Australia Travel Health, Medical Information, Medicare & Drugs

Medicare

Australia has a reciprocal health agreements with UK, Finland, Malta, Netherlands, Sweden, New Zealand & Ireland, which means that citizens of those countries are entitled to emergency treatment by the equivalent to the NHS (Medicare) without being charged.

What is emergency treatment? Anything you would ordinarily see a GP about and accident & emergency treatment in public hospitals.

Additional Info

To be eligible you have to have a Medicare card; we suggest you get it when you arrive rather than wait until you need medical treatment. Just take your passport and travel documents to the nearest Medicare centre.

When you make an appointment to see a Doctor ask if they "bulk-bill" this means that all you do is show your Medicare card and there is no charge for the consultation. If practices do not bulk bill you will be charged at the time of the consultation (around $30-40) and have to claim the cost back off Medicare yourself (but you are entitled to the rebate)

Alternatively if you're in Sydney and too unwell to make it to a surgery or it is out of surgery hours call the Hotel Doctor on 02 9962 6000.

Safe Tanning

When I first arrived in Australia one of the things that struck me was how the natives cover up and hide from the sun; long, linen outfits, hats and factor 30+ are all de rigeur. You can usually tell where people hail from before they open their mouths. Brits dripping in sun-oil and a little over-cooked, Aussies pale and interesting, dressed like bee-keepers.

Australia sits beneath a massive hole in the ozone layer and this is reflected by the fact that the country has the highest skin cancer rate in the world. And to make matters worse, skin cancer is the most common and rapidly increasing form of the disease.

Skin is your body's largest organ. You wouldn't consider putting your lungs, brain, liver or kidney out to fry, would you, so why do it to your skin? It is a bit of a silly hypothetical but you take my point, don't you?

As a recovering sun addict I know the temptation to slap on the no factor oil and self-baste. Here, that is lunacy. You should never go less than factor 15 and really 20 or 30 should be your protection factor of choice. You still go brown but it will be a healthier and more enduring tan. Burnt skin is damaged skin and you loose it faster than a snake at shedding time.

Points to Remember

* Avoid the sun between 11:30am and 2:30pm

* Use a broad-spectrum sunscreen 30 ideally but 15 as bare minimum

* Always protect your eyes from the sun

* Drink plenty of water to keep hydrated

* Get to know your skin and its own particular spots and blemishes and keep checking it. The Australian Health Service is geared-up to cope with the problems caused by the sun so if in doubt, check it out.

* The Cancer Council offer loads of services and information and can be called on 13 11 20 or visit their website

Sun stroke

You have been warned about safe tanning (or damage limitation tanning as it should be properly known) but if the risks of skin cancer and premature ageing are too distant to curb your reckless ways, think about the real and incredibly short-term risks of sunstroke. Symptoms include headache, nausea, dizziness, small pupils, high fever, disorientation, unconsciousness and possible convulsions. Worth risking for a tan? I think not. Clearly prevention is better than cure but if you've been a goose and over-cooked yourself, you had better hope your pal or attendant care-giver has read this - cause you'll be too ill to….

Loosen or remove clothing and immerse the sufferer in very cool water. If immersion isn't possible, cool with water, or wrap in wet sheets and fan for quick evaporation. Use cold compresses - especially to the head & neck area, also to armpits and groin. Seek medical attention immediately - continue first aid to lower temp until medical help takes over.

Do NOT give any medication to lower fever-it will not be effective and may cause further harm - and it is not advisable to give the victim anything by mouth (even water) until the condition has been stabilized.

Sexual Health

Contraception

All forms of contraception are available in Australia from most General Practitioners and Family Planning Clinics. To locate the closest Family Planning Clinic to you, contact:

FPA Health
328-336 Liverpool Road

Ashfield NSW

Phone: +61 (0)2 9716 6099
or +61 (0)2 9916 8313

or 1300 658 886 (within Australia)

Often the most convenient contraception for travellers is the oral contraceptive pill or the condom, as they are readily available and travel well.

Safe sex

Safe sex practices refer to the measures individuals take to avoid unwanted pregnancy or sexually transmitted diseases. They include:

Not having sex; cuddling, stroking, kissing, massage; vaginal sex with condom and water based lubricant (e.g. KY jelly), rubbing and anal sex with condom and water based lube, masturbation and oral sex using a dental dam; maintaining a monogamous relationship with one partner who is unaffected with any sexually transmitted disease.

If you have been with your partner exclusively for 3-4 months you may wish to both be tested for infection and if clear cease using protection against infection. You may still need to consider contraception.

Alcohol and drugs can be risky, as a normally cautious person may not take their usual precautions. BEWARE and always have condoms with you. Remember emergency contraception which can be taken within 72 hours of unprotected sex and may prevent a pregnancy.

Sexually Transmitted Infections (STIs)

Sexually Transmitted Infections, HIV and hepatitis can be transmitted by people when they have vaginal, anal and oral sex. Other infections such as herpes are transmitted by close skin contact.

In Australia, most people with STIs are in the 15 to 35-years age group. People having multiple sex partners are at a higher risk of STIs than the general community.

Most infections are easily treated, but if not treated can cause fertility problems and can be passed on to other sexual partners. A doctor, Sexual Health Clinic (attached to public hospitals) or the Family Planning Clinic can treat these infections. Do not feel embarrassed, as they deal with these problems frequently and will respect you for seeking advice.

HIV/AIDS

AIDS refers to the Acquired Immune Deficiency Syndrome. This is the final stage of an infection caused by immunodeficiency virus (HIV). HIV attacks the body's immune system putting the body at risk to other forms of infection and life-threatening disorders such as cancer.

Sometimes there are signs similar to the flu up to 3 weeks after becoming infected. These do not always occur. If you have a blood test, it may initially be negative but should be repeated three months after unprotected sex. HIV can also be contracted from needles and syringes and other unclean injecting equipment.

There is no vaccine or cure for the virus however the incidence of AIDS related deaths in Australia is decreasing. There were 279 AIDS-related deaths registered in 1997 compared with 568 in 1996 and 666 in 1995.

Hepatitis B

Hepatitis B is a viral infection that can be sexually transmitted, but can also be transmitted through needlestick injury, sharing of needles, close personal contact and contact with blood and body fluids. This viral infection, which affects the liver, is common in Australia.

The virus responsible for the infection causes acute illness including nausea, vomiting, headaches and chronic fatigue. Some people recover fully from this viral infection, but others may continue to carry it without knowing. Chronic (long term) effects of the virus include the possibility of cancer of the liver and persistent herpes infection. Symptoms include; dark urine, pale coloured stool, yellow skin and eyes, fever and stomach pains. 5% of people develop chronic liver problems. There is no absolute cure however it is possible to be immunised against the hepatitis B virus.

Hepatitis C

This is not commonly transmitted sexually, but is often checked as part of a screen for sexually transmitted diseases(it is diagnosed by a blood test). It is quite common in Australia and is mainly transmitted by blood. The main risk factor is injecting drug use or anal sex.

Syphilis

This is now fairly rare, but a screen for STDs will include a syphilis blood test. The first sign is a sore on the penis or vagina, anus or mouth which occurs 10 days to 3 weeks after sex with an infected person. The sore disappears after 1-2 weeks but the bacteria remain in the body. The second stage is when a red rash appears on the hands, feet, face and body. The rash might go away, but the infection is still in the body and requires treatment. Syphilis can be treated with antibiotics and cured if treated in the early stages.

Genital Herpes

This is the same virus that causes cold sores. Herpes type 1 causes cold sores around the mouth. Herpes type 2 causes painful blisters around the genital area and anus in men and women. The infection can be transmitted from mother to infant at birth, causing severe infection, brain damage or death.

It can recur even when treated. Medications reduce the pain and help it to clear more quickly. If it should recur the same medications are given to prevent it. Some people only ever have one attack, but the virus can still be transmitted to a partner.

Genital Warts

These are caused by a virus known as HPV - Human Papilloma Virus. Condoms reduce your chance of getting this, but are not 100% effective. Warts are usually painless and are noticed as small swellings on the penis in males or vulva, cervix or vagina in females. They may enlarge but those that are inside the vagina are difficult to detect.

They can be treated by painting or freezing. It is important for females who have had warts or whose partner has had warts to have regular sap smears as the virus can cause abnormal cells in the cervix (neck of the womb) which can only be detected microscopically. If found early on a Pap Smear these changes can be treated and cured. If untreated they can cause cell changes that have been associated with cervical cancer.

It is estimated that up to 60% of young, sexually active women could carry the HPV.

Other Medical Ailments

Deep Vein Thrombosis

This refers to development of blood clots in the deep veins of the legs. It has had a lot of publicity recently because of its association with air travel. The risk is that the blood clot may move through the circulation into the major arteries of the lungs, causing a pulmonary embolus which can be fatal.

Conditions which make DVT more likely are lack of movement (as in planes) because this slows down the circulation in the legs, as the muscles which help pump the blood are inactive.

Risk factors include; age, pregnancy, oral contraceptive pill use, smoking, being overweight, varicose veins and previous DVT, recent major surgery, serious illness such as heart failure and cancer.

While it seems likely that long journeys in cramped conditions could cause DVT, there are no studies to confirm this. A large-scale study on travel-related DVT is planned in Australia. Whether this will show that DVTs are more common in economy class remains to be seen. Certainly there is no evidence to suggest this so far.

People planning aeroplane trips longer than four hours should move their legs, walk around the plane and drink plenty of non-alcoholic drinks. Preferably not tea and coffee which tend to dehydrate, but good old water and fruit juices.

It has been suggested that taking aspirin 150mg prior to air travel may reduce the risk of DVT, but the studies are not available to prove this.

Aspirin has a property which makes the platelets in the blood less "sticky" and is used for this purpose in some conditions in medicine. So long as you are not allergic to it and do not have an ulcer it is quite safe to take.

If you have been on the oral contraceptive pill for some time and have had no problems with blood clots you should not cease it for a plane flight as pregnancy may be a greater risk. However you may wish to be vigilant with preventive measures.

Prevention

1. Exercise - especially the leg muscles. Move around and do the leg exercises that some in-flight programs outline-3-4 minutes every hour circle the foot in both directions several times, move the foot up and down and lift the knees and circle. It's best to wear loose clothing to make these easier. Don't worry about your fellow passengers - they may join in - it's a great way to meet people

1. Keep hydrated by drinking plenty of water before, during and after the flight. This will ensure you have to get up more frequently to go to the toilet also!

1. Compression stockings can be worn, but usually only by people who have had a previous DVT. Exercise performs the same function.

Symptoms and Signs

If you develop any of the following after travel it is wise to seek a medical opinion without delay:

1. Pain and swelling of the calf muscles, particularly on one side
2. Pain in the chest or shortness of breath should be urgently reported as they can represent a pulmonary embolus

Treatment

Treatment is available and consists of X-ray and/or scan for diagnosis and medication usually initially by injection. It is usually necessary for this to be done in a hospital, but attending a G.P. first is a good option if you are feeling well as they will be able to distinguish a muscle strain from a DVT and decide whether hospital is necessary.

Drugs

Most people use drugs in some form or another. A drug, by definition is any substance, other than food that alters the functions of your mind or body.

Legal Drugs - are those which the law allows to be sold and manufactured. Legal drugs include caffeine (found in tea, coffee and some soft drinks), some analgesics (such as aspirin and Panadol), other medical drugs obtained from a pharmacist with a doctor's prescription, and, for adults, tobacco and alcohol.

Illegal Drugs - either the law does not permit them to be sold (eg. marijuana, cocaine, heroin), or use of them is illegal under certain conditions. Eg. In most places in Australia people under 18 are not allowed to buy alcohol or tobacco, and it is illegal to obtain certain medical drugs (eg. sleeping tablets) without a prescription.

Club drugs - Club drugs are being used by young adults at all-night dance parties such as "raves", dance clubs, and bars.

MDMA (ecstasy), methamphetamine (speed), LSD (acid), GHB, Rohypnol and Ketamine are some of the club or party drugs gaining popularity.

Use of club drugs can cause serious health problems and, in some cases, even death. Used in combination with alcohol, these drugs can be even more dangerous. No club drug is benign. Chronic abuse of MDMA, for example, appears to produce long-term damage to serotonin-containing neurons in the brain. Given the important role that the neurotransmitter serotonin plays in regulating emotion, memory, sleep, pain, and higher order cognitive processes, it is likely that MDMA use can cause a variety of behavioral and cognitive consequences as well as impair memory.

Because some club drugs are colorless, tasteless, and odorless, they can be added unobtrusively to beverages by individuals who want to intoxicate or sedate others. In recent years, there has been an increase in reports of club drugs used to commit sexual assaults.

GHB

This "designer" drug (Gamma-hydroxybutyric acid) is often used in combination with other drugs, such as Ecstasy. GHB is synthesized from a chemical used to clean electrical circuit boards, and is available in clear liquid, white powder, tablet and capsule form.

GHB is odorless and nearly tasteless. Users report that it induces a state of relaxation. The effects can be felt within 5 to 20 minutes after ingestion and the high can last up to four hours.

GHB users risk many negative physical effects including vomiting, liver failure, potentially fatal respiratory problems, and tremors and seizures, which can result in comas.

Rohypnol

Rohypnol has been a concern for the last few years because of its abuse as a "date rape" drug. People may unknowingly be given the drug which, when mixed with alcohol, can incapacitate and prevent a victim from resisting sexual assault. Also, Rohypnol may be lethal when mixed with alcohol and/or other depressants.

Rohypnol produces sedative-hypnotic effects including muscle relaxation and amnesia. It is also known as "rophies," "roofies," "roach," "rope," and the "date rape" drug.

Ketamine

Ketamine hydrochloride, or "Special K," is a powerful hallucinogen widely used as an animal tranquilizer by veterinarians. Users sometimes call the high caused by Special K, "K hole," and describe profound hallucinations that include visual distortions and a lost sense of time, sense, and identity. The high can last from a half-hour to 2 hours. The Drug Enforcement Administration reports that overt effects can last an hour but the drug can still affect the body for up to 24 hours.

Use of Special K can result in profound physical and mental problems including delirium, amnesia, impaired motor function and potentially fatal respiratory problems.

Special K is a powder. The drug is usually snorted, but is sometimes sprinkled on tobacco or marijuana and smoked. Special K is frequently used in combination with other drugs, such as ecstasy, heroin or cocaine.

Liquid Ketamine was developed in the early 1960s as an anesthetic for surgeries, and was used on the battlefields of Vietnam as an anesthetic. Powdered Ketamine emerged as a recreational drug in the 1970s, and was known as "Vitamin K" in the 1980s. It resurfaced in the 1990s rave scene as "Special K."

Methamphetamine

Methamphetamine is an addictive stimulant drug that strongly activates certain systems in the brain.

Methamphetamine is closely related chemically to amphetamine, but the central nervous system effects of methamphetamine are greater. Both drugs have some medical uses, primarily in the treatment of obesity, but their therapeutic use is limited.

Street methamphetamine is referred to by many names, such as "speed," "meth," and "chalk." Methamphetamine hydrochloride, clear chunky crystals resembling ice, which can be inhaled by smoking, is referred to as "ice," "crystal," and "glass."

Neurological hazards. Methamphetamine releases high levels of the neurotransmitter dopamine, which stimulates brain cells, enhancing mood and body movement. It also appears to have a neurotoxic effect, damaging brain cells that contain dopamine and serotonin, another neurotransmitter. Over time, methamphetamine appears to cause reduced levels of dopamine, which can result in symptoms like those of Parkinson's disease, a severe movement disorder.

Addiction. Methamphetamine is taken orally or intranasally (snorting the powder), by intravenous injection, and by smoking. Immediately after smoking or intravenous injection, the methamphetamine user experiences an intense sensation, called a "rush" or "flash," that lasts only a few minutes and is described as extremely pleasurable. Oral or intranasal use produces euphoria - a high, but not a rush. Users may become addicted quickly, and use it with increasing frequency and in increasing doses.

Short-term effects. The central nervous system (CNS) actions that result from taking even small amounts of methamphetamine include increased wakefulness, increased physical activity, decreased appetite, increased respiration, hyperthermia, and euphoria. Other CNS effects include irritability, insomnia, confusion, tremors, convulsions, anxiety, paranoia, and aggressiveness. Hyperthermia and convulsions can result in death.

Long-term effects. Methamphetamine causes increased heart rate and blood pressure and can cause irreversible damage to blood vessels in the brain, producing strokes. Other effects of methamphetamine include respiratory problems, irregular heartbeat, and extreme anorexia. Its use can result in cardiovascular collapse and death.

LSD

LSD, aka "acid," is odorless, colorless, and has a slightly bitter taste and is usually taken by mouth. Often LSD is added to absorbent paper, such as blotter paper, and divided into small, decorated squares, with each square representing one dose.

Physical Psychological short-term effects. The effects of LSD are unpredictable. They depend on the amount taken; the user's personality, mood, and expectations; and the surroundings in which the drug is used. Usually, the user feels the first effects of the drug 30 to 90 minutes after taking it. The physical effects include dilated pupils, higher body temperature, increased heart rate and blood pressure, sweating, loss of appetite, sleeplessness, dry mouth, and tremors.

Sensations and feelings change much more dramatically than the physical signs. The user may feel several different emotions at once or swing rapidly from one emotion to another. If taken in a large enough dose, the drug produces delusions and visual hallucinations. The user's sense of time and self changes. Sensations may seem to "cross over," giving the user the feeling of hearing colors and seeing sounds. These changes can be frightening and can cause panic.

LSD trips are long - typically they begin to clear after about 12 hours. Some users experience severe, terrifying thoughts and feelings, fear of losing control, fear of insanity and death, and despair while using LSD. In some cases, fatal accidents have occurred during states of LSD intoxication.

Flashbacks. Many LSD users experience flashbacks, recurrence of certain aspects of a person's experience, without the user having taken the drug again. A flashback occurs suddenly, often without warning, and may occur within a few days or more than a year after LSD use. Flashbacks usually occur in people who use hallucinogens chronically or have an underlying personality problem; however, otherwise healthy people who use LSD occasionally may also have flashbacks. Bad trips and flashbacks are only part of the risks of LSD use. LSD users may manifest relatively long-lasting psychoses, such as schizophrenia or severe depression. It is difficult to determine the extent and mechanism of the LSD involvement in these illnesses.

Cocaine

Cocaine is a powerfully addictive drug of abuse. Individuals who have tried cocaine have described the experience as a powerful high that gave them a feeling of supremacy. However, once someone starts taking cocaine, one cannot predict or control the extent to which he or she will continue to use the drug. The major ways of taking cocaine are sniffing or snorting, injecting, and smoking (including free-base and crack cocaine).

Health risks exist regardless of whether cocaine is inhaled (snorted), injected, or smoked. However, it appears that compulsive cocaine use may develop even more rapidly if the substance is smoked rather than snorted. Smoking allows extremely high doses of cocaine to reach the brain very quickly and results in an intense and immediate high. The injecting drug user is also at risk for acquiring or transmitting HIV infection/AIDS if needles or other injection equipment are shared.

Physical effects. Physical effects of cocaine use include constricted peripheral blood vessels, dilated pupils, and increased body temperature, heart rate, and blood pressure. Some cocaine users report feelings of restlessness, irritability, and anxiety, both while using and between periods of use. An appreciable tolerance to the high may be developed, and many addicts report that they seek but fail to achieve as much pleasure as they did from their first exposure.

Paranoia and aggression. High doses of cocaine and/or prolonged use can trigger paranoia. Smoking crack cocaine can produce particularly aggressive paranoid behavior in users. When addicted individuals stop using cocaine, they may become depressed. This depression causes users to continue to use the drug to alleviate their depression.

Long-term effects. Prolonged cocaine snorting can result in ulceration of the mucous membrane of the nose and can damage the nasal septum enough to cause it to collapse. Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest.

Added Danger. When people mix cocaine and alcohol, they are compounding the danger each drug poses and unknowingly causing a complex chemical interaction within their bodies. Researchers have found that the human liver combines cocaine and alcohol to manufacture a third substance, cocaethylene, which intensifies cocaine's euphoric effects and possibly increases the risk of sudden death.

Heroin

Years ago, thoughts of using a needle kept many potential heroin users at bay. Not anymore. Today's heroin is so pure, users can smoke it or snort it, causing more kids under 18 to use it. Kids who snort or smoke heroin face the same high risk of overdose and death that haunts intravenous users.

Recent studies suggest a shift from injecting to snorting or smoking heroin because of increased purity and the misconception that these forms of use will not lead to addiction.

Heroin is processed from morphine, a naturally occurring substance extracted from the seed-pod of the Asian poppy plant. Heroin usually appears as a white or brown powder. Street names associated with heroin include "smack," "H," "skag," and "junk." Other names may refer to types of heroin produced in a specific geographical area, such as "Mexican black tar."

The short-term effects of heroin abuse appear soon after a single dose and disappear in a few hours. After an injection of heroin, the user reports feeling a surge of euphoria ("rush") accompanied by a warm flushing of the skin, a dry mouth, and heavy extremities. Following this initial euphoria, the user goes "on the nod," an alternately wakeful and drowsy state. Mental functioning becomes clouded due to the depression of the central nervous system.

Irreversible effects. Heroin abuse is associated with serious health conditions, including fatal overdose, spontaneous abortion, collapsed veins, and infectious diseases, including HIV/AIDS and hepatitis.

Long-term effects. Long-term effects of heroin include collapsed veins, infection of the heart lining and valves, abscesses, cellulitis, and liver disease. Pulmonary complications, including various types of pneumonia, may result from the poor health condition of the abuser, as well as from heroin's depressing effects on respiration.

Infection. In addition to the effects of the drug itself, street heroin may have additives that do not readily dissolve and result in clogging the blood vessels that lead to the lungs, liver, kidneys, or brain. This can cause infection or even death of small patches of cells in vital organs.