Home
Improving health and reducing inequities worldwide

RESEARCH

Currently Abroad

Upon Arrival Checklist

  1. Contact both on-site and UCSF advisor to confirm arrival.
  2. Buy a cell phone if you have not already done so. Send your cell phone number to your advisors, program administrator, and on-site students/colleagues.

Adhere to Local Protocol and Make Courtesy Visits

Determine on arrival the hierarchy of the organization for whom you work (e.g. NGO, hospital, clinic) and pay a courtesy visit to the director, supervisor, or department head to announce your arrival, describe your intentions, and ask if any special procedures need to be followed (e.g. credentialing for clinical care, registration of licensure, etc.). Some institutions will ask for a memorandum of understanding or letter of intent to formalize the relationship. A sample is provided in the Documents and Forms section. Be sure to express thanks to the host for allowing you to work in their country and ensure them that your work product will be shared with your local collaborators. Ask if there is a need to engage in the teaching program or if your expertise can contribute to local training. Ensure that all administrative personnel know who you are and what your business is in the organization. When in doubt, ask.

Living with a Host Family

Clear communication is perhaps the most important ingredient to successfully living abroad with a host family. It is best to know what is expected of you and what to expect in return. To avoid cross-cultural confusion, discuss important issues with your host family such as sleeping arrangements, eating and cooking with the family, curfews, laundry facilities, Internet and telephone use, alcohol and tobacco use as well as your responsibilities regarding younger children and pets and any chores you will be expected to complete.

Food and Water Safety

  • Avoid salads, uncooked vegetables, and unpasteurized milk and milk products such as cheese
  • Eat only food that has been cooked and is still hot
  • Eat only fruit that has been washed in clean water and then peeled by you personally
  • Do not consume food and beverages obtained from street vendors
  • Wash hands or use hand gel with more than 60% alcohol prior to eating, after using the bathroom, and after direct contact with children, animals or any feces.
  • Try to avoid swallowing water or submerging your head underwater while swimming
  • Avoid swimming with open cuts or abrasions that might serve as entry points for pathogens
  • Drink a beverage directly from the can or bottle than from a questionable container
  • Boiling is by far the most reliable method to make water safe for drinking. Water should be kept at a full boil for at least one minute (three minutes in higher altitude regions).

Protection against Insects

Tick-, mite-, and mosquito-borne parasitic and viral infections characteristically are diseases of “place” that are linked to known geographic or ecologic regions, and the amount of disease transmission in these areas often varies seasonally. Consult CDC’s Travelers’ Health web page for alerts and information on regional disease transmission patterns that may change periodically.

  • Avoid outdoor activity during twilight periods (i.e., dawn and dusk) as this is when vector mosquitoes are most active.
  • Wear long-sleeved shirts, long pants, and hats to minimize areas of exposed skin. Tuck in shirts.
  • Apply repellents to clothing, shoes, tents, mosquito nets, and other gear to enhance protection.
  • Inspect yourself and your clothing for ticks, both during outdoor activity and at the end of the day.
  • Bed nets are essential to provide protection and to reduce discomfort due to biting insects. Bed nets are most effective when treated with a repellent such as permethrin. Permethrin-containing repellents (e.g., Permanone) are recommended for use on clothing, shoes, and bed nets. It can be purchased online at the Great Outdoors Depot for $10.

Protection against Animals

  • Reduce your chances of getting rabies and other infections by avoiding contact with all animals, including stray or wild dogs that account for the highest incidence of rabies outside the U.S.
  • If bitten by any animal, rinse profusely with soap and water for 15 minutes and call your insurance company to seek immediate medical attention (within 24 hours).
  • You must immediately acquire the immune globulin and 5 doses of the vaccine to avoid getting rabies after a bite. If rabies is indicated, it is fatal.
  • Reduce the chance of being bitten or stung by snakes, scorpions, or spiders by wearing shoes with socks, shaking out foot gear immediately before putting it on, and covering headgear that is not being worn.
  • Avoid caves and bats.
  • Avoid live birds and poultry markets to minimize the risk of exposure to Avian Influenza.

Illness Abroad

During your medical elective or travel abroad, you will encounter diseases you have never seen during your training that are commonplace abroad. Take the time to find out more about the infectious diseases in the country you are visiting. For more information, see The Elective Pack: A Medical Student’s Guide to Essential International Health and Development.

Common Infectious Diseases in the Developing World

  1. Acute lower respiratory tract infections
  2. Tuberculosis
  3. Diarrhoea
  4. Malaria
  5. Preventable diseases (pertussis, measles, diphtheria, polio, tetanus)
  6. HIV
  7. Hepatitis B
  8. Trypanosomiasis
  9. Leishmaniasis
  10. Schistosomiasis
  11. Meningitis

Because you do not have partial immunity to local pathogens, it is essential for you follow standard preventative measures to decrease your risk of getting ill.

Hand Hygiene:

  • Is the most important activity to prevent transmission!
  • Clean your hands with soap or alcohol-based hand rub before and after routine patient care activities and after hand contaminating activities
  • Always clean hands after removing gloves

Personal Protective Equipment (PPE):

  • Use PPE (i.e., gowns, gloves, masks, eye protection) to reduce the risk of exposures to bloodborne pathogens
  • Gloves are worn:
    1) To provide a protective barrier and to prevent contamination of the hands
    2) For anticipated contact with mucous membranes and non-intact skin
    3) For invasive procedures

Review the UCSF Standard and Transmission Based Precautions document if you will be working or caring for patients. It contains important information on personal protective equipment (PPE), needles and sharps, solid waste, reusing equipment such as masks, blood spills, and exposures.

Traveler’s diarrhea is the most common health problem to affect travelers. Approximately 80% is bacterial, typically acquired from contaminated food or water. Prevention is key (see food and water precautions). If contracted, taking prophylactic bismuth subsalicylate (Pepto Bismol) is helpful, and we recommend 2 tablets 4 times a day unless you are taking Doxycycline. If prevention doesn’t work, and you find yourself suffering, the following table can guide you towards treatment. Stay well-hydrated.

Clinical Syndrome Recommended Treatment
Mild: 1-2 loose stools/ 24 hours, minimal symptoms Stay hydrated and continue Pepto Bismol
Moderate: >3 loose stools/24 hours, tolerable symptoms Lomotil; stay hydrated, add antibacterial therapy if symptoms persist >3days.
Moderate - Severe: nausea, moderate-severe abdominal cramps Antibiotics for 3-5 days and stay hydrated (may stop antibiotic sooner if symptoms resolve completely)
Bloody diarrhea or fever & diarrhea Same as above
Vomiting, minimal diarrhea Pepto Bismol, stay hydrated

Injury Abroad

Road Safety

The number one cause of mortality in student populations abroad is MOTORCYCLE accidents, closely followed by AUTOMOBILE accidents (including buses, vans, etc). We realize that you will not be able to avoid traveling by cycle or car or van, and we don’t expect you to, but you should absolutely be aware of some safety precautions to reduce risk. Wear a helmet and buckle your seatbelt whenever possible. Don’t walk alone late at night, and keep your valuables locked and as safe as possible. Political protests and uprisings should be avoided. In addition, be aware of traffic patterns and local road culture.

Resources:

If you rent a vehicle overseas, use one of the pre-negotiated UC contract agencies, if possible.

Violence-Related Threats

Preventative measures for violence-related injuries include limiting your travel at night and varying your travel routes, traveling with a companion, avoiding accommodations on the ground floor and immediately next to the stairs, and possibly carrying a portable door intruder alarm, a smoke alarm, and a rubber door stop that can be used as a supplemental door lock. Also, do not resist attackers if confronted but instead give up car and/or all valuables.

Resources:

  • SAFETI: Safety Abroad First - Educational Travel Information - an adaptation of Peace Corps resources for students and organizations

Be sure to register your travel before you leave at the UC TRIPS site to trigger your UC Student Off-Campus Travel Accident Benefit and iJet travel alerts.

  • UC Travel Accident insurance provides security evacuation assistance if you are threatened by a local uprising
  • iJet will alert you to political upheavals or threats in your area while you travel

Theft

Computers, cell phones, purses, watches, and wallets have high street value and can be quickly stolen if you are not alert. Also, be sure to back up the data on your computer on a regular basis because a stolen laptop without backup files can ruin your visit. Do not leave laptops unattended anywhere, and lock or secure them in safe places. Report stolen items to police, but beware that the majority of stolen items are never recovered.

Returning from Abroad »