your doctor that you have been traveling, where you've been and how long you've been away for.

If you have a fever or have flu like symptoms and have traveled to a malaria risk country (Papua New Guinea, Solomon Islands or Vanuatu), then suspect that you have the disease and see your doctor. Sometimes the symptoms of malaria can take up to four months to develop. The same applies for other diseases like dengue fever, hepatitis, typhoid and tuberculosis.

Gastrointestinal problems can persist after you return from travel or can appear for the first time after you get home. In most cases a return you your normal lifestyle fixes these problems but if symptoms persist see your doctor.

Skin rashes, cuts or strange blemishes need to be checked when you return. Take special note of any changes to freckles or moles especially if you have been subject to a lot of sun exposure.

It is possible that you may suffer some form of emotional turmoil when you get back from holidays to the 'real world'. Talk to your doctor if you have symptoms like loss of interest in normal life, feeling low or depressed.

Some things to remember
  • If you have visited a doctor or dentist while you were away remember to claim it on your travel insurance.
  • Keep taking your anti malarials for the entire course or you may put yourself at risk of contracting the disease.
  • If you have any symptoms that persist when you get back see your doctor.

References (and great travel resources):
Stanley, David. 1993. South Pacific Handbook. Moon Publications, Inc.
Wheeler, Maureen. 1995. Travel With Children. 3rd ed. Melbourne: Lonely Planet Publications.
McKinnon, R., B. Atkinson, C. Brash, J.B. Carillet, P. Dragicevich, J. Harewood, N. Luckham, C. McLachlan, and D. Starnes. 2009. South Pacific. Melbourne: Lonely Planet Publications.
Young, Isabelle. 2000. Healthy Travel Australia, NZ & the Pacific. Melbourne: Lonely Planet Publications.