Consider what food will be available to eat. The risk of diarrhoea or other “stomach bugs” (gastroenteritis) is high for travellers to remote locations. In some circumstances (for example, where no refrigeration is available) avoiding meat may limit the risk to some degree. If trekking, consider taking snacks with you from the UK, such as a fruit and nut mix, which will provide slow-release carbohydrate for energy.

Consider what drinking water will be available. If you need to take water purification tablets or filtration systems, ensure that they work before you leave. Remember that, if the water is not safe to drink, then neither is ice in other drinks, and that food such as salad may have been washed in the local water.

Be aware of environmental hazards

These include extremes of temperature, weather and altitude, which are discussed below. They also include dangerous animals (including insects and spiders), infectious diseases, natural disasters, and difficult terrain. Inform yourself before you travel.

Ensure you’re fit to travel

If you have ongoing health or fitness issues which are due for a medical review, then arrange this well before your travel. Your GP will not be able to certify you as fit to fly, or fit to travel in general, as they are not insured to do this. If you need this service then you should arrange it via a private travel doctor – again, allow plenty of time for this.

Make sure that you have declared any existing medical conditions to your travel insurer and that you are insured for any activities that you plan to carry out whilst away – not all policies include cover for certain sports or other activities.
Remember, if you travel against medical advice you may invalidate your insurance.
Be aware that some countries do not allow some medicines to be taken across their border. This may include some commonly prescribed pain medication. The penalty for breaking these laws may be severe and ignorance is unlikely to be accepted as an excuse, so do your homework before you go.

Remember that extreme environments stress the human body and if you are not well you may not be fit enough to enjoy the challenge.

Make dental preparations

When travelling to remote locations, a tooth problem can be distressing and difficult to solve. If you are expecting to be remote, then make sure that you have had a dental check-up within a reasonable interval of travel.

Think about eye protection: contact lenses and sunglasses

If you use contact lenses, consider whether conditions will allow you to manage your lenses hygienically. Take a pair of glasses with you just in case. Consider whether it would be sensible to switch to glasses or daily disposable lenses for your trip.

Travellers to altitude and to extremes of cold may find that contact lenses become uncomfortable because of the drier air at altitude. Take lubricating drops in addition to your lens steriliser.

If you are travelling to mountainous regions where there is snow, take a pair of good sunglasses, ideally those that protect your eyes at the side as well as the front. These will protect against snow blindness, a painful condition caused by overexposure to ultraviolet light.

Consider your children’s well-being during remote travel

Taking children to remote and exotic places can be exciting and educational for the child. However, children may also face risks to health. Consider whether there is enough medical provision at your destination to keep your child safe.

Ensure they are fully immunised against those diseases against which they can be protected.
Children are very susceptible to lack of fluids in the body (dehydration) if they develop traveller’s diarrhoea.
Children’s skin is more susceptible to sunburn, especially at high altitude.
Children are more likely than adults are to develop altitude sickness, but less likely than adults are to be able to describe how they feel and are more likely to have severe symptoms.
Children are less likely than adults to show caution with strange animals and are therefore at greater risk of rabies and other animal-related injury. They also tend to be at a higher-risk of accidents due to swimming or crossing busy roads.
If children become unwell, seek advice. Fever or other symptoms in a child may mean different medical conditions whilst travelling than it would at home.

Advice for humanitarian aid workers and remote travel

If you are travelling overseas to provide disaster relief of humanitarian support you face greater health risks than regular tourists. This is because of your close contact with the local population who may have different diseases that your immune system has not been exposed to before, and also the fact that you are going into a hazardous environment where you will have to contend with the aftermath of a natural disaster.

Travel with an approved aid organisation and attend their briefings before you leave. Look after your health whilst there.

Arrange your vaccinations

Visit your GP practice nurse some months before departure to plan a vaccination schedule. Some vaccinations require a course of two or three injections over a period of several months, and some cannot be given at the same time as each other. Follow the recommended schedule for the countries you will be visiting.

GP services in the UK are under severe pressure, with demand for healthcare exceeding supply. If there isn’t a travel appointment when you need it, you may need to visit a private travel clinic. Most GP practices do not offer travel vaccines, other than the very few that are required by their contract. If they do offer vaccines then you will need to book these many weeks, or even months, in advance.

Diseases against which you cannot be immunised
There are many diseases against which vaccination is not available. These include Zika virus, malaria, most viral haemorrhagic fevers, schistosomiasis, HIV, sleeping sickness, and leishmaniasis. Visit the Travel advice by country page for country-specific advice and to understand how you may minimise your risk of exposure to any or all of these. The risk of malaria can be reduced by taking tablets before, during and after your travel.

Yellow fever vaccination and certificate
A travel clinic can advise you whether you need yellow fever vaccination. You may need it because there is a risk of yellow fever in the country you are visiting, or because the country insists on yellow fever immunisation in all travellers as a protection for its own citizens. These countries require you to show a certificate of yellow fever vaccination on immigration: make sure you are prepared if this is the case.

Skin and sun damage

The sun is much stronger at the equator (and at altitude). Ultraviolet (UV) rays can reflect on to you from the sea and the ground, increasing your exposure. Shadow does not necessarily protect you from sunburn.

Protect yourself particularly from the midday sun (11 am-3 pm), or try to be inside during these hours if possible. Cover your skin, wear a hat and use the highest factor sunblock you can obtain. This does not block UV rays; however, it increases the time that you can be exposed to the sun without burning. This time may still be extremely short, particularly if you are near the equator and your skin is fair.
Protect children’s skin – it is thinner than that of adults. Ideally, wear a hat, but if not protect the tops of ears.

Health complications to do with high altitude

If travelling to high altitude, the thinner air means that the sun’s rays are intense. Severe sunburn can occur even if the temperature is low.

Travel to high altitude brings particular challenges. These partly relate to low oxygen levels and partly to extreme environmental conditions. Lower oxygen levels make exercise more tiring. If you have a heart or lung condition that is not troublesome at sea level, it can become a problem when expending effort at altitude.

Developing a lack of fluids in the body (dehydration) is common at altitude. This is because the air holds less moisture and because the body’s response to altitude is to dehydrate. Take lip salve for dry lips and eye drops if you tend to experience dry eyes, and keep your fluid intake high.

Read more about altitude sickness and be aware of the possible symptoms and also any risks that might make you particularly susceptible.

Health complications to do with very cold climates

Cold environments can be troublesome for young children and the elderly. A cold environment challenges your body by air temperature, air movement (wind speed), and humidity (wetness). See the separate leaflet called Frostbite.

Protective clothing is needed below 4°C. It should be in multiple layers, as the air between layers provides insulation. Wear a hat. Gloves are needed below 4°C. Below −17°C, mittens are advised.
In bright snow, eyes need protection against UV light.
Have balanced meals and make sure you drink enough. Avoid caffeine during the day as it increases dehydration. Alcohol also reduces your ability to keep warm.
Watch for the signs of frostbite. The risk of frostbite depends on the temperature and wind; however, exposed skin may develop frostbite at any temperature below freezing point.
Be aware of the signs of hypothermia, a condition which usually occurs gradually. These are:
- Shivering, cold, pale and dry skin.
- Tiredness, confusion, and irrational behaviour.
- Slow and shallow breathing.
- Slow and weakening pulse.

Illness after your return

Some tropical diseases have long incubation periods (meaning that it can be many days or weeks between exposure and developing symptoms). If you develop unexplained illness or a high temperature (fever) after remote travel, seek medical help and tell your doctor where you have been. Falciparum malaria, which is the severe form of malaria, is a serious cause of fever and chills in returning travellers. Whilst this normally occurs within a month of return, it may take longer to show and should always be considered as a possible cause.

Putting together a useful first aid kit is an important part of preparation for a remote holiday. If you need advice from a medical professional about a first aid kit then you will need to contact a private travel clinic. The purpose of taking this medication is so that you have it with you and can take it if advised by a health professional whilst travelling. Self-diagnosis and self-treatment are generally not wise except where there is no alternative and things are very clear.

Do not approach your GP to prescribe ‘just in case’ medication, unless it is something that you are given ‘just in case’ when at home – for example, some people with COPD have a standby prescription for antibiotics and steroids at home. If you consider that you might need ‘just in case’ medications due to the remoteness of your travel, then you would need to visit a private travel clinic. This is also the case if you are prone to urinary tract infections, for example; your GP will not be able to prescribe antibiotics in case you develop an infection whilst you are travelling.

You will have to pay for ‘just in case’ treatments, as use outside the UK falls outside the remit of the NHS. You will not be able to consult your GP by phone or email whilst travelling abroad, as they are not insured to offer advice to people outside of the UK, so make sure that you know how to access healthcare in the country that you are visiting.

Personal first aid kit for a remote trip

The following lists a comprehensive first aid kit for two people travelling together to a remote environment. It is based on the advice given in ‘Pocket First Aid and Wilderness Medicine’, a book written by two well-established expedition doctors with experience of remote locations.

The intention of such a kit is not that you bypass medical help and give yourself treatment when unwell. It is so that if you seek medical help from doctors and nurses in the country where you are travelling, they can advise you what medicines you need to take and you will then be able to follow that advice.

Self-treatment is a last resort as it is very difficult for anyone to make treatment decisions about themselves.

Reference book

Equipment

Thermometer.
Tweezers (pointed-end).
Scissors.
Sewing needle.
Safety pins x 2.
10 ml syringe, 2 ml syringe, and needles (in packets, sterile).
Protective gloves – 1 pair.
Sticking plasters – 1 pack.
Blister plasters – 1 pack assorted.
Gauze squares 5 cm x 5.
Sterile non-stick dressings x 5.
Sanitary pad x 1 (for absorbent padding).
Cotton bandage 10 cm x 1.5 cm.
Crepe bandage 10 cm x 1.5 cm.
Duct tape – 1 small roll.
Wound closures (Steri-Strips) – 1 packet.
Alcohol swabs x 5.
Sunscreen (high-factor if at altitude).
Burn cream – for example, silver sulfadiazine or aloe vera gel.
Insect repellent (ideally containing at least 20% DEET).
Lavender oil – mild antiseptic for wound sterilisation.

Medication

Antihistamine tablets – for example, chlorphenamine 4 mg x 10.
Hydrocortisone cream 1% 15 g tube.
It might be advisable to take certain antibiotics in case of bacterial infections when you cannot access local pharmacies – your private travel clinic will be able to advise about this.
Antibiotic ointment (for example, fusidic acid) 15 g tube.
Antifungal cream (for example, clotrimazole) 15 g tube.
Loperamide 2 mg (for diarrhoea) – pack of 10.
Senna tablets x 5.
Small bottle of antiseptic (for example, Savlon).
Antibiotic eye ointment (for example, chloramphenicol).
Indigestion remedy (for example, esomeprazole).
Buccastem antisickness tablets x 5.
Paracetamol 500 mg x 10.
Ibuprofen 400 mg x 20.
Dioralyte oral rehydration salts x 10 sachets.
Throat lozenges 1 packet (for example, Strepsils, Vocalzone).

Additional medication for very high-altitude trekking

Discuss with your private travel doctor and/or trekking group whether your very high-altitude trek requires you to take medication to prevent or reduce altitude sickness. Taking medication does not allow you to stay at high altitudes if you develop altitude sickness – you would still need to descend for your own safety.
Acetazolamide 250 mg tablets (Diamox – for prevention and management of altitude sickness) x 10-20.

Dr Mary Lowth is an author or the original author of this leaflet.

for informational purposes only. We do not claim ownership, accuracy, or liability for the content provided. All rights belong to the original publisher.

The Digital Solution Centre

The Digital Solution Centre

Health Advice for Travelling to Remote Locations

Ensure your personal safety

Conduct a self-assessment