Air Squadron

The Air Squadron

Africa 2003

Medical Briefing

Adapted from a lecture to UN emergency teams

1. Principles

  • Be sensible (avoid illness - don't rely on vaccinations or medical intervention afterwards)
  • Have your vaccinations up to date
  • Always take malarial prophylaxis when appropriate
  • Beware of road accidents (much higher risk in developing countries than flying)
  • Courtesy can kill ( don't accept questionable food/drink out of politeness)

2. Eat and drink safely

  • Always wash your hands before eating
  • Use only safe water for drinking, washing food and cleaning teeth
  • Use only safe water for drinking, washing food and cleaning teeth
  • Avoid ice
  • Avoid ice cream
  • Avoid unpasteurised milk
  • Beware of salads and water melons
  • Don't be greedy - often the degree of illness is related to the quantity eaten!

3. More obvious hazards

  • Traffic accidents
  • Insect bites: mosquitoes, sand flies and ticks
  • 14 contagious diseases
  • tropical sunshine (skin cancer incidence increasing at 10% pa)
  • animal bites

4. Road traffic accidents

  • The major cause of death and serious injury in developing countries
  • If necessary tell the driver to slow down
  • Think of the consequences of your vehicle knocking down a child/pedestrian (lynching)
  • In the absence of medical facilities you may die from a relatively "minor" injury

5. Malaria

  • 350 million new cases a year
  • 1 in 20 affected world-wide (World Health Organisation)
  • 30,000 Europeans/Americans infected yearly
  • long-term expatriates especially at risk
  • 100 countries affected
  • 2.4 billion at risk and one of them is you

6. Protection against Malaria

  • Avoid being bitten
  • Use insect repellent/mosquito coils
  • Long sleeves/light coloured clothing
  • Use mosquito nets
  • Take malarial prophylaxis

7. Malarial prophylaxis

  1. Chloroquine and proguanil (paludrine)
    Safe but only 50-70% effective
  2. Doxycyline
    Effective but less suitable for fair skinned (photosensitivity and thrush)
  3. Mefloquine (Larium)
    Not suitable for pilots Very effective but side affects experienced by 25-40%
  4. Malarone
    Prescription only £34.00 per packet Ingredients: paludrine and atovaquone Day before and 1 week after Once a day Alternative to larium, better than doxycyline

8. Malarial summary

  • Be sensible - avoid being bitten
  • Listen to your doctor not the "expert expatriate"
  • Malarial prophylaxis has side affects but so does malaria - death and chronic illness

9. Other major diseases

  • Rabies
    Don't touch animals
    Post exposure treatment now available
  • HIV
    Well publicised risks : infected blood /sexual contacts
  • Biharzia
    Avoid wading or bathing in streams, rivers or lakes
  • Cholera
    Wash your hands before eating
    Death through dehydration
    No vaccine available
  • Dengue
    Haemorrhagic fever transmitted by daytime mosquitos
    avoid being bitten - no vaccine
  • Diptheria
    Most Europeans have been vaccinated
  • Hepatitis
    Hep A food/drink/poor personal hygiene
    Hep B and C sex/drugs/transfusions
    Vaccine against A essential
  • Legionnaires disease
    Associated with poorly maintained air conditioning
    Over 50's at risk
  • poliomyelitis
    Booster vaccination required by most people
  • Tetanus
    Trivial injuries can lead to death
    Vaccination essential
  • Tuberculosis (TB)
    Endemic in all developing countries
    Vaccination essential
  • Typhoid
    Contaminated food/water
    Vaccination possible
    Treatment with antibiotics effective
  • Yellow fever
    Bite from an infected mosquito
    Vaccination certificate mandatory

10. Protection by immunization

  • Vaccination check-list Polio/tetanus/diphtheria (booster every 10yrs)
  • Hepatitis A (10yrs) Hepatitis B (3yrs)
  • TB once (normally in childhood)
  • Typhoid (3yrs)

11. Take a first Aid kit

  • Could save your life or some else's
  • There are often pictures of what to do to help those with no knowledge of first Aid

Gilbert Greenall December 2002.