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Before You Go

Planning before departure, particularly for pre-existing illnesses, will save trouble later. See your dentist before you go; carry a spare pair of contact lenses and glasses with you; and take your optical prescription. Bring medications in their original labelled containers, and a letter from your doctor describing your medical conditions and medications. If carrying syringes or needles, have a letter saying they’re needed, or buy a prepared pack from a travel-health clinic.

Insurance

If your health insurance doesn’t cover you for medical expenses abroad, consider extra insurance; see www.lonelyplanet.com/travel-insurance. Find out if your insurance plan will make payments directly to providers or reimburse you later; in both Vanuatu and New Caledonia private doctors expect payment in cash.

Make sure your insurance covers evacuation to the nearest major centre – the extra premium for this is usually not very much.

Recommended Vaccinations

  • Hepatitis A
  • Hepatitis B
  • Measles, mumps, rubella (MMR)
  • Tetanus-diptheria
  • Typhoid

Websites

Centers for Disease Control & Prevention (www.cdc.gov)

Fit for Travel (www.fitfortravel.scot.nhs.uk) User-friendly, up-to-date information about outbreaks.

Lonely Planet (lonelyplanet.com) A good place to start.

MD Travel Health (www.mdtravelhealth.com) Free travel-health recommendations.

Travel Doctor (www.traveldoctor.com.au) Australian site with user-friendly, up-to-date information.

World Health Organization (www.who.int/ith) The WHO's International Travel and Health guide is available free online.

Also consult your government’s travel-health website:

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

Canada (www.hc-sc.gc.ca)

UK (www.dh.gov.uk/policyandguidance/healthadvicefortravellers/fs/en)

USA (www.cdc.gov/travel)

In Vanuatu & New Caledonia

Availability & Cost of Health Care

New Caledonian health care is of a high standard; specialists in most disciplines are available and citizens of the EU have the same eligibility for government medical care as in France. Costs can be high, from AUD$4000 per day for an intensive-care bed.

In Vanuatu, Port Vila’s lack of quality systems may mean the equipment or medication you need is not available, even for simple problems. Outside Port Vila, diagnostic and treatment facilities are rarely available, but volunteer doctors may be present in some hospitals. Santo has a program within which international junior doctors work at its hospital.

Private medical practitioners in both countries will expect payment in cash. Consultation fees, X-rays etc cost around the same as those in Western countries. Where hospital facilities exist, a cash deposit will be required; credit cards may not be accepted. Public-hospital outpatient services are free, but waiting times can be very long.

Commonly used drugs, including oral contraceptives and antibiotics, are available in Port Vila and throughout New Caledonia, and special drugs can be flown in. Diabetics may not be able to obtain their usual type of insulin preparation, so it’s safer to have your own supply. Up-to-date anti-epileptics and anti-hypertensives may be hard to come by.

Private dentists practise in Port Vila and in the main towns in New Caledonia.

Infectious Diseases

Chikungunya Fever

New Caledonia reported its first cases of chikungunya in 2011. It’s a viral disease spread by mosquito bites and causes fever and severe joint pain. It has signs that resemble dengue fever and can be misdiagnosed. There is no cure but symptoms can be treated.

Dengue Fever

Dengue fever, spread by mosquito bites, is mainly a problem in the wet season (from November to April). It causes a feverish illness with headache and severe muscle pains; a fine rash may also be present. Be obsessive about using insect repellents. Self-treatment includes paracetamol (do not take aspirin as this can have very dangerous side effects), fluids and rest. Danger signs are prolonged vomiting, blood in the vomit and/or a blotchy, dark-red rash.

Hepatitis A

This is a viral disease causing liver inflammation. Fever, debility and jaundice (yellow skin and eyes, dark urine) occur; recovery is slow, and it can be dangerous to people with other liver disease, to the elderly and sometimes to pregnant women. It is spread by contaminated food or water. Self-treatment consists of rest, a low-fat diet and avoidance of alcohol. The vaccine is close to 100% protective.

Hepatitis B

Like hepatitis A, hepatitis B is a viral disease causing liver inflammation, but it is more serious and frequently causes chronic liver disease and even cancer. It is spread, like HIV, by mixing body fluids, by using contaminated needles and by accidental blood contamination. Treatment is complex and specialised but vaccination is highly effective.

HIV & AIDS

The incidence of HIV infection is on the rise in West Melanesia and unprotected sex carries huge dangers. Condom use is essential. If you require an injection for anything, have your own needles or check that a new needle is being used.

Malaria

Malaria is a parasitic infection transmitted by mosquitoes that feed in dull light (ie at night, when it’s overcast, in the jungle or inside dark huts). Since no vaccine is available you must rely on mosquito-bite prevention and taking antimalarial drugs before, during and after risk of exposure. No antimalarial is 100% effective.

There is no malaria in New Caledonia.

A few of Vanuatu’s islands claim to be malaria free (including Aneityum or Futuna) and it is rare in Port Vila. In the rest of the country, however, take extreme care.

If you develop a fever during or after your visit to Vanuatu, first rule out malaria; most clinics will do a blood-smear check. If you have self-treatment malaria medication, still try to get a diagnosis and go to a major medical centre to confirm a cure.

This applies up to a few months after leaving the area. Malaria is curable if diagnosed early.

Typhoid Fever

This bacterial infection from contaminated food or water can be transmitted by food handlers and flies, or be present in inadequately cooked shellfish. It causes fever, debility and late-onset diarrhoea but is curable with antibiotics. Untreated it can produce delirium and is occasionally fatal. Vaccination is moderately effective; taking care with eating and drinking is important.

Traveller’s Diarrhoea

Diarrhoea in the tropics is usually caused by bacteria or parasites in contaminated food or water. Drink plenty of fluids, especially rehydration solutions. If you have more than four stools a day, you should take an antibiotic (quinolone) and an antidiarrhoeal agent (loperamide). If diarrhoea is bloody, persists for more than 72 hours or is accompanied by fever, shaking, chills or severe abdominal pain, seek medical attention.

Giardiasis

A parasite in contaminated water in Vanuatu, giardia produces bloating and a foul-smelling and persistent, although not ‘explosive’, diarrhoea. Taking one dose (four tablets) of tinidazole usually cures it.

Environmental Hazards

Bites & Stings

If you see the blue-coloured Indo-Pacific man-of-war in the water or on the beach, don’t go in. Its whip-like sting is very painful. Treat with vinegar or ice packs. Do not use alcohol.

Coral Cuts

Live coral can cause prolonged infection. If you do cut yourself, treat the wound immediately, scrubbing it thoroughly with fresh water to get out all the coral, then with alcohol. Apply an antiseptic and cover with a waterproof dressing.

Coral Ear

This inflammation of the ear canal is caused when water activates fungal spores, leading to bacterial infection and inflammation. It usually starts after swimming but can be reactivated in a shower, especially if your wet hair lies over the ear hole.

It can be very, very painful. Self-treatment with an antibiotic plus steroid ear-drop preparation is very effective. Stay out of the water until the pain and itch have gone.

Diving Hazards

Strict depth and time precautions will be upheld by your dive operator. Temptation to stay longer at relatively shallow depths is great and is probably the main cause of decompression illness (the ‘bends’). Any muscle or joint pain after scuba diving must be treated as suspect. Novice divers must be especially careful.

There are decompression chambers in Port Vila and Noumea. Local planes fly patients in at a very low altitude. Check with Divers Alert Network (DAN; www.diversalertnetwork.org) about the current status and insurance to cover costs.

Food

Only eat fresh fruits or vegetables that have been cooked or peeled; be wary of dairy products that might contain unpasteurised milk. It's important to ensure restaurants you eat in have good standards of hygiene; food that comes to you piping hot is likely to be safe. Be wary of salads and avoid buffet-style meals. In the outer islands, wash lettuce in vinegar to ensure any contamination from snails is removed.

Otherwise safe and edible fish can sometimes carry ciguatera. Poisoning causes stomach upsets, itching, faintness, slow pulse and bizarre inverted sensations – cold feels hot, and vice versa. Ciguatera has been reported in large carnivorous reef fish, including red snapper, barracuda and Spanish mackerel. There is no safe test to determine whether a fish is poisonous, but the locals know what to eat. Fish caught after any reef disturbance, such as a hurricane, are more likely to be poisonous. Deep-sea fish such as tuna are perfectly safe.

Leptospirosis

Also known as Weil’s disease, leptospirosis produces fever, headache, jaundice and, later, kidney failure. It is caused by a spirochaete organism found in water contaminated by rat or bat urine. There is some concern that it can be contracted at Millennium Cave in Santo. If diagnosed early it is cured with penicillin.

Heat Exhaustion

This can be prevented by drinking at least 2L of water per day; more if exercising. Salt-replacement solutions are useful, as muscle weakness is due to salt loss and can be made worse by drinking water alone. The powders used to treat dehydration caused by diarrhoea are just as effective for heat exhaustion, or try a good pinch of salt to a half-litre of water. Salt tablets can give you too much salt, causing headaches and confusion.

Heatstroke

This is a dangerous and emergency condition, with muscle weakness, exhaustion and mental confusion. Skin will be hot and dry. Reduce your temperature by lying in water and, if possible, with cold drinks. Seek medical help.

Sunburn

The time of highest risk is between 11am and 3pm, and cloud cover does not block out UV rays. Sunburn is likely to be a particular problem for those taking doxycycline as an antimalarial. Do the Australian and Kiwi ‘slip, slop, slap’ thing: slip on a shirt, slop on sunscreen and slap on a hat. Seek shade where possible. Treat sunburn like any other burn – with cool, wet dressings. Severe swelling may respond to a cortisone cream.

Women’s Health

Tampons and pads can be obtained, but if it looks like they’ve been on the shelf for ages, check for evidence of cockroaches.

Vanuatu is not ideal for a pregnant woman. Malaria can cause miscarriage or premature labour, and pregnant women cannot take the antimalarial tablets recommended for Vanuatu.

Traditional Medicine

Local herbs, roots and leaves used by traditional healers often have effective ingredients; research institutions are currently investigating many of them. Extravagant claims (eg AIDS cures, aphrodisiacs) can be ignored, and it is best to avoid compounds made with animal ingredients. Tree-bark concoctions for fever are similar to aspirin.

Kava is a sedative and also has muscle-relaxant properties. It is drunk mainly in Vanuatu.