Sun, sea, sand and sick

Children can be refused hospital treatment abroad. So be insured.
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The Independent Culture
TODAY'S PARENTS think nothing of flying to Spain, America or even further afield with their children. Cheap packages have brought overseas holidays within reach of most dual income families. But every summer, the newspapers print horror stories of children falling ill abroad. The nightmare scenario is one of inadequate medical insurance along with language difficulties. However much we deplore deficiencies in our own NHS, we can't quite believe that a child could be refused treatment in civilised countries.

If you are travelling outside the UK, with or without children, it is essential to have medical insurance. Only 60 countries have a reciprocal arrangement with Britain, and even this extends only to resident UK nationals. Form E111, obtainable from Post Offices, entitles you to basic treatment in the EC - but there may be a charge, depending on that country's medical system. So wherever you are going, sort out a policy which will cover medical costs, repatriation and the rest of the family's expenses in the case of major illness or unexpected hospitalisation. Even a case of some minor ailment, such as chickenpox, may delay your journey home.

On holiday abroad, just like at home, children are most likely to become ill with the more common and familiar complaints. So it is worth taking a reasonably comprehensive minor illness kit, to minimise hassle. Include in it: Paracetamol syrup; antiseptic; plasters; scissors; gauze and bandaging; travel sickness remedies; Dioralyte tablets and antihistamines. These medicine cupboard standbys are easier to take with you than to buy.

Children are noticeably more susceptible to the horrors of food poisoning, and they also become dehydrated more easily than adults. Suspect foods include ice cream (especially from outdoor traders), uncooked food, reheated food, and water. Depending on the area, it may be worth using boiled water, bottled water or disinfectant tablets. Beware of rivers and beaches which can be contaminated with sewage, both at home and abroad, although this is less likely in most of the bigger European resorts. Sunstroke is a very British disease and casualty departments are filled with amazed lobsters, who can't believe they got sunstroke in England, on the very first hot day of each summer. Children, being more active and more easily dehydrated, are particularly likely to suffer from these effects of overheating. Reasonably frequent periods of rest during the heat of the day, and regular fluids, are the best way to prevent sunstroke.

Sunburn is another problem that is particularly dangerous to children. Their skin is thinner, and there are also concerns that sunburn at an early age may predispose children to skin cancers in later life. They need to be well covered, and protected with a high factor UVA and UVB sunscreen.

For most families travelling with children, no special vaccinations are needed beyond the standard childhood ones. In the wake of the recent scare about the MMR vaccination (measles, mumps and rubella), some parents decided to postpone or avoid vaccinating their children. Increasingly, homeopathic alternatives are being used, but the protection they offer, if any, is unknown. It is worth reviewing your family's vaccination records well before you travel. In the last few years, diphtheria has re-emerged in Russia and other countries of the former Eastern bloc. Measles, according to America's Centers for Disease Control, causes 10 per cent of deaths among children under five worldwide. Whooping cough is common in many countries, and at best it remains a prolonged and debilitating illness.

For children with special health problems, such as asthma or epilepsy, make sure that you have adequate supplies of medication and know that know how to store them appropriately. It is worth carrying a written record of medication, using generic rather than brand names, with your valuables. Your community pharmacist will help you with this, and may also have information on drug names in other languages.

Even the well-prepared may find themselves in need of medical care. Having checked your entitlements in the country to which you are travelling, make sure you understand how to get the care you need. Home visits by GPs are, by and large, an eccentricity of the NHS. In some countries, a paediatrician is consulted directly. Also, be sure you know the local code to call the emergency services if necessary.

Your local GP's surgery or a travel clinic will be able to offer advice on travel. The leaflet Health Advice for Travellers contains form E111, and provides very good information on all aspects of travel preparation. It is available from post offices, or from the Health Literature Hotline on 0800 555777. The information is also updated on CEEFAX and PRESTEL. The Health Information Service, on 0800 665544 also provides information on a number of travel-related topics. MASTA (Medical Advisory Service for Travellers Abroad) provides a 24-hour health line on 0891 224100. Finally, Maureen Wheeler's `Travel with Children' is published by Lonely Planet.