Travellers with Special Needs

These include:- · Children · Elderly Travellers · Pregnant Women · Disabled Travellers

Children

Parents should take special care when travelling with young children and being prepared in advance is important. Special seating arrangements in planes can often be arranged if advance notice is given. Prepare for possible travel sickness. Boredom during travel can be relieved by books or toys.

All children, regardless of their age will require a valid passport and a visa to enter most countries. Depending upon their country of origin, most travellers can do the appropriate paperwork on the plane as they fly out but it is always wise to check the visa requirements for the destination country prior to departure.

For 50 Top Tips when Travelling with Kids

Most major or larger hotels are happy to accommodate families, and finding a good location to stay should not present any difficulties.Dining, however, may present challenges for families with younger children since the exotic foods may not appeal to their palettes.

Vaccinations are important and schedules can differ for children so seek advice from your doctor or nurse. Doses of malaria tablets are usually less than for adults.

If children are too young to safely or comfortably be immunized against disease, the family should postpone travel until everyone can be sure of effective health measures.

Remember to avoid contaminated food and water. If your child has vomiting or diarrhoea lost fluid and salts must be replaced. It may be helpful to take rehydration tablets or powders for reconstituting with boiled water. You can usually buy these at your local chemist. Dehydration develops quickly in children so offer frequent cool drinks when it is hot.

Infections such as tuberculosis and diphtheria, spread from close personal contact with those infected, can be more serious in young children.

Keep children well away from stray or sick animals and seek medical advice without delay if any illness persists.

Sun protection

Studies have found that sunburn during childhood can increase the risk of skin cancer later in life.

Childrens' skin burns easily in the sun. Take sensible clothing, high factor sun screens and avoid exposure to 'mid-day' sun.

Another consideration is the child’s, or children’s, abilities to deal with the climate of some hot countries. Travelling abroad with children may involve long periods in the sun with high humidity.

Use at least a factor 15 sunscreen and apply it to areas that cannot be protected by clothing, such as the face, ears, feet and backs of the hands. Choose sunscreens that are formulated for children and babies' skin:

• Apply sunscreen before children go outdoors.
• Sunscreen can easily be washed, rubbed or sweated off, so reapply it often throughout the day.
• Keep babies in complete shade, such as under trees, umbrellas, canopies or indoors.
• Protect a baby’s skin with loose-fitting clothes and a wide-brimmed hat that shades their face and neck.
• Make sure children drink regularly.

Pool safety:

Between 2001 and 2007, 30 British children under 10 drowned in holiday swimming pools abroad. Children need to be watched constantly. Don’t depend on a lifeguard, who may not be trained to UK standards.

Swimming aids, such as armbands, are great for playing in the water but can easily slip off. Therefore, you still need to keep an eye on your child. Always supervise all young children near water. Even if a pool has a lifeguard, make sure you know where your children are and what they're doing in the water.

Travel Sickness:

Children often get motion sickness more than adults. It rarely affects children before the age of two, and those between the ages of three and twelve are the most likely to suffer. Early symptoms of motion sickness include hot flushes, dribbling and paleness.

Travel sickness is often worse on a boat or ship. Staying outside in the open air, rather than in a stuffy cabin, can assist in relieving your child’s symptoms. Try to stand in the middle of the ship on a low deck where there is least movement.

Long car journeys, especially along winding roads, can easily induce nausea. In this scenario, it is your responsibility to motivate your child to concentrate on the road ahead.

A number of travel sickness remedies are available to reduce or prevent symptoms of motion sickness.. All need to be taken before your journey begins. Don’t wait until the symptoms start making its presence felt.

You can buy them over the counter from pharmacies. Anti-sickness remedies containing hyoscine are the most effective medicines for motion sickness. There are several brands of medicines containing hyoscine and they come as a soluble form for children.

Keeping motion to a minimum may help. For example, sit over the wing of a plane or on deck in the middle of a boat. Avoid heavy meals before and during travelling including spicy or fatty food. If possible, on long journeys, it may help to have a break and get some fresh air, drink some cold water and take a short walk. Ginger can improve motion sickness in some people. It can be taken in ginger biscuits, sweets or as tablets before a journey.

2. Elderly Travellers More and more elderly people are now travelling abroad for holidays and to visit relatives. Special holidays can be arranged but age does not give natural protection against disease.
A greater life expectancy, better health in old age and increasing affluence have given elderly people more time and opportunity to travel or visit friends and relatives abroad. But there are some issues that elderly travellers should consider when planning the journey of a lifetime or a world cruise.

Getting adequate travel insurance can be a problem, particularly for those over 75, and especially for those with long-term illnesses such as diabetes or heart disease. However, purchasing full insurance is vital.

Read the small print of your insurance policy which should include repatriation in case of illness and ensure there are no important exclusion clauses.

Immunisations and malaria prevention remain as important in the elderly as in people of any other age – if not more so.

A weakened immune system makes infections more likely. Having had a disease previously, such as polio or diphtheria, does not always mean you are immune. If you are prescribed anti malaria tablets, be sure to mention if you are on any other medication.

If you suffer from any recurrent illness or are on regular medication check with your general practitioner. You may find a check-up helpful to ensure that you are fit to travel. A referral letter can be useful in case you you need treatment while abroad.

Take adequate personal medications. These must be clearly labelled and carried in hand luggage for easy access in case of delays or loss of luggage. While abroad store your medicines in a cool dry place. If you are crossing time zones, do not miss out doses especially if you are diabetic or have a heart condition.

Age affects the body’s function, which can increase the risks of travel generally.Declining senses can cause accidents or failure to see or hear important announcements. Poor balance and slow reaction time can increase the risk of falls and seasickness, and make adventurous walking more perilous. Thinning bones from osteoporosis increase the risk of fractures through falls.

Decreased lung capacity means there will be less of a reserve to deal with reduced oxygen at altitude or during chest infections. Decreased heart capacity makes it harder to bear stresses on the heart, through dehydration, altitude or exertion.

Remember to take care to with food and water hygiene. Reduced stomach acid raises the risk of food poisioning or infections through contaminated food. Poorer kidney function raises the risk that dehydration will lead to kidney failure and makes it harder for the kidneys to cope with salt loss through diarrhoea.

Poorer circulation leads to slower healing of scratches, bites and injuries making it more important to avoid insect and animal bites.

All this means that The elderly are more vulnerable to:

• High temperatures and heatstroke.
• Deep vein thrombosis.
• Hypothermia.
• The effects of low oxygen during air travel and at high altitude
• Fatigue and exhaustion

It is often said that "old age does not come alone". Age often brings with it long-term illness. This can also lead to various problems which arise during foreign travel;

There are more tablets to remember or worry about forgetting. Diuretics for high blood pressure can increase the risks of dehydration. Drugs for Parkinson's disease and for high blood pressure can cause dizziness, fainting, unsteadiness and falls. There is a higher incidence of diabetes in older people which can be more difficult to control overseas. A loss of intellectual function may be exposed - causing someone to struggle to cope with their changed surroundings.

Some importat issues to consider if you are elderly and travelling or taking elderly people overseas:

• Good insurance should be obtained.
• Travel should be planned carefully.
• A pre-travel consultation should be booked at the travel clinic.
• Contingencies should be planned for.
• Journeys should not be over-ambitious and there must be plenty of rest stops.
• Choose destinations with western equivalent medical facilities and infrastructure.
• Medication should be kept in hand luggage, with plenty of spare supplies.
• Travellers should take their time to ease the risks and stresses of travel.
  
  
  Please note: Even after taking all the preceding information into account, elderly people still can and often do travel without encountering any serious problems.
  
  It is important to bear in mind that many elderly people enjoy foreign travel and should not be prevented from doing so if they feel up to it. Indeed, nowadays many people enjoy good health and reasonable fitness well into their 70s & 80s.

Travel During Pregnancy

Travelling during pregnancy is usually possible and with the proper precautions, and armed with information on when to travel, vaccinations and insurance, most women can travel safely well into their pregnancy.

Always undergo a medical check-up before planning your trip and again shortly before departure. It is important to get the 'all clear' from your own doctor or obstetrician before departure. It’s a good idea to take your medical records with you so you can give doctors the relevant information if necessary.

Wherever you go, find out what healthcare facilities are available at your destination in case you require urgent medical attention.

Ante-natal facilities vary greatly between countries and you should think carefully before travelling to a country with poor medical facilities or where there are major cultural and language differences from home. This could be important if you have health problems such as threatening to miscarry or going into early labour.

Make sure your travel insurance covers you for any eventuality, such as pregnancy-related medical care during labour, premature birth and the cost of changing the date of your return trip if you go into labour. Bear in mind that insurance policies are only as good as the facilities available.

Some women prefer not to travel in the first 12 weeks of pregnancy because of exhaustion and nausea during these early stages.

Whether you're travelling or not, the risk of miscarriage is higher in the first three months.

However, if you feel well there’s no reason why you can’t travel at this time. If you have any worries, discuss them with your midwife or doctor.

Travel during pregnancy can be a concern for many women, but if your pregnancy has no complications then there’s no reason why you can’t travel safely, as long as you take the right precautions.

Some airlines will not accept a pregnant traveller after 28 to 32 weeks gestation and long air flights in the later stages can be very uncomfortable. The most risky times for travel are during the first 12 to 15 weeks of pregnancy when miscarriage is more likely.

Flying is not harmful to you or your baby, but discuss any health issues or pregnancy complications with your midwife or doctor before you fly.

The likelihood of going into labour is naturally higher after 37 weeks (around 34 weeks if you're carrying twins), and some airlines will not let you fly towards the end of your pregnancy. Check with the airline for their policy on this.

After week 28 of pregnancy, the airline may ask for a letter from your doctor or midwife confirming your due date, and that you aren't at risk of complications.

Long-distance travel (longer than five hours) carries a small risk of blood clots (deep vein thrombosis, or DVT) in pregnant women. If you fly, drink plenty of water and move about regularly – every 30 minutes or so. You can buy a pair of support stockings in the pharmacy over the counter, which will reduce leg swelling.

Appropriate immunisation and malaria prevention is sometimes difficult during pregnancy so seek advice. Some vaccines are best avoided during pregnancy, for example live vaccines. However vaccination may be safer than travelling to some high risk areas without protection.

Vaccines are generally not recommended because of concerns that the virus or bacteria in the jab could harm the baby in the womb. You are advised to avoid travelling to countries where immunisation is required. Live vaccines should not be routinely administered to pregnant women because of possible risk to the unborn child.

However, if you must travel to areas requiring inoculation, you should get vaccinated because the risk of catching an infectious disease far outweighs the risk from vaccination. One example of this is yelow fever.

Travel to malarious zones during pregnancy should be avoided. However, if travel is unavoidable, effective prophylaxis should be used as malaria is more severe during pregnancy and the risk of malaria to mother and fetus is greater than the risk from any anti-malarial drugs. Some anti-malaria tablets aren't safe to take in pregnancy. You should consult your GP or pharmacist for advice.

Chloroquine and Proguanil may be taken in usual doses throughout pregnancy but pregnant women taking Proguanil should be supplemented with folic acid. Mefloquine is not licensed for use during pregnancy and should normally be avoided. Doxycycline is contra-indicated during pregnancy and the safety of Malarone during pregnancy has not been established. Therefore travel to areas where chloroquine resistance occurs is strongly discouraged.

Illness during pregnancy can be more severe so take special care to avoid contaminated food and water and insect and animal bites. Avoid partially cooked meat, unpasteurised milk products and soft cheeses.

In some countries infections such as tuberculosis or meningitis can be spread from close personal contact with locals and these can be serious during pregnancy both to yourself and your unborn child.

Take care to avoid contaminated food and water which could lead to conditions such as stomach upsets and travellers’ diarrhoea (TD). But even if you are suffering from diarrhoea and vomiting, it is very unlikely that your baby will be harmed by a short-lived tummy bug.

Some medicines for treating stomach upsets and TD such as Imodium aren’t suitable during pregnancy. However, it is safe to take oral rehydration salts. Drink as much water or clear fluids as you are able to tolerate. If you are finding it hard even to keep water down, take tiny sips through a straw.

Always drink bottled water where possible. If you get ill, keep well hydrated and continue eating for the health of your baby, even if you may not be hungry.

Road accidents are among the most common causes of injury in pregnant women. Avoid making long trips on your own and get your companion to drive if possible or at least share the driving.

4. Disabled Travellers

Travelling with a disability is now commonplace and there is no reason why this should pose serious problems if good preparations are made. The more you know about a place, the less likely you are to experience problems or obstacles, so before you travel, do your homework.

Adapting to unexpected situations is a part of the challenge of travelling but advance knowledge of facilities available, during travel and at your destination, can be very important. Some organisations and tour companies arrange trips for the disabled when mobility problems, for example, are taken into account.

The Disability Holidays Guide has been specifically created to bring a choice of holiday opportunities to those living with special needs and mobility difficulties.

People with a disability often experience problems when travelling. However, in many cases these problems are not directly related to their disability, but rather discrimination. Some of the most common forms of discrimination are; denied boarding, degrading treatment, poor assistance, additional charges to receive assistance and loss or damage to mobility equipment and assistive devices.

Airlines are usually helpful and provide assistance at airports and offer special facilities on aircraft if advised in advance. However this may not be the case with some airlines and at small airports especially in African, Asian and South American countries.

Most people will agree that getting on a flight is almost as easy as taking a train or a bus these days. However, it is still an adventure for many travellers with a disability, reduced mobility or visual and hearing impairments.

The whole process of check in, security etc. is much more difficult for disabled travellers who are often faced with problems from the very moment they arrive at the airport to leaving the airport at their destination.

It is also a good idea to arrive at the airport in good time so that you can find your way around and avoid any mishaps. It will also give you plenty of time to register and label your wheelchair so that it doesn’t get lost along the way….and to pick the best seat on the plane.

You should check in at least two hours before international flights and 90 minutes before domestic flights.

Most airports and airlines have special facilities and assistance for travellers using crutches, a guide dog or a wheelchair. However, there is always room for improvement.

Before you set off you should ring the airport or check its website to find out what facilities it has. Find out if it has disabled parking spaces, elevators, disabled toilets etc.

Some airports have special check-in desks for wheelchair users. You should check out the airport’s website to find out or ring in advance.

In 2008, the Disabled Air Passengers' Rights Regulation was put in force by the European Union in order to prevent these forms of discrimination.

Wheelchair users often have problems which most travellers who do not use a wheelchair are unaware of. Up until only recently some airlines charged wheelchair users to take their wheelchair from check-in to the aircraft. Other airlines refused some wheelchair users to fly as they claimed there were too many disabled travellers on the flight.

Thanks to the law, airlines can no longer make these excuses. In fact, most airlines offer very good services for disabled travellers and they are aware that wheelchair users need more space and an aisle seat aboard the aircraft, as well as ground and onboard assistance etc.

In other cases, blind travellers were unable to fly accompanied by their guide dog and were not entitled to any form of aid to get from check-in to the aircraft. Thankfully, this is no longer the case today.

These regulations have helped to make travelling a right for everyone. However, discrimination is something that will be difficult to eliminate completely. If you experience neglect and maltreatment at an airport you should make the relative authorities aware.

When selecting accommodation check good lifts are available, the condition of staircases and bathroom equipment. Ask in advance if special food requirements are necessary.

Make sure that you have comprehensive health insurance with no important exclusion clauses which affect disability and which includes repatriation if necessary.

Many travellers share their experiences online and so this also may be helpful for you. It is an excellent way of helping you decide which airline to choose and may give you more information about the help available for passengers with reduced mobility, a visual impairment or some other form of disability. All these comments are written by people who have tried and tested the services. They write based on their experiences and so all feedback and comments about the airport facilities or the airlines are unbiased.

Some useful web sites relating to disabled travel are: