Tour operators/travel agents: Student standards of care/risk management when traveling abroad?

[Peter Tarlow]

 I am seeking to learn if anyone knows of health standards of care. other than telling them to buy insurance,  for students traveling abroad

[David Paul Appell]

Hi Peter, I'm intrigued by your question, but can you be a little bit more specific about what type of info you're looking for?

[Peter Tarlow]

Sure, when I take students abroad (or for that matter take anyone abroad) I was wondering if someone had developed a standard of care regarding issues of health and safety. For example, is it enough to simply tell the "client" to go to website X?  I never take college students to a place which I have not checked out, but is this a question of tarlowian overprotection or neurosis>> or does a tour operator have an obligation to know exactly what his/her clients should expect vis-à-vis good travel risk management.  I hope that this clarifies the question a bit and thank you for having responded. Peter Tarlow 

[Maralyn D Hill]

For students or individual travelers, I do not find their is a consistent care/risk management when traveling abroad. Many countries are well equipped, and others are not. 

Personally, I recommend Medjet Assist or a similar program. It is an annual premium and covers medial evacuation to any destination of your choice.

There are other insurance policies that cover individual trips, but my own main concern is a true emergency. If I were running a tour, I would recommend insurance or build it into the price, as it is easier.

On a cruise line with excellent facilities, I've paid $190 per visit for an ear infection--two visits (insurance would have been good).

One visit to an ER in Japan for a torn meniscus was free. They wanted to do surgery, I opted out to wait until I got home.

I've seen people in severe accidents who have had to be airlifted home, others with heart attacks getting great treatment, and many young travelers with broken limbs--some great treatment, others questionable.

In other cases, I have seen excellent care throughout the world. But, no way, have I seen a consistency. 

[Jacquie Whitt]

I have been traveling with middle and high school students to Peru & Ecuador for 5 years. Hopefully, you won't need care while traveling.  But if you do, having reliable local contacts is the key. I use the same people for all our trips to Peru & Ecuador.  There is not one single resource to tell you how to do this.  I tap in to several resources and use what works for me.  I have over 20 years experience in the adventure travel industry, so I rely on my instincts as well.

The worse health incident I have ever had was on the first trip we ever took to Peru.  Of course it happened in the most remote part of our journey. (Chota, in northern Peru)  It was my 16 yo son who came down with unexplained fever.  The guides took us to a tiny ER which looked abandoned, but we got the best care available.  The dr. offered to admit him & administer IV.  I decided to start with booking in to a local hotel to see how things went.  It got worse before it got better when the full impact of the virus hit him.  The locals were incredibly helpful. There was not much to do except let it pass.

Tips for traveling with students:

• Get medical profile on each student before traveling - allergies, chronic conditions, medications (health conditions that require medication to be refrigerated or administered with hypodermic, might be a case where student traveler should not participate - there are travel programs designed for students who have medical conditions )
• Make sure you meet with students/guardians prior to travel, to breakdown and discuss the itinerary & environmental factors that might affect the comfort of travelers (I am taking a group to the Amazon next June - we are spending couple nights in a research center where each room has 3 walls/the fourth is open to the jungle)
• No matter how small your group, ALWAYS have another adult travel along.  Could be a parent or a teacher.  (when I was stuck in the ER with my son, the other teacher was able to continue our itinerary with the other students)
• Make sure you know what the evacuation procedures are for the destination to which you are traveling.  Be sure you convey this to students and their families. The operator can provide the details, but you may have to prod for more. It might take several hours to get to a clinic. They might have to ride on the back of a mule.   
• Use licensed guides who are trained to know where medical facilities are and how to get there. 
• Check every detail of every single travel document of every traveler.  An exchange student from Cambodia came on our trip to Peru last March.  The US agency who placed her took care of her US visa. (I took care of her Peruvian visa) The airlines did not accept the document provided by the agency and the student was not allowed to board our return flight to the US.  I had to send the other students home and stay with her for a week in Lima. (Our guide in Cusco helped us get emergency accommodations in Lima. One of these days, I'll write THAT story!)
• Get yourself trained/certified to handle basic first aid and more advanced if needed.  (I am getting Wilderness First Aid certified because of the remote destinations we sometimes travel to)
• Prevention is the key to safety.  If you are the teacher in the field with the students, it is incumbent upon you to make the call if something appears unsafe.  Students need to know the boundaries ahead of time and so do their parents. 
• Set your boundaries for alcohol use and stick to it.  (the first time I got drunk I was 17 yo in Moscow on a GS trip) I don't fight students about alcohol.  I let everyone know in advance that students will have access to it and what my boundaries are.  If students want to go out in the evening, I may go with them or send a guide who will look out for their safety.  I don't allow alcohol consumption at meals or as a group activity.  Students who want to drink will have to do it on their own time.  I have never had students get belligerent, out of hand or not be able to participate in our activities. (disclaimer:  I work in a small, private school where I know most of the students' families personally-so I am not dealing with unknown factors)

The bottom line is that travel abroad is not without risk.  Traveling is the best way to teach students how to identify potential risks.  They must learn to pay attention to what is happening around them. 

Good Luck and safe travels,

Jacquie

[Peter Tarlow]

Thanks, I follow many of these same procedures and it is good to know that I am not 'overly

protective"  I also do not take students to places that I have not personally inspected (or have someone whom I trust inspect). Do you do the same? 
 

[Burton Robertson]

Great comments below but I would add the following:

Make sure you have the right insurance , for the most part simply having US health insurance isn't enough it it not valid outside the country.  With the Education programs at most colleges they require the students to purchase health insurance and I think that is a good thing and protects everyone.  It is simply part of the costs.

As for visiting every place a student goes... Great if you can do but not always practical.  Sometimes you just have to use trustworthy suppliers, just like the student or school who is trusting you. At some point there will be an unknown, minimizing it through experience and trustworthy vendors is again part of the process.

The tour operator has an obligation to explain fully what is included, they can not read minds to know what someone else is expecting. The purchaser the responsibility to ask and not assume something is included as well.  If there is a agent in between to help facilitate this it may be best.

I hope this helps need further info please feel free to contact me

Burt Robertson

Latitudes Travel

www.latitudesWI.com

www/StudyAbroadAirfare.com

[Peter Tarlow]

I want to thank everyone for their input. It is beginning to be clear to me that we need some form of 'accepted standard-of-care" that goes beyond insurance.  Insurance is midway between proactive and reactive, while a standard of care is pro-active. For example, when I take students into certain rural areas, they must have specific bug spray and light colored clothing or they do not get on the bus.  Does anyone know of any written guidelines for the proactive part?  Once again, thank you all for your words of wisdom. Peter Tarlow

[Anil]

Accepted standard of care ? Given how charged the whole health care issue has become, I do not know what that phrase would involve, and how to insure that one gets the acceptable care, and how to price it for students in a group ? Some adults (let alone young underage students) follow strictest of CDC, and other HMO suggested travel innoculation plans and carry meds for every possible outcomes, and some do nothing. 

Most health care organisations will give you list of equivalent medicines based on pharmacological name of the medication. It is important to find equivalent of say Lipator, or Cipro and common daily use multiple dosage tablets. 

Taking responsibility for other people's kids must be a challenge. You can never be off-guard and off-message.

PS: A great idea for an App though :)