Don't Drink the Hype

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Don't Drink the Hype Water no - it's not a hairpiece, just a bad haircut

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by Joe Harkins - Sep 30, 98

This is scary stuff. You may want to leave the room while you read it.

Some while back, The Royal College of Physicians of London published a study by Dr. Robert Steffen of the University of Zurich and Director of the Communicable Diseases Center for the UN's World Health Organization. He reports that, depending on which countries are visited and length of stay, 40%-50% of tourists suffer an episode of Traveler's Diarrhea. Drownings and traffic accidents account for the majority of traveler's deaths.

For every one million people traveling to West Africa, about 24,000 will contract malaria, while 500 visitors to Latin America will. About 3,000 will develop Hepatitis A and 3,000 may pick up a sexually transmitted disease such as gonorrhea or AIDS.

Knowing how to avoid getting sick or caught in an accident is as important as knowing how and where to find treatment when things go wrong far away from home and health insurance coverage. (You mean you didn't know your HMO doesn't have a branch office in Santo Domingo? We'll cover traveler's health insurance in another column later this month.)

To put it crudely, an ounce of Pepto Bismol is worth a pound of Immodium AD. Doctors active in the relatively new field of Travel Medicine now routinely recommend a daily preventive dose of the pink stuff for short-term exposure. That remedy used to be pooh-poohed by formerly less well-informed General Practitioners.

Web sites by private Travel Medicine specialists are about as scarce as a roll of Charmin in Katmandu but Dr. Steven Blythe's Travel Health Information Service ranks among the best individual service sites. His lucid, jargon-free text makes it a must for every traveler.

I also like the sassy approach taken by Lonely Planet, publishers of an extensive series of excellent destination guides. A click on the Band-Aid icon delivers sound advice that starts by asking, "Who can appreciate the joys of exploring exotic locations when you'd sell your grandmother for directions to the nearest toilet?" The style may be light but the information is solid.

Self-assembled first-aid kits are worth the minor effort and expense. The Medical Guide for Third World Travelers seems to have it all covered. Just before I leave a poor country I make it a practice to give away my unused kit to someone such as a local school teacher or minister who can put it to good use.

The International Society of Travel Medicine claims 514 member clinics in 44 countries. While that suggests your destination may have a pre-qualified medical resource, that is not necessarily true. ISTM members (important updates *) obviously are not held to a universal standard of medical professionalism.

Caribbean-based Global Health Center and Resorts, an ISTM member, blares the animated headline "Viagra - The New Erection Pill for Men - Now Available Online - Click here" and offers to sell it by mail, apparently without regard for the dangers it also involves absent monitoring by a patient's knowledgeable physician. The page also contains lurid links to an online gambling operation and to another page that basically tells you how to buy a citizenship so you can hide there from the annoyances of civilization such as taxes or criminal charges. Of course, such lapses do not apply to all ISTM members. The next time I'm in Milwaukee, I'm not going to ask ISTM member Medical College of Wisconsin where I can drop a C-note on nine the hard way.

Shoreland's Travel Health Online is a reflection of the fact that Shoreland's primary business is serving corporations. Protecting employee health during travel is more than just humanitarian. Companies active across international borders often have multi-million dollar investments in personnel. However, because Shoreland also lists the pill-pushing, nickel-grabbing Global Clinic, the Shoreland click-through disclaimer should be heeded. Perhaps corporations who pay Shoreland an annual retainer get more conservative advice.

ISTM's loose standards (see updates #1 and #2) may explain why some centers affiliated with major universities do not list themselves with that organization. Vanderbilt Medical Center's Travel Clinic is one. A list of travel health clinics that seems to be based on more stringent professional standards is at Emory University's MedWeb.

-30-

The Doctor Will See You Now:
(*The mini-reviews below may or may not have been published in your local newspaper depending on the available space in this week's edition.)

University of Washington Medical Center
The UWMC site is unremarkable except for a link to "The Plants of Machiguena." In November, 1995, Dr. Ethan Russo, a neurologist, spent two months in Eastern Peru's rainforest looking for plants to treat headaches. You'll find photos of the plants he gathered here, along with botanical and medicinal information about them. You'll also find photos of birds, people and the rich forests of Peru.

Tropical Medicine Bureau of Dublin
This is the largest provider of travel health services in Ireland.

University of Wisconsin Health Services
Good collection of travel health links.

American Society of Tropical Medicine Clinic List
For an oversight of how complex and important the field of travel medicine is becoming, look at the list of "Clinical Resources."

Travel Healthy
This is one of the most useless web sites I’ve ever encountered. I mention it here only so you’ll understand what it takes to put together this column and why I sometimes get pissy when I encounter a badly designed site. I found this one through a search engine and clicked on the listing. The page downloaded veeeerrrry sloooooowwwly due to too many animated icons, banners and decorative graphics. The first page has no useful information, just a bunch of ads announcing that so-and-so or such-and-such is "A Proud Sponsor of Travel Healthy". Then I learned that each of the menu links, starting with "Enter" and including "Government Guides" plus "Travel Mall" requires a password and user name, but there is no place on the site to register!!

Doesn’t that site’s builder realize or care that wasting all that bandwidth only brings all of us that much closer to entropy and our universe’s Heat Death? Although the end may not come for a few gazillion years more, it has just been shaved down by another couple of milliseconds. Keep this up and we can start turning off the lights in just a few hundred million years.

OutBreak
If you are a timid traveler, this is not a web site that will encourage you to leave the safety and comfort of your local Department of Health. In fact, even you are the adventurous type, this is not something to read while you are sitting in your hotel room in some foreign country and planning to mingle in the local marketplace or perhaps sample the food from that little stand down the block. The title refers to epidemics and plagues.

Virtual Hospital
Emporiatrics: An Introduction to Travel Medicine. Advice for travelers with special medical conditions such as pregnancy, diabetes and heart disease, plus care for children. (That word "emporiatrics" is not in any dictionary of mine. If a reader knows an authoritative definition, I'd like to hear it.)

TMV Centre
Australia's largest privately operated travel medicine provider with 18 clinics (and growing). The site offers details on travel immunizations, gastro prevention, STDs, plus what to pack in a travelers' medical kit.

*UpDate #1 re:
International Society for Travel Medicine:
Shortly after the print version of this column was released to subscribing newspapers (Sep 30, 1998), Travel The Net spoke with Dr. Bradley Conner, MD who represents International Society for Travel Medicine.

When TTN informed him of the content of the Global Clinic web site linked from the ISTM page, he went online as we spoke, saw what is reported above and then expressed his great professional "distress and outrage" at what he was seeing. He explained that Global's web site is inconsistent with the policies and goals of ISTM. He suggested the original and approved version of Global's site probably had been modified after the link was installed on the ISTM site. He said that the organization is working steadily towards codification and implementation of uniform standards for ISTM Clinics, their staff and their facilities.

We agreed he would add Travel The Net to the press distribution list of developments in that direction. I told him TTN will revisit the situation and report again on it again in another month or so after his organization's next meeting at which standards will be discussed. I suggest readers reserve judgement of ISTM until the organization has an opportunity to handle the Global situation.

Update #2 re:
Global Health Center and Resort
The above phone conversation was the last time I ever heard from ISTM. It's now late December; almost 90 days have passed. They've not kept their promise about letting me know how they would handle their alleged distress and outrage.

A check of the site today shows that the link to Global is gone. A long page of legal jargon has been added. It says, in effect, ISTM does not have any responsibility for the conduct or claims of any of its members. I read that as an admission that the ISTM either has no professional and ethical standards or is unable or unwilling to enforce them. If you wish to see the list of ISTM members, you are required to click that you have read and accept the statement and agree to hold ISTM harmless for anything that may arise from your use of the information.

Oh BTW. Global's web site still flaunts both the Viagra ad and a claim of membership in ISTM. The links to the casino and the so-called "investment program" that offers refuge from criminal prosecution are unchanged.

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