Alcohol

Most of us enjoy a drink every now and then and this is no exception when we’re relaxing in the sun on holiday with our friends and family.

Whilst it’s important to immerse ourselves in new places and cultures, and the appeal of sipping cocktails on sandy beaches can be enticing, it's vital to approach alcohol consumption abroad with the same care we exercise at home.

When in unfamiliar environments it's easy to overlook the importance of responsible drinking and this can lead to accidents and medical emergencies occurring.

The more you drink, the more likely you are to have an acciden including drowning.

Heavy drinking more than doubles your risk of being injured and it can increase the risk up to five-fold.

Because everybody reacts differently to alcohol, there isn’t any ‘safe’ cut-off point for the amount of alcohol which can minimise the risk.

But did you know that claiming on your travel insurance for an incident related to drinking alcohol abroad could result in your claim being voided?

This is evidenced by one of the following:

• A medical practitioner stating that your alcohol consumption has caused or actively contributed to your injury or illness.
• The results of a blood test which shows that your blood alcohol level exceeds 0.19% which is approximately 2.5 times
  the drink driving limit in the UK.
• A witness report from a 3rd party or a police incident report.
• Your own admission.

It’s a scary thought and has left many in the past having to pay more than the actual cost of their holiday on medical bills! Read the small print!

Many countries have different laws when it comes to drinking alcohol in public places, they may only allow the buying and selling of alcohol from licenced venues, the times that the selling of alcohol is permitted and different legal drinking ages to our own. So, it’s important to make sure you understand the rules and customs around drinking alcohol for your next trip away.

Know your limits: Each person is different and their bodies will react differently to alcohol. Don’t try to compete with friends or keep up with the drinking habits of others. Additionally, look out for signs of intoxication in yourself and others such as slurred speech, impaired coordination, nausea, increased risk taking and poor decision making.

Be aware of drink spiking: Unfortunately drink spiking is a regular occurrence and being abroad can make you more vulnerable and an easier target. Make sure to never leave drinks unattended, accept drinks only from trusted sources such as friends and family, and try to keep your drink covered where possible.

Drugs

Using mind altering substances can risk placing you in unwanted or dangerous situation, increases in risk-taking behaviour and can lead to unsafe choices such as violence or risky sexual practices.

Loss of control, disorientation, psychiatric disassociation, psychosis, or the effects of withdrawal (such as anxiety, agitation, hallucinations, delusion, delirium tremens, seizures, and hyperactivity) in an unfamiliar environment increases stress levels and could result in a medical emergency or arrest.

If you are going to use, buy or sell prohibited substances abroad, be aware that the posession and/or use of some drugs is illegal in the majority of countries and can lead to criminal charges, heavy fines, imprisonment, or the death penalty (i.e. Singapore, Iran, Saudi Arabia and others).

In addition, the quality of the substance may be different from what you may be used to back home. Consuming a drug of an unknown quality may lead to unwanted physical or mental effects or cause you to overdose. If you do intend to use drugs, make sure you know the risks of accidental overdose, where to get clean injecting equipment, and always practice safe sex.

Fire

Hotels in some countries may be built to poor standards and have inadequate fire escapes. You should always check to see where the emergency exits (if any) are located. Gas and electrical appliances may in a dangerous condition. Balconies and staircases may be unsafe.

Fire is a significant cause of death and injury abroad. In many countries, fire regulations are slack or non existent. Never smoke in bed and ensure that cigarettes are properly extinguished.

Remember, smoke inhalation can also be fatal and the best way to avoid it is to crawl low under the smoke.

If you travel internationally you should buy appropriate travel insurance before you go, covering you for existing physical or mental health and any activities you will be doing whilst you are away.

Travel insurance provides financial cover for many eventualities and situations that you might encounter when abroad. This can include: medical expenses (paying for medical treatment whilst you are abroad) medical repatriation (return you to your home country).

If you do not have appropriate insurance before you travel, you could be liable for emergency expenses, including medical treatment, which may cost thousands of pounds.

You should arrange travel insurance as soon as you book your holiday. (So you are covered if something happens and you need to cancel).

Personal Security
To reduce any risk of mugging travel in groups, avoid remote areas after dark, use a torch, keep on the move, carry an alarm or an anti-personnel spray (may be illegal in some countries), wear modest clothing, do not display wealth.

Be aware that pickpockets are active in crowded areas such as markets and tourist attactions.

Many areas are not safe to wander around at night, including those that look safe by daylight. While driving consider locking your car doors at stopping points especially at night in isolated areas.

Be aware of political unrest. Up to date information is available from the Foreign and Commonwealth Office on line. Do not rely on information from local residents.

In some countries, producing cameras, tape recorders etc. in sensitive areas such as near airports and railway stations can result in arrest on suspicion of spying.

Road Safety

Road accidents are responsible for more deaths amongst tourists than any of the diseases mentioned on this site.

When crossing the road remember the traffic may come from the opposite direction to the one in your home country.

Drivers in many countries do not observe pedestrian crossings or traffic signals. e.g. in Bangkok you are likely to be run over on a zebra crossing if you treat it like you would in the UK and expect the traffic to stop for you.

Transport

Whilst receiving wide publicity, accidents in the air and on ships are extremely rare. Some airlines are safer than others (published data available). Ferries in developing countries are often overcrowded and carry inadequate safety equipment.

Trains and buses are often overcrowded. You should think twice about taking an overloaded up-country bus and avoid local habits like travelling on the roofs of trains and busses and jumping on and off while they are moving.

Motor vehicles may be poorly maintained. Check over any hire vehicle very carefully for mechanical defects especially brakes and tyres.

When you are driving, always wear a safety belt, strictly observe speed limits, traffic lights and signs. Never drink and drive.

Local drivers may not observe traffic rules but you always should. Remember, in some countries they drive on the right, it is easy to forget.

Be very careful on potholed and non-tarmacadamed 'dust' roads which can become badly eroded from continual exposure to the elements.

Scooters and motorcycles are frequently unstable on poorly maintained roads and those riding have very little protection in the event of an accident. Always wear a safety helmet.

Water Hazards

Alcohol and swimming do not mix!

Beware of fast moving tides and currents, especially the undertow from waves in deep water where even strong swimmers may find it difficult to get back to the shore.

Avoid swimming alone. Swim in approved places when there is a beach patrol or lifeguard service. Always wear proper life jackets when taking part in certain types of watersports like sailing, windsurfing, canoeing etc.

Sunburn is common and may be unexpected since the swimmer is kept cool by the water.

Avoid using airbeds or inflatable dinghies in the sea. If there is an offshore wind they can easily been blown a long distance off shore. If this happens the scenario is often panic, jumping off, exhaustion and hypothermia. Invariably it is better to stay 'aboard', try to attract attention and await rescue.

Water is the home of some very dangerous creatures like crocodiles, hippos and sharks. Sea creatures like urchins, jellyfish, molluscs or fish may be unexpectedly venomous. Be aware of local dangers.

Do not swim immediately after a big meal when cramp is more likely to occur. Low water temperature can induce hypothermia. This can be rapidly fatal - within minutes.

Both the sea and inland deep water lakes may be very cold even during hot summer months.

Visibly dirty recreational water in pools, lakes and rivers especially in the tropics should be avoided. There is always a danger of contracting water borne diseases like shistosomiasis or leptospirosis in these areas.

Foot injuries on beaches are common in those not wearing shoes.

Outdoor & Adventure Activities

Pursuits such as scuba diving, mountain climbing, white water rafting and hang gliding can be dangerous in unfamiliar surroundings. Additional insurance may be required for these and similar activities.

Get physically fit in advance of your trip. Do not be over ambitious - make sure you are fully trained for the degree of skill required.

Avoid excessive fatigue - accidents often occur before lunch and in the evening. Keep up your carbohydrate and fluid intake.

If you are travelling in mountainous areas become familiar with the terrain and the hazards involved, including avalanche potential. Use guide books and local maps when available. Observe adverse weather warnings.

Do not 'economise' on protective clothing, boots and safety equipment. In snow conditions watch out for skiers and snowboarders. It is your responsibility to avoid skiers in front of you.

Consider helmets for younger skiers and snowboarders.

Skiers should learn to fall correctly and to release your ski stick before it causes skiers thumb!

Serious injuries that may require a blood transfusion can be of concern where HIV screening of blood products is not universal.

Skin injuries can lead to tetanus and therefore, ten yearly boosters of tetanus toxoid are advised before travelling to many countries.