Monday, 17 October 2011

Surviving Travel Emergencies


What should you do when your dream holiday turns into a front-page news story? If John Simpson and a BBC news crew arrive in town, is it time for you to leave?

Brits take almost 60 million overseas trips each year, and nearly a quarter of these are to non-European destinations. The world may be getting smaller but, unfortunately, our exposure to risk is not: the past year has seen British tourists caught up in revolutions in Kyrgyzstan, Tunisia and Egypt; violent demonstrations across North Africa, the Middle East and Iran; natural disasters in Pakistan, Australia, New Zealand and Japan; and terrorist attacks in every corner of the globe. Whilst your chances of being caught up in such an event are remote, there are certain things you can do before and during a trip to increase your safety.

Before You Go

Read up about your destination. Check the FCO website (www.fco.gov.uk) for security updates, guidance on local laws and customs, and issues affecting foreign visitors. Buy a reputable, up to date guidebook for more detailed information on what you can expect (as well as useful local tips and contact numbers), and keep abreast of any regional news stories that may affect your trip. The BBC World Service websites are a fantastic and reliable resource.

Buy a comprehensive travel insurance policy before leaving home: single trip cover can cost as little as £3. One in five British tourists travelling abroad does not have travel insurance, meaning that if something does go wrong, they are in very real danger of being left stranded or with stratospheric bills to pay. If you are visiting a country that does not have reliable medical provision, select a policy that includes medical evacuation (Med-Evac). A tourist trekking in the Wakhan Corridor in 2010 broke his leg and had to be flown by helicopter to the nearest hospital in Faizabad: his insurance covered the $99,000 bill. Check that the policy covers you for your destination and any activities you’ll do once you get there: many policies exclude areas to which the FCO advises against travel, and even going to the USA may demand an increased premium.  Some insurance companies offer coverage for terrorism and kidnapping: your destination will probably dictate whether this additional cover is advisable.

There are, unfortunately, instances when your insurance may not cover you – natural disasters and other ‘acts of God’ for example – or when there is a delay in the insurance company providing assistance or funds. Make sure that you purchase emergency funds in local currency (or US dollars) that you can keep about your person throughout the trip. ATM cards and traveller’s cheques are undoubtedly useful, but banks are often the first places to close during unrest and you may not have access to a working cash machine. Nothing beats hard cash in a crisis.

Make copies of your expected itinerary, any local contact numbers (e.g. hotels where you’ll be staying), your passport, visas, driving license, insurance documents and any other important paperwork. Send yourself a copy as an email attachment, put a paper copy in your luggage, and leave a copy with someone you trust at home. This will speed things up immeasurably if something gets lost or you are reported missing. Register your details online with the FCO’s LOCATE service and remember to update any changes to your travel plans whilst you’re away.

Pack a first aid kit. If you are travelling somewhere with limited medical facilities, make sure it includes a variety of needles and syringes, bandages, multi-purpose antibiotics and strong pain killers (both available on prescription from your GP). You may also want to carry water purification tablets, iodine, high-energy snacks, a torch and a Swiss army knife. These items can be exceptionally useful even in non-emergency situations.

While You’re Travelling

There are a variety of emergency situations you could face whilst travelling but although on the surface they might appear quite distinct – you might wonder, for example, what a bomb attack has in common with a tsunami or earthquake – there are similarities in the way you should respond before and during the incident to increase your survival chances.

Be vigilant
Keep your eyes and ears open for information. Whilst local media or fellow travellers may warn you that trouble is brewing, your own senses can give you a far faster indication. Abandoned cases or parcels, vehicles parked in an awkward place, or individuals acting suspiciously, may indicate an increased risk of a bomb attack; seeing the sea retreat rapidly from the beach implies a tsunami will follow; and walking along empty streets with hastily boarded up shop fronts in a normally busy area suggests civil unrest is anticipated. Before rioting started in Darjeeling in August 2008, we noted shops had shut early, and women and children retreated inside. Half an hour later, mobs were setting fire to cars and smashing windows, but the locals had known they were coming. If you see something that concerns you, or you have a gut-hunch that something is just not right, leave the area and go somewhere else. The worst thing that can happen is that you miss a few hours sightseeing and instead spend it in a café on the other side of town.

Avoid large crowds and official personnel
Bomb attacks are rarely targeted specifically at tourists. Whether in Afghanistan and Iraq, Russia and Turkey, or even the US and UK, recent bombings have been overwhelmingly aimed at the authorities (police, soldiers, politicians or the judiciary) or high-profile, densely populated targets (public transport, places of worship, shopping malls etc.) that are guaranteed to garner attention for the terrorist’s cause. When tourists have been hit, therefore, it’s largely because they were in the wrong place at the wrong time.

Large crowds can pose their own threat. On the most basic level, it’s easily to become separated from your companions and/or belongings, and even celebrations have been known to turn tragic when rumours or small, localised incidents have prompted a stampede. Keep a clear head, don’t get sucked in to the centre of a group without knowing how you will get out again, and arrange a meeting point a short distance away in case you become separated from one another or simply feel uncomfortable caught up in the crowd. Do not rely on mobile phones to organise such a rendezvous on the spot as network coverage can be sketchy and may be turned off entirely in the event of a crisis.

If the reason for the crowd amassing is political or religious, beware that the response of the authorities, or, indeed, groups with conflicting views, may be aggressive, even if the crowd is relatively peaceful. If things do turn violent, it is imperative that you keep calm and think: do not just follow the herd. During the revolution in Bishkek, we were photographing protesters in Ala Too Square. When snipers began firing from the rooftops, the majority of people ran out of the square in one direction, only to face a volley of shots fired by the police. The road was littered with bodies from this second round of shooting.  We were relatively safe from the gunshots as we’d temporarily sought shelter beneath a set of concrete steps rather than running straight into the unknown. We were able to catch our breath, assess the situation, and identify a safer route away from the square.

Protect your head and chest
In the event that something goes seriously wrong, be it an explosion or an earthquake, your head and chest are the two things you can’t live without: in a worst-case scenario, limbs and belongings are all repairable or replaceable. If debris is flying and there is no immediate cover, drop to the floor in a foetal position with your head tucked in to reduce your chance of being hit. As soon as there is a lull, look to see if you can move quickly and safely to a more secure place: this could be an open area if buildings are potentially unstable or, if there is shooting, somewhere with better cover. Do not attempt to retrieve belongings, and only move if you can reach your new location without disproportionate risk. Sometimes it is even best to stay still as you will not draw attention to yourself.

There are a variety of helmets and protective jackets on the market but, unless you are going to be reporting from the middle of a known war zone, you’d be unlikely to include them in your suitcase. There is also an argument that the weight of Kevlar and ceramic plates (the main components of a bullet-proof jacket) actually limit your ability to move quickly and escape from a problem when speed and agility can be among your greatest assets.

Know where to go
Whenever you find yourself in a new situation, always have a cursory glance around. If you are in a building, find out where the exits are. If one route is blocked, how would you leave? If you’re travelling with friends, agree a meeting point in each new city where you can reconvene if you’re separated or there is a problem. Choose somewhere you’ll both remember that is easily accessible on foot. Get to know where the closest hospital is and how to get there: even if you’re only suffering from Delhi-belly, it’s useful information to have to hand.

Establish where you can get information and/or assistance from in the event of an emergency. If you’re in a capital city, these are likely to be embassies and consulates, but also consider international banks, hotel chains or other companies and organisations that have regular interaction with foreigners and a brand that they want to protect. When the Marriott hotel was bombed in Islamabad in 2008, many survivors fled to the Serena, the city’s other 5* hotel. In Bishkek in 2010, the Hyatt became a refuge for the capital’s expats, providing security, reliable information and a constant supply of food that went far beyond the required level of customer service.

The Aftermath

If you or your companion is injured, your first priority should be getting medical attention. Be aware that many countries do not operate a reliable ambulance service, hospitals may be overcrowded and ill-equipped and, if there are a lot of casualties, you may be left entirely to your own devices. Be prepared to administer emergency first aid (see box) whilst calling for help. Contact the closest British Embassy and your insurance company to confirm your whereabouts and request assistance. This is important even if you are unhurt as it will ensure you are not listed as a missing, making sure search and rescue resources are deployed where they’re most needed.

Your next priorities are food and water, as supplies can quickly run out. Forget your normal balanced diet and focus on obtaining high-energy products such as fizzy drinks, chocolate and tinned goods, as well as staples such as rice or bread. Our somewhat eclectic shopping basket on the morning of Kyrgyzstan’s 2010 revolution included 32 Snickers bars, bottles of Coke and water, a bag of flour, pasta, carrots, and tinned peaches. They didn’t need refrigerating and kept us running until food shops reopened and restocked. Drinking bottled water or carbonated drinks will reduce the likelihood of getting sick from contaminated drinking water. If you can’t get hold of them, boil and add purification tablets to anything you drink.

Be aware of your personal safety. Tempers run high among desperate people, and grief and anger can quickly turn to violent outbursts. Looters and armed gangs stalked the streets of Bishkek last year after the revolution. The police were in hiding and a significant minority took advantage of the situation to make a quick buck or settle old scores. The sexual assault on a foreign journalist in Cairo when Mubarak fell, and the recent kidnappings of foreigners in Libya further reminds us of the very real dangers of a sudden lack of law and order.

Treat personnel in uniform with politeness but be cognisant of the fact that they may not be legitimate, or maybe seeking to abuse their authority. Do not hand over original documents unless you are inside a police station or at your consulate; use photocopies instead to identify yourself. If you are asked for a payment or fine, again try to pay it only inside the police station, and request a receipt. Make a note if you can of the name and/or badge number of the officers involved as this is a strong deterrent if they are acting beyond their remit and it helps minimise the corruption.

Think carefully about returning home. In the event of a large-scale incident, such as the recent Japanese earthquakes, the local authorities and emergency response units are overstretched and simply do not have the resources to look after tourists as well. Their priority, quite rightly, is on people who have lost everything and not those who have a safe home to go back to. Unless you have specific skills that are needed (e.g. search and rescue or medical training), or are staying with an injured person, change your travel plans to another area or finish your trip early.

BOX 1: Emergency First Aid

First Steps
-          Call for help – this can be the emergency services, or even bystanders.
-          Check your surroundings: watch out for falling debris, live wires, traffic and anything that poses a danger.
-          Check if the casualty is conscious.
-          Don´t attempt to move the casualty unless absolutely necessary.

ABCDE
-          Airway: Check for obstructions blocking the casualty´s airway. If you are confident they do not have a spinal or neck injury, turn their head to prevent choking if they are sick.
-          Breathing: Is the casualty breathing? If not, pinch the casualty´s nose. Place your mouth over theirs, making a seal with your lips. Blowing slowly but firmly, give one breath every five seconds. Watch for the chest to rise as you give these breaths. If the chest does not rise, reposition the head and try again.
-          Circulation: Does the casualty have a pulse? If not, you will need to administer CPR. Give 30 chest compressions, followed by 2 rescue breaths. Repeat for 2 minutes before re-checking for signs of life. For detailed instructions see www.rescus.org.
-         Disability/Deformity: Ask the casualty to move their hands and feet. If they can’t, they may have spinal damage. Check for obvious fractures, dislocations or anything that looks out of place.
-    Exposure: Systematically expose each part of the body to check for wounds. This includes hard-to-see areas such as buttocks and armpits.

Control Bleeding
-     If your casualty is breathing, stopping bleeding is the most important thing to do.
-     Apply direct pressure to the wound. Ideally use an absorbent pad or piece of clothing but, if nothing else is available, even your hand will do.
-     Use pressure points in the arm (between the elbow and armpit), groin (along the bikini line), or behind the knee to control bleeding in the arm, thigh, or lower leg.
-    Wounds to the head, face and neck typically bleed severely. Keep the casualty upright and be careful not to obstruct breathing whilst applying pressure.
-    If you need to apply more bandages to stop bleeding, put them over the top of the old ones so as not to disturb any clotting. 

      This article was originally published by Real Travel magazine in Spring 2011. However, as the magazine has now gone bancrupt without paying for the article and its pictures, I am reproducing it here.

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