INTRODUCTION

The Return Should Be Planned before the Expedition Leaves Home

In any expedition, the overriding goal is to ensure the safety and health of the expedition members. These duties extend to the communities where they reside and those they have visited. Carrying out these responsibilities and reports is a primary medical and public health obligation. Careful preexpedition planning will help ease the burden and ensure their prompt and satisfactory completion.

What are the expedition's responsibilities? What reports are needed upon return? When should these be considered and planned for? Who should be accountable? What are the full spectrum and most likely illnesses associated with the expedition's return? Who should follow through with these? What reports are needed when? To whom should they be made?

Travel is associated with medical risks. Generally, 15–50% of all travelers to developing countries will report some illness (Cossar et al., 1990; Yung and Ruff, 1994). The most likely event is diarrhea and the most likely fatal event is a motor-vehicle accident (Steffen et al., 2003). Figure 12.1 shows monthly incidence rates of health problems during stays in developing countries. In one study, 64% of those who traveled to developing countries became ill, of whom 8% sought medical care (Hill, 2000). In a general survey in the United Kingdom, 42% of respondents reporting travel had become ill while abroad and nearly half required further medical attention upon return (McIntosh et al., 1994).