BEFORE YOU GO BEING PREPARED FOR YOUR ELECTIVE HAZARDS ARE BEST ANTICIPATED AND AVOIDED

1. BEFORE YOU GO BEING PREPARED FOR YOUR ELECTIVE HAZARDS ARE BEST ANTICIPATED AND AVOIDED BUT YOU NEED TO KNOW WHAT YOU WOULD DO IN AN EMERGENCY

3. HIV

4. PERSONAL SAFETY – traffic accidents

5. PERSONAL SAFETY – violence and robbery

6. TRAVEL INSURANCE – covering electives, not ordinary travel insurance, must cover transportation home in case of accident or illness. MEDICOLEGAL COVER – if you need it, often free from one of the defence societies VISA – in countries which require it; a tourist visa is often sufficient, but check LETTER OF INTRODUCTION – from the Dean of the Medical School COPIES OF ALL IMPORTANT DOCUMENTS – including passport and flight tickets, and accessible to you in case of loss SELF-MEDICATION KIT – for minor illnesses and accidents PEP – in case of needlestick injury or splash exposure IMMUNISATIONS/VACCINATIONS – as appropriate for the country visited. Do not leave to the last minute. The Brownlee Centre will not accommodate you. ALTERNATIVE SUPPLY OF CASH – in case of robbery

7. PERSONAL SAFETY ISSUES Check FCO advice before you go Know the territory; take local advice Arrange transfer from airport to the elective setting Keep company you know Be wary of strangers who are too friendly Keep to well-lit public places; public roads (avoid short-cuts); know your route and don’t consult a map in public Obtain secure accommodation, keep doors locked Don’t be a target for pickpockets Carry only small amounts of money Do not flaunt personal possessions (expensive watches, jewellery, cameras, mobile phones) Don’t keep all your money in one place Take malaria prophylaxis for the full period; wear appropriate clothing Avoid alcohol excess – you are not in Glasgow. Illegal drugs are an absolute No Don’t swim in freshwater (e.g. Lake Malawi – risk of schistosomiasis)

8. CONTACT NUMBERS Supervisor Where you would go for local medical help British embassy/consulate/high commission – contact in serious emergencies (students who are British nationals can register with the LOCATE service at http://www.fco.gov.uk/en/travel-and-living-abroad/staying-safe/Locate/) University of Glasgow emergency contact number – will take details and pass on to your stated emergency contact Travel insurance company Telephone number for reporting stolen plastic cards Be sure that family/next of kin know where you are and can contact you urgently if necessary

9. WHAT WOULD YOU DO IF YOU :- find on arrival that arrangements have changed or fallen through have a needlestick injury are bitten by a dog are robbed lose your passport (BHC) find yourself in jail (BHC) become a hospital patient have a high fever fall ill are involved in a traffic accident have been exposed to TB risks (see Occupational Health on return) need to claim from your insurance (keep all receipts)

10. WHAT TO DO AFTER A NEEDLESTICK INJURY Wash area thoroughly with soap and water and encourage wound to bleed Report the incident to a senior person in the hospital where you are working Establish the status of the patient (Hepatitis and HIV). If status is unknown get consent for a blood test. Start post exposure prophylaxis (PEP) within one hour of exposure. Carry one tablet with you at all times to allow a quick response if necessary. Keep your travel insurer informed (policies usually require that you keep the insurer informed if you seek medical advice. Do this and they cannot say they have not been informed. If patient is negative for both hepatitis and HIV, stop PEP. Continue and complete your elective. If patient is positive for either, you are advised to return home as soon as possible Obtain advice from a local UK infectious disease department (e.g. the Brownlee)

13. CULTURAL ISSUES Remember that you are a guest, benefitting from the generosity and hospitality of your hosts Can you say simple things in the local language? Dress appropriately Understand local customs How to respond to requests for money (e.g. from hospital staff, patients, beggars, priests in temples) Don’t take Scottish banknotes Be careful in talking to strangers on political and religious issues Ask permission before taking photographs of people Stay true to your own values, but do not try to convert others – other cultures have different attitudes to patient consent, autonomy and privacy

14. PROFESSIONAL ISSUES Be adaptable Inform yourself about local safety procedures Stay within your level of clinical competence Let your supervisor know what you can and cannot do Only carry out new procedures under appropriate supervision Be prepared to say “No”, politely and without causing difficulty Confine your practical involvement in clinical care to situations that are safe, protected and predictable Your insurance may not cover you for being out of your depth When asked for advice by local staff, be aware that what you say may be taken as being true; it may be better to say that you are a medical student and do not know Avoid clinical responsibility beyond your level As in the UK, you have a duty of care to provide first aid when witness to emergencies, with the guardian principle – First do no harm.

15. FOOD SAFETY AND HYGIENE Ensure hands are clean and dry when handling food Boil water, or filter or chemically treat Do not drink in treated water (ice cubes, ices) Protect food from flies Only eat food you know is freshly prepared and cooked Cooked food should be placed in sealed container in fridge, if not eaten straight away Do not eat meat that is undercooked (i.e. red) Do not eat shellfish Fruit and vegetables should be freshly cooked or peeled Do not eat unpasteurised milk or milk products (e.g. ice cream, yogurt, cheese) Beware of hospitality: if the food is not safe, refuse it politely. If unavoidable, eat a very small amount Select food from menu that is likely to be safe, not what you think will taste good Do not take chances. If unsure at all, miss the meal.

16. CHECKLIST Stethoscope and ophthalmoscope* Oxford handbooks of clinical medicine and specialities BNF* Old trainers (=theatre shoes)* Lonely Planets guidebook (up to date) Torch Candle and matches Sink plug Gifts : pens, crayons and paper for paediatrics ward* obstetrics dates chart/wheel* Extras : photos of home Skipping rope or other small “Keep fit things” (it may not be safe to go for a run) Radio* Loo paper Alarm clock * Be prepared to leave as gifts to the hospital