Expedition & Remote Travel

Expedition groups vary greatly in their size, aims, and intended destination. They often plan to reach remote areas in countries with poor medical facilities. This may also involve exposure to extreme climatic conditions. Many of the larger expedition groups will have qualified medics with them. Smaller groups may have a couple of people who have undertaken a first aid course. However, all travellers going into remote areas should be responsible for looking after their own basic health needs.

General Advice for Expeditioners

  • Seek advice about vaccines and malaria tablets in plenty of time before the trip. For students, vaccines could be given well before exams start so that any possible side effects will not cause difficulties with last minute swotting.
  • Consider malaria standby treatment if the group will be going to remote risk areas and the expedition doctor will not have these treatments.
  • Basic travel health advice on avoiding contaminated food and water and insect bite avoidance is worthwhile.
  • A trip to the dentist should be made at least 2 months before departure.
  • Research into the local health risks in the area should be undertaken. Specialist information on dealing with climatic extremes may be appropriate, altitude illness, hypothermia or hyperthermia can be life threatening.
  • Prepare for physical exertion and get fit before departure.

First aid

  • All expedition members should carry a basic first aid kit to deal with minor problems themselves. The contents of the pack can be tailored to the destination, but should include wound dressings and plasters, antiseptic, basic analgesia and sunblock. Blisters and fungal infection of the feet are particularly common on expeditions. These can cause great problems if travel on foot is essential. Ensure boots are well broken in and cover sore / rubbed areas of skin immediately with an elasticated plaster or similar cover before it develops in to a blister. Antifungal powders can be useful to treat athletes foot.
  • For larger or more ambitious projects, a comprehensive group first aid pack should also be put together; this may include prescription drugs and sterile medical equipment. This kit must be packed, stored and handled carefully to protect it from damage. Useful information can be found through the British Mountaineering Council website.
  • A first aid manual for remote areas can also be extremely helpful. Try ‘Where there is No doctor’ by David Werner (1993) or ‘Medicine for Mountaineering’ James A. Wilkerson (Editor), Mountaineers Books, (2001).

Hygiene

  • Those going away from the normal ‘tourist track’ may have to treat water to make it safe to drink. Boiling is effective. Iodine resin water filters or a basic water filter followed by a chemical treatment (ideally 2% tincture of iodine 4 drops or 2 iodine tablets per litre left for 20 minutes, longer if very cold) can also be recommended.
  • Rules for food hygiene should be developed. Hands should be washed before preparing food. If anyone is ill with travellers’ diarrhoea, they should not be involved with preparing food for the group.
  • Pits can be dug for human waste; these should be well away from food preparation areas and drinking water collection areas. Ideally it should be downhill and downwind of the camp. A sign to indicate the toilet is in use and facilities for hand washing after visiting the toilet should be set up where possible (environmentally kind mountain soap can be bought to protect local water supplies becoming polluted with soaps and detergents).
  • Rubbish should be buried deeply, burnt or carried out so that it does not damage the environment or attract rodents and in turn snakes.

Emergencies / Insurance:

Comprehensive insurance for the group that will cover search and rescue, medical treatment and repatriation is important. Emergency evacuation plans should also be made. Some expeditions will carry satellite phones and GPS systems so they can contact a base with their exact location. An assessment of the local health care facilities may be helpful, some hospitals will be better than others.

Bites and stings

  • In areas with snakes, spiders and scorpions, wear appropriate footwear at all times (not sandals). Take care if collecting firewood and turning stones. Avoiding putting hands in to cracks and crevasses where possible. Pack away bedding during the daytime. Do not corner snakes, most will move away from humans if they can. Keep rubbish packed away so that it does not attract rodents.
  • If bitten, immobilise the affected limb, keep calm and evacuate the casualty to seek medical advice. A description of the snake, spider or scorpion will be helpful. Take great care handling a dead snake, don’t touch the head.
  • Avoid contact with wild animals, rabies post exposure vaccines must be sought immediately if bitten or scratched by any animal.

Women’s issues

  • Some women consider starting the contraceptive pill to prevent menstruation on an expedition. In practice many women find this is not worthwhile, periods are often lighter and less regular. The pill may not completely prevent bleeding and may cause unwanted side effects. However, if a traveller is keen to try this, she should start trialing the drug a good 2-3 months before travel to check for adverse reactions. Take sanitary supplies in addition as they may still be needed.
  • Occasionally women find their periods become more painful, supplies of their tried and tested analgesia should be taken out in the personal first aid kit.
  • Sanitary protection should be protected from damp and damage in a sealed tub. It may be difficult to dispose of used items on a trek; some women find that carrying nappy sacks with them is helpful. These can be burnt or buried with other rubbish when possible.
  • Be aware that emergency contraception may not be available in many countries.