This article originally appeared in Star Chronicle, a newsletter
published for the Children's Medical Center.
Have a safe trip, and remember...
"Do not drink the water." We have all heard that warning when traveling to a
foreign country, especially a third world or developing country. How about
adding "Do not walk barefoot on the beach." Why not? According to UMass Memorial
Travelers Health Services, going barefoot is not a good idea especially in a
developing country. "There are things in that soil you just don't want to step
in," says Richard Moriarty, MD, who is board-certified in pediatric infectious
disease. He gives a further example: "Parasites, which thrive in the soil of
tropical climates, can easily enter the body when in contact with bare skin."
Dr. Moriarty discusses many precautions with patients in Travelers Health
Services Clinic, the first of its kind in Worcester. The clinic director is
Richard Glew, MD, vice chair of the Department of Medicine, who specializes in
adult infectious diseases. It is a centralized, comprehensive service that
includes medical exams, vaccinations and information on destinations for
travelers.
"The rate of global travel is amazing," Dr. Glew says. "In clinic, we see
people from all walks of life - business travelers, college students,
missionaries, and families going on vacation or visiting home countries. And Dr.
Moriarty is our children's expert."
Dr. Moriarty is concerned for the vulnerability of children when traveling to
developing countries. Because children are nearer to the time of receiving
routine immunizations and because they may not have developed immunity to as
many organisms as adults, he stresses an extra level of care. Children are much
more at risk for developing travelers' diarrhea, a very common affliction that
can lead to serious dehydration.
"One of the things I have to remind parents is not to let children drink the
water when they are taking a bath or shower," Dr. Moriarty says. He explains
bathwater is frequently not as safe as boiled water or bottled drinking
water.
It is not only drinking the water that causes diarrhea and other problems;
eating the wrong foods can put children and adults at risk. A general precaution
suggests that foods should not be eaten raw, including fruits and vegetables. On
their list of recommendations, Travelers Health Services states "Wash it, peel
it, boil it or forget it."
Sometimes, Dr. Moriarty finds misunderstandings among parents who grew up in
foreign countries and are returning for visits. The parents assume their
children will be fine because they, themselves, survived in that country. But
children who are born and raised in the United States are not subjected to the
organisms and diseases that are found in other countries. The problems are sewer
and water systems. In North America, Australia and most European countries,
there are systems for sewage treatment and distribution of clean water, but in
many developing countries, such systems are substandard or nonexistent, thereby
compromising health and safety.
With his interest in international adoption, Dr. Moriarty is known for his
skill in caring for infants and children who are brought to the United States
for the first time. He knows what to look for in screening and treating various
diseases, and often continues care as the children's primary care provider. In
many instances, he is involved with families going back to foreign countries to
adopt other children.
Overall, the goal of Travelers Health Services is teaching prevention methods
to individuals and families, which includes a colorful, interactive video. It
covers subjects from jet lag to insect precautions.
Another important goal of the clinic is timing. Instead of thinking of it as
a last minute step, people should incorporate a visit to the Travelers Clinic
into their planning. They need to schedule their trips well in advance, so they
should make appointments at the same time. Vaccinations often have to be given
over a few weeks, so patients need to come in a minimum of six weeks before
traveling.