More travellers die being hit by cars than from mosquito bites. Dr Jane Wilson-Howarth looks at how to avoid accidents that frequently assail travellers
Travellers might spend a lot on immunisations, but the truth is that the biggest holiday health risks are not vaccine-preventable. Less than 4% of deaths among travellers overseas are due to communicable diseases. The vast majority of fatalities are caused either by illnesses that would have killed anyway (eg heart attacks – although the stress of travel can precipitate them) and trauma – accidents, falls, violence. Here’s a run-down of travel’s most deadly, and how you can lessen the risk...
Being in, or near, a car isn’t especially good for your travel health. Road traffic accidents – car collisions and vehicles hitting pedestrians and cyclists – are the biggest cause of death of otherwise-healthy travellers.
The risk is especially high in resource-poor destinations: 90% of fatalities on the road happen in low- or middle-income countries (many in South-East Asia). Vehicles in such places may not have seat belts, and lights and brakes may not work.
Also, our increasing reliance on gadgets means many self-drivers head out with a GPS and no map, which can result in getting awfully lost if weather or malfunction causes the device to fail.
Familiarise yourself with local driving/traffic laws. Think before crossing roads (is traffic coming the opposite way? Is jay-walking illegal?). Avoid travelling in overcrowded vehicles. Avoid travelling after dark in Africa or war zones. Wear a seatbelt if there is one.
Don’t drink and drive – the permitted alcohol limit is likely to be lower than in the UK. If walking along a roadside, face oncoming traffic so you can see vehicles approaching. If driving, take maps and a compass in addition to GPS equipment, in case it fails; also consider buying a local sim or phone.
According to the Swimming Teachers’ Association (STA), a UK citizen is 5.5 times more likely to drown abroad than in the UK. Most people will assume they need to be more cautious when wild swimming, but the STA reveals that pools are more dangerous: the drowning risk is more than 12 times higher in a swimming pool than in open water; children under seven are most vulnerable. Rules are strict in the UK but, even at popular overseas holiday destinations, there may not be lifeguards.
Know your own limits: don’t swim out of your depth or ability range. Check for local warning signs. Stay sober – many drowning incidents can be put down to alcohol or drugs: drunks are more likely to fall, get knocked unconscious, plunge into unknown waters and suffer hypothermia quicker.
There are a surprising number of injuries, and even deaths, connected with travellers’ accommodation. Hotels lacking smoke alarms or sprinkler systems, and poorly- vented heating devices emitting carbon monoxide are risks.
Wild camping in remote spots can be dangerous if you don’t know the local terrain – for example, is it bear country, or are flash-floods a possibility?
In a hotel know the fire escape routes. Think about what kind of hotel you’ve chosen – bus-station hotels can attract unsavoury clientèle. Sleep with a torch by your bed, especially if you are in a destination where there are frequent power cuts or earth tremors. Never smoke in bed.
If camping, don’t light a stove in the entrance while you’re inside; if you do, keep a knife handy so you can cut your way out if the tent catches fire.
Thin air, sheer drops, changeable weather – mountains are dangerous places. Of 275,950 trekkers who visited Nepal over 4.5 years, there were 40 deaths. Most died from falling off cliff paths – one common cause of which is being pushed over by passing yaks, mules or even goats. Ten died from altitude sickness, something travellers climbing over 3,000m need to be very aware of.
Falling into crevasses on Himalayan treks is not uncommon, even on trips led by experienced guides. These groups usually carry the correct equipment yet may not bother to rope-up; it is crucial that trek-leaders be gently reminded to follow sensible safety precautions.
Do your homework: know the hazards of ascending into the mountains, take precautions, pack the right kit (including emergency supplies). If passing animals on a narrow mountain path, always stand on the uphill side. Consider taking acetazolamide (Diamox) to combat acute mountain sickness – talk to your GP. Ensure your travel insurance covers you for rescue as well as repatriation.
Scuba-diving has a reputation for being dangerous, but under proper conditions with safe equipment the risks are small: one death per 200,000 dives. However, the risks are higher at some destinations: medical examinations, or even ability to swim, are not always mandatory when hiring scuba equipment.
An examination of 947 deaths in recreational divers over a ten-year period suggested heart disease was a significant cause of death, so people should be fit to dive.
Take personal responsibility: are you fit to dive? Have a medical before trying. Check the credentials of any dive-trainer or dive-leader. Check equipment before diving. Do not fly less than 24 hours after diving (ascent to altitude immediately after diving can cause decompression sickness).
Rafting, bungee jumping, jetboating, via-ferrata-ing... The list of possible extreme sports you can try overseas is long and terrifying. Few travellers die but there are fatalities even in experienced venturers; it can be instructive to Google the possible injuries and likelihood of death before signing up. The list for bungee-jumping, for example, is especially impressive.
Be sensible: are you capable or experienced enough to try the sport in question? Don’t try it when intoxicated; lots of accidents are attributed to alcohol and drugs. Check if you need a guide and enlist a good local one. Check the safety record and equipment of any provider. What safety equipment should you be wearing? Avoid shooting small dams – 10% of whitewater river fatalities are caused by them. Find room for a small, personal first aid kit and make sure your travel insurance covers extreme activities.
1.2 million People killed globally each year in road crashes
73% Percentage of road fatalities who are male
15-44 More than half of all global deaths on the road are within this age bracket
14 in 100,000 Trekking death rate in Nepal
10% Approximate chance of dying when climbing above 6,000m
20 million+ Significantly injured people in crashes each year, globally
309 UK citizens who drowned abroad, 2006-2010
Dr Jane Wilson-Howarth lived in Asia while her sons were toddlers and their only serious health challenge was a skull fracture – from slipping on a marble bathroom floor. See www.wilson-howarth.com for more travel health advice.
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