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Introduction

This chapter provides some practical guidance on other essential travel needs. These include considerations for appropriate and necessary documentation, mechanisms to contact you in case of emergency and prearranged safeguards prior to travel. In addition, having an idea of what to pack, how much money to bring, and how to budget for short or longer term trips are essential to having a meaningful and enjoyable experience.


Essential travel documents

In addition to having a valid passport, other documents should be obtained and or readily available to indicate your qualifications. Simple measures can help to ensure safe and timely recovery of documents if they are misplaced, lost or stolen. Implementing redundant measures can help to ease some of the stress that can be associated with missing documents. Some of this may seem obvious, but it never hurts to review and ensure that these are on hand.

Passport

Be sure your passport is up to date, at least 6 months prior to expiration. Passport agencies will do rush renewals, but at a premium cost. Also ensure that you have enough pages in your passport. Previously, you could pay for the insertion of extra pages if you did not have adequate space for entry/exit visa stamps. However, beginning January 1, 2016, people in need of additional pages in their valid passports must obtain a new passport. It is a good idea to carry extra passport size photos, especially if you will be traveling for an extended amount of time or plan to visit multiple countries. If you will be traveling to an area that requires a yellow international immunization card, be sure to have it readily available.

Visas

Be sure to check visa requirements prior to travel. While many countries do not require visas, some will allow you to obtain visas on arrival. More countries are requiring visas ahead of time, i.e. Kenya, and may not let you in the country without obtaining a visa prior to arrival.
In addition, be sure to budget visa costs as they can range anywhere from $50 to $200 USD. Inquire with your host institution or program what
type of visa will be required, i.e. is a tourist visa sufficient or will you require a business visa. If a business visa is required, you may have to get a letter or documentation from your host institution or program of your intended travel and work.

Duplicates of your travel and work documents

Have copies of your passport electronically and in paper form. Using a cloud-based service will allow you to access them anywhere, but be sure that you are able to access them offline also.
If you will be doing any type of clinical work, it is a good idea to keep a copy of your professional license with you. Remember to bring business cards if you have them. Some countries treat the exchange of business cards very formally.
Have copies of your relevant insurance cards/policies (health, travel, and medical evacuation). In addition, you should have a list of your emergency contacts on hand and be sure to share or distribute this list to people who are at home.

Emergency and Other Contact Information

While it is important for you to have a list of emergency contacts, it is just as important to share this list of names, numbers and relationships with other people who are not traveling with you. This list should include a list of family or friends as emergency contacts and contacts of those with whom you will be working or staying with.
Including contact information for the local U.S. Embassy or Consulate office for yourself and family members or friends is extremely helpful if they need to try to get a hold of you. All travelers should register for STEP, the U.S. Department of State Smart Traveler Enrollment Program. By doing so, there is a record of your travel through the State Department and in the event of emergency, the State Department will send out specific travel warnings and contact family members.
Many institutions or organizations will require you to identify emergency contact information as well. Sponsoring academic institutions may have additional requirements to account for their students, staff, and faculty when they travel and may also require release of information and waivers for FERPA (Family Educational Rights and Privacy Act) and documentation of health and/or medical evacuation insurance.


Money and Budgets1

There are some very practical considerations in regards to the amount and type of money that you should bring. Access to money, the amount and type needed will vary with the country or region that you are traveling to. Being aware of the availability of banks, ATMs, wire transfer services is invaluable, especially if your money is stolen or misplaced. Having some
emergency cash on hand if you have the means can also alleviate the need to rely on more expensive options.
Also, establishing and sticking to a budget for the duration of your trip can avoid undue stress due to insufficient funds. More on this a little later in this chapter.

Cash

Cash is still the main type of money used in many countries. Even if you opt to primarily use a bank or credit card, it is still useful to carry a minimum amount of cash for emergency purposes. U.S. dollars, Euros, and British pounds are often accepted in many countries as currency (check prior to traveling if this is the case). They are also the easiest type of currency to change in low-resource settings.
In regards to exchanging money, you have several options, some which are better than others. Some banks in the United States will convert U.S. dollars to a desired currency, but you should check whether they offer this service and their rates. If you are able to plan in advance, you will likely find better rates. Several options to buy foreign currency exist: online, offline, from banks or private retailers (i.e. exchange bureaus). Typically, exchanging at an airport is an expensive option. Pay close attention to conversion rates. Also ignore advertisements that state “no commission” as the cost is often hidden through other means. Generally, changing money on the street is a good way to get scammed, especially if you are not familiar with the local currency. You should always try to exchange money at a recognized trader or bank.
In regards to the types of cash to bring, many countries will have a different exchange rate for the type and condition of the bills you desire to exchange. Most countries will not accept cash that looks old, worn, or has tears in them. The most prudent option is to go to your bank prior to departure and ask for newer bills. Depending on how much money you need, most currency exchange places will extend a better rate for larger denomination bills ($50 or $100). But you may opt to use smaller denomination bills ($20) due to your budget or to not feel like you have to exchange all of your money at a disadvantageous rate.
Regardless if you are carrying local currency or U.S. dollars, you should never carry all of your cash with you or keep it in one location. If you get robbed or misplace your stuff, there goes all of your spending money. Typically, only carry the amount of cash that you will need for that day or a short period of time. There are many options to spread your money. These include money belts, secret pockets, Ziploc bags tucked into the lining of your suitcase, small canister in your laundry, etc.






Credit Cards

Credit cards or debit/ATM cards are a good alternative to cash, and in some places may be the preferred means to pay for things. If the country you are visiting uses ATMs, a bank debit card is often the best option to get local currency. You are able to access money pretty much in the same that you do at home and you do not have to carry large amounts of cash. It is a good idea to notify your bank of your expected travel and inquire about any fees that might be associated with withdrawing money internationally. While exchange rates are often favorable, if there is a significant fee, it may not be the most economical option. Some international banks have reciprocity with American banks and may waive fees. Be sure to check if these exist to help save some money. For example Bank of America has international partnerships https://locators.bankofamerica.com/international.html with Barclays, BNP Paribas, ABSA, BNL D’Italia, Deutsche Bank, Scotiabank, Banco Santander, amongst other banks throughout the world.
Credit cards are useful as a backup in case you lose or run out of your main source of money. They are also useful for making reservations, larger purchases, and in case of emergency. In most major cities you will be able to purchase things you need with a credit card. Again, be sure to check with your bank card to see if they charge any foreign transaction fees. In addition, many countries will charge you a higher rate for using credit (or debit) cards to purchase goods than they do for cash. This is sometimes negotiable and if you have cash, you may be able to get a better deal. It never hurts to ask if there is a discount applied if you pay via cash and you have the means to pay cash.
A couple of additional rules to keep in mind if you use plastic:
. Make sure your card is accepted in the country you plan to visit (i.e. Cuba)

. Call your bank and tell them where you are going and when, so they don’t block your card the first time you use it on your travels.

. Never let your card out of your sight. Most credit card scams require time alone with your card – if you don’t see an electronic-point-of-sale machine, better to play it safe and pay with cash from an ATM.

. Check the layout of the keypad on the ATM. Loads of travelers have their cards deactivated by entering the right pattern but the wrong numbers on a foreign ATM keypad.

. Do not rely on ATMs as your means of cash if you will be in a country where electricity and a phone signal are not reliable. They need them to function.

. If you have the option, pay in the local currency on your debit or credit card when abroad. Bank rates will be better than the retailer rates.


. Some credit cards incur no transaction fees for foreign purchases. This can save you considerable money, so investigate your card’s fees prior to travel.

. Many foreign electronic point-of-sale machines now require a chip in the credit card, so ensure that yours has this feature prior to leaving.



Travelers Checks

Travelers checks are not used much anymore and are not as widely accepted as they previously were. They can be a hassle to change them into local currency. The advantage of them is that they are generally still accepted by most banks and money exchange bureaus all over the world and they are easily replaced if stolen or lost. You can get checks in different currencies depending on where you will be going. The most common vendor is American Express https://www.americanexpress.com/us/content/prepaid/travelers-cheques.html

Wiring money

This is probably the last option for having money, to be used in case of emergency or if your other options are unavailable, such as due to theft or deactivation of your cards. Wiring money tends to be associated with high fees and you need to have someone who is willing to wire you the money. Western Union https://www.westernunion.com/us/en/home.html and Moneygram www.moneygram.com are the two most common and have locations all over the world.


Travelling On a Budget

Once you have secured your funding, the next step is to make sure that those hard-earned dollars (or Euros, shillings, rubles, rupees) stretch as far as possible. Obviously, budgets will vary depending on location, duration, type of mission etc. but there are some basic guidelines that will help you defray costs regardless of setting.

Fly with Foresight: Start searching early through multiple booking sites, set programmable alerts on these sites for tickets below your target price, and aim for two months in advance. There is extraordinary variability in the price for a given seat depending on the day of the week you buy, the website through which you book, and how far in advance you book. A recent study by the Airline Reporting Corporation suggests that the cheapest time to book is 57 days in advance, on a Sunday or Saturday.

Pack Light / Pack Smart: Try to pack the staples of your wardrobe with particular attention to garments that wash and dry easily and can do double-duty; nice pants that will be comfortable for casual days but can be dressed up for the evening and can even survive low-impact outdoor
activities. Have your bases covered by versatile and layerable practical choices. Anticipate the range of weather conditions you’re likely to face, in addition to local cultural norms such as covered knees/shoulders. Fewer bags make you more nimble for last-minute changes of plan.

Eat like a Local / Cook like a Local: The cardinal rule here is that dining out will drain your budget. Learn the local cuisine and how to safely clean and prepare food, and then try your hand. These dishes will employ cheap, readily available and often novel ingredients. Take advantage!

Consider Alternative Lodging: Hotels are expensive, even those geared towards extended-stays. Prior to your trip investigate the possibility of guesthouses, homestays, hostels, or a reputable local host. You’ll appreciate the cultural immersion and socialization while saving money. Airbnb www.airbnb.com has also taken the world by storm. You can find places to stay through Airbnb (or any other room/home share site) in many places throughout the world.

Bargain for Everything: Confirm that this is the local culture before you put on your haggling game-face, but recognize that prices are negotiable for consumer goods at markets around the globe. Get an idea of what your local colleagues pay before you head to the market. While bargaining may not always get you down to local price, you often save significantly. Plus, it’s fun!

Walk or Bus: Taxis may come with high price tags. Avoiding them in favor of walking, train or bus can save cash and lead to a more enriching cultural experience. Depending on your destination, public transportation may be fraught with hassle or outright danger. Rely on the advice of trusted hosts or local friends. In many developing countries, it is safest to avoid travel after dark, especially by public transport. It is also best to avoid opening the can of worms of driving yourself, even if it means more expensive taxis are needed. Also consider ride share services like Uber www.uber.com and Lyft www.lyft.com are more global than they used to be.

Partner with Industry: While you may not have been able to extract hard cash from potential industry sponsors, many may be willing to make material contributions to your cause. If your project involves substantial physical supplies, some corporations may donate equipment for the opportunity to improve relationships with your home institution or increase market penetration at your host program. Yet, be sure to consider conflicts of interest with your leadership in advance.


The following is a helpful table to help to estimate costs for a trip.
TRAVEL BUDGET WORKSHEET


Cost/day
# of Days
Estimated Cost
Actual Cost

TRAVEL





International Airfare





Regional Transport





Daily transport

x
=


Travel Insurance

x
=


ACCOMMODATION





Locale 1

x
=


Locale 2

x
=


Locale 3

x
=


DINING





Meals

x
=


Special Events

x
=


Equipment costs





Vaccines/prophylaxis





Visas





Medical licensure





Other costs

x
=


TOTAL





What to pack

What you pack will depend a bit on where you are traveling, what kind of work you will be doing and how long you will be there for. However, there are a few helpful items to remember to pack regardless of the type of travel that can prepare you for almost any type of trip.


Suggested Packing List

Documentation
. Valid passport and *photocopy of front two pages (in case of loss)

. *Immunization Records (yellow card)

. *Health and travel insurance information

. *Copy of your professional license

. *Emergency contact information

. A record of useful in country numbers (i.e. EMS systems, the U.S. embassy/consulate, etc.)

. List of medications you are taking

. Documentation regarding any pre-existing illness/allergy that might require medical treatment

. *Note: good to keep copies in a separate plastic/Ziploc bag



Clothing
. Scarf, wrap or sarong (good for makeshift blanket, towel, etc)

. Warm fleece or hooded sweatshirt

. Rain jacket

. Flip flops or shower shoes

. Baseball cap/sun hat/bandana



Other
. Head lamp

. Multi-country travel adapter (even just for connecting airports or travel before/after)

. Hand sanitizer

. Reusable water bottle

. Sunglasses

. Sunscreen

. Lip balm

. Chewing gum (good also in case no water to brush teeth in emergencies)

. Ear plugs

. Alarm clock (battery operated) or smartphone

. Camera or smartphone

. Insect repellent (generally DEET or newer alternative recommended)

. Mosquito net

. Pocket knife or multipurpose tool (not in carry-on!)

. Duct tape rolled on a pencil (this saves space and comes in handy for all kinds of problems)

. Small packets of laundry detergent (useful for washing clothes in sinks/buckets)

. Moist wipes (good for quick “bath” or cleaning and hygiene)

 

. Feminine hygiene products (party-liners can extend wear of underwear)

. Condoms (hey, you never know)

. Snacks (great for sharing with locals as a cultural exchange and good comfort food)

. Journal/notebooks and lots of pens

. Books, e-books, cards and board games, small musical instruments



Personal health related
. Personal Medical Kit (See Chapter 15)

. Include prescription medications in original containers



Professional health related for clinical work
. Common equipment: stethoscope, blood pressure cuff, otoscope, gloves, N95 masks, safety goggles.

. Alligator forceps if you are doing clinical work (great tool for FB removal)

. Small stickers for pediatric populations


*Note: you will rely heavily on your PE skills in certain resource limited settings



List of Useful Resources

Once you have made the decision to travel, gotten approval from your institution, and purchased all the appropriate gear and insurance for your trip, it is important to check out some specific resources that will help make your travel go smoothly. All of the sites listed below are fantastic and a few of them have overlapping information. Many of them have been identified elsewhere throughout this book, but this is a good repository of those specifically for travel.
So take 15 minutes and click on each link so you can get a flavor of the information they contain. No seriously…just check them out…now!
Also, other great resources include: Travel books/websites, students from previous trips, and in country contacts. The CDC has an excellent website that details the health information and pest protection suggestions by region.

The U.S. Department of State Country Specific Information site
This site provides information about specific required vaccines for entry, passport requirements, visa requirements, country specific diseases, and embassy locations. http://travel.state.gov/content/passports/english/country.html

The U.S. Department of State Country Travel Warning site
This site describes the specific country travel alerts and warnings issued by the State Department and the reasons behind those advisories. http://travel.state.gov/content/passports/english/alertswarnings.html

The U.S. Department of State Smart Traveler Enrollment Program (STEP)
A definite must!!! This free service allows you to register your planned trip with the State Department. In the event of emergency, the State Department will send out specific travel warnings and contact family members. https://step.state.gov/step/

The U.S Government International Travel site
A clearinghouse for international travel information, ranging from international driver’s licenses to passport renewals to embassy information. http://www.usa.gov/Citizen/Topics/Travel/International.shtml

The Centers for Disease Control Travelers’ Health site
Main page for CDC information with travel warnings, advice for clinicians, and country-specific information. http://wwwnc.cdc.gov/travel/

The Centers for Disease Control Clinician Information Center
A comprehensive listing of CDC resources for clinicians, including downloadable references, journal articles, and online courses. http://wwwnc.cdc.gov/travel/page/clinician-information-center

Global TravEpiNet Travel Tools
Similar to the CDC's Travelers’ Health site, this site offers easy to navigate pick and choose selections and dropdown menus allowing for tailored pre-travel health advice for both clinicians and patients. http://www2.massgeneral.org/id/globaltravepinet/tools/

The American Society of Tropical Medicine & Hygiene Travel Medicine Consultant Directory
A directory listing many of the travel medicine clinics providing pre-travel immunizations and consultations, and post-travel evaluations and treatments. https://www.astmh.org/for-astmh-members/clinical-consultants-directory


References

1. http://www.lonelyplanet.com/budget-travel/best-of-budget-travel/content/travel-tips-and-articles/76996#ixzz3yXyYfhFe