1) You fill out a form explaining your health/medical/medicinal history as well as where you are going, when, and for how long. They make copies of your immunization history if you brought it.
2) Then the receptionist prints out general advisories for the countries you write down. For my four countries (Peru, India, Kenya, Ghana), I was given 113 pages. Some excerpts for you (pages turned to at random; emphases copied from text):
It is illegal to wear military-style or camouflage clothing. Photography of sensitive installations, including military sites, government buildings, bridges, and Accra's international airport, is prohibited. Permission should be sought before photographing official buildings and individuals.
- Pg 8, under Ghana's country profile
High Altitude Pulmonary Edema (HAPE) is a buildup of fluid in the lungs that can occur along with HACE or as a separate illness. Like HACE, it is a medical emergency. Those affected will be breathless and very tired when walking and have a sense of fullness or pressure in the chest. Eventually victims will be short of breath even while resting. At this point the illness can rapidly progress to death. Victims must be guided back down and receive drug and oxygen treatment as soon as their illness is recognized as HAPE. They should be kept warm and assisted as much as possible, since exertion will make their condition worse.
- Pg 30, under "Altitude Sickness" (relevant for Cuzco, Peru)
Swimmers are especially at risk in choppy, windy conditions, when tentacles can get wrapped around an arm or leg. Waders, beachcombers, and divers who may see the float but not the tentacles are also at risk. Envenomation causes instant severe pain, local wheals, blisters, and necrosis of skin. General symptoms include nausea, vomiting, cardiac and respiratory difficulties, and loss of consciousness leading to drowning. Deaths have occurred in the Atlantic coast of the U.S. (including Florida) and some Carribbean islands.
- Pg 75, under Marine Hazards
It's definitely fun bedtime reading!
There was a secondary packet that is only 11 pages. It was a summary of general safety, security and other precautions... like not rinsing your toothbrush in tap water and avoiding rabid animals.
Check and check.
3) You go into a private room and talk for at least an hour about your past immunizations, places you intend to visit, activities in which you intend to participate, the seasons of your destinations, altitude considerations, flight lengths, time zone changes, diet and medical history, travel experience, and on and on. That all boils down to what kind of warnings they'll give and vaccinations they recommend. They don't do physicals or checkups like that.
At the time of my visit, there was a new hire RN who was observing the staff and procedures. As the doctor knocked on my door to enter, she glanced at my chart, paused, and turned behind her, saying to the nurse, "You might want to sit in on this one. This could be interesting."
That was funny :-)
4) Conclusions are made and prescriptions are written. I was prescribed 6 vaccines and 2 medications. This I will write about in a separate post. Needless to say, I will be immune to pretty much everything. And probably glow in the dark.
Good times!
