4 ~ PREPARING FOR ano COPING WITHWhat Do I Do When Struck by Lightning? Maintaining Health in the Field In 1997 Shawn Wight, a gtaduate student at Ohio State University, died fol- lowing an emergency evacuation ftom a geological expedition in the Himals. yas. At 10,000 feet he developed symptoms of altitude sickness that worsened when the team ascended to 23,000 (Basinger 2001). After descending to 19,100 feet, Shawn’s conditions worsened and he developed a blood clot. Af. ter several days on the mountain, he was evacuated to Tibet and then evacu- ated to the Cleveland Clinic, where he eventually died due to an opportunistic infection. This unfortunate incident served as a wake-up call regarding the health and safety of students traveling abroad, although there is still a lack of consistency and little in the way of “best practices” for faculty-led research Projects, or students conducting independent research outside of organized Study-abroad programs. Despite the lack of established best practices, there are many aspects of health to consider when conducting research abroad. There is probably more information about travel health than any other aspect of international field research but many researchers and students still travel without taking Proper precautions. Yet, given travel health statistics, chances are good that field researchers will suffer from an accident or iliness while abroad (Ansart et al. 2005; Field et al, 2010; Hill 2000). Furthermore, many field-based researchers live and work in remote areas with limited ace cess to medical care. In her survey of anthropologists in 1986, Nancy Howell found that many anthropologists teported being greater than two hours 153154m CHAPTER 8 from the nearest hospital or doctor, yet few had good quality first aid kits or first aid training (Howell 1990). Only 67 percent of surveyed anthropolo- gists received immunizations prior to travel, although the percentages were much higher for those traveling to Latin America and Africa (Howell 1990). About half of the participants reported checking their health insurance to see whether it covered care abroad, yet only few had plans in place for emergency evacuation. Travel health insurance is likely more readily available to univer- sity students and professors today than at the time of Howell’s survey, and many universities have contracts that offer reduced rates to students and staff. At the same time, budget restrictions and university policies may limit reim- bursement for health precautions such as immunizations, medications, and travel medical insurance. Researchers may elect to limit their expenditures on personal health preparation due to such constraints. Graduate students are perhaps more likely to do so because of their budget limitations. _ WHY BE CONCERNED ABOUT YOUR HEALTH? Although we do not have reliable data that specifically enumerate the health risks encountered by researchers, the data collected on anthropologists by Howell, combined with travelers’ health statistics can provide some insight into the health risks. that field researchers can face, The travel medicine literature suggests that 20 to 70 percent of travelers experience health prob- Jems (Hill 2000; Winer and Alkan 2002; Redman et al. 2006; Freedman et al. 2006). The most salient health issues for people traveling to developing countries are diarrhea, respiratory problems, dermatologic and febrile ill- nesses (Hill 2000; Hagmann et al. 2010; Cossar, Allardice, and Whiting 2006; Chen et al. 2009; Winer and Alkan 2002; Redman et al. 2006; Schla- genhauf et al. 2010; Bhatta et al. 2009; Freedman et al. 2006). One of the strongest risk factors for illness is duration of travel. In one study, 80 per- cent of those who traveled for more than thirty days became ill (Hill 2000), These data suggest that most researchers conducting long-term research in low- and middle-income countries will eventually experience some kind of illness. Travelers to India report more illnesses than do those spending time in other regions (Hill 2000). Patterns of illness also vary by region. GeoSen- tinel clinics (2 global network of travel medicine clinics) report those with systemic febrile illness predominantly traveled in sub-Saharan Africa and Southeast Asia whereas those presenting with diarrhea were more likely to