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. You will have no problem getting new glasses or contact lenses made up quickly and competently in Norway, but you will pay for the privilege. Bring medications in their original, clearly labelled containers. A signed, dated letter from your physician describing your medical conditions and medications is also a good idea. Most medications are available in Norway, but may go by a different name than at home, so be sure to have the generic name, as well as the brand name. If carrying syringes or needles, be sure to have a physician’s letter documenting their medical necessity.
Insurance
If you’re an EU citizen, an E111 form (available from health centres, or post offices in the UK) covers you for most medical care, except nonemergencies or emergency repatriation home. Citizens from other countries should find out if there is a reciprocal arrangement for free medical care between their country and Norway. If you do need health insurance, strongly consider a policy that covers you for the worst possible scenario, such as an accident requiring an emergency flight home. If you’re planning on engaging in activities such as hiking, dog-sledding, skiing, rock climbing or more high-speed pursuits such as bungee jumping, make sure that your insurance policy doesn’t exclude such ‘dangerous’ activities. Find out in advance if your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. The former option is generally preferable, as it doesn’t require you to pay out of pocket in a foreign country.
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Recommended vaccinations
The World Health Organization (WHO) recommends that all travellers should be covered for diphtheria, tetanus, measles, mumps, rubella and polio, regardless of their destination. Since most vaccines don’t produce immunity until at least two weeks after they’re given, visit a physician at least six weeks before departure.
Online resources
The WHO’s publication International Travel and Health is revised annually and is available online at www.who.int/ith. Other useful websites include www.mdtravelhealth.com (travel-health recommendations for every country, updated daily), www.fitfortravel.scot.nhs.uk (general travel advice), www.ageconcern.org.uk (advice on travel for the elderly) and www.mariestopes.org.uk (information on women’s health and contraception).
Further reading
Health Advice for Travellers (currently called the ‘T6’ leaflet) is an annually updated leaflet by the Department of Health in the UK available free in post offices. It contains some general information, legally required and recommended vaccines for different countries, reciprocal health agreements and an E111 application form. Lonely Planet’s Travel with Children includes advice on travel health for younger children. Other recommended references include Traveller’s Health by Dr Richard Dawood (Oxford University Press), and The Traveller’s Good Health Guide by Ted Lankester (Sheldon Press).
Dangers & annoyances
Your personal belongings are safer in Norway than in most people’s home countries, and the cities – even east Oslo, which has a relatively poor reputation – are reasonably safe at all hours of the night. However, don’t become blasé about security: be careful near the nightclubs in the Rosenkrantz gate area of Oslo and beware of pickpockets around the Torget area of Bergen. Normally, the greatest nuisance value will come from drug addicts, drunks and/or beggars (mainly in Oslo) who can spot a naive tourist a block away. Oslo and other larger cities suffer from a growing drug problem. Although dope may be readily available in places, it isn’t legal.
While the risk of theft in Norway is minimal, it’s wise to keep photocopies of all your important documents (passport data page, air tickets, insurance policy, travellers cheques serial numbers) in a separate place in case of loss or theft; stash US$100 alongside, just in case. Leave copies of these documents at home, too.
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 greater 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. Travellers with 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 and move leg muscles by completing exercises while sitting, drink plenty of fluids and avoid alcohol and tobacco.
Jet lag & motion sickness
To avoid jet lag (common when crossing 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.
Antihistamines such as dimenhydrinate (Dramamine) and meclizine (Antivert, Bonine) are usually the first choice for treating motion sickness. A herbal alternative is ginger.
While you're there
Availability & cost of health care
Good health care is readily available in Norway, and for minor, self-limiting illnesses, pharmacists can dispense valuable advice and over-the-counter medication. They can also advise when more specialised help is required. The standard of dental care is usually good; however, it is sensible to have a dental checkup before a long trip. Remember that, like almost everything else, medical care can be prohibitively expensive in Norway.
Infectious diseases
Tick-borne encephalitis is spread by tick bites. It is a serious infection of the brain and vaccination is advised for those in risk areas who are unable to avoid tick bites (such as campers, forestry workers and hikers). Two doses of vaccine will give a year’s protection; three doses up to three years.
Traveller’s diarrhoea
Stomach upsets are as possible in Norway as they are at home and the same rules apply. Take great care when eating fish or shellfish (for instance, cooked mussels that haven’t opened properly can be dangerous). As autumn approaches, collecting mushrooms is a favourite pastime in this part of the world, but don’t eat any mushrooms unless they have been positively identified as safe by someone qualified to know.
If you develop diarrhoea, be sure to 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 quinoline drug) and an antidiarrhoeal agent (such as loperamide). If diarrhoea is bloody, persists for more than 72 hours or is accompanied by fever, shaking, chills or severe abdominal pain, you should seek medical attention.
Giardia
Giardia is an intestinal parasite that lives in the faeces of humans and animals, and is normally contracted through drinking water. Problems can start several weeks after you’ve been exposed to the parasite and symptoms may sometimes remit for a few days and then return; this can go on for several weeks or even longer.
The first signs are a swelling of the stomach, followed by pale faeces, diarrhoea, frequent gas and possibly headache, nausea and depression. If you exhibit these symptoms you should visit a doctor for treatment.
Tap water is always safe to drink in Norway, but it’s wise to beware of drinking from streams, as even the clearest and most inviting water may harbour giardia and other parasites. For extended hikes where you must rely on natural water, the simplest way of purifying water is to boil it thoroughly. Vigorous boiling should be satisfactory; however, at high altitude water boils at a lower temperature, so germs are less likely to be killed. Boil it for longer in these environments (up to 10 minutes).
If you cannot boil water it should be treated chemically. Chlorine tablets (Puritabs, Steritabs or other brands) will kill many pathogens, but not giardia and amoebic cysts. Iodine is more effective in purifying water and is available in tablet form (such as Potable Aqua). Follow the directions carefully and remember that too much iodine can be harmful.
Although some unpopulated lands in Norway serve as sheep pastures, there seems to be little giardia. However, while most people have no problems drinking untreated surface water, there’s still a possibility of contracting it.
Hypothermia & frostbite
Proper preparation will reduce the risks of getting hypothermia. Even on a hot day in the mountains, the weather can change rapidly – carry waterproof garments and warm layers, and inform others of your route.
Acute hypothermia follows a sudden drop of temperature over a short time. Chronic hypothermia is caused by a gradual loss of temperature over hours.
Hypothermia starts with shivering, loss of judgment and clumsiness. Unless rewarming occurs, the sufferer deteriorates into apathy, confusion and coma. Prevent further heat loss by seeking shelter; wearing warm, dry clothing; drinking hot, sweet drinks; and by sharing body warmth.
Frostbite is caused by freezing and subsequent damage to bodily extremities. It is dependent on wind-chill, temperature and length of exposure. Frostbite starts as frostnip (white, numb areas of skin) from which complete recovery is expected with rewarming. As frostbite develops, the skin blisters and becomes black. Loss of damaged tissue eventually occurs. Wear adequate clothing, stay dry, keep well hydrated and ensure you have adequate calorie intake to prevent frostbite. Treatment involves rapid rewarming. Avoid refreezing and rubbing the affected areas.
Insect bites & stings
In northern Norway, the greatest nuisances are the plagues of blackflies and mosquitoes that swarm out of tundra bogs and lakes in summer. Fortunately, malaria is unknown, but the mental risks can’t be underestimated, as people have literally been driven insane by the ravenous hordes. Midsummer is the worst, and regular mosquito coils and repellents are scarcely effective; hikers must cover exposed skin and may even need head nets to keep the little buggers from making kamikaze attacks on eyes, nose, ears and throat. If you’re camping, a tent with mosquito netting is essential. Most people get used to the mosquito bites after a few days as their bodies adjust and the itching and swelling become less severe. An antihistamine cream should help alleviate the symptoms. Use a DEET-based insect repellent.
Bees and wasps cause real problems only to those with a severe allergy (anaphylaxis.) If you have such an allergy, make sure you carry EpiPen or similar adrenaline injections at all times.
Rabies
Rabies, caused by a bite or scratch by an infected mammal, is found in Svalbard and (occasionally) in eastern Finnmark. Dogs are a noted carrier, but cats, foxes and bats can also be infected. Any bite, scratch or even lick from a warm-blooded, furry animal should be cleaned immediately and thoroughly. Scrub with soap and running water, and then apply alcohol or iodine solution. If you’ve been infected by a rabid animal, medical help should be sought immediately.
Snakes
Snakes are rarely seen in Norway and adders (the only poisonous variety) don’t exist north of Tysfjorden in Nordland. To minimise your chances of being bitten always wear boots, socks and long trousers when walking through undergrowth where snakes may be present. Don’t put your hands into holes and crevices, and be careful when collecting firewood.
Adder bites aren’t normally fatal and antivenins are available. Immediately wrap the bitten limb tightly, as you would for a sprained ankle, and then attach a splint to immobilise it. Keep the victim still and seek medical help, if possible with the dead snake for identification; don’t attempt to catch the snake if there is a possibility of being bitten again. Tourniquets and sucking out the poison are now comprehensively discredited.
Sunburn
You can get sunburnt surprisingly quickly, even through cloud. Use a sunscreen, a hat, and a barrier cream for your nose and lips. Calamine lotion or Stingose are good for mild sunburn. Protect your eyes with good-quality sunglasses, particularly if you will be near water, sand or snow.
Ticks
Check your body after walking through tick-infested areas, as ticks can cause skin infections and other more serious diseases. If a tick is found, press down around its head with tweezers, grab the head and gently pull upwards. Avoid pulling the rear of the body as this may squeeze the tick’s gut contents through the attached mouth parts into the skin, increasing the risk of infection and disease.
Travelling with children
All travellers with children should know how to treat minor ailments and when to seek medical treatment. Make sure the children are up-to-date with routine vaccinations and discuss possible travel vaccines well before departure, as some vaccines are not suitable for children under the age of one.
Remember to avoid contaminated food and water. If your child has vomiting or diarrhoea, lost fluid and salts must be replaced. It may be helpful to take rehydration powders for reconstituting with boiled water.
Children should be encouraged to avoid and mistrust any dogs or other mammals because of the risk of rabies and other diseases.
Sexual health
Condoms are widely available at apótek (pharmacies). When buying condoms, look for a European CE mark, which means they have been rigorously tested, and then keep them in a cool, dry place or they may crack and perish.
Emergency contraception is most effective if taken within 24 hours after unprotected sex. The International Planned Parent Federation (www.ippf.org) can advise about the availability of contraception in different countries.
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