HEALTHRECOMMENDATIONS
ForVisitorsandMissionTripstoInstitutionUnivers
Revised12/08/2014
YouwillfindthepeopleofOuanaminthearedelightful,polite,receptive,andgenerous;andthose
associatedwiththeschoolarefurthergratefulandinquisitive.AtriptoInstitutionUniversandthe
opportunitytomeetthestudentsandtheirfamiliesisamostrewardingexperience.
However,itisimportanttobeawarethatOuanaminthelacksemergencyservices,firstresponders,
adequatepolice,andmedicalservices.TheInstitutionUniversMedicalClinichasfinedoctors,well
trainedtocareforinfectiousdiseases,minorinjuries,andsomemedicalproblems.Theclinicdoeshave
abasiclaboratory,onex-rayroom,andultrasoundwithwhichtodiagnosemedical/surgicalproblems;
yetitisnotthehealthcarewehavebeengracedwithinAmerica.
Travelgroupsshouldobtainevacuationinsurance,andleadersshouldconsiderenrollingintheSmart
TravelerEnrollmentProgramthroughtheU.S.DepartmentofState.Medicalriskscanandshouldbe
viewedattheCentersforDiseaseControlandPreventionwebsite(www.cdc.gov/travel).Thesite
providesthelatestinformationaboutmosquitoborneillnessessuchasmalaria,denguefever,andthe
chikungunyavirus.
PREVENTIONofmosquitobitesiskey.FollowtheCDCinstructionscarefully.Rememberthatthe
mosquitosthatcarrythesevirusesbiteduringthedaytime,andindoorsaswellasoutdoors.Sprayyour
clothingwithpermethrin(nottobeusedonskin)beforepacking.Carryanduseinsectrepellents(pack
largervolumesinyourcheckedluggage,andcarryasmalllessthan3oz.repellentinyourcarryonbags).
Non-DEETalternativesincludeRepelLemonEucalyptusorcompoundswith20percentpicaridin,a
chemicalsimilartoacompoundinblackpepper.Productsthatcontain25to30percentDEETseemto
workwell,andcanbereappliedtoexposedskinthroughouttheday.
MALARIAPREVENTION:Pleasetakeandfinishthemalariaprophylaxisprescribedbyyourdoctor.Do
notassumewhenyouarebackhomethatthereisnofurtherneedtofinishtheprescription.
CHIKUNGUNYAINFECTION:Atthefirstsignsoffeverandjointpain(headache,musclepain,joint
swelling,andrashmayappear)getrest,drinkfluids,andtakeacetaminophenandanon-steroidalantiinflammatorymedication.Althoughnolongeranepidemic,itmayremainanendemicriskfortravelers
toOuanaminthe,similartoDengueFever.
DENGUEFEVERpresentswithsimilarsymptoms(fever,severeheadaches,retroorbitalpainbehind
eyes,muscleaches,jointaches,andadiffuse,red,slightlyraisedbumpyrash).Atip-offofDengueFever
isecchymosis(bleedinginskinthatdoesnotblancheorgoawaywhenyoupressontheskin)atthesite
oftheinsectbite.Duetoariskofbleeding,theCDCrecommendsthatifyoususpectyoumayhave
DengueFever,youshouldstoptheanti-inflammatorymedicationsandonlyuseacetaminophen.Rest,
plentyofliquids,andanti-nauseamedicationsarerecommended.Denguefevercanprogresstoan
illnessrequiringIVfluids,whichtheUMCcliniccanprovide.
GASTROINTESTINALILLNESSES(vomitinganddiarrhea)arecommonwithtraveltoOuanaminthe,
despitethecarefulfoodpreparationattheschool.Muchofthisillnessresultsfromchangesin
gastrointestinalorganismsthatarenewtoourbodies,andnotnecessarilydangeroustous.Manyofus
carryCiproorotherantibacterialdrugstouseifwegetdiarrhea.Wecautionnottotakethese
antibioticstooquickly.WaitadayortwoandusebismuthsulfateandImodiumfirst,aswellasa
fluid/electrolytereplacement(everyoneshouldtakeGatoradepacketstomixwithwater),andseeifit
improveswithoutantibiotics.Ifyouhaveafever,continuedseverediarrhea,orevidenceofblood,then
taketheCiproandconsiderintravenousreplacementoffluidslost.
PREVENTIONisbest.Washhandswithsoapandwaterforatleast20seconds,or,ifnotavailable,usea
handsanitizercontainingatleast60percentalcohol.Othercommon-senseprecautionsmightinclude
limitingoravoidingsalads,tomatoes,andfreshfruit,andeatingfullycookedandhotfoodonly,or
peanutbuttersandwiches.
TheCDCstatesthatbismuthsubsalicylate(Pepto-Bismol)canbetakenprophylacticallywhenyouarrive
andthroughoutyourstayatadoseoftwotabletsfourtimesperday(reducesyourchancesof
developingdiarrheabyabout50percent).Thisdosewillcauseyourstooltoblacken,andmaycause
constipation.
INJURIEScanoccur.Becautiouswhenwalkingoutsidethecompound.Speedingvehiclesandreckless
drivingarecommon.
Alltravelerstotheschoolarestronglyadvisedtoseetheirmedicaldoctororatravelclinictobe
updatedonimmunizations,bothroutineandrecommendedfortravel,andtohaveanypersonalhealth
issuesaddressedthatmightbecomeaconcerninatropicalthirdworldcountrywithlimitedhealthinfra
structure.Weallneedtobepreparedsowecanremainhealthyandproductiveonthetripandwhenwe
returnbacktoourownhomes.
PreparedbytheCOCINAUniversMedicalCentercommitteeusinginformationfromtheCDC,theMedical
Letter,andConsumerReportsonHealth,June2014