Most travellers who come to the South Pacific won't experience anything worse than an upset stomach or a hangover. But if you have an immediate and serious health problem, phone or visit the nearest public hospital, or call into the nearest pharmacy for advice. The Solomon Islands and Vanuatu share the one serious health hazard: malaria. Elsewhere the main danger is from mosquito-borne dengue fever.

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Before You Go

A little planning before departure, particularly for preexisting illnesses, will avoid trouble down the line. A signed and dated letter from your physician describing your medical conditions and medications that you may have in your baggage, including generic names, is a good idea.

Insurance

A comprehensive travel and health insurance policy is essential for the South Pacific. Check whether you're covered for 'dangerous' activities (surfing, snorkelling, diving etc) and make sure your policy has provision for evacuation. Under these circumstances, hospitals will accept direct payment from major international insurers, but for all other health-related costs cash upfront is usually required.

Worldwide travel insurance is available at lonelyplanet.com/travel-insurance. You can buy, extend and claim online anytime – even if you’re already on the road.

American Travellers Check whether your health plan covers expenses in American Samoa.

EU Travellers You have the same rights in French Polynesia, New Caledonia, and Wallis and Futuna as you do in France, but remember to obtain the European Health Insurance Card (EHIC) before leaving home.

New Zealand Travellers You may have free access to public but not private facilities in the Cook Islands.

Recommended Vaccinations

For all countries in the region, vaccinations are recommended for hepatitis A, hepatitis B and typhoid fever. A current influenza shot is also recommended. And check how long it's been since you had a tetanus booster (once every 10 years is the going rate).

Medical Checklist

Some of the following list will fall into the 'overkill' category for most travellers, but if you're serious about being ready for anything or if you're heading into remote areas for any length of time, consider packing a nifty little bag with:

  • acetaminophen (paracetamol) or aspirin
  • antibiotics
  • antidiarrhoeal drugs (eg loperamide)
  • antihistamines (for hayfever and allergic reactions)
  • anti-inflammatory drugs (eg ibuprofen)
  • antibacterial ointment in case of cuts or abrasions
  • steroid cream or cortisone (for allergic rashes)
  • bandages, gauze, gauze rolls
  • adhesive or paper tape
  • scissors, safety pins, tweezers
  • thermometer
  • pocket knife
  • DEET-containing insect repellent for the skin
  • permethrin-containing insect spray for clothing, tents and bed nets
  • sunscreen
  • oral rehydration salts
  • iodine tablets or water filter (for water purification)

Websites

For up-to-date information on health issues across the South Pacific, the World Health Organisation (www.who.int/en) is a font of knowledge. Government travel advice websites also list current health warnings:

  • Australian Department of Foreign Affairs & Trade (www.smarttraveller.gov.au)
  • British Foreign & Commonwealth Office (www.gov.uk/fco)
  • Government of Canada (www.travel.gc.ca)
  • New Zealand Ministry of Foreign Affairs & Trade (www.safetravel.govt.nz)
  • US State Department (www.travel.state.gov)

Further Reading

For a sobering reminder of the power of disease, have a read of The Great Influenza: The Epic Story of the Deadliest Plague in History by John M Barry (2004), concerning the 1918 influenza (or 'Spanish Flu') pandemic, which killed many thousands of islanders in the South Pacific.

In the South Pacific

Availability & Cost of Health Care

In Fiji, French Polynesia and American Samoa there are doctors in private practice, and standard hospital and laboratory facilities with consultants and specialists. In the Cook Islands, New Caledonia, Samoa, Solomon Islands, Tonga and Vanuatu, specialised services may be limited but private general practitioners, dentists and pharmacies are present. On smaller islands there may be no services at all, or perhaps just a nurse. Medical costs vary between countries, but are generally comparable to Western prices.

Infectious Diseases

Dengue Fever

Risk All countries, especially in the hotter, wetter months

Symptoms & Treatment Mosquito-borne dengue fever causes a high fever, headache and severe muscle pains. A fine rash may also be present. Self-treatment includes paracetamol (do NOT take aspirin), fluids and rest. Danger signs are prolonged vomiting, blood in the vomit, a blotchy dark red rash and/or bruising.

Eosinophilic Meningitis

Risk Cook Islands, French Polynesia, Fiji, Tonga

Symptoms & Treatment An illness manifested by scattered abnormal skin sensations, fever and sometimes meningitis symptoms (headache, vomiting, confusion, stiffness of the neck and spine). Eosinophilic meningitis is caused by a microscopic parasite – the rat lungworm – that contaminates raw food. There is no proven treatment, but symptoms may require hospitalisation. For prevention, pay strict attention to advice on food and drink.

Leptospirosis

Risk American Samoa, Fiji, French Polynesia, possibly elsewhere

Symptoms & Treatment Also known as Weil’s disease, leptospirosis produces fever, headache, jaundice and, later, kidney failure. It’s caused by the spirochaete organism found in water contaminated by rat and pig urine. Often confused with dengue fever, this disease is the more serious of the two. The organism penetrates skin, so swimming in flooded areas is a risk. If diagnosed early, it’s cured with penicillin.

Malaria

Risk Solomon Islands (except outlying atolls), Vanuatu

Symptoms & Treatment Both malignant (falciparum) and less threatening but relapsing forms are present. Avoid getting bitten by mosquitoes and take antimalarial drugs before, during and after risk exposure. No antimalarial is 100% effective and there’s no vaccine. The essence of the disease is fever. In a malarial zone it is best to assume that fever is due to malaria unless blood tests rule it out. This applies to up to a few months after leaving the area as well. Malaria is curable if diagnosed early.

Yaws

Risk Solomon Islands

Symptoms & Treatment A bacterial infection that causes multiple skin ulcers. Once thought to have been eliminated, there has been a recent resurgence. Infection is by direct contact. Treatment with penicillin produces a dramatic cure.

Environmental Hazards

Beyond the odd mosquito bite, threats to health from animals and insects are rare in the South Pacific. But there are a few things for travellers to be aware of.

Bites & Stings

Jellyfish Watch out for the whip-like stings of the blue-coloured Indo-Pacific man-of-war. If you see these floating in the water or stranded on the beach, play it safe and stay on dry land. The sting is very painful and is best treated with vinegar or ice packs. Do not use alcohol.

Cone Shells Poisonous cone shells abound along shallow South Pacific coral reefs. Avoid handling them. Stings mainly only cause local reactions, but nausea, faintness, palpitations or difficulty in breathing are signs that medical attention is needed.

Sea Snakes As in all tropical waters, sea snakes may be seen around coral reefs. Unprovoked, sea snakes are extremely unlikely to attack – and their fangs will not penetrate a wetsuit (...in Tonga, locals joke that death by sea snake bite is a voluntary undertaking – you'd have to force one to bite you!).

Sharks Sharks do swim around these warm tropical waters, but rarely pose a threat to humans. Whitetip and blacktip reef sharks are too small to do any damage, but grey reef, tiger and bull sharks occasionally get nippy. If you're in the sea, remember that so are they.

Coral Ear

This is a fungal infection caused by sea water entering the ear canal. Seemingly trivial when it happens, it can be very, very painful and can spoil a holiday. Apart from diarrhoea it is the most common reason for tourists to consult a doctor. Self-treatment with an antibiotic-plus-steroid ear-drop preparation is very effective: see a doctor for a prescription, and stay out of the water until the pain and itch have subsided.

Staph Infection

Infection of cuts and scrapes is very common, with cuts from live coral particularly prone to infection. If you get a scrape, as soon as you can, cleanse the wound thoroughly (getting out all the little bits of coral or dirt), apply an antiseptic and cover with a dressing. You can get back in the water with these kinds of cuts, but healing time will be prolonged if you do. Change the dressing regularly, never let it sit wet and check often for signs of infection.

Diving Hazards

Because the South Pacific has wonderful opportunities for scuba diving, it is easy to get overexcited and neglect strict depth and time precautions. If you're inexperienced, make sure you're diving with a licensed operator who knows what they're doing, and has a realistic understanding of your limits. If you're not diving with a group, make sure you tell someone where you're going and when you'll be back.

Fish Poisoning

Ciguatera poisoning – a food-borne illness caused by eating toxic reef fish – is characterised by stomach upsets, itching, faintness, slow pulse and bizarre inverted sensations (cold feeling hot and vice versa). Ciguatera has been reported in many carnivorous reef fish, including red snapper, barracuda and even smaller reef fish. There is no safe test to determine whether a fish is poisonous or not and, although local knowledge is not entirely reliable, it is reasonable to eat what the locals are eating. Deep-sea tuna is perfectly safe.

Treatment consists of rehydration and if the pulse is very slow, medication may be needed. Healthy adults will make a complete recovery, although disturbed sensation may persist for some weeks – sometimes much longer.

Heat Sicknesses

Sunburn Apply sunscreen liberally and often, especially after swimming. And look after your eyes with a decent pair of sunglasses.

Heat Exhaustion Symptoms include dizziness, fainting, fatigue, nausea or vomiting, and pale, cool and clammy skin. Treatment consists of rest in a cool, shady place and fluid replacement with water or diluted sports drinks. Rule #1: stay hydrated.

Heat Stroke More dangerous than heat exhaustion, heat stroke happens when the cooling effect of sweating fails. This condition is characterised by muscle weakness and mental confusion. Skin will be hot and dry. If this occurs, ‘put the fire out’ by cooling the body with water on the outside and cold drinks for the inside. Seek urgent medical help.

Dogs

Dogs have free reign across most of the South Pacific island groups, but their bark is generally worse than their bite. Play it safe on the streets: cross the road to avoid packs and don't try to pat or befriend wandering mutts. And if you are barked at, don't hang around and continue the conversation.

Tap Water

To steer yourself clear of diarrhoea, avoid tap water unless it has been boiled, filtered or chemically disinfected (with iodine tablets), and also avoid ice unless you've made it yourself from bottled water. This is a sensible overall precaution, but the municipal water supply in capital cities in the region can be trusted.