Curriculum for General Practice - The Royal New Zealand College ...

Travel Medicine
T
Travel Medicine
New Zealanders are a mobile population
and New Zealand is also a popular travel
destination, so travel-related consultations
are common in general practice. These may
be related to either inbound or outbound
travel, temporarily or permanently.
In February 2012 visitor arrivals numbered 259,100. Overseas
trips by New Zealand residents numbered 116,400, the most
common destinations being Australia, US, Fiji, UK, China and
Cook Islands. 1 In February 2012 seasonally adjusted figures
showed a net loss of 400 migrants. However, of those who
moved permanently to New Zealand, 1,000 came from India,
900 from China, 400 from the UK and 300 from Malaysia. 2
For outbound travellers, it is important to have a clear
understanding of what travel people have planned and the
travel medicine issues that relate to their particular destinations.
Many people leave travel advice until too late or rely on advice
they have accessed via the internet. Though travel medicine
consultations can be complex, they are often tacked on to
the end of a visit, almost as an afterthought. Chronic disease
management can be a challenge in another country and
obtaining medication can be fraught with difficulty.
Our desire for adventure tourism often sends us up high
mountains, into remote places, out on the ocean and to places
where health care is nowhere near as comprehensive as
the services we have in our own country. Though ACC may
provide some support for accidental injury, comprehensive
travel insurance that includes repatriation costs is essential.
Not all travellers are on holiday. Some will be working
overseas and those who will be away for extended periods
in high-risk environments, or who make frequent journeys
between New Zealand and other countries, will benefit from
specialist advice.
For inbound or returning travellers, it is important to know
where they have arrived from and the circumstances in which
they have lived before, or during, travel. Infectious diseases
acquired during travel may not present immediately.
For those with temporary visas, such as rural migrant workers
or overseas student’s permits, access to funded services
is variable. To attain permanent residency or citizenship, an
immigration medical assessment may be required and this
is often another role for the GP. However, some who are new
to New Zealand bring with them significant health issues
that are not always apparent initially, particularly those who
are refugees. With the added complexity of language and
cultural differences, fostering a mutually trusting therapeutic
relationship is vital.
1
Statistics New Zealand, International Travel and Migration: February 2012. http://www.stats.govt.nz/browse_for_stats/population/Migration/IntTravelAndMigration_
HOTPFeb12/Commentary.aspx
2
Ibid.
www.rnzcgp.org.nz
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