Patients who are travelling to areas where there is limited access to medical facilities or where these facilities are more than twenty four hours away, should be advised to carry a comprehensive first aid kit.

This kit should include sterile needles, syringes, sutures and intravenous giving set in addition to the usual plasters and antiseptic wipes.

Limited availability of medical facilities may also influence the vaccines that are recommended prior to travel. For example, pre-exposure rabies vaccination is recommended for all travellers to endemic areas but is most applicable for those where medical facilities are not accessible within twenty four hours or where contact with animals or bats is particularly likely, such as vets, volunteers in animal sanctuaries or cavers.

Availability of medical facilities would be especially relevant to pregnant women, patients with pre-existing medical conditions and young children. These patients should be advised to investigate the availability of medical facilities prior to departure.

All patients should be advised to ensure that they have appropriate travel insurance; patients with a pre-existing medical condition should ensure that this will provide medical treatment abroad and also repatriation to the UK if necessary.