GLOBAL HEALTHPREPARATION

JOSEPH J SCHWERHA MD MPH

PROFESSOR OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE

DIRECTOR OF THE OCCUPATIONAL AND

ENVIRONMENTAL MEDICINE RESIDENCY PROGRAM

GRADUATE SCHOOL OF PUBLIC HEALTH

UNIVERSITY OF PITTSBURGH

HOW LONG IS THE ASSIGNMENT

• FEW DAYS OR WEEKS

• FEW MONTHS

• ONE OR MORE YEARS

EMPLOYEE OR CONTRACTOR

AREA OF THE WORLD

• LANGUAGE• GOVERNMENT

EMBASSY• SAFETY

– STABLE GOVERNMENT

– INTERNAL THREATS

– EXTERNAL THREATS

GLOBALIZATION

• ECONOMIC• ETHNIC• POLITICAL• FINANCIAL

TRANSACTIONS

• ATTITUDES• RELOCATION• RELATIONSHIPS

OVERSEAS EXPERIENCE

• SAFE

• EFFICIENT

• EFFECTIVE PREPARATION

CULTURE SHOCK

• PERSONAL AND ENVIRONMENTAL DISRUPTION CAN BE SEVERE

SOME ISSUES TO CONSIDER

• CAREER REQUIREMENTS• SUITABILITY FOR ASSIGNMENT• PSYCHOLOGICAL AND FAMILY• IMMUNIZATIONS AND MEDICAL KITS• PROPHYLAXIS FOR DISEASES• MEDICAL INSURANCE• MEDICAL SUPPORT• EDUCATION OPPORTUNITIES• LIVING CONDITIONS

FAMILY CONSIDERATIONS

• MEDICAL

• EDUCATION

• RECREATION

• ORIENTATION

MEDICAL NEEDS

• MEDICATIONS• COMPLETE MEDICAL

HISTORY• CONSULTATION• EMERGENCY SERVICES• EVACUATION• TRAVEL MEDICAL KIT

– SHORT TERM– LONGER TERM

AVAILABILITY OF MEDICAL CARE AND EQUIPMENT

• GENERAL

• SPECIALTY

• HOSPITALS

• TRANSPORTATION

• GLASSES AND CONTACT LENS

• DENTURES

EDUCATIONAL NEEDS

• PRESCHOOL

• GRADE SCHOOL

• HIGH SCHOOL

• PRIVATE SCHOOL

• COLLEGE

• GRADUATE SCHOOL

• PROFESSIONAL SCHOOL

HOUSING AND NUTRITION NEEDS

• HOUSE

• APARTMENT

• FOOD AVAILABILITY

• SANITARY CONDITIONS

TRANSPORTATION NEEDS

• PASSPORT• PERSONAL• PUBLIC

TRANSPORTATION• DRIVER• ROAD TRAVEL• AIR TRAVEL• STOPOVERS

AIR TRAVEL

• REMEMBER IF THE ENGINE STOPS, GRAVITY CANNOT BE REASONED WITH

RECREATIONAL NEEDS

• WHAT IS AVAILABLE

• PHYSICAL

• INTELLECTUAL

• LOCATION

MEDICAL EMERGENCIES

• LANGUAGE

• EMERGENCY EXERCISES

• OUT OF COUNTRY EVACUATION

• BASIC LIFE SUPPORT

• MAJOR ACCIDENT PROCEDURES

• EMERGENCY EQUIPMENT

PERSONAL SAFETY

• AVOID ADVERTISING WEALTH

• TRAVELERS CHECKS

• MONEY BELT• WOMEN

STRAPLESS PURSE

• WALLET IN FRONT POCKET

• PROTECT PERSONAL INFORMATION

• MAJOR HOTELS• FIRE SAFETY• LAWS OF

COUNTRY

GENERAL MEDICAL ADVICE

• SUNBURN• INSECT

PROTECTION• SEXUALLY

TRANSMITTED DISEASES

• BLOODBORNE DISEASES

HEALTH INSURANCE

• UNITED STATES• OTHER COUNTRIES• SPECIAL

INSURANCE• ARRANGEMENTS

FOR EMERGENCY MONEY

• S.O.S.

PRETRAVEL MEDICAL SCREENING 1

• TREAT OR ASSESS BEFORE DEPARTURE– INFECTIOUS DISEASE– ANEMIA– DENTAL CONDITIONS– GASTRIC ULCERS– PREGNANCY– CHRONIC

CONDITIONS

PRETRAVEL MEDICAL SCREENING 2

• POSSIBLY UNSUITABLE– CARDIAC DISEASE– CEREBROVASCULAR DISEASE– THROMPHLEBITIS– UNSTABLE CHRONIC CONDITIONS

PRETRAVEL MEDICAL SCREENING 3

• DERMATOLOGICAL• ENT• ENDOCRINE• GASTRO-

INTESTINAL• HEMATOLOGICAL• MEDICATIONS

• MUSCULO-SKELETAL

• NEOPLASM• NEUROLOGICAL• PSYCHIATRIC• PULMONARY

IMMUNIZATIONS

• DT• MMR• SMALL POX• HEPATITIS• FLU• POLIO• PNEUMONIA

• HAEMOPHILUS• MENNINGOCOCCUS• PERTUSSIS• YELLOW FEVER• ETC.

KEEP ON HAND

• RETURN TICKET• TRAVEL

DOCUMENTS• EXTRA

MEDICATIONS• EXTRA GLASSES

OR CONTACT LENS• EXTRA DENTURES• ETC.

WHILE AN EXPATRIATE OR REGULAR OUT OF COUNTRY

TRAVELING

• YEARLY PHYSICAL AND PSYCHIATRIC EXAMINATIONS

• CONTACT WITH CURRENT DEVELOPMENTS

• FAMILY CONTACTS

REPATRIATION

• PSYCHOLOGICAL STRESS

• CAREER PATH• ORIENTATION• PHYSICAL AND

PSYCHIATRIC EXAMINATION

• HOUSING• EDUCATIONAL

NEEDS