International Travel Handbook

HEALTH AND WELLNESS ABROAD

Physical Health
Many students visit their physician for a physical before going abroad; some programs require a physician’s statement of good health. See a dentist in case you require dental work before you go. If you have preexisting conditions or concerns about your health, be proactive and consult your physician about managing your health while abroad. If you take prescription medications, including birth control, figure out how to obtain them while abroad. If you own a medical bracelet, make sure to wear it while abroad.

Students with chronic conditions such as asthma, diabetes, and food or drug allergies should learn important words about their condition in the host country language, and carry a written explanation in that language, in case you are unable to communicate verbally in an emergency. Harvard College recommends that you share your medical information with your overseas contact.

Students are encouraged to ask for a copy of their program’s in-country communicable diseases risk reduction and prevention plan prior to departure.

Prescriptions
If you take a prescription medication, ask your physician to prescribe in advance a supply that will last the length of your stay. In some cases, it may not be possible to prescribe or purchase in advance the amount of medication necessary for your planned time away, so make a plan now with your physician for obtaining your medication while abroad. Research regulation of medications in your destination country. Carry a copy of your prescription and keep medications in the labeled containers in which they were dispensed.

Immunizations
Be sure that you are up to date on routine U.S. vaccinations. Additional immunizations are needed primarily for destinations in Africa, Asia or Latin America where you may be exposed to tropical diseases, but certain immunizations are suggested for other destinations. Check the on-line recommendations made by the U.S. Centers for Disease Control and the World Health Organization (see links below) and consult with your physician. You may also want to consult InternationalVaccines.com, which offers a Travel Vaccine Clinic Locator, Pre- and Post-Travel Health Tips, and Additional Travel Health Resource Links. If you need immunizations, arrange appointments several months in advance, since some immunizations must be administered over a period of time to become effective. Harvard University Health Services (UHS) Travel Clinic, located on the 3rd floor of Holyoke Center (617) 495.5812, provides immunizations, including Yellow Fever (which is not available at many clinics). Obtain a certificate of immunization and carry it with you since some countries require it at the border.

Destination-Specific Health Concerns
Be aware of current health conditions in your destination country. The Centers for Disease Control and Prevention (CDC) provides information by destination about health risks, immunizations, and food and water precautions as well as world and regional health conditions and disease outbreaks. The CDC also maintains an International Travelers’ Hotline (404)332.4559. The World Health Organization (WHO) offers health conditions and information by country.

Avian Influenza (Bird Flu)
Students staying in countries where avian influenza is present should know the risks and stay informed of developments. The Centers for Disease Control and Prevention advises avoiding contact with poultry, including contact with surfaces that may be contaminated and visiting live animal markets or poultry farms; consuming only well-cooked poultry, including eggs; and washing your hands frequently with soap and water or alcohol-based hand sanitizer. Seek medical assistance if you develop a fever plus cough, sore throat or have trouble breathing. Notify your health care provider of possible exposure to Avian Influenza and defer further travel until you are free of symptoms. If you become sick with symptoms or if you develop any illness that requires prompt medical attention, a U.S. Consular officer can assist you in locating medical services and informing your friends and family. Consult the U.S. Department of State site, Key Officers of Foreign Service Posts, for contact information.

MDR/XDR Tuberculosis
Tuberculosis (TB) is a disease caused by germs that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. In most cases, TB is treatable; however, persons with TB can die if they do not get proper treatment. Multidrug-resistant (MDR) is TB that is resistant to at least two first-line anti-TB drugs, isoniazid and rifampicin; these drugs are used to treat all persons with TB disease. Extensive Drug Resistant Tuberculosis (XDR-TB) was first described by the WHO and the U.S. Centers for Disease Control and Prevention in early 2006; XDR-TB is additionally resistant to at least three of the six main second-line drugs. The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. Symptoms of TB disease in other parts of the body depend on the area affected. If you have these symptoms or if you think you have been exposed to someone with TB disease, you should contact your doctor or local health department about getting a TB skin or blood test.

HIV/AIDS
AIDS was first reported in the United States in 1981 and has since become a major worldwide epidemic. AIDS is caused by the human immunodeficiency virus, or HIV. By killing or damaging cells of the body’s immune system, HIV progressively destroys the body’s ability to fight infections and certain cancers. People diagnosed with AIDS may get life-threatening diseases called opportunistic infections. These infections are caused by microbes such as viruses or bacteria that usually do not make healthy people sick. HIV is spread most often through unprotected sex with an infected partner. The virus can enter the body through the lining of the vagina, vulva, penis, rectum, or mouth during sex.

HIV can infect anyone who practices risky behaviors such as sharing drug needles or syringes; having sexual contact, including oral sexual contact, with an infected person without using a condom; and having sexual contact with someone whose HIV status is unknown. HIV also is spread through contact with infected blood.

HIV is often spread among injection drug users when they share needles or syringes contaminated with very small quantities of blood from someone infected with the virus. It is rare for a patient to be the source of HIV transmitted to a healthcare provider or vice versa by accidental sticks with contaminated needles or other medical instruments. Women can transmit HIV to their babies during pregnancy or birth. Some countries require incoming foreigners to have an HIV antibody test. It is wise to know your HIV status in advance. Testing takes about two weeks. It is possible to be anonymously tested through state organizations, which allows you the privacy to decide if you want to get a second test through a physician who can provide you with an official certificate to be used for immigration. Some locations overseas may present greater risks to those who are HIV positive or are living with AIDS due to limited medical facilities or availability of sterile needles and screened blood. Individuals who test positive for the human immune deficiency virus (HIV) that causes AIDS will find useful recommendations for traveling with HIV here.

Food and Nutrition
Learn about the regional diet, as it is an integral part of the culture. If you have specific dietary restrictions, learn how to explain your food choices in a culturally sensitive way. Be prepared to change your eating habits, both in terms of timing of meals and kinds of food, to adjust to the local culture. Take note of food and water precautions recommended by the CDC. If you have food restrictions or allergies, learn how to communicate this in the local language(s).

Medical Facilities and Services
Become familiar in advance with the health care system of the country, including the quality and cost of medical care. Learn in advance the name and location of the hospital nearest to your residence abroad and how to summon emergency medical care (many countries have an equivalent to 911).

Medical Kit
All travelers are susceptible to minor illnesses while abroad, as they are exposed to new viruses and bacteria and under additional stress.

Suggested Medical Kit:
• painkillers: aspirin, acetaminophen or ibuprofen
• HIV/Malaria prophylaxis medications
• anti-diarrhea medication: loperamide or diphenoxylate and oral rehydration mixture
• antacids for stomach upset
• motion sickness pills
• allergy medication/antihistamine, also eases insect bite itch and prevents motion sickness
• decongestant; flu medicine; lozenges
• permethrin-containing insect repellant (and/or bednet); calamine lotion or topical antihistamine
• aloe vera; sunscreen; lip balm; eye drops
• antiseptic/antibiotic cream ointment; band-aids
• prescribed antibiotics in consultation with your doctor (carry the prescription with you)
• non-mercury thermometer
• prescriptions and/or extra sets of contact lenses or glasses
• contraception; condoms
• plus any other items appropriate for your destination and personal health

Mental Health
Going abroad and venturing out of one’s comfort zone can often be an emotionally challenging experience. We advise you to anticipate potential stressors before you go abroad. If you are currently seeing a therapist at UHS, make arrangements to continue therapy via UHS or an in-country therapist that they recommend while abroad if that would be beneficial to you. You may also contact UHS at any point while you are abroad.

The Harvard Bureau of Study Counsel offers individual pre-departure planning and consultation for students planning to go abroad, and recommends that all students take advantage of this resource as a way of preparing to spend time abroad. If you are already coping with heightened emotional or psychological concerns, the Bureau of Study Counsel strongly encourages you to make an appointment to discuss and anticipate the impact of stressors you might face abroad when your support may be limited. The Bureau of Study Counsel wants you to feel confident that this is the right time for you to travel abroad.

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You should be aware that Harvard has a policy regarding sponsored undergraduate activities in any country for which there is a current State Department travel warning.