Lack of preparation and knowledge about potential travel-related risks can have serious consequences. Risks include impact on health caused by:

• Affliction such as jet lag
• Diseases caused by contaminated food, contaminated water, contaminated air,
• Inadequate immunization, which may consequently require receiving injections with potentially unsanitary needles in developing countries

Injuries caused by:

• Transportation related crashes – aircraft, vehicles, trains, boats, motorbikes
• Lack of training to carry out field work in unfamiliar terrain

Make certain the health and safety of each student is protected when they travel. Develop a process to make sure students and parents have received up-to-date information regarding security issues in the country of destination.
Students and chaperones:

• Make sure your travel documents are valid.
• Make sure your inoculations are up-to-date, especially for overseas travel. Check for up- to-date information regarding health risks at the destination(s).
• Be informed and check for up-to-date information regarding security issues at the destination.
• Wear a seat belt when travelling in any vehicle, including taxis.

Be fully prepared before departure. The following is an information checklist to consider, especially when visiting a country for the first time. Note that the information has to be considered relative to the passport that you travel with.

Before travelling to a new location, access government websites, for example those of Canada, Australia or the USA among others, for information regarding the country of destination. Especially check the website of the government of the country of which you are a citizen. The specific government website should help you note the entry requirements and review any travel alerts and background notes in and around the destination country relative to the passport you travel with. Sources include:

Canada - Foreign Affairs and International Trade Canada:
http://www.voyage.gc.ca/index-eng.asp

Canada - Travel Reports and Warnings:
http://www.voyage.gc.ca/countries_pays/menu-eng.asp

USA - International Travel Information:
http://travel.state.gov/travel/cis_pa_tw/cis_pa_tw_1168.html

USA - Department of State, Background Notes:
http://www.state.gov/r/pa/ei/bgn/

USA - Overseas Security Advisory Council:
https://www.osac.gov/

Make sure you have a valid passport that will not expire until well beyond your anticipated return date. Some countries require a passport to be valid for six months beyond the return date on the ticket. Obtain any necessary visas, documents or references. Obtain the correct type of visa, as some countries require separate visas if you visit as a tourist or on business. Leave a copy of your itinerary and travel documents with your office and family and carry a copy in addition to your passport.

Travel medicine clinics provide immunizations and up-to-date information regarding travel health and disease issues throughout the world. Clinics are located throughout Canada and can be located on the following website: http://www.phac-aspc.gc.ca/tmp- pmv/travel/clinic-eng.php

Bring more than sufficient prescription and over-the-counter medications for the duration of the trip plus a possible delay. Carry them in the original packaging and do not pack them all in your checked luggage. It may be advisable to carry a duplicate prescription with the identification of the doctor, dispensing pharmacy, and the dosage and drug identification numbers of the medications. Carry duplicate prescriptions for eye glasses or contact lenses. Diabetics etc., who carry syringes, should take a medical certificate to verify their requirement for medical use. Arrange for any necessary refrigeration of medication if necessary. Translate prescriptions or any other medical-related document into the language of the country you are visiting whenever possible.

In all countries, use common sense. You may encounter situations over which you have little control. Be aware of the risks and be alert to potential threats, particularly when leaving your flight, taking taxis, and entering or leaving hotels. Use local knowledge whenever possible for advice on how to reduce personal risk.

To minimize and avoid robbery:

• Carry cash separately from credit cards. Keep your valuables in several locations (money belt, several wallets)
• Be very careful when exchanging currency to prevent being cheated or robbed. If exchanging large sums of money, you may be observed and marked for robbery.
• Leave nonessential money, valuables and documents in the hotel safe. Take with you only what you need. In some countries you must have your passport and visa with you at all times.
• Carry a small amount of money available for tipping so it is not necessary to expose your wallet to view.
• Do not announce your travel plans in a public place, hotel lobby, airport etc.
• Know where your bag with valuables, documents and electronics is at all times. Be especially careful in public locations such as airports, as it can be stolen very quickly.
• Always notify others of changes to your schedule and itinerary; maintain a record of local emergency contact numbers.

Additional tips to reduce personal risk:

• Show respect for local customs and cultures and be aware of any current cultural or political events that might result in civil disorder. If you encounter a disturbance, leave the area immediately and do not become involved.

Although fire, theft or assault can occur in any hotel around the world, Educational World tours always lodge groups at hotels or hostels in a safe area. Use common sense and follow a few routines whenever you check in or approach your hotel room. This may prevent disaster – especially if there is a fire.

To prevent theft:

• Never leave clothing or luggage unattended anywhere – especially in hotel lobbies, restaurants, and airports.
• Be careful about being distracted by someone talking to you while an accomplice takes your briefcase or other belongings.
• Never leave valuables, papers, travel documents, computer or cash lying in your room; use a hotel safe. Do not think that hiding something in your room is sufficient.
• Check that all locks on hotel doors and windows work properly, including those on sliding doors that open onto a balcony.
• Keep all the doors and windows locked at all times, even when you leave the room briefly. Keep the door chain-locked until you visually identify visitors.
• Leave the "Do Not Disturb" sign on the hotel door at night and also when you are out in the evening to give the impression that you are in the room
• Do not leave the sign on the door requesting that the room be made up; this advertises the fact that you are not present.
• Become familiar with regular hotel staff and stay clear of staff you are unsure of.

Educational World Tours staff are not licensed medical professionals so we recommend you always consult medical professional for any health related questions or concerns. Below are a few of the more common problems you may want to discuss with a physician.

It is not unusual for people to become ill when travelling abroad. The most common ailments are related to consuming contaminated food and/or water that result in "traveler's" diarrhea.

General travel health information can be found on the following websites:
http://www.phac-aspc.gc.ca/tmp-pmv/info/index-eng.php
http://www.phac-aspc.gc.ca/tmp-pmv/travel/advice-eng.php

Other common Ailments include:

• Ear Barotrauma

Ear barotrauma (also known as aero-otitis,) is caused by variations in aircraft cabin pressure and occurs most commonly during descent. It can cause acute pain, noise in the ear and temporary deafness.
Additional information about ear barotraumas or "airplane ear" can be found on the following website: http://www.mayoclinic.com/health/airplane-ear/DS00472

• Jet Lag

Jet lag develops when your personal internal day-night pattern (circadian rhythm) does not fit with the day-night pattern at the destination. This can result in fatigue, insomnia, loss of appetite and forgetfulness etc.

Additional information regarding jet lag is available on the following websites:
http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/03vol29/acs-dcc-2-3/acs-3.html
http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/jet-lag.aspx

• Legionnaires' Disease

Legionnaires' disease, a serious form of pneumonia, is a bacterial infection that is spread by breathing aerosol droplets of water contaminated with the Legionella bacteria.

Prevention:
You cannot determine when you risk exposure to Legionnaires' disease, as you have no control over the maintenance of water systems in public places. You may become exposed even by being downwind from a contaminated water system.
Areas of concern: Worldwide

Additional information regarding Legionnaires' disease: http://www.ccohs.ca/oshanswers/diseases/legion.html

• Travelers' Diarrhea

Travelers' diarrhea is a common and uncomfortable problem. It is caused by eating food or drinking water that has been contaminated with microorganisms.

Prevention:
Always wash hands thoroughly after using the toilet and before eating.Never drink tap water unless it is first boiled or purified. (Keep iodine solution in your medical kit for this purpose.Use bottled water or other pre-packaged drinks (e.g., bottles or cans of soft drinks, hot drinks such as tea and coffee).

Additional information regarding travellers' diarrhea:
http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/01pdf/acs27-3.pdf
http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/98vol24/24sup/acs1.html
http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/travelers-diarrhea.aspx

• Deep Vein Thromboses (Blood Clots)

When you sit during long fights or long uninterrupted vehicle travel, blood clots may develop in the leg which can be very painful.


Safe Food and Water

When you travel in places where hygienic standards are questionable, be cautions about what you eat and drink. Food or drink may cause illnesses if they are contaminated. Contamination may easily occur where there is a sub-standard water supply or an inadequate standard of cleanliness for food storage, preparation and handling. Diarrhea is the most common disorder caused by food or water contamination and affects many travelers. Be aware of potential sources of food and drink contamination.

Students should become well briefed on health issues including diseases, food and water safety, personal safety and travel hazards in the area where they will travel. Obtain up-to-date information from a travel medicine clinic or medical advisor.

Educational World Tours is always researching, selecting and testing the restaurants they offer for groups. Yet it is always good to keep in mind what are safe food guidelines regarding restaurants and on-route stops:

• Never eat food sold by street vendors unless there is no alternative. Then, eat it only if it has been thoroughly cooked in front of you and handled minimally by the vendor.
• Wash your hands thoroughly before eating and carry hand sanitizer for use when handwashing is not possible. If possible, do not eat with your hands.

Also, when traveling to undeveloped destinations:

• Only eat meat and fish that have been completely cooked (boiled, steamed, grilled) and served hot. Beef and pork should be well done with no pink or "rare" areas. Do not eat rare or raw fish, shellfish or meat. Try to avoid eating cold meat or cold cuts (cold preserved meats) if it appears.
• Only eat vegetables that are thoroughly cooked. Do not eat raw vegetables– especially those served in restaurants, as it is impossible to clean greens thoroughly.
• Be cautious about eating peeled fruits and vegetables. Choose those that are unblemished and peel them yourself. Wash the skins, the knife, and your own hands before peeling so that you do not transfer bacteria directly to the food (bacteria are easily carried from peel to knife to food). Do not eat fruits with punctured skins, that show signs of mould
• Canned and boiled milk is safe. Do not eat unpasteurized dairy products because they may be tainted
• Do not eat raw or soft-cooked eggs. Hard-boiled eggs served in the shell are safest.
• Sauces and salad dressings containing eggs such as mayonnaise are not safe.
• If microwaving your own food, microwave it thoroughly until it is very hot. The microwave process does not uniformly heat food and therefore it does not always raise the temperature enough to destroy bacteria on the surface of food.

When travelling (usually outside Canada, the USA, and Europe) it maybe necessary to purify your drinking water, even in cities, as it may be impossible to be absolutely certain that it is safe to drink. By drinking untreated water, you may be exposed to many water-borne diseases. In most countries, it is best to regard all surface water sources as unfit to drink.

Commercially bottled water is safe if it is from a large dependable company. Request carbonated water to verify that the bottle was not simply refilled with local water and recapped. Break the seal yourself to make sure the seal has not been broken.

Beverages made with boiled water such as tea and coffee, canned or bottled carbonated drinks are safe to drink as long as it is clear the bottle has not been opened.

Ice is only safe if it is made from safe water. Avoid ice blocks and ice cubes in restaurants, as they are often made from untreated water. Freezing water or adding alcohol to water will NOT make it safe to drink.

Always brush your teeth with water that is safe to drink. If safe water is unavailable, put the hottest possible tap water into a clean glass and let it cool (without ice) before using it.

Do not drink water from natural waterways, dams or livestock watering points, as it may be contaminated with bacteria, viruses or chemicals, or it may have a high salt content.

Additional information regarding water purification can be found at the following websites:
http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/water-disinfection.aspx#Drinking
http://www.hc-sc.gc.ca/ewh-semt/pubs/water-eau/outdoor-plein_air-eng.php
http://www.epa.gov/OGWDW/faq/emerg.html
http://www.high-altitude-medicine.com/water.html

Some water may not be safe for swimming or bathing. Be aware of the quality of surface waters where you travel:

• Avoid swimming in any fresh water or seawater where there is any suspicion of sewage contamination.
• Do not swim in or dive into stagnant waters; they often contain bacteria that can enter your mouth, ears, nose and sinuses and cause illness.
• Unpolluted seawater and chlorinated swimming pool water are safe.

An attack of diarrhea or vomiting can leave your body dehydrated. There are several choices when fluid replacement therapy (oral rehydration) is required. Commercially available pre- packaged mixes of balanced electrolyte-glucose solutions are easy to prepare.

You can also mix your own from commonly available ingredients. Sip alternately from each glass if you use the two-glass method. Drinking a succession of hot caffeine-free teas, broths and carbonated drinks will also help replace fluids and salts, but avoid milk and beverages that contain caffeine. Be sure to use purified water when preparing fluid replacement solutions. If purified water is not available, it is better to use impure water than to avoid fluid replacement therapy altogether.

In an emergency, an adequate rehydration mixture can be made using:

• 2 ml (½ level teaspoon) table salt
• 30 ml (6 level teaspoons) regular table sugar (not substitute)
• 1 litre of boiled water

While this mixture contains no potassium or bicarbonate, it is better than drinking plain water or soft drinks. "Sports drinks" can also be used; it is advisable to dilute a full-strength sports drink by adding 50% more water to the solution. The additional water helps dilute the high level of sugar and assists with the absorption of the electrolytes. Do not use a high caffeine "energy drink" for rehydration purposes. It is never advisable to administer drinks containing caffeine to anyone suffering from dehydration, hyperthermia or hypothermia.

Insects carry organisms that cause many diseases with a single bite. Some insects may cause serious diseases in some parts of the world. Fortunately, by protecting yourself from mosquito bites, you also protect yourself from ticks, sandflies, blackflies, tsetse flies and leeches. Avoid colognes, perfume or hairsprays, as the scents attract insects. Use unscented shampoo and soap.

Keep in mind the following:

• Insect repellents contain an active ingredient that repels insects from the body. They do not kill insects.
• Insecticides contain an active ingredient that kills insects on contact (adults, larvae or eggs).

In Canada and the USA, biting insects may be a mere nuisance or a serious distraction. Depending on the destination you choose, it may be important to prevent bites. To help reduce the numbers of insect bites, wear appropriate clothing, use insect repellent on exposed skin and apply insecticide to clothing.

In Central and South America, Africa, and Asia, insects may carry significantly more serious diseases than in North America. The following website has extensive information regarding important disease carrying insects, the prevention of insect bites, the use of various repellents and insecticides: http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/05vol31/asc-dcc-4/index-eng.php

Barriers - physical and chemical - are the best means of protecting yourself from insect bites.

• Wear long sleeves and long pants tucked into your socks. Protect yourself any time you work in areas where ticks and day-feeding insects are a problem. Make a special effort to protect yourself between dusk and dawn to avoid being bitten by night-feeding mosquitoes.
• Clothing fabric should be tightly woven and thick enough to provide an added barrier.
• Clothing should be sprayed with insect repellent (DEET) or treated with permethrin, a contact insecticide.
• Permethrin-treated expandable athletic cuffs and headbands act as barriers, especially for ticks and blackflies. Pyrethroid-containing sprays (insecticides) are more effective than DEET against deer ticks that may cause Lyme disease.
• Wear shoes and socks; do not wear sandals.
• When using both sunscreen and insect repellent, apply the sunscreen first, preferably 30 minutes before applying insect repellent.

Insect repellents and insecticides

• Apply repellent to all exposed skin and reapply it every two to four hours, depending on the strength. Follow the application instructions and take time to apply it evenly and thoroughly onto your face, neck and limbs. Insects tend to bite where veins are near boney surfaces so pay extra attention to these areas (wrists, ankles, skull, jaw line, and shoulder blades). Do not apply it next to your eyes, on your lips or over cuts or skin irritations. Wash repellents off your skin when protection is no longer needed.
• Reapply insect repellent more frequently if you get wet (sweating, swimming, rain) or when there are lots of insects.
• Avoid breathing the sprays of repellents and insecticides and do not apply them near food.
• Warning: DEET will affect the surface of plastic or synthetics, including vehicle seats and the plastic lenses of eyeglasses.
• Do not use insecticide on your skin. Pyrethroid-containing sprays should be applied to clothing and living quarters. These sprays can also help control bed bugs.