Tourism is a major social, cultural and economic phenomenon that has significant health implications. They are, in fact, its important component aiming at the improvement of human health. Tourism is by definition the activity of promoting health and its basic motivations are relaxation and recreation, combined with cultural curiosity. At the “First Conference on International Travel and Tourism” in Rome 1963, “health”, by definition, was set as the primary motivation for travelling. Traveling, first of all, means experience and change, and tourists actually invest in the experience providing personal satisfaction to them, both during the trip and afterwards. Illness, misfortune or just “not feeling well” may compromise the traveller’s experience as well as the profits of tourist organizations. Travellers travelling abroad, just by leaving their usual environment, are under mental stress (business travels are especially stressful), and they are also facing physical conditions of different water, food, climate or altitude, inevitably affecting the body. There is also a high probability that the traveller’s personal immunity does not correspond to a foreign environment, and a significant number of tourists bears the consequences. For example, of the 15 million Americans travelling abroad every year, on average one of five returns ill.
There is probably no experience more horrendous than illness or an accident in a foreign country, and therefore a timely provision of accessible medical care, adequate both in quality and price, is one of key factors of organizing the care of travellers in the receptive area. A particular problem is an ill traveller, since his/her physician in the home country usually is not familiar with rare exotic diseases which the same cannot find in the casuistry, and even if the physician is familiar with them, he/she does not have insight in the epidemiological situation of the area from which the traveller returns. Unrecognized or untimely recognized diseases are usually fatal or have significant implications for the health. Travellers are inevitably exposed to accidents and diseases, but it is important to know that most of these risks can be prevented by preventive measures. If that is achieved, the vacation becomes pure joy and the benefit will be mutual, both for the tourist and for the country in which he/she is staying.
HEALTH INFORMATION AND HEALTH ADVICE FOR TRAVELLERS
Promotion and protection of health of travellers are two basic conditions for achieving what we nowadays call the health of travellers. Travellers must have useful and the latest information on prevention through chemoprophylaxis and immunization and instructions on behaviour in case of accidents and diseases.
In terms of their characteristics, travellers can be divided in six groups:
- Average healthy persons representing a relatively small problem, although, due to the scope of travels, they may come in contact with exotic diseases.
- Very young travellers representing a particular problem in terms of diet and they require special attention when using drinking water.
- Old persons who, due to impaired health, have difficulties in handling the stress of travelling and change of climate as well as mental stress due to exposure to an unfamiliar environment.
- Ill people – both the ones who know they are ill and the ones who unknowingly bring the illness with them.
- Disabled persons represent a very specific problem and they are practically prevented from travelling without the services of “Traveller’s Clinic”.
- Pregnant women.
Proper health advice prevents unnecessary illness of the traveller and prepares him/her to face health problems which could be encountered during the trip or upon returning from the trip.
The traveller must know why and where to get such information. The traveller must have instructions what to do before the trip, during the trip and what to do if the disease occurs after the trip (for example, every fever, diarrhoea or rash, occurring even three months after returning, are a reason for visiting a physician). The colourful brochures of tourist agencies contain advice on health risks only on an exceptional basis, usually printed in small letters.
Tourists require two types of information:
1 ) General – these are information required by all tourists:
– Immunization: these information are divided in two categories – immunizations legally required from tourists and immunizations recommended to tourists for protecting their health.
– Prevention of malaria: not only information about chemoprophylaxis but also information on measures of personal prevention.
– Food and water: information about the quality and rules on prevention of pollution and protection from contaminated water and food.
– Sexually transmitted diseases: tourists need to be well informed about the risks of infection, especially about AIDS.
– Direct health care: tourists must have the information whom to contact, how and when in case of illness or injury.
2) Specific – these are information required by only certain groups of tourists:
– Climate: in certain countries adjustment to climate is necessary and requires certain time, and travellers to these areas should be warned about it. This includes advices about clothing and fluid replenishment.
– Altitude: with the development of tourist alpinism (Trekking) the incidence of “altitude sickness” has increased.
– Accidents: they are the most common cause of death or serious injury abroad.
It is clear that those who travel to an undeveloped tropical country and those who are going on a cruise on the Baltic Sea are not equally endangered. Travellers are also of different ages, medical history and way of life so the advice provided to them also cannot be the same.
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