International Travel Preparation, Safety, & Wellness

国际旅行准备、安全及健康

Johns Hopkins University

本课程为全球卫生基础（Foundations of Global Health）系列课程的第三门课程。公卫的东西听起来都是很泛泛的东西，我当时学习公卫的时候也是这种想法，但很有用。比如说流行病学那些很泛泛的概念，最后全部成为实际应用时候的标杆。本课程听起来更倾向于是全球公共卫生的学生去到另一个地方进行实践的时候的注意事项课程……不过对于旅行来说也很有必要。

Week 1 Nuts and Bolts of Travel Preparation

第一周课程 旅行准备的具体细节

Key Concepts

• Determine what resources and services (visas, consular services, insurance, travel assistance, etc.) are required for international travel and work, and understand when to engage them
• Define travel warnings and travel alerts, and differentiate between the two
• Determine the type of insurance required for international travel, and understand barriers to coverage and reimbursement
• Explain the role of ISOS: List at least three of its services and three limitations

Section 1 Project Planning and Working in the Field

1. Common Issues

• Loneliness
• homesickness
• language barriers
• isolation
• lack of guidance
• institutional review board (IRB) delays

2. Dive in

• Projects often go awry or scopes of work change
• dive into the experience, and offer to do anything and everything
• most organizations are overscoped and understaffed
• do your best to be an asset

3. Relationship building
   Relationship building is to effectively work in the field you must build trust, and positive relationships with the international and local staff. Anyone that you're going to be working with. Education level is not always an indicator of the level of insight that someone can bring to the table.
4. Reference: Brian DO Ouma et al., Views from the global south: exploring howstudent volunteers from the global north can achieve sustainable impact in global health, Globalization and Health2013,9:32

Section 2 Travel Documentation and Responsibilities

PART 1 PREPARING TO TRAVEL

1. Do your Research

• State Department
  • Travel warnings
  • Travel alerts
• Centers for Disease Control and Prevention (CDC)
  • Traveler’s Health: Travel Safe, Travel Smart
• Faculty and students who have traveled to your destination

2. Program Requirements

• Different programs have different requirements
  • Read carefully
  • Follow deadlines
  • Complete all paperwork
• Realize that you could have multiple sets of requirements
  • One for your program
  • Another for your department

3. Travel Documents

• Ensure passport is up to date and will not expire within six months
• Visa is your responsibility!
  • Use your principal investigator (PI) as your first resource, but be aware that PIs are not always right
  • Research the country’s consulate requirements, and follow them!
• International students might need to work with home embassy
• Make copies to bring with you and copies to leave behind with friends, family, and program

4. Travel Health and Medications

• Your personal health considerations
• Medications
  • Adequate supply
  • Original containers
  • Carry-on bags
• Glasses and contacts: Bring extra!
• Personal health checklist (in documents)
• CDC Traveler’s Health
  • The most up-to-date and country-specific travel health information available
  • Information on:
    • Vaccinations
    • Medications
    • Staying safe and healthy
    • Health warnings (e.g., Ebola)

5. Communication

• Phones: Personal cell phone versus new phone in-country?
• Communication plan: With family, faculty, in-country partners, etc.
• Internet: Can you get any?

6. Money

• How much do you need?
• Who is paying for what?
• How will you maintain cash flow?
  • ATMs aren’t everywhere
  • Consider cash versus credit cards
• Be aware of exchange rates and charges for international withdrawals
• Money spending priorities:
  • Travel insurance
  • vaccinations
  • medicine
  • airfare
  • safe housing
  • documents

7. Travel Warnings and Alerts

PART 2 TRAVEL WARNINGS AND ALERTS

1. State of the country/Region

• Advisory levels
  • Level 1: Exercise normal precautions
  • Level 2: Exercise increased caution
  • Level 3: reconsider travel
  • Level 4: do not travel
• Travel Warnings versus Travel Alerts
• Travel Warnings can be specific to a region or city within a country
• Often provide information for embassy services in-country
• Outline reasons for warning (recent attacks, weather, etc.)

Example of statement of the country
“The Department of State continues to warn U.S. citizens that the level of crime and violence in Honduras remains critically high, although it has declined in the past two years. This Travel Warning supersedes the Travel Warning dated March 2015 and includes additional information on crime and security in Honduras.”
(Source: U.S. Department of State, last updated October 30, 2015)

2. Resources

• State Department: Smart Traveler Enrollment Program (STEP)
• Embassies
• Institutional travel registries: Example: Johns Hopkins International Travel Registry (JHITR)
  • For many programs, travel registration is required
  • Set up a profile with your general information (passport number, emergency contact, etc.)
  • Log travel as you plan for it (flights, housing, local transport, etc.)

3. Travel Advisory Risk Indicators
   C - Crime: Widespread violent or organized crime is present in areas of the country. Local law enforcement may have limited ability to respond to serious crimes.
   T - Terrorism: Terrorist attacks have occurred and/or specific threats against civilians, groups, or other targets may exist.
   C - Civil unrest: Political, economic, religious and/or ethnic instability exists and may cause violence, major disruptions, and/or safety risks.
   H - health: Health risks, including current disease outbreaks or a crisis that disrupts a country’s medical infrastructure, are present.
   N - Natural disaster: A natural disaster, or its aftermath, poses danger.
   E - Time-limited event: A short-term event, such as an election, sporting event, or other incident that may pose a safety risk.
   O - Other: There are potential risks not covered by previous risk indicators. Read the country’s Travel Advisory for details.

Section 3 Health Insurance and Emergencies

PART 1 HEALTH INSURANCE
**Don’t wait until you are overseas to think about health insurance! **

1. Questions to ask about your insurance

• What does your insurance cover?
• Will it cover you while you are overseas?
• To what extent?
• How will they cover you?
  • Expect to pay up-front in-country
  • Get reimbursement by submitting a claim

2. Supplemental insurance

• If your insurance company doesn’t cover you overseas or doesn’t cover you to your level of comfort, you should consider supplemental insurance
• Ask questions: What is the cost?
  • What is covered?
  • To what extent?
  • How will they cover you?
• Many insurance policies do not cover evacuation
  • You could have to pay if you are evacuated
  • If this cost is a concern to you, consider evacuation insurance

3. Learn about submitting a claim before you go

• This process will vary, and requirements will differ
• Keep all receipts
  • Are they in English?
  • Is there sufficient information?
  • Be your own advocate!

PART 2 EMERGENCIES

1. International health regulations

   
   
   International health regulations
   
   

   Source: World Health Organization. Strengthening health security by implementing the International Health Regulations (2005).

2. In the Event of an Emergency

• Work with your in-country contacts to get assistance for your immediate needs
• International SOS (ISOS) provides immediate emergency assistance
  • Under contract by Hopkins
  • Evacuation in case of natural disaster, political unrest, illness/injury, etc.
  • Assistance with medical care, advancing funding for care, legal assistance, etc.
  • Full list of services on the ISOS website
  • ISOS is a service, not insurance: Someone will ultimately pay for some of their services
  • ISOS has some limitations and rules: For medical referrals/evacuations:
    • Personal resources are first method of payment for these services
    • In an emergency, ISOS can guarantee payment for medical services with authorization from Hopkins
    • If payment guarantee is made, student will need to reimburse JHU (insurance might cover some of the cost)
    • There are some exclusions (e.g., caving, mountaineering or rock climbing, potholing, skydiving, parachuting, bungee jumping, etc.)

3. State Department

• Learn what the Department of State can and cannot do for you
• Enroll in the Smart Traveler Enrollment Program (STEP)

4. Contact Information

• Make sure your family can contact you or your in-country supervisor in case of emergency: Print your itinerary

• Keep contact information for your insurance company, ISOS, and in-country supervisor.

  
  
  Contact page
  
  

  Image: Johns Hopkins International Travel Registry.