Health and safety

Health and Safety

The health and safety of Study Abroad participants is the highest priority for the Mexico Solidarity Network. Tom Hansen, the program director, has 25 years of experience leading groups in Mexico and Central America. Tom and other Mexico Solidarity Network staff work closely with local partners to assess current health concerns and safety issues, and we adapt quickly to changing political conditions. Our close, working relationships with local organizations in each location enable us to respond quickly and effectively if emergency situations arise.

Health

Participants receive pre-trip orientation materials and an extensive orientation during the first week of the program, which includes:

- Water and food. Participants have bottled or treated water available at all times.

- Advice regarding cleanliness and other precautionary measures that can prevent illness.

- Orientation regarding emergency situations and nearby medical facilities.

- A private discussion with each participant concerning pre-existing medical conditions.

- Orientation on specific health issues and conditions in each of the sites visited during the program.

The U.S. Department of State Consular Information Sheet notes that in Mexico, "adequate medical care can be found in all major cities." Most of the study abroad program sites are in major cities, including San Cristobal de las Casas in Chiapas, Mexico City, and Ciudad Juarez. Rural areas may have less ready access to adequate medical facilities. Participants spend five weeks in the indigenous community Oventic, a rural community located in the highlands of Chiapas. Oventic has a small clinic that effectively treats most common illnesses and minor to moderate injuries, but the facilities do not compare with medical care participants may be accustomed to in the United States. Oventic is located 45 minutes from San Cristobal de las Casas via paved roads. The Study Abroad program has transportation available for evacuation from Oventic to San Cristobal de las Casas in emergency cases. Participants spend three weeks in the rural communities in Tlaxcala. Rural clinics are available in communities throughout the state, and all of the communities are located within an hour or less of major medical centers via paved roads. The study abroad program has transportation available for evacuation to Tlaxcala City in emergency cases.

Pre-departure health issues

The Mexico Solidarity Network is not licensed to practice medicine. As such, we do not make medical recommendations, including pre-departure vaccinations. We strongly encourage participants to consult with their physicians before departure concerning vaccinations and other pre-travel health care options. We understand that ascribing to a particular school of medicine or religious belief may influence the ultimate decision regarding vaccinations and other health care procedures. That said, we provide the following information on pertinent health issues. For further information, please contact your physician and/or the Centers for Disease Control and Prevention (CDC), or tel. 877-394-8747.

Malaria

Malaria is a serious disease transmitted to humans by the bite of an infected mosquito. Symptoms may include fever and flu-like illness, including chills, headache, muscle aches, and fatigue. Malaria may cause anemia and jaundice. Infections, if not immediately treated, may cause kidney failure, coma, and death. Malaria can often be prevented by using anti-malarial drugs and by taking protective measures to prevent mosquito bites. However, in spite of all protective measures, travelers may still develop malaria. Malaria symptoms will occur at least 7 to 9 days after being bitten by an infected mosquito. Fever in the first week of travel in a malaria-risk area is unlikely to be malaria; however, any fever should be promptly evaluated. Malaria is always a serious disease and may be a deadly illness. If you become ill with a fever or flu-like illness either while traveling in a malaria-risk area or after you return home (for up to 1 year), you should seek immediate medical attention and should tell the physician your travel history. In Mexico, there is risk in rural areas of the following states: Campeche, Chiapas, Guerrero, Michoacán, Nayarit, Oaxaca, Quintana Roo, Sinaloa, and Tabasco. In addition, risk exists in Jalisco State (in its mountainous northern area only). Risk also exists in an area between 24° north and 28° north latitude and 106° west and 110° west longitude, which lies in parts of the states of Sonora, Chihuahua, and Durango. There is no malaria risk along the United States-Mexico border. There is no malaria risk in the major resorts (that is, resorts located in urban areas) along the Pacific and Gulf coasts, although tourists should use insect repellent and other anti-mosquito measures. Malaria is not a problem at altitudes over 3,500 feet above sea level, which includes Mexico City, San Cristobal de las Casas and Oventic. However, travel through lower altitudes may be necessary to reach these areas. The following measures should be followed to prevent mosquito bites by which malaria is transmitted:

- Use long sleeved shirts and long pants to avoid mosquito bites, particularly at dark.

- Use mosquito netting over bedding.

- Use insect repellents on bedding and netting.

- Use insect repellents on skin and clothing. DEET-containing products, e.g., Off, Deep Wood, Jungle Juice, Muskal, may be used on skin in concentration up to 30-40% and on clothing in higher concentration. Permethrine (Permanone) used on clothing and bed netting is also quite effective.

The Centers for Disease Control and Prevention recommend Chloroquine phosphate for malarial prevention. Side-effects may occur, such as gastrointestinal disturbance, headache, dizziness, blurred vision, and puritus, but generally these effects do not require discontinuance of the drug. If you experience any of these side effects as a result of taking chloroquine, consult a physician. According to the Centers for Disease Control and Prevention, the adult dosage of Chloroquine phosphate (brand name Aralen) is 500 mg to be taken weekly, starting 1-2 weeks before travel. Prophylaxis are continued weekly during travel in malarious areas and for 4 weeks after a person leaves such areas. Alternatives should be discussed with your physician. Dengue Fever This is a viral disease transmitted by mosquitoes. There is no licensed vaccine against it, but personal protective measures against mosquito bites are effective in prevention. Insect repellents, protective clothing such as long- sleeved shirts and pants, plus the use of Permethrin-treated mosquito netting are therefore essential. The disease causes considerable discomfort (fever, body aching), but is self-limited in adults.  

Typhoid Fever

Typhoid is an infection caused by a species of the Salmonella bacterium. In about half the cases, it includes bloody diarrhea, but often is characterized only by fever, severe toxicity, and a rash. It is spread by the oral route from contaminated food and water. Untreated, there is a 30% mortality rate. Vaccines are 60-70 % effective in prevention. Careful dietary discretion is the main line of defense. One vaccine involves a single injection, with immunity lasting 2 years. A second one is administered orally every other day for 4 doses, and lasts 5 years. Antibiotic resistance has been developing, but the bacteria are still sensitive to certain well-known antibiotics.  Salmonella is an ocasional problem in Chiapas, and two students (from a total of about 200) have contacted the disease during the study abroad program.   

Hepatitis A

Hepatitis A is a highly contagious virus that causes liver inflammation. It is most commonly spread through person-to-person contact or through contaminated food or water. Most people from the United States have not been previously exposed to the Hepatitis A virus and are at risk of contracting the disease during travel to areas where the disease is more prevalent. A very effective vaccine is now available and is given 2-3 weeks prior to travel.

Rabies

Rabies is a viral disease almost always caused by animal bites (especially dogs) and is considered a uniformly fatal disease. It is endemic in Mexico. There are two methods of prevention:

- avoid contact with possible rabid animal saliva, including items which may have come in contact with the saliva; and

- immunization, both pre- and post-exposure.

Pre-exposure immunization can be given by either intramuscular or intradermal injection, both requiring completion of the 3-shot series five weeks prior to travel. Post-exposure treatment is required immediately following any suspected contact. Avoid bites from all animals and especially avoid handling or feeding puppies, kittens, monkeys or other animals. They can have rabies before it is obvious. If you should be bitten or have direct contact with the saliva of a suspected rabid animal, immediately wash the affected area with a soap solution and running water for about 20 minutes to neutralize and to rinse out the virus. Then proceed immediately for post-exposure treatment, the sooner the better; depending on the location of the bite, you may have little time. If at all possible, the animal should be captured and kept under cautious surveillance until the diagnosis and therapy are completed. If capture is not possible, a clear description of the animal and the circumstance of contact should be recorded.

Tuberculosis

Tuberculosis is a bacterial disease spread by airborn droplets from a person with untreated pulmonary TB or by ingestion of TB-contaminated unpasteurized milk products. Transmission is more likely in conditions of crowding and poverty. A TB skin test can indicate prior exposure to tuberculosis. If negative, a repeat test after returning to the United States will reveal exposure to the disease. Infection with Tuberculosis may not be apparent for months or even years after exposure, but the skin test becomes positive rather soon. The development of clinical disease can be easily prevented by a course of antituberculosis antibiotic.

Hepatitis B

Hepatitis B is a serious and often chronic viral infection of the liver. Since this type of hepatitis is most often acquired from contact with infected blood, or sexual contact, or from skin-to-skin contact of mutual open cuts and sores, appropriate precautions to avoid exposure via these routes must be observed. This includes avoiding tattooing, ear/body piercing, and cuddling children with sores and draining insect bites. A series of three immunizing injections is available, requiring at least two doses taken previous to departure. This will provide partial protection. The third shot may be taken five months after the second dose, and may be given after returning home to achieve full, long-lasting immunity. An accelerated schedule can also be used as an alternative.

Immunizaions

In the case of Mexico, no immunizations are required for entry into the country from the US or into the US from Mexico. However, several are available. You should discuss with your physician which immunizations you may want before traveling to Mexico. Immunizations require advance planning, generally at least eight weeks before departure. Among the possible immunizations are the following:

- MMR (measles, mumps, German measles)

- Polio

- Diphtheria-tetanus

- Typhoid

- Hepatitis A

- Hepatitis B

- Influenza

- Rabies

With reasonable attention to health and hygiene rules, your stay in Mexico should be a healthy one, aside from minor ailments due to adjustments to new food, water and climate. We recommend you see your physician on returning to the US in order to test for any possible lingering infection contracted overseas.

Student responsibility for personal health

Each study abroad participant must submit a health report based on an examination within the past twelve months by a physician. The exam should reveal any current health problems. The participant and physician should develop strategies for dealing with current health problems, taking into consideration that the participant will be spending 14 weeks in Mexico and may not have access to the quality of health care to which s/he may be accustomed in the United States. Participants who require regular medication, either prescription or over-the-counter, should bring a sufficient supply for the 14 week program. This includes eye care products. Participants who require, or who are likely to require, specific medications for their conditions must communicate with the Mexico Solidarity Network about the process for obtaining these medications in the host country. This needs to be done well in advance of the beginning of the program so that appropriate planning can take place. Included in this group are students who need to know about managing diabetes, epilepsy, allergies, or other chronic ailments.  

Mental health issues

Students who are in counseling or therapy, who have received treatment for psychological or emotional problems in the past two years, or who feel the need for these services should schedule appointments with their mental health professional before they leave to discuss the overseas program and the related issues of living and working in a new environment. Psychological counseling will not be easily available during the 14-week program in Mexico, especially counseling in English.

STIs and HIV/AIDS

Sexually transmitted infections (STIs) exist in every country and every society. This is also true in Mexico, but they are not always discussed as openly and frankly as they are in the US. For the protection of participants and their partners, sexually active students should be certain they are disease-free before leaving this country (where diagnosis and treatment are relatively easy to obtain). Participants should take all appropriate precautions when involved in sexual activity. AIDS is a health threat in every country in the world, including Mexico. Everything that students know about AIDS avoidance in this country applies in Mexico. Participants should be no less vigilant abroad than they are at home. Because discussion of STIs and AIDS is often less open in Mexico than in the United States, this may create an impression of freedom from risk. This is not true. Those participants who will be sexually active are encouraged to practice safe sex. Condoms are available in most pharmacies.  

Alcohol and other drugs

Excessive consumption of alcohol affects the ability of students to make rational decisions, and may result in the immediate expulsion of a participant from the program. The legal age for alcohol consumption in Mexico is 18 years old, which means that alcohol will be legally available to participants. This may be a new experience for some participants, and we encourage participants to consider the potential consequences of reduced motor skills and impaired judgment that can often result from alcohol consumption. We strongly encourage participants to avoid alcohol consumption. Consumption of alcoholic beverages is strictly prohibited during class hours and while in indigenous communities. If participants decide to consume alcohol, please do so carefully and in a culturally appropriate manner. Never drive a vehicle, operate machinery or swim while or soon after drinking. Marijuana and other drugs that are banned in the United States are also illegal in Mexico. Penalties for possession or use of illegal drugs can be quite sever. Possession or use of illegal drugs is strictly prohibited and is grounds for immediate expulsion from the study abroad program.

During the time in Mexico, it is important for participants to monitor their own health. When problems arise, it is the responsibility of the participant to inform group leaders and to work with group leaders to take appropriate measures.

Health insurance

All students must either purchase health insurance from the Mexico Solidarity Network or provide proof of their own health insurance.  At a minimum, health insurance should cover emergency hospitalization and emergency repatriation to the US. The Mexico Solidarity Network offers insurance through a policy written by Travel Health and Accident insurance through U.S. Fire Insurance Company, policy #US022072. The policy covers accident/emergency hospitalization coverage with a limit of $25,000 per person/per incident and has a $100 deductable per person/per incident. The additional cost is $125 per student for the Fall and Spring semesters and $62 for Summer semesters.

Emergency contacts

Emergency contact info is provided in each participant's oreintation material. A card containing additional emergency contact numbers will be distributed to every participant during the first week of classes.  

More information

Extensive health information is available from the Centers for Disease Control and Prevention. Travel warnings and other useful travel information is available from the US State Department. Safety The safety of participants is central to the Mexico Solidarity Network's Study Abroad Program. Staff have many years of experience leading groups in Mexico, and our best assurance of safety is based on this experience. Staff have spent significant time in each of the areas visited by the program, developing strong relationships with local groups who can provide the best advice on current political conditions and safety issues. The U.S. Department of State Consular Information Sheet notes "sporadic outbursts of politically motivated violence occur from time to time in certain parts of the country, particularly in the southern states of Chiapas, Guerrero and Oaxaca." The Mexico Solidarity Network staff understand the local political situation and closely monitor changing situations in consultation with local partners who have extensive knowledge of the local situation. While there are never any guarantees of safety in travel situations, to date none of our program participants in Chiapas have been adversely affected by political violence.

The U.S. Department of State Consular Information Sheet notes "crime in Mexico continues at high levels, and it is often violent, especially in Mexico City, Tijuana, Ciudad Juarez, Nuevo Laredo, and the state of Sinaloa." The Mexico Solidarity Network staff carefully orients participants to avoid activities that may expose them to crime. For example:

- We strongly encourage participants to travel in groups rather than alone.

- We avoid night highway travel.

- We travel on toll roads rather then non-toll roads whenever possible.

- We orient participants about careful use of ATM machines, public taxis and public transportation systems.

- We orient participants in techniques to avoid pickpockets and other common crimes.

Anecdotal evidence suggests that participant behavior (and occasionally misbehavior) is a major cause of illnesses, injuries or fatalities. Sometimes young people act as though they are invulnerable or reject the advise of more experienced leaders. In particular, excessive alcohol consumption can lead to unfortunate incidents. Excessive consumption of alcohol or use of illegal drugs by a participant can place the entire program at risk and will result in immediate expulsion of the participant from the program. Staff members work to gain the trust and confidence of participants so that advice and guidance are taken seriously. The cooperative interaction of staff and participants is an important element in the overall health and safety program. As in any travel situation, there are no guarantees of complete safety. With years of experience taking groups to Mexico, the Mexico Solidarity Network has the know-how, experience, local connections and commitment to taking the necessary steps to maximize the safety and health of participants.