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Preparing for International Travel, Part 2

by Dr Gordon Coates

Last Updated: January 2011


Disclaimers, Warnings and Acknowledgements

Please see the disclaimers, warnings and acknowledgements relating to the whole series, as stated in in the first article of the series, Travel Health Series - Introduction.

Please note that the early articles in this series will be very general in nature. They will therefore, inevitably, leave many questions unanswered. Later articles in the series will provide more detail about selected aspects of Travel Health.

Series Context

In the previous article, Preparing for International Travel, Part 1, I discussed some important travel preparations relating to personal health, under the headings "Service and Repairs", "Jabs and Tabs" and "Insurance". In this article, I will discuss the documents which need to be procured before leaving, and kept available during travel, and I will also comment briefly on some essential items of luggage and some useful knowledge. Then, in Preparing for International Travel, Part 3, I will consider specific issues relating to departures and arrivals (and some important things to remember after returning home). After that, some convenient Travel Checklists will complete the preparatory articles, and future articles in the series will concentrate on remaining healthy while travelling.

Essential Documents

I think it is worth mentioning a few general points about essential documents before considering specific examples. Firstly, if any of these essential documents expire before you return home, it can be very inconvenient, not to mention expensive, to arrange for their replacement. Secondly, in case any of them get lost or stolen, it is a good idea to keep photocopies of all essential documents in two or more different locations, such as in hand luggage, main luggage and pocket or money belt. Finally, because some of these documents can take a long time to procure, the earlier you start the application process, the better!


The process of applying for a passport varies from country to country. Travel agents can advise about local requirements. Alternatively, entering "passport application" into a search engine while situated in your own country will soon provide the necessary information. If applying from outside your own country, you would need to contact its nearest embassy or consulate.

Importantly, some countries, such as Belgium, Brazil, Ecuador, India, Indonesia, Israel, Malaysia, Paraguay, Romania, Singapore, Sri Lanka, Thailand, Tunisia and the United Arab Emirates, refuse entry if your passport expires within six months of your date of arrival. Others, such as Cambodia, Croatia, Denmark, Estonia, Fiji, New Zealand, South Africa and Switzerland, refuse entry if your passport expires within three months of your date of arrival. Therefore, it may sometimes be necessary to renew your passport early, in order to ensure that it will still be valid for six months after returning home.


While your passport is, of course, issued by your own country's government, visas to enter the various countries in your itinerary must be obtained from the embassy or consulate of each individual country. Again, a travel agent or a search engine will be able to provide the necessary addresses.


Tickets to each major destination are perhaps the most obvious examples here, but it is also well worth enquiring about any transport passes available to tourists travelling within a particular country or region. Rail passes, such as the Eurail pass, can reduce the cost of such travel to a small fraction of the cost of purchasing separate tickets for each journey. Importantly, Eurail passes, and most similar transport passes, can only be purchased before entering the country or region in which they will be used.

Accommodation Vouchers

If you have any accommodation vouchers, perhaps as part of a package deal, these must obviously not be left behind. It is a good idea to keep a copy of the receipt separately from the voucher itself, in case one or the other is lost. The address of the accommodation, and any special instructions (especially regarding check-in times) must also be readily available.


It is important to organise a variety of financial options before departure. The most useful are usually credit cards, travellers' cheques and cash. In many cases, creating a positive balance in a credit card account (by putting in more than the amount that is owing) avoids excessive interest payments. Otherwise, interest is often charged on the total amount, including credit transactions, from the date of the first cash withdrawal.

It is very useful to have some local currency, including coins, before arriving in a new country, especially if arriving late in the day. However, there are usually limits on the amount of cash that can be moved across borders. Travel agents and transport operators may be able to provide information about currency restrictions. If not, enquiries can be addressed to appropriate government departments, embassies or consulates.

Medical Documents

In some situations, documents relating to existing medical conditions can be just as important as your passport, visas and tickets. For example, they could provide a much needed explanation if medications in your possession excite the interest of Customs authorities (although there is no guarantee that such authorities will actually accept the explanation). In some cases, the availability of accurate medical documentation might even save your life. More details about medical documentation are provided under the next three headings.

General Medical History

The first essential is accurate documentation of any significant past medical history and current medical conditions, including any known allergies and any regular or occasional medications. Potentially life-threatening allergies and major diagnoses should also be recorded in a device such as a MedicAlert bracelet or necklace. A more economical alternative is a pet identification capsule. These are available from any pet shop. (Critical information is also sometimes recorded in the form of a tattoo. However, there is no generally agreed standard for the position of such tattoos.)

Medications and Equipment

In addition to your overall medical history, you should obtain a separate letter from your doctor, stating what medications you are advised to take with you (including the quantity, if more than one standard pack of each medication is involved). This is especially important if you are prescribed strong painkillers, stimulants or anything else likely to disturb Customs officers.

Medications should be identified by their generic names, both on the containers and in the documentation, as brand names vary from country to country. There is no harm in having the brand name stated as well, but it should not be the only identification. (The medications themselves should always be left in their original packs, with your name printed on the pharmacist's label.)

Importantly, a letter from your doctor may be little or no help if one or more of your medications is illegal in a country which you enter. For example, travellers to Greece have been imprisoned for possessing combination analgesics containing small quantities of codeine, which can be purchased without prescription in most countries.

Similar problems may occur in other places, including (but not limited to) Japan, Southeast Asia and the Middle East. It is therefore essential to contact the relevant embassies or consulates and enquire specifically about any medications you will need to take with you, whether they are carried in your luggage or on your person. (Cough and cold remedies containing pseudoephedrine are also illegal in some countries.)

Medical documentation is also necessary in order to carry equipment such as syringes, needles or auto-injectors for insulin, adrenaline or other essential medications onto an aircraft. Again, there is no guarantee that the documentation will be accepted. (Quite recently, a passenger travelling from Norway to Australia was denied permission to carry insulin and injecting equipment for the treatment of diabetes mellitus onto the aircraft, and very nearly died as a result. [1] )

It might be thought that some of the above problems could be solved by purchasing necessary medications in each country visited. However, the names, formulations and availability of medications vary so much from country to country that even experienced doctors sometimes have difficulty finding a suitable equivalent. Also, counterfeit medications (which may be ineffective, toxic or both) account for a significant proportion of all medication sold in many developing countries which are popular travel destinations.

Vaccination Records

Certificates for any vaccinations required by countries you will visit are absolutely essential. If you don't have these, you could be refused entry, held in quarantine or even subjected to compulsory vaccination, possibly with vaccines, syringes and needles of dubious safety standards. An official International Certificate of Vaccination should be used to record travel vaccinations. It is also sensible to take a record of your overall immunisation history. This would be useful if you became unwell during the trip and required medical assessment. It would be particularly important if an epidemic occurred in a country while you were visiting it.

Other Documents

Vouchers and receipts for any goods or services purchased in advance, such as car hire or excursion tickets, must obviously not be forgotten. In some circumstances, various other documents may also be needed. For example, if intending to work abroad, copies of birth certificate, professional qualifications and resume or CV may be required. If it is necessary to apply for further visas while travelling, a copy of your birth certificate may again be needed, and spare photos of passport size and type will save time. As always, spare copies of anything that may be needed should be kept in two or more locations, as well as leaving a copy with a friend or relative at home.

Essential Luggage

Anything you use at least once a month is likely to be needed when travelling. Comfortable shoes, and clothing which provides protection from the elements and from insects, are likely to be even more important when away than they are at home. In many countries, it is also important to dress (and behave) in ways that do not offend local customs and sensitivities, and this need should influence the choice of clothing when packing. [2]

A first aid kit is also essential. First aid kits will be addressed in a future article in this series, so I will not discuss their contents here. (Travel medicine clinics often sell first aid kits of varying complexity, suitable for various types of travel.)

Many other items which are not specifically related to first aid are also worth including in your luggage, especially if they may not be readily available in some of the countries you intend to visit. Depending on individual circumstances, these items might well include some or all of the following:

         Treatments for the possible effects of a known problem [3]

         Compression stockings for in-flight use

         Alcohol-based hand cleaning gel [4]


         Insect repellent [5]

         Mosquito nets

         Permethrin or deltamethrin [6]

         Tampons or other sanitary supplies [7]

         Condoms and related items [8]

         Water purification tablets


         Mobile or satellite phone

         Global Positioning System

         Miniature computer

         Ear drops containing acetic acid and isopropyl alcohol [9]

         The addresses of your country's embassy or consulate in each country you will visit [10]

Those items which could be needed at short notice should form part of your hand luggage. However, regulations governing permissible hand luggage (which are usually prominently displayed at airports, and can also be sourced in advance from travel agents and airlines) might preclude this in some cases.

More information about the many complex regulations governing luggage, and a much more comprehensive list of items to consider when packing your carry-on luggage and your unaccompanied baggage, is provided in a later article in this series, entitled Travel Checklists.

Essential Knowledge

Of course, knowledge about almost anything might be useful in some circumstances. However, in this article I will just mention a few examples of knowledge which may be particularly important when travelling.

Firstly, first aid training, which is potentially useful at any time, can be invaluable when travelling.

Secondly, knowledge about the possible effects of travel on any existing medical condition or disability, or its treatment, is absolutely essential. This should be discussed with your doctor before leaving, so that you know exactly what to do. [11]

Thirdly, oral contraception may be rendered less effective by various possible results of travel. Travellers using oral contraception should discuss this with their doctor before leaving. [12]

Finally, knowledge about local customs and conditions at the destinations on your itinerary is important, not only to make the most of the trip, but also, sometimes, for your own safety.

Useful Websites

Some very useful Travel Health websites are listed at http://www.wanterfall.com/Travel-Health/Travel-Health-Series-Introduction.htm#App1.


A partial bibliography for the whole Travel Health series can be found at http://www.wanterfall.com/Travel-Health/Travel-Health-Series-Introduction.htm#App2.

Declaration of Interest


Not Copyright

The above article may be freely reproduced, remixed and shared, in any format and any quantity, under its Creative Commons License. For more information about the license, see


If you have any comments about this article, please address them to travelhealth@wanterfall.com


Last Updated: January 2011


For more free articles and ebooks by the same author, on a wide range of topics, visit http://www.wanterfall.com

Preparing for International Travel, Part 3

(Click the number of a footnote to return to its reference in the text)

[1] Skowronski, G. Airline security and diabetes. MJA 2007; 187 (4): 249.

[2] Inappropriate dress and behaviour may be regarded as offensive, indecent or even a criminal offence in many parts of the world particularly in designated holy places. For example, bare shoulders, tightly fitting pants or simply wearing shorts, which might be perfectly normal at home, would be completely unacceptable in some travel destinations.

[3] For example, you should carry an adrenaline auto-injector such as EpiPen if you have previously had an anaphylactic reaction to a food, bite, sting etc.

[4] This is a valuable part of the overall strategy for avoiding gastro-intestinal, respiratory and other infections, which will be discussed in future articles.

[5] Ideally, the repellent should contain 30% to 50% diethyltoluamide (DEET).

[6] These insecticides (for the treatment of mosquito nets and clothing) are often available from camping stores or pharmacies.

[7] These can be extremely difficult to obtain in many developing countries.

[8] These can also be very difficult to source in many developing countries.

[9] These are useful for preventing "swimmer's ear", especially in the tropics.

[10] These can provide valuable assistance in a wide range of emergencies.

[11] Especially when crossing many time zones, clear instructions about the timing of food, medications and blood glucose testing are absolutely essential for diabetic travellers. Various other conditions may also require some modifications to their usual treatment when travelling.

[12] Many things can reduce the efficacy of oral contraception. Common examples include diarrhoea; vomiting; antibiotics (such as doxycycline, which is often taken by travellers as an antimalarial agent, and is also used for various other purposes); other medications; high doses of vitamin C; or a time interval of 36 or more hours between one pill and the next (which can sometimes occur as a result of the confusing effects of time zone changes).

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