Determine on arrival the hierarchy of the organization for whom you work (e.g. NGO, hospital, clinic) and pay a courtesy visit to the director, supervisor, or department head to announce your arrival, describe your intentions, and ask if any special procedures need to be followed (e.g. credentialing for clinical care, registration of licensure, etc.). Some institutions will ask for a memorandum of understanding or letter of intent to formalize the relationship. A sample is provided in the Documents and Forms section. Be sure to express thanks to the host for allowing you to work in their country and ensure them that your work product will be shared with your local collaborators. Ask if there is a need to engage in the teaching program or if your expertise can contribute to local training. Ensure that all administrative personnel know who you are and what your business is in the organization. When in doubt, ask.
Clear communication is perhaps the most important ingredient to successfully living abroad with a host family. It is best to know what is expected of you and what to expect in return. To avoid cross-cultural confusion, discuss important issues with your host family such as sleeping arrangements, eating and cooking with the family, curfews, laundry facilities, Internet and telephone use, alcohol and tobacco use as well as your responsibilities regarding younger children and pets and any chores you will be expected to complete.
Tick-, mite-, and mosquito-borne parasitic and viral infections characteristically are diseases of “place” that are linked to known geographic or ecologic regions, and the amount of disease transmission in these areas often varies seasonally. Consult CDC’s Travelers’ Health web page for alerts and information on regional disease transmission patterns that may change periodically.
During your medical elective or travel abroad, you will encounter diseases you have never seen during your training that are commonplace abroad. Take the time to find out more about the infectious diseases in the country you are visiting. For more information, see The Elective Pack: A Medical Student’s Guide to Essential International Health and Development.
Common Infectious Diseases in the Developing World
Because you do not have partial immunity to local pathogens, it is essential for you follow standard preventative measures to decrease your risk of getting ill.
Review the UCSF Standard and Transmission Based Precautions document if you will be working or caring for patients. It contains important information on personal protective equipment (PPE), needles and sharps, solid waste, reusing equipment such as masks, blood spills, and exposures.
Traveler’s diarrhea is the most common health problem to affect travelers. Approximately 80% is bacterial, typically acquired from contaminated food or water. Prevention is key (see food and water precautions). If contracted, taking prophylactic bismuth subsalicylate (Pepto Bismol) is helpful, and we recommend 2 tablets 4 times a day unless you are taking Doxycycline. If prevention doesn’t work, and you find yourself suffering, the following table can guide you towards treatment. Stay well-hydrated.
|Clinical Syndrome||Recommended Treatment|
|Mild: 1-2 loose stools/ 24 hours, minimal symptoms||Stay hydrated and continue Pepto Bismol|
|Moderate: >3 loose stools/24 hours, tolerable symptoms||Lomotil; stay hydrated, add antibacterial therapy if symptoms persist >3days.|
|Moderate - Severe: nausea, moderate-severe abdominal cramps||Antibiotics for 3-5 days and stay hydrated (may stop antibiotic sooner if symptoms resolve completely)|
|Bloody diarrhea or fever & diarrhea||Same as above|
|Vomiting, minimal diarrhea||Pepto Bismol, stay hydrated|
The number one cause of mortality in student populations abroad is MOTORCYCLE accidents, closely followed by AUTOMOBILE accidents (including buses, vans, etc). We realize that you will not be able to avoid traveling by cycle or car or van, and we don’t expect you to, but you should absolutely be aware of some safety precautions to reduce risk. Wear a helmet and buckle your seatbelt whenever possible. Don’t walk alone late at night, and keep your valuables locked and as safe as possible. Political protests and uprisings should be avoided. In addition, be aware of traffic patterns and local road culture.
If you rent a vehicle overseas, use one of the pre-negotiated UC contract agencies, if possible.
Preventative measures for violence-related injuries include limiting your travel at night and varying your travel routes, traveling with a companion, avoiding accommodations on the ground floor and immediately next to the stairs, and possibly carrying a portable door intruder alarm, a smoke alarm, and a rubber door stop that can be used as a supplemental door lock. Also, do not resist attackers if confronted but instead give up car and/or all valuables.
Be sure to register your travel before you leave at the UC TRIPS site to trigger your UC Student Off-Campus Travel Accident Benefit and iJet travel alerts.
Computers, cell phones, purses, watches, and wallets have high street value and can be quickly stolen if you are not alert. Also, be sure to back up the data on your computer on a regular basis because a stolen laptop without backup files can ruin your visit. Do not leave laptops unattended anywhere, and lock or secure them in safe places. Report stolen items to police, but beware that the majority of stolen items are never recovered.