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Bermuda

Health & safety

Before you go

Prevention is the key to staying healthy while abroad. A little planning before departure, particularly for pre-existing illnesses, will save trouble later. See your dentist before a long trip, carry a spare pair of contact lenses and glasses, and take your optical prescription with you. Bring medications in their original, clearly labeled, containers. A signed and dated letter from your physician describing your medical conditions and medications, including generic names, is also a good idea. If carrying syringes or needles, be sure to have a physician's letter documenting their medical necessity.

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Insurance

If your health insurance does not cover you for medical expenses abroad, consider supplemental insurance. Check out www.lonelyplanet.com/subwwway for more information. Find out in advance if your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures.

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Medical checklist

It is a very good idea to carry a medical and first aid kit with you, to help yourself in the case of minor illness or injury. Following is a list of items you should consider packing.

Acetaminophen (paracetamol) or aspirin

Anti-inflammatory drugs (eg ibuprofen)

Antihistamines (for hayfever and allergic reactions)

Antibacterial ointment (eg Bactroban) for treating cuts and abrasions (prescription only)

Steroid cream or hydrocortisone cream (for allergic rashes)

Bandages, gauze, gauze rolls

Adhesive or paper tape

Scissors, safety pins, tweezers

Thermometer

Pocket knife

Sun block

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Internet resources

There is a wealth of travel health advice on the Internet. A superb book called International Travel and Health, revised annually, is available online at no cost; it's published by the World Health Organization (www.who.int/ith/). Other websites of general interest are MD Travel Health (www.mdtravelhealth.com), which provides complete travel health recommendations for every country, updated daily, also at no cost; the Centers for Disease Control and Prevention (www.cdc.gov); and Fit for Travel (www.fitfortravel.scot.nhs.uk), which has up-to-date information about outbreaks and is very user-friendly.

It's also a good idea to consult your government's travel health website before departure, if one is available:

Australia (www.dfat.gov.au/travel/)

Canada (www.hc-sc.gc.ca/english/index.html)

UK (www.doh.gov.uk/traveladvice/index.htm)

USA (www.cdc.gov/travel/)

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Further reading

If you're traveling with kids, Lonely Planet's Travel with Children by Cathy Lanigan may be useful. The ABC of Healthy Travel, by E Walker et al, is another good resource.

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Dangers & annoyances

Crime

Although Bermuda is relatively safe, it has its fair share of crime and drug abuse problems just like any other place. Violent crime has been on the increase in recent years, and tourists are occasionally targeted for muggings. Travelers should use the standard precautions they would use anywhere when walking alone at night, especially in areas that are not well lit. Women carrying handbags should keep them close to their bodies to prevent purse snatchings. One local mugging offense is the drive-by in which a thief rides by on a motorbike and snatches the purse of a pedestrian from behind.

Still, the most common problem encountered by visitors is motor scooter theft, which is at epidemic proportions in Bermuda. It's so great a problem that it's virtually impossible to get theft insurance on scooters anymore. Some of the bikes end up in 'chop shops' where they are stripped for parts, although others just end up being taken for a joyride before being dumped over a cliff. If you rent a scooter, you can cut down on the odds of having it stolen by locking it every time you stop and by parking in well-lit public places.

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In transit

Deep Vein Thrombosis (DVT)

Blood clots may form in the legs during plane flights, chiefly because of prolonged immobility. The longer the flight, the higher the risk. The chief symptom of DVT is swelling or pain of the foot, ankle, or calf, usually but not always on just one side. When a blood clot travels to the lungs, it may cause chest pain and breathing difficulties. Travelers who have any of these symptoms should immediately seek medical attention.

To prevent the development of DVT on long flights you should walk about the cabin, contract the leg muscles while sitting, drink plenty of fluids and avoid alcohol.

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Jet lag & motion sickness

To avoid jet lag (common when flying across more than five time zones) try drinking plenty of nonalcoholic fluids and eating light meals. Upon arrival, get exposure to natural sunlight and readjust your schedule (for meals, sleep and so on) as soon as possible.

Eating lightly before and during a trip will reduce the chances of motion sickness. If you are prone to such upsets, try to find a place that minimizes movement - near the wing on aircraft or close to amidships on boats. Fresh air and a steady reference point like the horizon usually help; reading and cigarette smoke don't.

Antihistamines such as dimenhydrinate (Dramamine) and meclizine (Antivert, Bonine) are usually the first choice for treating motion sickness. There are also natural preventatives in the form of ginger (available in capsule form) and peppermint (including mint-flavored candy).

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While you're there

Availability & cost of health care

For an ambulance in Bermuda, call 911.

Bermuda has one general hospital, the King Edward VII Memorial Hospital (236-2345; Point Finger Rd, Paget Parish), which has an emergency room, an obstetric unit, an intensive care unit, a dialysis unit, and a variety of other specialty services. There is also a separate psychiatric hospital. There are no private hospitals. The quality of medical care is generally good, but complex medical problems will usually require evacuation to the USA. For nonurgent medical matters, ask the concierge at your hotel to recommend a local physician.

Medical care in Bermuda is expensive. Though British, Bermuda does not participate in reciprocal health care agreements either inside or outside the European Economic Area. Make sure you're covered for medical costs while in Bermuda.

Most pharmacies are well-supplied and the pharmacists well-trained. The Phoenix stores are a reputable chain of pharmacies. There are also a number of good independent pharmacies listed in the phone book.

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HIV/AIDS

As with most parts of the world, HIV is a health problem in Bermuda. You should never assume, on the basis of someone's background or appearance, that they're free of this or any other sexually transmitted disease. Be sure to use a condom for all sexual encounters.

If you have any questions regarding AIDS while in Bermuda, you can call the Allan Vincent Smith Foundation (295-0002).

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Traveler's diarrhea

If you develop diarrhea, ensure that you drink plenty of fluids, preferably an oral rehydration solution (eg Dioralyte). A few loose stools don't require treatment, but if you start having more than four or five stools a day, you should start taking an antibiotic (usually a quinolone drug) and an antidiarrheal agent (such as Loperamide). If diarrhea is bloody, persists for more than 72 hours or is accompanied by fever, shaking, chills or severe abdominal pain you should seek medical attention.

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Bites & stings

Do not attempt to pet, handle or feed animals, with the exception of domestic animals known to be free of any infectious disease. Most animal injuries are directly related to a person's attempt to touch or feed the animal.

Any bite or scratch by a mammal, including bats, should be promptly and thoroughly cleansed with large amounts of soap and water, followed by application of an antiseptic such as iodine or alcohol. (Bermuda's Department of Agriculture claims that there have been no cases of rabies for more than 40 years.) It may also be advisable to start an antibiotic, since wounds caused by animal bites and scratches frequently become infected. One of the newer quinolones, such as levofloxacin (Levaquin), which many travelers carry in case of diarrhea, would be an appropriate choice.

If you are stung by a jellyfish or a Portuguese man-of-war, quickly remove the tentacles and apply vinegar or a meat tenderizer containing papain (derived from papaya), both of which act to neutralize the toxins - in a pinch, you could use urine as well. For serious reactions, including chest pains or difficulty breathing, seek immediate medical attention.

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Heat stroke

This serious, sometimes fatal, condition can occur if the body's heat-regulating mechanism breaks down and the body temperature rises to dangerous levels. Long, continuous periods of exposure to high temperatures and insufficient fluids can leave you vulnerable to heat stroke. Avoid strenuous activity in open sun when you first arrive.

The symptoms of heat stroke are feeling unwell, not sweating very much or at all and a high body temperature (39° to 41°C or 102° to 106°F). Where sweating has ceased, the skin becomes flushed and red. Severe, throbbing headaches and lack of coordination can also occur, and the sufferer may be confused or aggressive. Eventually the victim may become delirious or convulse. Hospitalization is essential, but in the interim get victims out of the sun, remove their clothing, cover them with a wet sheet or towel and continually fan them. Give fluids if they are conscious.

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Sun exposure

Ultraviolet radiation may be a health hazard during the summer. To protect yourself from excessive sun exposure, you should stay out of the midday sun, wear sunglasses and a wide-brimmed sun hat, and apply sunscreen with SPF 15 or higher, with both UVA and UVB protection. Sunscreen should be generously applied to all exposed parts of the body approximately 30 minutes before sun exposure and should be reapplied after swimming or vigorous activity. Travelers should also drink plenty of fluids and avoid strenuous exercise when the temperature is high.

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Water

Although several of Bermuda's larger resort hotels have their own desalination plants, the rest of Bermuda depends upon rain for its water supply. Because the rain is caught on rooftops and directed into individual storage tanks, the bacteria count in the water can vary. If you're staying at a smaller hotel or guesthouse, it's best to inquire with the manager about the water's suitability for drinking.

If in doubt, you can always treat the water first. The simplest way is to boil it vigorously. Chlorine tablets kill many but not all pathogens. Iodine is more effective in purifying water and is available in tablet form. Bottled water is available in Bermudian grocery stores.

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Children & pregnant women

When traveling with children, make sure they're up-to-date on all routine immunizations. It's sometimes appropriate to give children some of their vaccines a little early before departure; you should discuss this with your pediatrician. If pregnant, you should bring along a copy of your medical records in case complications develop while abroad.

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