GLOBAL HEALTH PREPARATION

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GLOBAL HEALTHPREPARATION
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JOSEPH J SCHWERHA MD MPH

• PROFESSOR OF OCCUPATIONAL AND ENVIRONMENTAL
  MEDICINE
• DIRECTOR OF THE OCCUPATIONAL AND
  ENVIRONMENTAL MEDICINE RESIDENCY PROGRAM
• GRADUATE SCHOOL OF PUBLIC HEALTH
• UNIVERSITY OF PITTSBURGH

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HOW LONG IS THE ASSIGNMENT

• FEW DAYS OR WEEKS
• FEW MONTHS
• ONE OR MORE YEARS

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EMPLOYEE OR CONTRACTOR
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AREA OF THE WORLD

• LANGUAGE
• GOVERNMENT EMBASSY
• SAFETY
• STABLE GOVERNMENT
• INTERNAL THREATS
• EXTERNAL THREATS

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GLOBALIZATION

• ECONOMIC
• ETHNIC
• POLITICAL
• FINANCIAL TRANSACTIONS

• ATTITUDES
• RELOCATION
• RELATIONSHIPS

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OVERSEAS EXPERIENCE

• SAFE
• EFFICIENT
• EFFECTIVE PREPARATION

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CULTURE SHOCK

• PERSONAL AND ENVIRONMENTAL DISRUPTION CAN BE
  SEVERE

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SOME ISSUES TO CONSIDER

• CAREER REQUIREMENTS
• SUITABILITY FOR ASSIGNMENT
• PSYCHOLOGICAL AND FAMILY
• IMMUNIZATIONS AND MEDICAL KITS
• PROPHYLAXIS FOR DISEASES
• MEDICAL INSURANCE
• MEDICAL SUPPORT
• EDUCATION OPPORTUNITIES
• LIVING CONDITIONS

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FAMILY CONSIDERATIONS

• MEDICAL
• EDUCATION
• RECREATION
• ORIENTATION

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MEDICAL NEEDS

• MEDICATIONS
• COMPLETE MEDICAL HISTORY
• CONSULTATION
• EMERGENCY SERVICES
• EVACUATION
• TRAVEL MEDICAL KIT
• SHORT TERM
• LONGER TERM

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AVAILABILITY OF MEDICAL CARE AND EQUIPMENT

• GENERAL
• SPECIALTY
• HOSPITALS
• TRANSPORTATION
• GLASSES AND CONTACT LENS
• DENTURES

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EDUCATIONAL NEEDS

• PRESCHOOL
• GRADE SCHOOL
• HIGH SCHOOL
• PRIVATE SCHOOL
• COLLEGE
• GRADUATE SCHOOL
• PROFESSIONAL SCHOOL

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HOUSING AND NUTRITION NEEDS

• HOUSE
• APARTMENT
• FOOD AVAILABILITY
• SANITARY CONDITIONS

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TRANSPORTATION NEEDS

• PASSPORT
• PERSONAL
• PUBLIC TRANSPORTATION
• DRIVER
• ROAD TRAVEL
• AIR TRAVEL
• STOPOVERS

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AIR TRAVEL

• REMEMBER IF THE ENGINE STOPS, GRAVITY CANNOT
  BE REASONED WITH

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RECREATIONAL NEEDS

• WHAT IS AVAILABLE
• PHYSICAL
• INTELLECTUAL
• LOCATION

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MEDICAL EMERGENCIES

• LANGUAGE
• EMERGENCY EXERCISES
• OUT OF COUNTRY EVACUATION
• BASIC LIFE SUPPORT
• MAJOR ACCIDENT PROCEDURES
• EMERGENCY EQUIPMENT

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PERSONAL SAFETY

• AVOID ADVERTISING WEALTH
• TRAVELERS CHECKS
• MONEY BELT
• WOMEN STRAPLESS PURSE

• WALLET IN FRONT POCKET
• PROTECT PERSONAL INFORMATION
• MAJOR HOTELS
• FIRE SAFETY
• LAWS OF COUNTRY

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GENERAL MEDICAL ADVICE

• SUNBURN
• INSECT PROTECTION
• SEXUALLY TRANSMITTED DISEASES
• BLOODBORNE DISEASES

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HEALTH INSURANCE

• UNITED STATES
• OTHER COUNTRIES
• SPECIAL INSURANCE
• ARRANGEMENTS FOR EMERGENCY MONEY
• S.O.S.

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PRETRAVEL MEDICAL SCREENING 1

• TREAT OR ASSESS BEFORE DEPARTURE
• INFECTIOUS DISEASE
• ANEMIA
• DENTAL CONDITIONS
• GASTRIC ULCERS
• PREGNANCY
• CHRONIC CONDITIONS

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PRETRAVEL MEDICAL SCREENING 2

• POSSIBLY UNSUITABLE
• CARDIAC DISEASE
• CEREBROVASCULAR DISEASE
• THROMPHLEBITIS
• UNSTABLE CHRONIC CONDITIONS

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PRETRAVEL MEDICAL SCREENING 3

• DERMATOLOGICAL
• ENT
• ENDOCRINE
• GASTRO-INTESTINAL
• HEMATOLOGICAL
• MEDICATIONS

• MUSCULO-SKELETAL
• NEOPLASM
• NEUROLOGICAL
• PSYCHIATRIC
• PULMONARY

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IMMUNIZATIONS

• DT
• MMR
• SMALL POX
• HEPATITIS
• FLU
• POLIO
• PNEUMONIA

• HAEMOPHILUS
• MENNINGOCOCCUS
• PERTUSSIS
• YELLOW FEVER
• ETC.

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KEEP ON HAND

• RETURN TICKET
• TRAVEL DOCUMENTS
• EXTRA MEDICATIONS
• EXTRA GLASSES OR CONTACT LENS
• EXTRA DENTURES
• ETC.

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WHILE AN EXPATRIATE OR REGULAR OUT OF
COUNTRY TRAVELING

• YEARLY PHYSICAL AND PSYCHIATRIC EXAMINATIONS
• CONTACT WITH CURRENT DEVELOPMENTS
• FAMILY CONTACTS

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REPATRIATION

• PSYCHOLOGICAL STRESS
• CAREER PATH
• ORIENTATION
• PHYSICAL AND PSYCHIATRIC EXAMINATION
• HOUSING
• EDUCATIONAL NEEDS