Guest: Professor Danforn Lim
Presenter: Tabetha Moreto
Guest Bio: Professor Danforn Lim is the Executive Vice President of the Specialist Medical Services Group. Professor Lim is one of the two principal partners at the Practice. Professor Lim graduated from the University of New South Wales and he is a medical practitioner, university clinical academician and a well-known media personality in the Chinese community in Sydney NSW. In 2016, Professor Lim was also awarded to be the Business Person of the Year at the Local Business Award. He is one of the very few doctors in the country to hold both registrations as a Registered Medical Practitioner (with Specialist Registration) and Registered Chinese Medicine Practitioner in Australia. With knowledge in both Western and Chinese Medicine, Professor Lim keeps an open mind in his clinical practice and aims to deliver the best possible care to his patients.
Segment Overview: In today’s interview, Professor Danforn discusses about Australian travellers may be neglecting their family and friends by failing to seek out necessary health advice before travelling to ”at-risk” destinations especially international ones. He also talks about what travellers can do to protect their health before and even during traveling.
Tabetha Moreto: Hello everyone. Welcome to Health Professional Radio. I’m your host for today, Tabetha Moreto. Our guest today is Professor Danforn Lim, Executive Vice-President of the Specialist Medical Services Group. Today we’re going to talk about how new research shows that Australian travellers may be neglecting their families and friends by telling to seek out necessary health advice before travelling to at risk destinations especially international one. Without further ado, welcome to the show Professor. It’s so nice to have you here.
Professor Danforn Lim: Hello everyone.
T: So Professor can you please tell the audience more about yourself and your company?
D: I’m a specialist GP myself with a special interest in travel medicine and travel vaccination. And I work predominantly in Sydney. On my other time I work in the University of Technology Sydney as an Adjunct Professor to oversee some research there as well.
T: Excellent. So Professor I’m very curious about this topic because it’s very interesting. Because Australians love to travel but it looks like their neglecting to get the necessary health advice that they need before going travelling. So Professor, what is classified as at risk destination?
D: For a number of places for example, like particularly Southeast Asia, some of the Central American countries as well African countries. And it’s also depending on where this particularly diseases or group of diseases is more prevalent in that particular season of the climate in years as well.
T: I see. Okay so what are the common vaccine preventable diseases travellers are at risk of?
D: For example, most commonly we’re talking about Typhoid and Hepatitis A. These are sort of of trouble diseases that you can get it from the food that you eat. If you can tend to have a risk behaviour that oversee as well, Hepatitis B and Hepatitis C of course is something that we should be looking at as well. Furthermore, things like influenza and also Measles, Mumps and Rubella, chickenpox, the poxes which is the whooping cough are all diseases that is at risk of catching at overseas. A lot of Australians think we don’t really need to have the vaccination, particularly we forgot that while unvaccinated people they get protected from the disease as such a measles that I just mentioned through to the large number of Australians be vaccinated already. However they forgot when they go to the places where vaccination rate are low, they are actually at much higher risk of catching it at overseas rather having it in Australia.
T: This is very interesting. Yes, because I have heard so many stories of travellers when they go to at risk destinations and when they come back home they usually find out they got sick because of these diseases that they caught from travelling to at risk destinations. Aside from this common, vaccine preventable diseases – are there any unusual diseases that people can get from travelling to at risk destinations?
D: For example, malaria, cholera, those are some – we don’t often see in Australia anymore however they are all preventable. There are vaccines that can help them to make sure that they didn’t catch that overseas. And at the same time, with a lot of changes with older people and people with chronic illnesses travelling as they become more accessible to them. They are also from phenomena of what we so call visiting friends and relatives’ travellers. These are people who have been born in one country, moved to country in Australia and then go back to visit their relatives. They actually are at a particular risk because that’s a big different with what we call the tourist travellers. And they thought when they go back to their countries, that should be fine but they completely forgotten that the environment has changed, their lifestyle has changed. When they go back to their country the risk of catching the disease is over there is much higher.
T: Yes, very interesting. Can you tell us, when should someone see a doctor before travelling? Should this be done like a week before they travel, two weeks before they travel?
D: That’s a very good question. Patients don’t necessarily see travel medicine as a priority. Some of them will mention to their GP on the way out of their door and say, “Oh by the way I’m going to for example, Bali, next week. Do I need to do anything?” These can actually present a problem, that’s certain travel medicine preparation. That should be required significant amount of time to takes properly effect. For example, from vaccine, some estimation has to start early 6 months before travel. You can have a rapid course of vaccination for hepatitis B for example. But the best course is to do this for over 6 months before travel. Typhoid and hepa type a vaccine, you need to do at least 2 weeks in advance before you go. Malaria tablets, if you want to take it, you need to take it on 2 days before you leave the country and continuous during the whole duration of trip and then 2-4 weeks after you return to Australia as well. If go to some African countries, you need to have a yellow fever vaccines, it has to be done at least 2-4 weeks before.
T: Excellent advice Professor. Yes, because as you know when people are travelling they have a lot of things on their minds. Unfortunately, sometimes they forget to get vaccinated or to get the necessary medication that they need before they go travelling because they always think about, “Oh I need to pack my things, what do I need to bring?” So sometimes vaccination is not on their minds unfortunately.
D: Exactly, and travel vaccinations are not used as much as it should be. There are a lot of people who travel, particularly to Asia thinking that it’s just part of their backyard, similar to travelling to the Gold Coast. Not thinking about the fact that there’s a risk from exotic diseases. We sometimes get very excited about some high profile diseases like Ebola or mostly recently the Zika virus. However, we forget that the common thing, that the influenza virus is actually a bigger risk to us and to travellers as well.
T: That’s right. Professor, can you tell us why is this particular topic relevant to health professionals?
D: It is, because we see a lot of the people actually bring the disease back with them from overseas. We’ve been seeing a number of Australian travelling overseas who are not seeking professional health advice. That actually impacts the itinerary and not only to themselves but to the group of people that they traveling as well. Because we know that there’s a popularity of the group travel is on the rise. That’s why we emphasize, it is important not only think about yourself to consider, the impact of your health can actually have when you travelling with other people as well. Some statistics also show us that 3 in 5 Australian travellers has never considered the probability of bringing a disease that they contracted overseas back home to Australia with them and half of them, 55% of them incorrectly believe that they can’t expose friends or families to disease unless the symptoms are obvious.
T: Yes. That’s very unfortunate that people don’t realize that, for example, if they go to at risk destination and when they come home they probably caught one of these diseases and they easily spread that to their family and friends. That’s why I agree with you Professor, this is a very important topic that travellers especially when they go tho these types of destinations they need to seek medical attention or rather medical advice before they go.
D: Exactly. For example, Australia – we are a very clean country, we have a very low Typhoid, Hepatitis A rate. However, just simply last year we have 104 cases of Typhoid recorded and 121 cases of Hepatitis A. A lot of travellers are actually bringing home this sort of unwanted and sometime life threatening diseases.
T: That’s right. Speaking of travellers, I want to ask you something Professor. What about for example, children and pregnant women. Do you advice children and pregnant women to travel to at risk destinations?
D: Generally speaking, we don’t completely recommend or advice that. However, depending on whether the child or the lady have any chronic diseases with them or not. At a certain degree of protection, we can arrange through the vaccination and it’s not only the vaccination itself. It’s also about the efficiency of health measures, they’re going to have that overseas. I often tell my patients do not drink the tap water at overseas if they’re not sure where source of water comes from, don’t use the ice. It’s better to drink the bottled water,l don’t share any of your toiletries, equipment or towels with anyone that if you’re not sure. Keep your own or even bring your own food. All food must be cooked instead of any type of raw food, if they have any sort of food that you’re not sure at overseas. It’s not really about the vaccination, also about the health protection or preventive measure that we do while we are overseas.
T: That’s right. I agree with the saying, ‘Prevention is better than cure.’ Now let’s talk about, prevention. Aside from getting vaccinated or taking any medication, what else can travellers do and order to avoid getting sick while away?
D: Number one, obviously we have to be very fit ourselves. You need to be fit and healthy before you travel and this will help even if you are not climbing a mountain or anywhere else. Because if you do get a disease overseas you have a greater strength to fight this if you are fit and healthy. If you’re in a plane, you worry about someone is sneezing or coughing in there close by, you should actually equip yourself with some facemask as well as put it on if that person if not doing it himself or herself. In an enclosed space, often germs can be easily spread between individuals and you can see it a lot to Asian countries. A lot of population people that they actually wear facemasks all the time. You prevent people to pass on the diseases to you, wash your hands all the time. Make sure that you do wash your hands properly. Our 10-15 infectants and surely don’t eat raw food, any water that you’re not sure whether they come from. Don’t use the ice, don’t drink the tap water, make you sure boil the water and go to the places that is more popular and pick places that you understand the quality of the services tend to be accessible. If you do notice any problem, if you return to Australia, anytime you have fever, you have cough, or even something that you’re not sure. Go and speak to your GP or to the local emergency, explain to them where you have been through because we’re constantly receiving notifications from the Department of Health as well as WHO regarding to which particular country you have which type of infectious disease to be more prevalent so that we can link you up and then to find out whether you have contracted one of the infectious diseases overseas or not.
T: That’s great Professor, thank you for sharing that. If you don’t mind Professor, I have a personal question for you. Why are you so passionate about educating travellers about protecting their health before they go to these at risk destinations?
D: It is part of my role as a GP is about preventive medicine. We used to say that the best doctor is not actually the doctor who can cure the disease but essentially to educate the people to prevent the disease. We see that a lot of diseases being brought back to Australia and I recently see a lot of my patients suffer from unnecessary illnesses contracted overseas that can’t be completely preventable. This essentially very important message to our fellow populations, our people in Australia here that it’s something we can prevent. Why don’t we prevent it? It is better that we prevent it rather than we suffer from it and get cured from it because the process of curing the disease actually definitely not nice. And sudden diseases while you contracted at overseas, you can actually lose life over there and I have seen patients paying massive amount of overseas bill simply because they didn’t get a vaccination before they leave. In certain countries they do not have tender care as much as we do in Australia here. They end up having to come back to Australia and receive further treatments and they suffer unnecessarily from this.
T: That’s true. That’s a good thing because like you Professor, people like you. Your educating people, you’re giving the message out there and educating travellers especially. They need to take preventative measures and take care of themselves. That’s why, when they come home to Australia, they won’t have to worry about, thinking about let’s say contracted any of these diseases from these at risk destinations.
D: Exactly. The other thing as well, some patients do tell me that a certain vaccine is quite expensive. But I always tell them, “Compare the price that you pay for the vaccines and compare to the price that you do contract disease overseas, the medical bill that you’re going to pay. That’s not comparable here because that vaccine that you’ll pay for is far cheaper than the medical bill you’re going to have overseas. In Australia, we’ve been privileged to have a medicare system to cover most of our medical expenses while you at overseas that would not be the case. So travel insurance is another must that everyone who go overseas is to purchase. I alway tell my patients double check if your health fund. If you do have one, majority of the health funds will cover price of medications and vaccinations, check and under that category and you can claim some money back.
T: Excellent. I also agree with you on that Professor. A lot of people complain that vaccines are too expensive but once if a person gets sick that’s the time they’re going to realize that treating their disease or treating their sickness is actually more expensive than getting the vaccination.
D: Exactly. That is very, very true.
T: Thank you very much Professor. What is your main takeaway message to all our listeners out there?
D: Travel vaccination and travel medicine is the priority before you go while you pack everything, prepare to leave the country and enjoy your good time. Do not pack any diseases back to Australia and to yourself as this can be properly presentable by having a simple vaccination.
T: Excellent message. Professor, I hope you don’t mind I have one more personal question for you. Do you like travelling yourself?
D: So-so, yeah.
T: Thank you so much Professor, our last question for today. For those interested in obtaining your services. How can they get in touch with you?
D: Of course, I always suggest that if you need to get any travel vaccination or advices, go to speak to your GP because they are the best person and the first person that you can get to in touch with. Most of the software in the GP practices would already be equipped with World Health Organization’s travel medicine and information so you can get all the information downloaded from there.
T: Excellent, thank so much Professor for coming on the show today. I really appreciate it. That was Professor Danforn Lim, Executive Vice-President of the Specialist Medical Services Group. We just been talking about what Australian travellers can do in order to protect their health about travelling to at risk destination. If you like this interview, transcript and archive are available at www.hpr.fm. We’re on all social media platform, don’t forget to follow, like and subscribe. We’re also available for download on SoundCloud and iTunes. I’m Tabetha Moreto and you’re listening to Health Professional Radio.