Should Study Abroad Programs Carry Epinephrine?

Mari Dark of Naropa University recently posted a question to the SECUSS-L listserv asking if members included epinephrine in their medical supply kits for faculty led trips. She received 13 responses: 9 argued against it and 4 were for it.

She reported that the majority of respondents’ programs did not provide epinephrine. Presumably that also means that their programs do not authorize carrying epinephrine. This distinction is important as illustrated by the University of New Hampshire faculty leader whose trip to Nicaragua was cancelled in 2013 and whose appointment was not renewed by the University after it came to light via her submission of an invoice that she carrying unauthorized epinephrine on program.

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Safety vs. Liability in International Risk Management

In most aspects of international risk management, safety and liability fly in formation. When you are working to improve safety, you are reducing your liability exposure and vice versa. However, there are some areas where safety and liability come into conflict.

Safety is generally spoken of as a good with the implication that more is better. And, while safety specifically refers to freedom from accidental harm, it is most generally used to refer to freedom from all harm (folding in both illness and intentional harm).

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Vetting in International Programming: Pre-Program Evaluation of Staff, Vendors, High-Impact Activities and Providers

According to Wikipedia, vetting is a term that comes from horse racing. It referred to a requirement that horses be checked out for health and soundness by a veterinarian prior to being allowed to race.

As the hegemony of the OSHA certified world is carried into the furthest corners of the globe, an American vision of responsibility is sweeping away all notions of accident, bad luck and karma before it. Anything bad that happens is someone’s fault. Who is at fault and to what degree is most likely to be determined back in the U.S in a civil court as per a participant agreement.

A positive aspect of this is that liability from a cross-cultural point of view is a much less squishy concept than is safety.  When talking about safety with a Kenyan, a Bhutanese or a Costa Rican, it is difficult to be sure that you are all understanding the same things in the same way. However, everyone gets the concept that if anyone gets hurt, this program dries up and blows away or that the following year’s budget will be substantially reduced.

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Travel Health, Safety and Security: Professionalizing Study Abroad

Travel Health, Safety and Security: Professionalizing Study Abroad

Traditionally, the majority of study abroad programs were conducted in High Income Countries (HIC – a World Bank designation) where students visited and viewed various cultural and artistic sites while perhaps trying to develop language skills. A faculty member would invite their students to participate and the trip would be conducted with minimal school oversight or involvement.

While some fraction of international education has always been somewhat more adventurous, there is an increasing trend to travel to “non-traditional” destinations in primarily Low and Middle Income countries (LMIC). Generally, lower income destinations mean greater hazards and fewer mitigating resources owing to lesser-developed infrastructure, torte law, regulations, enforcement and the fact that a high proportion of lower income countries also have greater natural disaster exposures, less political stability and higher incidents of crime.

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Preventing Students from Becoming Prey

Many of the health, safety and security incidents that befall study abroad students involve their being victimized by predatory persons.

Most study abroad students are exposed to some cautionary information from their school or program in the form of handbooks, assumption of risk forms, orientations, and/or in-country briefings. However, as reported by Hartjes et al, 2009, 85% of students on study abroad programs report getting most of their risk management information from youth oriented guide books such as the Lonely Planet Guides and Rough Guides and only 9% cite their campus study abroad program materials as a resource for pre-departure information. Additionally, the study shows that students  tend to be under-informed about hazards abroad, under-concerned about them and overconfident in their abilities to manage them.

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Psychotropic Medications: How to Manage in Remote Programming

Back in 1980 I became a somewhat disillusioned psychology major at the University of Colorado when upon taking a cooking job in the local psychiatric hospital, I discovered that mental healthcare was all about psychotropic medications.

Ten years later at Outward Bound, instructors were having anxiety attacks when reviewing their students’ medical forms and seeing the prevalence of psychotropic medication use.

Since then I have worked in and with a variety of programs which operate in remote or international locales, all of which have wrestled with how to manage potential issues for students/participants who were taking a variety of psychotropic medications.

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Fire Safety Strategy in Low and Middle Income Countries

U.S. students going abroad come from an OSHA certified world where torte law ensures that anyone with potential responsibility for injury has a stake in preventing accidents. The big upside of this is that we have far fewer accidental deaths than we might otherwise. The downside is that our students have been deprived of the opportunity to develop the risk management skills necessary to navigate a goodly portion of the low and middle-income world.

I was in a typical Bhutanese hotel last year. There were 6 floors and only one stairwell winding around the one elevator. There were no fire escapes, sprinkler systems, smoke alarms, evacuation diagrams or fire extinguishers. There were candles and matches provided for guests in each room. When I visited the local fire department, it was apparent that their ladders would not reach beyond the third floor and they’d only have access to those windows that opened onto the street.

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Travelers’ Diarrhea: Data, Old Adages and Current Controversies

Have you ever held a condescending view of the adventurous eater who courts gastronomic disaster, only to be laid low yourself despite a religious adherence to “boil it, cook it, peel it, or forget it”?

Or are you the adventurous eater?

The old adage of boil, cook, peel, or forget it has persisted as the conventional wisdom since 1985 when the National Institutes for of Health issued the statement that “meticulous attention to food and beverage preparation can decrease the likelihood of developing Travelers’ Diarrhea (TD).” However, six of the seven studies that the NIH had available to them at that time, showed no correlation between the recommended food and water precautions and the likelihood of developing TD, so it is not surprising that the overall risk of acquiring TD has not decreased in 50 years. (Shlim, 2005).

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Managing Food Allergies in Study Abroad

I was sitting up with a visiting program affiliate, a syringe laid out on the table between us. She had come to my room and awakened me to say that she had a problem. She had a pronounced history of being allergic to nuts and at the buffet table she’d carefully reviewed all the ingredients of all of the dishes being served – except the salad dressing. Some 20 – 30 minutes after eating, she started to experience some unpleasantly familiar sensations.

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