Does Duty Of Care Stop At Passport Control?

Many organisations send their staff to see a travel health specialist before they embark on a big journey. But what about afterwards? DR. TED LANKESTER explains why this is just as important.

Many years ago, my wife and I spent ten months in a remote Himalayan valley. A group of drug addicts had made a home in the area, and we were there to support their recovery. It was a remarkable experience. A story for another time perhaps! 

But in the final few weeks of our stay, we noticed that neither of us were feeling quite right. We’d both tightened the notches on our belts, and the mountain paths we used to climb with relative ease started to feel much steeper. 

We were unwell, but we didn’t know the cause. As the symptoms felt very mild, we resolved to wait until we got home before seeking some medical advice.

When we did get home, and stepped on the bathroom scales, we realised we’d both lost about three stone in weight. We ended up at the Hospital for Tropical Diseases in London to try and find the cause and get some treatment. 

We found out that we had severe tropical malabsorption. We were placed into a research project, and fortunately cured!

Pre-travel medical care is common

Nowadays, rather than a Himalayan valley, I’m more likely to be found at Thrive Worldwide’s medical centre in London. Here, the consultations I provide remain a highlight of my week. 

Typically, I see someone before they head out to somewhere new. We meet, they tell me their story, I do some tests, ask them questions, start to get a sense of their health, and we discuss what they can do to look after themselves on their trip. 

I’m always enriched by the experience. Who wouldn’t be? I try to make sure people who are responding to natural disasters, conflict and poverty, travel to do their job in the best possible condition.

But I’m also sometimes surprised by what I find in these consultations. Undiagnosed illnesses such as raised blood pressure, diabetes or high cholesterol are not uncommon. These are issues which, if caught early (which is what we often do) will prolong lives and sustain health. 

It’s of course a ‘no brainer’ to see people before they travel. If you’re reading this, there’s a good chance your organisation does this as a key part of their Duty of Care.

But what about afterwards? 

Why post-travel care is so important 

In my Himalaya experience, seeing a specialist after I got home was an absolute necessity. Without it, there’s a chance I wouldn’t be here writing this now! 

And in my thirty years of experience as a Travel Health specialist, I’ve seen the immense value of these post-travel assessments. For example, among the patients I’ve seen recently who are back from their assignments, there has been plenty to diagnose and treat. 

This has included several cases of Bilharzia; one person harbouring a worm several inches long; a disabling bowel problem; a serious but symptomless prostate issue which led one person to later tell me “I think you helped to save my life”. 

But on top of these ‘headline’ problems there are nearly always a list of other physical and mental health worries. We can often provide practical help with these too. One person told me “I feel a different person” following treatment from us. 

Reversing the decline

There was a time that my colleagues and I saw so many people returning from their travels, that we wrote books, medical articles and delivered lectures worldwide on the subject of travel health. 

But I’ve noticed a decline in organisations booking these for their staff. This is the case even when people return from places where water-born diseases such as Cholera are commonplace, or when they get home after years away and have accrued a collection of half-diagnosed and unexplained symptoms.

This decline, you won’t be surprised to hear me say, is bad news.

Small problems can occur whilst travelling. And while they may not seem significant at first, they can slowly worsen. And as with any medical issue, the earlier it is discovered the better. And the reality is that the general health service in your country is usually not really able to engage with them at the depth and level of care which they need 

So this is my belief: if an organisation routinely deploys staff to different parts of the world, then their Duty of Care policy should clearly spell out the need for a health screening before leaving, and medical care on return. Duty of care should never stop at passport control.

Our medical consultations are designed for staff before, during and after travel. Read more about them and book an appointment here.