insights

By Chris Knight, Head of Assistance for Charles Taylor Assistance

The Foreign and Commonwealth Office says, “British nationals in the area should monitor local media reports and follow the advice of local authorities, including any evacuation orders.”

Kilauea is described as one of the world’s most active volcanoes. It has been erupting almost constantly for the last 35 years.

If you’re planning to travel to Hawaii

• Get the right advice before you set off. Check the latest travel guidance from the Foreign and Commonwealth Office: https://www.gov.uk/foreign-travel-advice/usa
• Take out a good travel insurance policy that covers emergency repatriation and medical costs.

• Stay informed about real-time safety and security risks by keeping a close eye on news reports from the State of Hawaii: http://dod.hawaii.gov/hiema/category/news-release/

• For more information about volcanic eruptions, see https://www.ready.gov/volcanoes

Advice from the Hawaii Department of Health:

“The best way to protect yourself and your family from the extremely dangerous volcanic gases is to leave the immediate area of the volcano defined by the police and fire department. This is especially important if you or a family member has asthma or other respiratory disease or illness.”

Yellow fever is an acute viral disease that is spread to humans via infected mosquitos. It is endemic in tropical areas of Africa and Latin America.

Symptoms of yellow fever usually appear 3 to 6 days after the bite of an infected mosquito. In the initial phase, they include fever, muscle pain, headache, shivers, loss of appetite, and nausea or vomiting. For most patients, these symptoms disappear after 3 to 4 days. However, 15% of patients enter a second, more toxic phase, when high fever returns, and several body systems are affected, including the kidneys.

There is no cure for yellow fever and treatment is based on symptom management.

Travelling to Brazil?

• See a health professional at least four to six weeks before you travel, to find out about yellow fever and other recommended vaccinations for the area(s) that you plan to visit.
• Bear in mind that Rio de Janeiro state authorities recommend that all visitors to the state, including to the island of Ilha Grande, are vaccinated against yellow fever.
• You can find out more about vaccination requirements for Brazil from the National Travel Health Network and Centre: https://travelhealthpro.org.uk/country/34/brazil#Vaccine_recommendations

• Check the latest travel advice from the Foreign and Commonwealth Office at https://www.gov.uk/foreign-travel-advice/brazil and take out a comprehensive travel insurance policy before you set off.
• Once in Brazil, avoid mosquito bites both day and night by using a DEET-based insect repellent, covering up exposed areas with clothes and screening windows.
• If you’re travelling (or have travelled) to an area in which yellow fever is a risk, seek immediate medical advice if you have symptoms of the disease. 

Advice from the World Health Organisation   

• Vaccination is the single most important measure for preventing yellow fever.
• The vaccine has been used for many decades and is safe and affordable, providing effective immunity against yellow fever within 10 days for more than 90% of people vaccinated and within 30 days for 99% of people vaccinated.
• A single dose provides lifelong protection.
• Travellers with children below 9 months, pregnant or breastfeeding women and people with severe hypersensitivity to egg antigens, and severe immunodeficiency, or over 60 years of age, should consult their health professional for advice.

• South Korea will be hosting this winter’s big sporting event between February 9th and 25th 
• PyeongChang County, Gangwon Province (about 170km from Seoul) will be the epicentre of the action. See https://www.pyeongchang2018.com/en/spectator-guide for schedules, venues and transport information.
• 2,500 athletes will compete, with more than 500,000 tickets sold so far. 
• South Korea is expected to deploy more than 5,000 security staff, to use metal detectors and x-ray scanners at all major venues and to have a heavy police presence in both PyeongChang and Seoul (the major international transport hub for the event). 
• Potential terror threats will be monitored, and the event will (reportedly) be protected against cyber threats. Additional security measures, such as no-fly zones and increased maritime patrols, are also likely.

Wherever you’re going for your winter sun abroad, follow these tips from CEGA, the international assistance and claims company. They’ll help you have a safe and healthy holiday, that you remember for all the right reasons.

Get ready….

·      Check the latest Foreign and Commonwealth Office travel advice for the country you plan to visit, at https://www.gov.uk/foreign-travel-advice.

·      Buy a good travel insurance policy that covers you and any family members for all the activities you want to do while you’re away. At the very least this should cover the costs of cancellation, emergency repatriation, essential medical treatment and lost or stolen possessions.

·      Tell your insurer about any pre-existing medical conditions that you or close relatives have. You may not be covered in an emergency if you don’t.

·      Find out from your GP or local travel clinic if you need any vaccinations, at least six weeks before you set off. 

·      Apply for any visas that you may need.

·      Check your passport is in-date. And bear in mind that some countries need passports to be valid for six months after arrival.

·      Scan important documents, such as your passport, travel tickets and insurance policy and e-mail them to yourself and a trusted friend or relative. You’ll need these if the originals are lost or stolen.

·      Research the place where you’ll be staying. Find out about the nearest chemists, the prevalence of muggings and burglaries, the transport networks etc.

·      Make sure you know the local emergency services number.

·      Pack a first aid kit with essential medication - and take extra, in case your trip is longer than you plan. Also include insect repellent, sunscreen, antiseptic and plasters.

·      Remember your phone charger.

 Get set…

·      Ask your airline about restrictions on items allowed in hand luggage.

·      Where possible, keep your valuables and any essential medication with you.

·      Drink plenty of water to reduce jet lag.

·      Keep the assistance helpline that comes with your travel insurance with you at all times – then you can access help quickly in an emergency, either on your journey or during your holiday.

 Go…

·      When you arrive, lock up your valuables in your hotel safe, don’t flaunt expensive devices, jewellery or cash, and make sure your bags are zipped up when you go out.

·      Check the windows and doors in your room are secure and that the phone works. If not, tell the hotel manager.

·      Slap on the sunscreen during the day, wear a hat, and drink plenty of bottled water so you don’t get dehydrated.

·      If there’s any risk of mosquito-borne diseases, guard against bites with loose-fitting clothes that cover your arms and legs, use insecticide treatments day and night and keep bedroom windows screened.

·      If tap water isn’t safe, drink bottled or boiled water to avoid gastroenteritis and water-borne diseases such as hepatitis.  Raw salads, ice cubes in drinks and ice creams carry the same risks, so avoid them.

·      Be sensible about how much alcohol you drink. Travel insurers don’t usually set specific limits on alcohol, but if it’s obvious an accident has been caused by excessive drinking, they’ll be reluctant to pay a claim.

·      If you’re staying in a risky area, use ATMS inside shopping centres or banks and avoid going out alone at night. If you’re mugged, don’t put up a fight - you could be badly injured.

·      In less developed areas, stick to recommended pharmacies for over-the-counter medication such as painkillers, so you’re sure you’ve got what you asked for.

·      Reduce the risks of road traffic accidents by using licensed taxis, wearing a seatbelt and being extra careful when you’re crossing the road. Bear in mind that cars won’t always stop for you.

·      Stay away from stray animals if there’s any risk of rabies.

 Did you know?

A recent ABTA (Association of British Travel Agents) survey showed that 25% of British travellers set off abroad without travel insurance in the last year. ABTA says, “some hospitals may refuse to treat patients if they do not have holiday insurance or sufficient funds to cover their treatment.”

On November 24th, at the end of Friday prayers, a Sufi mosque in Bir-al-Abed was attacked by insurgents using explosives and automatic weapons. This was the first substantial attack in the region to target civilians and a Muslim minority. More than 300 people were killed and over 100 were injured.

The Foreign and Commonwealth Office (FCO) advise against all travel to within 10 kilometres of Mount Agung. A local authority exclusion zone currently extends between 8 and 10kms from the crater.

Mount Agung last erupted in 1963; killing over 1500 people.

Bali travel advice

• If you are within 10km of Mount Agung, follow FCO advice to leave the area immediately.
• If you are in another part of East Bali, check the FCO travel advice website regularly: https://www.gov.uk/foreign-travel-advice/indonesia.
• Heed advice given by local authorities and monitor local and international media for developments. If you are told to evacuate, do so.
• If you are in an area affected by ash clouds, wear a face mask and seek medical help if necessary.
• Take extra care if you suffer from a respiratory condition.
• Talk to your airline or tour operator before travelling to the airport.
• Keep any receipts relating to medical treatment or travel disruption, should you need to make a travel insurance claim.
• If you need emergency assistance or repatriation, call your travel insurance helpline.
• If you are planning to travel to Indonesia, check the latest FCO travel advice first and make sure you are covered by travel insurance.

Current information from the Foreign and Commonwealth Office

• Ash clouds have caused airport closures for periods in both Bali and Lombok, and disruption to flights in the region.
• The authorities are monitoring the situation closely and airports in the region are likely to continue to be closed for periods of time.
• The British Embassy currently has a team of consular staff based in the international departures area at Bali’s Ngurah Rai International Airport to provide support and advice to British nationals.

THE SITUATION

Affected areas include the capital, Antananarivo, and the port city of Toamasina.

Cases of plague are rare amongst international travellers.

Already in California?

Stay well away from areas affected by wildfires. If you are already in or close to an affected area, listen to local news reports and follow instructions from the local authorities. If you are told to do so, evacuate immediately.

Need to get back home in an emergency?

Call the assistance helpline that comes with your travel insurance policy.

The Foreign & Commonwealth Office has issued the following advice for British tourists in California: “Large wildfires have broken out in the counties of Napa, Sonoma, Yuba, Butte, Nevada, Calaveras, Humboldt, Mendocino and Lake in the State of California. A state of emergency has been declared in Napa, Sonoma and Yuba. Evacuation orders are in place in several areas and emergency shelters have been opened. Some infrastructure has been damaged, including phone communications and internet access. Wildfires can spread swiftly so always remain cautious. Follow the instructions issued by the local authorities, and obey all evacuation orders. Local authority advice and information on emergency shelters is available at the California Governor’s Office of Emergency Services (Cal OES).

Advice to Monarch customers, issued by CAA

• Customers in the UK yet to travel: don't go to the airport

• Customers abroad: everyone due to fly in the next fortnight will be brought back to the UK at no cost to them. There is no need to cut short your stay

• All affected customers should check monarch.caa.co.uk for more information

• The CAA also has a 24-hour helpline: 0300 303 2800 from the UK and Ireland and +44 1753 330330 from overseas

Here are some tips from CEGA to help keep young gap year travellers both safe and solvent:

Before you set off

Take out travel insurance

As soon as you’ve booked your trip, buy travel insurance that covers all the countries you want to visit for as long as you want to travel – and bear in mind that most standard policies will only cover you for 31 days, so you may need special gap year cover. Your policy should cover you for travel cancellation, medical treatment abroad, lost or stolen possessions and emergency repatriation back home.

Make sure you’re covered for risky sports

Sports like paragliding, mountain biking or climbing may not be covered by a standard travel insurance policy, because they expose insurers to extra risk. If you plan to do some risky sports, you’ll need to check that your policy includes them, or add them as an extra before you set off abroad.

Tell your insurer about any medical conditions

If you have a pre-existing medical condition you may have to pay an extra premium or shop around for an insurer that’s willing to cover you. You’ll also need to come clean about any close relatives who are ill, in case you need to come home early to see them in an emergency.  You may not be covered in an emergency if you don’t.

Get an EHIC for Europe

If your gap year travels are within Europe, you’ll need both travel insurance and a European Health Insurance Card (EHIC). The EHIC entitles you to basic state medical treatment in Europe, but it won’t cover you for repatriation back to the UK, if you need it, nor for medical treatment at a private hospital (that’s where travel insurance comes in). Most travel insurers will waive their claims excess for medical costs if you have an EHIC.

Book your vaccinations

Find out about vaccinations and anti-malaria treatment at least 6 weeks before you travel and tell your doctor or travel clinic exactly which areas you’re visiting, even if you’re just passing through, as you’ll need to take different precautions for each.

Do your research

Find out as much as possible about the area/s in which you’re staying. Are there often muggings?  Where are the no-go streets at night? How would you contact the local emergency services if something went wrong?  And check the latest country-specific travel advice from the Foreign Office, at https://www.gov.uk/foreign-travel-advice

Pack sensibly

Limit your packing to things you really need, that are easy to replace. Include a first aid kit with essential medication (it’s worth taking extra, in case your trip is longer than you plan), insect repellent, sunscreen, antiseptic and plasters. And remember your phone charger.

Copy important documents

Take copies of your passport, driving licence, travel insurance policy and credit cards and e-mail them to yourself and a friend or relative at home. You’ll need these if the originals are lost or stolen.

When you're away

Keep your assistance helpline number close

This comes with your travel insurance policy and will enable you to reach help quickly if there’s an emergency.

Look after yourself and your belongings

Keep an eye on your possessions, or they may not be covered by your insurance if they are lost or stolen.  Don’t carry around expensive tech or large amounts of cash and make sure bags are zipped up. If you’re in a risky area, use ATMS inside shopping centres or banks and avoid going out alone at night. If you’re mugged, don’t put up a fight - you could be badly injured.

Avoid mosquito bites

If there’s a risk of mosquito-borne diseases, avoid bites by wearing loose clothes that cover your arms, legs and feet and use a DEET-based insect repellent. If you can, screen your bedroom windows. And bear in mind that daytime bites can be as dangerous as their night-time counterparts.

Be wary of water, food and medicines

If you’re travelling in the developing world, it’s not just the tap water that may be unsafe, but also any salad or fruit that’s been washed in water - and even ice cream and ice cubes. They could leave you with diarrhea, typhoid or hepatitis. Drink bottled water and stick to cooked food that is piping hot. And always use recommended pharmacies for over-the-counter medication such as painkillers - so you’re sure you’ve got what you asked for.

Keep cool

Avoid heatstroke and sunburn by using sunscreen and wearing a hat, and drink plenty of bottled water to stop yourself getting dehydrated. Always make sure that bottle seals haven’t been broken.

Go easy on the alcohol

There’s no need to be teetotal on your gap travels, just to be sensible about how much alcohol you drink. Travel insurers don’t generally set specific limits on alcohol consumption, but if you have an accident that’s obviously been caused by excessive drinking, they may not pay up.

Watch out on the roads

Road traffic accidents cause more injuries than anything else in the developing world. Reduce the risks by using licensed taxis, wearing a seatbelt and being extra careful when you’re crossing the road – cars won’t necessarily stop for you. And don’t drive at night.

CEGA’s Chief Medical Officer Dr Lynn Gordon says:

 “Travel insurance isn’t a luxury, it’s an essential safety net. Your insurers won’t just cover your costs in an emergency, they will also manage your medical care and give you professional support when you may be thousands of miles from home. But it’s also important to take responsibility for your gap year travels by researching the risks and finding out how to avoid them, so that your trip leaves you with positive memories.”

Top 10 gap year destinations (Source: ABTA members specialising in gap years)

Although Irma has now been downgraded to a tropical depression, the danger isn’t over yet.

Areas affected by Irma include Florida, Georgia and South Carolina, as well as many Caribbean Islands; not least Cuba, the British Virgin Islands, Barbuda and Anguilla. 

The danger is not over yet. According to European weather service, Meteoalarm, parts of Italy and Austria, as well as Croatia, Hungary and Poland, are among several areas still struck by extreme heat. For those travelling to affected countries, CEGA offers this advice:

Make sure that you’re registered with a GP; be open and honest about your medical history when you buy travel insurance and don’t drink excessively on holiday. This is the advice for winter holidaymakers from Dr Tim Hammond, Chief Medical Officer at CEGA, the claims and global assistance providers. Ignoring it could invalidate a travel insurance claim for medical expenses.

Dr Hammond’s first warning is made more pertinent by NHS England plans that could see patients removed from GPs’ lists if they do not contact their surgery for five years. “Even if a visit to the doctor isn’t necessary, it’s important to keep in touch at least once every five years,” says Dr Hammond. “If a travel insurance policyholder is not registered with a GP, an insurer cannot check their medical history - and this could invalidate a claim for medical expenses.”

 “It is also important”, explains Dr Hammond, “for holidaymakers to volunteer information about any existing or historic medical problems when they buy a travel insurance policy. They can then find out if their existing condition is covered by their policy, if they need to pay an extra premium or if they need specialist cover.”

Other common causes of holidaymakers’ medical claims being turned down, says Dr Hammond, include excessive drinking. “If an accident follows a session of heavy drinking, any related travel insurance claim may well be turned down,” advises Dr Hammond. “With most insurance cover there’s no need to be teetotal on holiday – just be moderate.”

Dr Hammond tells holidaymakers: “Always talk to your travel insurer before you set off abroad if you have any questions about your policy. Your travel insurance provides an invaluable safety net if an emergency strikes while you’re overseas.”

Dr Tim Hammond, Chief Medical Officer for assistance and claims specialists CEGA sets out the less obvious risks of winter sports holidays - for devotees of skiing, strolling and après-ski alike.

Alcohol

The risks: Drinking alcohol at altitude will exacerbate its effects and increase the risk of feeling disoriented, having an accident and getting lost. And, if something does go wrong after over-indulging, your travel insurance may not cover you.

What to do: There’s no need to be teetotal on holiday – but avoid drinking excessively, and don’t walk home alone after an indulgent night out: temperatures drop dramatically after dark in the mountains and ski resorts are not the safest places in which to be lost.

Altitude sickness

The risks: Oxygen levels in high altitude resorts, especially in North America, are much lower than you may be used to. Nausea, confusion, headaches and shortness of breath can all be signs of altitude sickness. So too can concentration problems and slow reaction times.

What to do: Drink plenty of water and avoid excessive activity on the first day at high-altitude. You can even stagger your journey and gradually increase altitude over a few days. Bear in mind that children and sufferers of respiratory illnesses or reduced lung function will be most affected.

White-outs

The risks: Mountain weather is unpredictable and a “white-out” on the slopes can come from nowhere. It can make it hard to see anything more than a few feet away and increase your chances of getting lost – even if you’re not skiing.

What to do: Stay close to other people and keep the person in front in view until you get to the bottom of the mountain. If it’s windy, stay away from the mountain edge and try to find shelter under trees. Call for help if you can’t find your way back.

Extreme temperatures

The risks: Extremes of temperature can be felt in a single afternoon. A fierce sun can burn, whilst intense cold and wind can quickly cause frostbite (as can touching frozen metal with bare skin). Occasionally, hypothermia can even set in, causing excessive shivering, weakness and exhaustion, as well as slurred speech and mental uncertainty.

What to do: Wear plenty of sunscreen, cover your extremities and keep skin away from frozen metal. If your fingers, toes or ears begin to feel numb, get inside as quickly as possible to warm up. Finally, wear layered clothing so you can increase or decrease warmth as the temperature changes. And, if you think you’re experiencing signs of hypothermia, get professional help.

The cost of medical repatriation

The risks: You don’t have to be on skis to have an accident: slipping on ice outside your hotel could give you a broken leg. And if you need an emergency repatriation from a European ski resort, it could set you back up to £8,000 without insurance (even if you have a European Health Insurance Card). From the US or Canada it could cost you up to £70,000.

What to do: Take out a good travel insurance policy that covers everyone in your party for every activity that they plan to do (even if it’s only walking).  And remember that a travel insurance policy doesn’t just cover the costs of repatriation - it also offers you a helping hand when you need it most.

Injuring a third party

The risks: You could be sued for an injury to a third party, if it’s deemed to be your fault.  A personal liability claim can be made months after the event, when the full implications of an injury are clear – and it could bankrupt you if you don’t have insurance

What to do: If you want to avoid potentially high costs and litigation headaches, make sure your travel insurance policy includes personal liability cover.

One Solution, One Platform, One Assistance Service

INtrinsic is an innovative global risk management programme that mitigates risk for insurers and organisations that operate and send employees abroad. By providing a full range of medical and secuirty expertise via a single contact point.

INtrinsic services aim to ensure that companies with employees overseas are able to prepare for the unexpected, to keep staff safe and to respond to an emergency, anywhere in the world, 24/7. A strategic partnership between CEGA and Solace Global, it comprises; pre-travel planning,travel tracking mobile technology, comprehensive staff training, travel risk mitigation measures, usable technology, intelligence, in-country support, 24/7 response and evacuation capabilities and post-event evaluation.

INtrinsic provides the unified support and services that enable you to operate with confidence globally.

Jonathan Brown, Risk Team Manager at CEGA, the global risk, assistance and claims specialists, shares some pre-travel tips with employers:

 1.         Health

Be prepared for every eventuality – and go well beyond pre-travel vaccinations. Just for a start, you need to think about the current health needs of your employee/s: for instance, do they rely on regular prescriptions or are they diabetic - and do accompanying family members suffer from any medical conditions?  Also find out about the capabilities and limitations of local routine medical and dental care in situ. Will it meet your employee’s needs or will you have to provide access to extra support? And you’ll need to know about the prevalence of contagious diseases, rabid dogs, poisonous stings and unsafe drinking water, as well as the suitability and accessibility of emergency care. Above all, make sure your employee/s can take the right precautions and knows exactly what to do and who to contact in an emergency.

2.         Security

Find out if the political situation is stable and if conflict or terrorism is likely to strike in the future – and remember that things can change quickly. Is it safe for your employee to walk around alone at night or during the day, or is kidnapping and mugging prevalent? Do they know how to avoid unwelcome attention and cultural clashes?  What about protecting themselves against credit card or mobile phone cloning or insecure Wi-Fi networks? It’s up to you to have the right processes in place to keep them safe and to make sure they know how to mitigate risk and react to security threats.

3.         Environment

Get advice about the climate: is there a danger of excessive heat or cold? Are earthquakes, hurricanes or floods likely? Let your employee/s know the procedure if a natural disaster strikes. And educate them about heatstroke and other heat-related problems, or how best to cope in plunging temperatures.

4.         Emergency assistance

How will you locate your employee/s if an emergency strikes? Could an evacuation be implemented quickly and what would it involve? How do you know that your emergency planning will work? Will your staff know exactly what to do? A matter of minutes can turn a minor incident into a catastrophe - but planning ahead with real-life scenarios can help to avert this.

5.         Reassurance

Make sure your employee/s feel supported and prepared, not just for their destinations but also for their journeys. Many employers forget that travel itself can be hazardous, especially if it involves crossing high-risk countries. Anticipate the risks before a deployment overseas and put in place the appropriate safeguards, training and procedures. You won’t just be meeting duty of care obligations, you’ll also be investing in a safe and productive workforce.

It’s set to attract more than 10,500 athletes, 380,000 visitors and sales of over 7.5 million tickets.

With less than 60 days between now and one of the biggest sporting events on the planet, it’s time to start thinking about the health and safety of individuals travelling to see the action - whether that’s you, your employees or your customers.

Click here to read our 'Ready Steady Go to Rio' guide.

A disease linked to the Zika virus in the Americas and other countries presents a global public health emergency. Pregnant women in particular are advised not to travel to areas where there are current outbreaks of the virus.

CEGA is directing customers planning a trip to the Americas or other locations to our pre-travel risk management services and is also communicating important advice about the virus from the World Health Organisation and Foreign Office.

In the meantime, our multilingual teams of assistance, medical and travel experts are ready and waiting to help individuals adversely affected by the virus - drawing on our 40 years’ experience and trusted network of partners all over the Americas and beyond.

For the most recent updates we recommend you refer to the following websites:

World Health Organisation information

http://www.who.int/mediacentre/factsheets/zika/en

Foreign Office travel advice

https://www.gov.uk/foreign-travel-advice

Advice from Dr Tim Hammond, Chief Medical Officer for CEGA.

It’s not just skiing that may be enticing you to the slopes. There’s also snowboarding, snowshoeing, sledging, paragliding, ice-skating and ski jeering … the list goes on. And with this greater choice comes greater risk. Here are ten tips to help keep you and your family safe…

With baby Nubia's discharge from hospital, there are now no known Ebola cases in Guinea and the country is counting down the days until the all clear can be declared.  Liberia and Sierra Leone are both free too. Continued vigilance is necessary but the focus now turns to a whole host of health challenges for citizens and visitors alike.

Following the recent announcement from the UK Foreign office (https://www.gov.uk/foreign-travel-advice/egypt), advising against all but essential travel by air to or from Sharm el Sheikh. UK carriers will not take passengers directly to Sharm el Sheikh airport. Please contact your tour operator to confirm your travel policy and refer to the telephone number provided.