Adventure Kokoda

Health & Medical

Personal Hygiene

A high standard of personal hygiene is essential to avoid discomfort and disease when trekking in the jungles Adventure Kokodaof Papua New Guinea.

The tropics are unforgiving on those who are slack in this regard. Microscopic There are no large predators high up in the Owen Stanley Ranges but there are billions of bugs that will cause just as much grief if they are enter the system via a crack in the skin, a dirty hand or food that has not been prepared hygienically.  In some cases the bugs don’t even need a crack in the skin. For example if you walk around in bare feet and inadvertently tread in some dried dogs poo you could contract strongyloides – if you haven’t heard of this condition please click here.

You just can’t be too careful in this regard.

The best way to stay healthy is to follow these guidelines:

  • Keep a clean set of underwear and clothes to change into after you have showered or bathed at the end of each day’s trekking.

  • Wash the clothes you have trekked in when you shower/bathe at the end of each day – you will be able to dry these over the fire in the drying hut at each campsite.

  • Carry a small bottle of hand-sanitizer in your pocket (you will need to bring at least two of these) – apply it to your hands before you eat anything or rub your eyes.

  • Keep a small bottle of hand-sanitizer in a waterproof zip-lock bag with your toilet roll.

  • After you shower/bathe at the end of each day apply Tea Tree Oil (antibacterial and antifungul) to your feet to kill any bacteria.

  • Wash your socks and the inner of your boot with antibacterial soap each day.

  • Use water-sterilization tablets in your water bottle.

  • DO NOT walk anywhere at any time in bare feet – ALWAYS, wear camp slippers or sandals. I use camp slippers as socks to sleep in so if I need a pit-stop at night I don’t have to fish around in the dark for my sandals.

Click here to see how Cindy converts her camel-back into a portable shower.

  1. Malaria
  2. Heat and Humidity
  3. Signs of dehydration
  4. Fainting
  5. Heat Stress
  6. Heat Exhaustion & Heat Stroke
  7. Cholera
  8. CAUTION
  9. Medical Clearance
  10. Personal Travel Insurance
  11. Public Liability Insurance
  12. Personal Travel Insurance Claims Process
  13. Immunisations for PNG

MalariaMenari Village

Malaria is the most serious health hazard you will face in PNG. It is a potentially fatal disease and is becoming more common and more difficult to treat because of drug resistance. Most cases of malaria occur with people who did not take their anti-malarial medication or who did not take it as prescribed. Most malarial deaths occur because the diagnosis is delayed or missed.

Malarial mosquitos are night-biters (unlike day-biting dengue mosquitoes) so you need to take particular care to cover up at dusk and night-time. It is best to wear long sleeve shirts and long pants during these periods and to cover any exposed skin with tropical strength mosquito repellant.

The most important preventative measure is to sleep in a mosquito proof tent (Adventure Kokoda provides one for each trekker for this reason). If you elect to sleep in huts or guesthouses along the trail you will increase your chances of contracting malaria substantially because many villagers carry the malarial parasite. If a malarial mosquito bites one of them in their hut - then bites you in the next hut or guesthouse - bingo!

Malarial risks and antimalarial drug resistance patterns are constantly changing, so its important to get the most up-to-date information before you trek. The following webistes provide the latest information on malaria and the most appropriate prevention measures:
. www.malaria.org
. www.tvmc.com.au

Tell your Doctor you are going to PNG for 10 days and will be spending eight of those on the Kokoda Trail in the Owen Stanley Range. He or she will then prescribe the appropriate anti-malarial medication for you.


Heat and Humidity

You need to give your body the best possible chance to acclimatise to the heat and humidity you will experience along the Kokoda Trail. More trekkers are evacuated from the trail from the effects of heat (dehydration) than any other cause. It is therefore vital to ensure you are physically prepared for your trek and to understand the need for fluid replacement.

The most importand change that occurs with acclimatisation is that you sweat more readily and in larger quantities. Sweating helps cool you down, as heat is lost when sweat evaporates off your skin.

Heat and dehydration can affect your physical performance and mental judgement, even when you're not ill as such. This is especially important in an environment such as the Kokoda Trail.

You can lose more than two litres of fluid an hour in sweat on the trail. If you don't balance this by drinking more, you will be in serious danger of dehydration or heatstroke.

You should not rely on thirst to prompt you to dring - by the time your thirst mechanism kicks in you will already be dehydrated. How much urine you are passing is a much better indicator of how dry you are. If you're only passing a small amount of concetrated (dark yellow) urine, you need to drink more. Cool fluids are absorbed more rapidly than warm ones.

As a rough guide you will need to drink between three and five litres of water each day during your trek.

Sweat contains water and salts. As you acclimatise, your body learns to conserve salt better, and less is lost in sweat. You generally lose more water than salt in sweat, and your main requirement is to replace water. At first you can lose more salt than normal, but so long as you're not on a salt reduced diet, you should still be able to make it up from your diet without needing to add extra salt. The current thinking is that you don't need to actively replace salt unless you experience symptoms, usually muscle cramps, or are doing strenuous exercise. As a rule, salt tablets are best avoided - our diets tend to be relatively high in salt anyway, and too much salt can cause kidney and heart problems in the long term.

It is a good idea to carry some electrolyte replacement powder (staminade or gatorade) to mix with your water. You should mix the powder in strict accordance with the directions supplied because if you 'overdose' it can have the opposite effect.


Signs of Dehydration


Any condition that leads to an excessive loss of body fluids can cause dehydration, including heat, fever, diarrhoea, vomiting and strenuous physical activity. Signs of dehydration are:

  1. nausea and dizziness
  2. headaches, and dry eyes and mouth
  3. weakness and muscle cramps
  4. passing small quantities of dark urine
  5. raised tempreture

The best treatment if you experience any of these symptoms on the trail is to dring lots of fluids. Oral rehydration salts (ORS) are best at replacing lost salts as well as fluid, but any (nonalcoholic) fluid will do.


Fainting


This is quite common when you first arrive in a hot climate, and its more likely to affect older travellers. It occurs because heat causes the blood to pool in your legs when you're standing, meaning that less blood reaches your brain, causing you to feel dizzy and faint.

If you begin to feel dizzy you should lie down and raise your legs to a higher level than your head, spray some cool water over your face and sip some fluid.


Heat Stress


Heat can cause a range of symptoms, from relatively mild discomfort to more serious heat exhaustion and potentially fatal heatstroke. Although these condidtions are usually described as seperate entities, in practice they overlap to a certain extent, so its best to treat any heat illness as heatstroke. Mild heat illness can progress to a more severe one if you don't take actioin to prevent it.

Some of the indicators of heat stress are:
. heavy sweating; your skin fells moist and cool
. tiredness and ittitability
. nausea and loss of appetite
. prickly heat rash
. muscle spasms or twitching
. muscle cramps - painful, occurs in your limbs and abdomen

If you experience any of these symptoms, take this as a sign to take a break from the trek. Rest in a cool envirionment or take a cool bath if there is a stream nearby, and drink lots of water. If you have muscle cramps, drink oral rehydration salts (ORS), gastrolyte and plain water. You can also add a little extra salt to your food and massage your muscles to ease the spasms.


Heat Exhaustion & Heatstroke


Both conditions are more likely to occur if you've experienced heavy and prolonged sweating, without adequate fluid replacement or sufficient time for acclimatisation. The two conditions overlap to a degree, so if you're not sure of the diagnosis, always treat for heatstroke. You are unlikely to be capable of recognising or treating severe symptoms of heat exhaustion or heatstroke in yourself - so keep a lookout for signs of these disorders amongst your fellow trekkers.

Some of the indicators of heat exhaustion or heatstroke are:

  1. heavy sweating, with cold clammy skin
  2. headache, dizziness and nausea or vomiting
  3. tiredness, weakness and restlessness
  4. muscle cramps

If you take the trekker's tempreture and pulse, you'll find their tempreture is normal and the pulse is fast. The aim of treatment is to cool the trekker down to encourage them to drink plenty of fluids. You should:

  1. lie the trekker down in the shade, apply wet cloths to their head and body and fan them
  2. as soon as you can, move them to a cooler place
  3. encourage them to take sips of water
  4. arrange for medical help if they continue to vomit or show no signs of improvement

If untreated, heat exhaustion can progress to heatstroke. In heatstroke, sweating stops and you get a dangerous rise in body tempreture. Heatstroke can be fatal. Signs include:

  1. confusion, headache
  2. lack of sweating; skin feels hot and dry and looks flushed
  3. incoordination, confusion, fits and unconsciousness
  4. .raised body tempretures

Heatstroke can be rapidly fatal, so you need to take immediate action to lower the person's tempreture while you get medical help:

  1. arrange for emergency medical evacuation as a matter of urgency
  2. move the trekker into the shade or a cooler environment
  3. if they're conscious, give them cool water to sip
  4. apply wet cloths and fan them - sponging or spraying them with cold water can also help

Cholera

There have been some reported cases of cholera in Port Moresby in recent months. This is obviously due to contaminated water.
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We recommend you dring bottled water in Port Moresby and do not eat fish and vegetables from the local markets. Adventure Kokoda treks are accommodated at Sogeri Lodge or Loloata Island Resort. Both are locataed outside the Port Moresby city boundary and are safe and hygenic.


Some Words of Caution!

Two trekkers have died on the Kokoda Trail over the past couple of years. In both cases the trek operator did not have a satellite phone to call for emergency assistance. More than a hundred trekkers have been evacuated - most from heat related illness caused by a lack of physical fitness and dehydration. It is therefore VITAL that the trek operator you choose has a satellite phone and a VHF radio in your group to ensure you can communicate from along the Kokoda Trail. You are taking an unnecessary risk with your own life if your trek operator is not equipped with both of these important items.

You should also ensure you trek with a company that provides an experienced Australian trek guide as they are qualifed to recognise the symptoms of heat stress and begin immediate treatment. They are also the most qualified to take control and execute the necessary actions required for an emergency evacuation.

Emergency evacuation from along the Kokoda Trail will invariably involve the carriage of the patient by stretcher to the nearest village or to a suitable place for a helicopter to land. This takes a fair bit of time and a fair bit of manpower to arrange. Very small groups do not have capacity to arrange for this and usually have to wait for a larger group to come along to render assistance.

Larger trek operators such as Adventure Kokoda and Executive Excellence have had to render assistance to such groups on many occassions over the past couple of years.


Physical Fitness - Medical Advice

The trek is tough and physically demanding.

The Kokoda Trail is located in remote mountainous jungle terrain in a tropical region. The climate is hot and humid. Much of the area is inaccessible by helicopter and remote from the nearest medical facility in Port Moresby. The trek itself is physically demanding and strenuous.

It is therefore important that you be physically fit.

We strongly recommend that you visit a Medical Doctor and advise them of you intentions to trek across the Kokoda Trail and request that he/she conducts a thorough medical examination to ensure you are physically capable of completing the trek.


Personal Travel Insurance

It is mandatory for you to have a suitable Personal Travel Insurance Policy prior to your departure from Australia. The policy must cover the cost of emergency evacuation by air from any point along the Kokoda Trail, and medical/hospital treatment within PNG and/or Australia.

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Public Liability Insurance

It is your responsibility to ensure the trek operator you choose has a current Public Liability Insurance policy to protect you from permanent disability caused by an accident during the trek. It would be an irresponsible risk to trek across the Kokoda track without this type of protection.


Personal Travel Insurance Claims Process

Airlines in PNG require prior payment before they will dispatch a plane or a helicopter for an emergency evacuation. It is therefore important for you to have an international credit card with you on the trek so that prior payment can be authorised in the event of an emergency.


Immunisations

Whilst no vaccinations are required for entry to PNG you should seek advice from your Doctor in regard to the need for cholera, typhoid and hepatitis vaccinations and to ensure your tetanus cover is up to date. Advise you doctor that there have been reports of cholera in Port Moresby and request that he/she immunise you against it.

To assist you in your discussions with your Doctor and to allow you to make informed decisions the following wesite may be useful to potential and actual trekkers: http://www.traveldoctor.com.au

Plan well ahead for getting your vaccinations. Some of them require an initial shot followed by a booster, while some vaccinations should not be given together. This also applies to some malaria prophylactics, which have to be begun at least a week before you leave home.