AYUDA Volunteer Programs Travelers’ Health & Wellness Information
Introduction
In a few months you will be traveling on behalf of AYUDA to Latin America to make a difference in the lives of children and youth living with diabetes. As a volunteer, it is easy for you to think of health only in terms of the children you will be working with, however, you must also consider your own health and wellness to be an effective volunteer and role model for others. This document serves as a guide for preparing for your departure as well as for ensuring your continued health during your time abroad. Using this Guide
Please remember that while we can pass along recommendations from the CDC’s travel guide (http://www.cdc.gov/) and our programs’ experiences abroad, there is no one perfect formula for everyone and you must make the choices about your own health with which you are most comfortable. CDC Health Information for Travelers to the Dominican Republic http://wwwnc.cdc.gov/travel/destinations/dominican-republic.htm
Additionally, different health insurance plans offer varying coverage, so check with the travel clinic for the pricing based on your own insurance.
Please read these materials carefully, including the attached pamphlets regarding the various vaccinations and/or medications that you may be taking.
Vaccinations
The best place to get your vaccinations is a travel clinic, which you should visit a minimum 4-6 weeks prior to your departure. There, you will consult with the staff about the areas in the country you will be traveling, and they will advise you of the best vaccinations and practices while in the country. There are certain vaccinations which are a requirement, while others are up to you. Discuss these options with the clinic physician.
Please take the time to visit the CDC website link above (recommendations often change without AYUDA’s knowledge).
[NOTE: if you are not immune to Hepatitis B and want to get those immunizations before your travel, see your doctor as soon as possible; that immunization requires multiple injections over a period of time].
Malaria prophylaxis (ie, taking pills to prevent you from getting malaria) is a common question. While malaria exists in the Dominican Republic, there is no malaria in the capital Santo Domingo where we will be based. Be sure to check the CDC malaria traveler’s website, which has interactive country maps of endemic areas (http://www.cdc.gov/malaria/travelers/index.html).
Also be sure to think about if and where you might travel on your own accord while abroad.
If you are planning (or even thinking) about visiting any other countries aside from the DR while abroad, then be sure to look at those country recommendations as well and/or speak to your travel clinic.
List of Vaccinations
R = Required HR = Highly Recommended O = Optional N/A = Not applicable * = You likely already received this vaccination upon entry to school or university
Dominican Vaccination CDC Description Republic Hepatitis A
Recommended for all unvaccinated people traveling to or working in countries with an intermediate or high level of hepatitis A virus infection (see map) where exposure might occur through food or water. Cases of travel-related hepatitis A can also occur in travelers to developing countries with "standard" tourist itineraries, accommodations, and food consumption behaviors.
Hepatitis B *
Recommended for all unvaccinated persons traveling to or working in countries with intermediate to high levels of endemic HBV transmission (see map), especially those who might be exposed to blood or body fluids, have sexual contact with the local population, or be exposed through medical treatment (e.g., for an accident).
Typhoid *
Recommended for all unvaccinated people traveling to or working in the Caribbean, especially if staying with friends or relatives or visiting smaller cities, villages, or rural areas where exposure might occur through food or water.
Tetanus *
Everyone needs protection from tetanus. If you have not had a booster shot in 10 years or more, you should receive a tetanus shot.
If you will be visiting an area of the Dominican Republic with malaria, you will need to discuss with your doctor the best ways for you to avoid getting sick with malaria. Ways to prevent malaria include the following:
Using insect repellent and wearing long pants and
Sleeping in air-conditioned or well-screened rooms or
All of the following antimalarial drugs are equal options for preventing malaria in the Dominican Republic: Atovaquone-proguanil, chloroquine, doxycycline, or mefloquine. For detailed information about each of these drugs, see Table 3-11: Drugs used in the prophylaxis of malaria. For information that can help you and your doctor decide which of these drugs would be best for you, please see Choosing a Drug to Prevent Malaria.
Recommended for travelers spending a lot of time outdoors, especially in rural areas, involved in activities such as bicycling, camping, or hiking. Also recommended for travelers with significant occupational risks (such as veterinarians), for long-term travelers and expatriates living in areas with a significant risk of exposure, and for travelers involved in any activities that might bring them into direct contact with bats, carnivores, and other mammals. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites.
Staying Healthy in Developing Countries
• Wash hands frequently with soap and water. • Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. • Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself.
Remember: boil it, cook it, peel it, or forget it.
• Protect yourself from mosquito bites (to avoid malaria)
• …drink tap water, fountain drinks, or ice cubes. • …eat from roadside stands (“street food”) • …consume non-pasteurized dairy products (and don’t assume they all are!) • …touch any animals, most especially farm or stray animals. • …swim in fresh water. Salt water is usually safer. • …share needles with anyone.
We will provide a full packing list; the items below are relevant to Health & Wellness.
• Small bottles of hand sanitizer. • Small packets of toilet paper (not all bathrooms come equipped!) • Tampons and feminine hygiene products.
• Pepto Bismol • Strong mosquito repellent • High protection sunscreen • Sunglasses
A Note for our Volunteers with Diabetes
Keep in mind that you are expected to bring all of the diabetes supplies that you will need for your own care. Just as whenever you travel, we recommend that you bring extra supplies, just in case of some
unforeseen situation or emergency. However, we will always be in close contact with the local foundations, which have supplies available for purchase if necessary.
Also, please note, at camp we request that everyone to avoid using the donated supplies (insulin, strips etc) for personal use, unless of course it is an emergency. This is to ensure that the supplies go to the communities we are working with who rely on the additional in-kind support Travel Clinics
You may choose to contact your primary care physician or search the internet for a list of travel clinics in your area. However, below are two clinics that past AYUDA volunteers have found helpful and that come recommended: Travelers Medical Clinic of Washington 2141 K Street, NW Suite 408 Washington, DC 20037 Phone: (202) 331-0287, 466-8109 Fax: (202) 331-0290 Travelers Medical Clinic of New York 595 Madison Ave, Suite 1200, New York, NY Phone: (212)-230-1020 Fax: (212) 230-1888
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5. Prescription sous DCI et substitution INTRODUCTIon La prescription sous dénomination commune internationale (DCI) et la substitution font depuis de nombreuses années l’objet de divergences entre médecins généralistes, pharmaciens et autorités. De plus, la récente modification de la législation a probablement augmenté la confusion. La prescription sous DCI permet néanmoins de
AYUDA Volunteer Programs 
Malaria prophylaxis (ie, taking pills to prevent you from getting malaria) is a common question. While malaria exists in the Dominican Republic, there is no malaria in the capital Santo Domingo where we will be based. Be sure to check the CDC malaria traveler’s website, which has interactive country maps of endemic areas (http://www.cdc.gov/malaria/travelers/index.html).
Also be sure to think about if and where you might travel on your own accord while abroad.
If you are planning (or even thinking) about visiting any other countries aside from the DR while abroad, then be sure to look at those country recommendations as well and/or speak to your travel clinic.
List of Vaccinations 
All of the following antimalarial drugs are equal options for preventing malaria in the Dominican Republic: Atovaquone-proguanil, chloroquine, doxycycline, or mefloquine. For detailed information about each of these drugs, see Table 3-11: Drugs used in the prophylaxis of malaria. For information that can help you and your doctor decide which of these drugs would be best for you, please see Choosing a Drug to Prevent Malaria.
Recommended for travelers spending a lot of time outdoors, especially in rural areas, involved in activities such as bicycling, camping, or hiking. Also recommended for travelers with significant occupational risks (such as veterinarians), for long-term travelers and expatriates living in areas with a significant risk of exposure, and for travelers involved in any activities that might bring them into direct contact with bats, carnivores, and other mammals. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites.
Staying Healthy in Developing Countries 
• Pepto Bismol • Strong mosquito repellent • High protection sunscreen • Sunglasses