As the pandemic continues to distract attention away from other health issues, Travel Medicine Specialist DR. TED LANKESTER makes the case that organisations need to ensure their staff have a good medical review before going on assignment.
I’ve been involved in travel medicine for thirty years. And I continue to be amazed and alarmed by the many crucial signs of important disease we discover through our medical reviews. These are often mainly relevant for a person’s longer term health. But sometimes they are crucial in regard to an imminent assignment.
Recently, in one week of seeing patients who were soon to travel, I made two unexpected findings in two apparently well people. The first was a healthy man in his 30s who was found to have diabetes, despite having no symptoms. It was discovered by finding high amounts of sugar in his urine and confirmed by a blood test. The second was an older healthy man with no relevant symptoms found to have prostate cancer. He is now receiving urgent treatment.
Why are we missing more health risks than usual?
Where I live, in the UK, nearly 6 million people are currently waiting for hospital-based diagnosis or treatment. A significant number of these will be found to have early (or late) signs of cancer, non-communicable diseases (such as raised blood pressure, high cholesterol) or other conditions. All of these could shorten or diminish their lives.
In addition, many people during the pandemic have not attended doctor’s surgeries or hospitals when they should have done. Reasons include a fear of catching COVID-19 or a reluctance to add to pressures on their health facilities. And so some people are harbouring important but undiagnosed indicators of illness.
Also relevant is the vast inequality in access to health, and life expectancy, between different ethnic groups and between wealthy and deprived areas. For example, there is a 27-year gap in life expectancy for those living in two different parts of the UK. People from these poorer groups and regions are more likely to have undiagnosed but important conditions.
“If an organisation sends staff away from home, and they ignore key physical health issues prior to doing so, then their duty of care is seriously flawed.”
And in rural parts of the African continent 83% are not covered by essential health services. In late 2021, UN research indicated that the economic effect of COVID-19 has led at least 20 million more people worldwide into extreme poverty. About 23 million children have missed out on basic childhood vaccinations. And up to 283 million people in 80 countries face acute food insecurity. These figures are indicators of the faltering or collapsed health systems in many low and middle-income countries.
At Thrive Worldwide we review people who travel all over the world. Often they have been recruited for humanitarian support, or by mission agencies, to work outside their own borders. If they do not have a medical review, a significant number will have important health indicators missed, including conditions which could cause acute illness during their time away. In addition, if they become ill while working in such countries, health systems will often have been seriously depleted by COVID-19 and other causes, making it harder to access timely or accurate health care.
Why is this important?
It must be obvious by now that if an organisation sends staff away from home, and they ignore key physical health issues prior to doing so, then their duty of care is seriously flawed. Pre-travel medical reviews are essential for those travelling to a country different from their own.
However, many organisations fail to arrange this form of medical review. This can be for several reasons. Some lack information on its importance. And others hope to reduce their overall costs and improve their bottom line (although we would suggest that the opposite is true). It’s also easy for organisations to forget that an avoidable death, disaster or one episode of failed safeguarding can damage, sometimes irretrievably, the reputation of the organisation.
At Thrive Worldwide we aim to make this information more widely known. And we aim to provide the best evidence-based medical reviews for travellers. We have tried to make this service as accessible as possible offering face-to-face, remote and paper based reviews. And often we suggest a psychological assessment as well, to help highlight and respond to any mental health problems.
I have not even mentioned post-travel care here. Although there are moral and scientific reasons why this is also important, it is often seen to be unnecessary. The sending organisation might feel it has carried out its duty of care if it has avoided a death, or episode of obvious or severe illness persisting after returning home. That’s a blog post for another time. For now let’s remember that a pre-travel medical review is an essential part of any organisation’s Duty of Care.
If you‘d like to book a medical review with us, or any other travel health service, then get in touch. We’re ready to chat.