Health Care for worldtravellers Health Care Abroad
Caring for your employees is our concern Your company sends employees abroad to work. The more your employees travel, the greater the chance that something may go wrong. The risks to health are much higher abroad: risk of disease, but also of violence and accidents, in traffic or in the workplace. The local medical care provision may not be sufficient, because medicines, health personnel or adequate facilities may be lacking. The Travel Clinic at the Havenziekenhuis in Rotterdam has over 25 years experience in the provision of health care services for various international organisations in the Netherlands. We ensure that your employees can rely on the best medical help before departure, whilst abroad and on their return to the Netherlands. The added value which the Travel Clinic provides is based not only on unique knowledge but also on years of experience in the field of tropical medicine and of health risks to travellers. The whole world is our practice area, so we know all about local risk-situations, what preparations are therefore necessary and how best to respond in emergency situations. The Travel Clinic is open to your employees 24 hours a day, seven days a week and thus makes an invaluable contribution to the quality of the health and safety provision for your employees while they are abroad. Our services therefore underpin your own Duty of Care towards your employees. You are both morally and legally responsible for ensuring that all employees are given as much help as possible whilst abroad. The Travel Clinic can help with every aspect of this. Caring for your employees is as much our concern as it is yours. Perry van Genderen, Director Travel Clinic
The Travel Clinic and the Havenziekenhuis The Travel Clinic is part of the Havenziekenhuis (the Port Hospital) in Rotterdam. The Havenziekenhuis and Institute for Tropical Diseases in Rotterdam is one of the oldest port hospitals in the world. In addition to being a regular hospital, our specialists have specific expertise and knowledge in the field of tropical diseases and travellersâ€™ diseases. This expertise is put into practice in the Travel Clinic, which is renowned globally for its preventive care, teaching and scientific research.
Tabel of Contents Preface
Health Care for World Travellers
Health Care Abroad CVRM: Screening for cardio vascular diseases Medical audit
4 6 8
Safe and healthy working and living conditions Site Medical Centre Lost Time Injuries International Projects
In case of emergency
10 12 13 14
Good care close to home
Not only medical risks ...
â€œIt can often be the case that here in the Netherlands an individual experiences no health issues but does so under different circumstances abroad. For example, pain in the chest in warmer climates or at higher altitudes. That is why a thorough risk assessment, for example in the field of cardiovascular disease, is so important.â€? Dr. Perry van Genderen, internist at the Havenziekenhuis and director Travel Clinic
Health Care for World Travellers Health Care Abroad If your employees travel abroad, thorough and effective precautions should be taken. The Travel Clinic provides a comprehensive medical examination, a careful individual risk assessment and the necessary protective measures. This information is recorded in a central digital personal medical record. If necessary, a medical audit will be carried out to establish the current situation at the location. The Travel Clinic provides 24/7 support.
Medical examination Before your employee travels abroad we need to establish whether he or she is medically fit to do so. The Travel Clinic will invite your employee for a personal interview and physical examination. During this process, a record is made of the individual’s medical history and a doctor gives advice on diseases and the conditions the employee will experience in the country to which he or she is travelling. By means
of the physical examination, the doctor will assess whether or not the employee is fit to work in an area with specific local features, such as the climate, the level of accessibility and the quality of care available. The interview and examination are carried out by a doctor who has experience of living and working in the tropics.
“Cordaid sends employees to areas of conflict where health care is often limited and the risk of disease is high. At the same time, the health and well-being of our employees in these difficult working conditions is our top priority. We have worked with the Travel Clinic Havenziekenhuis for years and have learned through experience that by doing so we ensure the best possible medical support and care for our employees.” Jan Kees den Bakker, director of HR & Services, Cordaid
Components of Health Care Abroad
After a medical examination a follow up visit to the vaccination department is arranged so that your employee can receive all necessary vaccinations, tailored to the risks he or she will be exposed to in the area to which they are being sent and determined according to the activities they will be carrying out. If necessary, the employee will receive an official vaccination certificate, which lists all their vaccinations. This information is also stored in a central digital medical record.
For employees who regularly reside abroad, Health Care Abroad is a godsend. The main components of this package are: - adequate preparation and personal check-up - centralised digital medical records - consultation at a distance 24/7 - provision of medical care during leave - direct access to care - specific medical examinations and certificates such as the maritime certificate or the off-shore certificate
â€œ Effective preparation begins at home.â€?
This package is not the same for every person. A complete package will be put together, in consultation with you: the destination, the nature of the work, length of stay and the number of travellers all play an important role.
Information is always up-to-date thanks to the medical record The Travel Clinic maintains a central record with complete current information about all registered employees. This record is indispensable if your employee experiences health issues whilst abroad. The Travel Clinic enters all the results of medical examinations into its digital medical record. After each examination, we send a medical report (in English) to the employee and, on request, to the medical service and/or medical advisor. The information in the medical record is an essential part of medical care abroad. An up-to-date digital medical record for your employees is a high priority and must be accessible at all times.
Provision for all the family Employees who go abroad for longer periods often take their families with them. The whole family can therefore benefit from the Travel Clinic’s “Health Care Abroad” Service.
“ After each examination, we send a medical report in English” 6
Global Health Risk Assessment; Traveller, location, activity The Travel Clinic makes a personal assessment of the risks facing each employee who is travelling abroad. This assessment is made using the ‘TLA’ method. First and foremost is the Traveller, who may or may not have his or her own health risks. Is your employee healthy on departure or not?
This is the first factor we take into consideration. Then comes Location. Which diseases are prevalent at the location? What quality of healthcare is available? Is there pollution? What about road safety? This imformation is supplemented by consideration of the Activity. What sort of work will the employee be undertaking? And what implications does this have for his or her health? Will he or she be flying back and forth on a regular basis, or living abroad for a significant period of time? What are the living conditions at the location?
“ The Travel Clinic makes a personal assessment of the risks facing each employee who is travelling abroad”
CVRM: Screening for cardiovascular diseases More and more people in our country are at risk of cardiovascular diseases. Moreover the number will continue to grow, especially as people are working longer. Cardiovascular diseases are also the leading cause of death abroad. Therefore Cardiovascular Risk Management (CVRM) is an essential part of the services offered by the Travel Clinic.
People with cardiovascular diseases are at greater risk during a stay abroad because risk factors experienced abroad that can increase the risk of cardiovascular diseases. These include: - a different climate - the presence of tropical diseases - different food - labour-intensive work - the lack of acute care or the means of accessing adequate care quickly
Personal assistance A special CVRM programme has been developed for persons with an increased risk of cardiovascular disease. Such persons are supervised and treated by a nurse, a doctor, a dietician and/or a lifestyle coach. Guidance includes medication and lifestyle advice, for example concerning a healthy diet and sufficient exercise.
To provide guidance to your employees who are at risk of cardiovascular diseases, we have developed CVRM: Cardiovascular Risk Management.
â€œ Cardiovascular disease is the leading cause of death of Dutch people abroad.â€?
CVRM: for whom? After an analysis of the risk factors we can determine who would benefit from CVRM. CVRM is intended both for people who already have a cardiovascular disease, but also for people with an increased risk of developing one.
Medical audit: What standard of medical care is available locally? In case of emergency, your employees abroad will need to be able to be confident that effective local care will be available. Unfortunately, in practice, this is not always guaranteed.
A medical audit carried out by the Travel Clinic involves an assessment of the local medical care available. Doctors experienced in tropical medicine travel to the area where your project is to take place. They establish what risks exist and which diseases are known to occur in the area and they also check that the local medical aid posts and hospitals are adequate. They also check out the local arrangements for emergency health care and possible repatriation as well as establishing contact with the best trained local doctors. By doing so, Travel Clinic ensures that the best possible preparations are made at the location for all foreseeable eventualities.
“Working in a safe and healthy manner is part of our company’s culture. Through our cooperation with the Travel Clinic we are able to ensure the most effective health care of our frequent travellers.“ Nel van Gaalen, Occupational Health Officer CRODA
Quickscan Knowing the local situation Through many years of experience of medical problems and facilities abroad the Travel Clinic knows what issues you will have to deal with as a business operating beyond the Netherlands. We know what diseases occur in which countries - not necessarily in another continent; closer to home medical care facilities are not always up to the standard you would wish. With ‘Quickscan’ Travel Clinic can provide a company’s management with a clear picture of the health care issues its employees will be facing.
Abroad Safe and healthy working and living conditions The Travel Clinic can help ensure that your employees have safe and healthy working and living conditions while abroad in a variety of ways.
Remote Consultations 24/7 availability The Travel Clinic’s doctors specialising in tropical medicine are available 24 hours a day, seven days a week, to address any questions you or your employees may have about medical issues. During office hours you can ask your question by mail, fax or telephone. Outside office hours, the specialist in tropical medicine then on duty in the Havenziekenhuis is always available to answer your question.
The Travel Clinic has a worldwide network of health care providers and hospitals. Our services are not only available to employees who are sent abroad from the Netherlands, but also to partner employees so-called “global nomads” or “Host Country Nationals”. Via the Internet we can make an assessment of diseases and other ailments from a distance.
Malaria Self Test: Reliable diagnosis People who stay in areas where malaria is prevalent for a long time have a greater chance of being infected with this disease. Thanks to malaria prophylaxis the contracting of malaria can be prevented or the severity of the disease reduced. In spite of this, however, cases of the disease can still be much more severe for the traveller than for the local population. In practice, local protection against malaria is not always as effective as it could be. Therefore it is vital that your employees have access to adequate diagnostic facilities locally and to effective medication. The Travel Clinic uses a specical Malaria Self-Test, which can be carried out quickly and reliably by a health care professional. Because our experience tells us that high quality anti-malaria medication is not always available locally, the Travel Clinic ensures that your employees abroad always have access to such medication.
Chemical Exposure Up-to-date database ensures quick and effective response During the performance of their work your employees can unfortunately be exposed to harmful chemicals. The standard information available about the effects of these substances, and how to respond in an emergency, is often inadequate. Travel Clinic maintains an extensive database of potentially hazardous substances, supplemented by a plan of action in case of exposure to any one of them. We can adapt this database to meet the specific requirements of your company. Our database is available to your employees 24/7, so that in case of emergency immediate and effective action can be taken.
On-Site Medical Centre If local care is insufficient As an organisation you may be contracted to carry out a substantial long-term assignment at a location where the quality of medical care is seriously inadequate. In such a case, the Travel Clinic can assess the overall situation for you and, if necessary, set up an On-Site Medical Centre. One of the Travel Clinic’s own doctors and/or a paramedic will be deployed to work at the Centre. The doctor or paramedic from the Travel Clinic is then the first point of contact for your employees. He or she provides primary care in case of accidents, gives vaccinations and makes referrals if necessary. On some projects you may not only employ Dutch nationals but also other host country employees, so called “Host Country Nationals”. These persons can
also be covered by our Health Care Abroad programme. Medical examinations and training of personnel locally directly contributes to the prevention of illness, disease and accidents.
The Golden Hour If a serious accident occurs, action taken during the first hour - the so-called “Golden Hour” - is crucial. Such action can determine the long term prognosis of a patient. It is therefore vital that the initial care and response are of the highest quality. When the ‘Golden Hour’ is properly used, the patient’s chances of survival and recovery are at their greatest.
Lost Time Injuries Thorough assessment together with an independent medical report An accident at work which prevents an employee from performing his or her planned activities for at least one days work is called a Lost Time Injury (LTI). If one of your employees experiences an LTI, careful documentation is very important. In order to provide an expert assessment of LTIs, the Travel Clinic has developed a special programme that can be adjusted to meet the needs of your own organisation.
In the event of Lost Time Injuries it is important that the seriousness of the situation is objectively assessed. The Travel Clinic is independent and our company doctors make speedy, thorough, knowledgeable assessments of the reports of the LTIs explaining the nature of the injury and the associated loss of function. Using their knowledge of the field of work of the patient, the doctors can give him or her personal advice. If more detailed or follow up advice is necessary, a team of specialists is always available including internists, infectious disease specialists and nurses.
“ The Travel Clinic is independent and our doctors make prompt and knowledgeable assessments”
“ Wherever there is water you find Damen. Our engineers therefore face challenges worldwide. The reassuring 24/7 service we receive from the Travel Clinic is an ideal fit.” Marcel van Hemert, operations manager Damen Services
International Projects The Travel Clinic has carried out a large number of international projects including the establishment of on-site clinics and the performance of medical audits for a variety of clients over the years. The world map below provides an overview of locations where the Travel Clinic is currently, or has been, active. For more information about these and other projects, please get in touch with us.
Asia Europe / Middle East
Europe / Middle East
Asia / Australia
Russia, St. Petersburg
Democratic Republic of Congo
India, Kakinada India, Navi Mumbai
Russia, St. Petersburg
India , Kakinada
Papua New Guinea
In the event of emergency Fast and purposeful response In the case of an accident, epidemic or other emergency action needs to be immediate and appropriate. The Travel Clinic can provide your business with support in various ways.
Emergency Response Plan Risk Management tailored to your company As a center of medical expertise and an experienced business service provider, we specialise in risk management in the event of a serious epidemic. The Travel Clinic has gained a wealth of experience in this area, for example during outbreaks of SARS and
avian flu. In order to be able to respond appropriately to the outbreak of an epidemic Travel Clinic has developed a plan that can be adapted to the specific circumstances in your organisation: the Emergency Response Plan. Essential elements of this plan are a vaccination campaign, delivery of the medication and logistical support.
Asbestos Measurement provides clarification All exposure to asbestos should be avoided. Nevertheless it is possible that during their work your employees may come into contact with this harmful substance. Careful record keeping is extremely important. The Travel Clinic has developed specific policies for the complete documentation of where, when and to what extent the employee has been exposed to asbestos. The respiratory performance of the employee is then tested, using the most advanced pulmonary function and imaging techniques. All information gained is recorded and kept in the individualâ€™s personal file. Such records provide the necessary clarity about exposure and helps reduce anxiety. Long-term follow-up monitoring is also very important.
Medevac Assessing the actual circumstances
Repatriation Quick and responsible return home
If a medical evacuation is necessary, quick and effective action must be taken. The Travel Clinic can help. A Travel Clinic delegation will make a swift on the spot assessment of the situation. Based on its findings, the Travel Clinic then puts together a health plan so that you know exactly how to act in cases of medical evacuation or emergency. Through collaboration with our various partners, the Travel Clinic provides global coverage.
Quick and responsible return home In some circumstances local medical care is not sufficient and an employee needs to be repatriated. This must be done in a responsible manner; the safety of your employee should never be compromised. Over the years, the Travel Clinic has regularly advised and supported organisations during repatriations of their employees.
Dedicated care close to home People who work abroad usually return home at least once, sometimes several times, a year for holidays or short term leave back in the Netherlands. Because they are living abroad they often have no family doctor at home anymore and they may lack the network for referrals to specialist help. After returning to the Netherlands they can however turn to the Travel Clinic for any necessary medical support.
During periods of leave, your employees and their families can come to us for their vaccinations and medical check-ups. On return home they receive a complete medical check-up. This means their medical record can be kept up-to-date and the correct advice can be given if an individual needs medical attention later while abroad. Thanks to a complete medical check-up on returning home the individualâ€™s digital medical records remain up-to-date.
Logistical support Fast access to a specialist Your employees may need to see a specialist during their stay in the Netherlands. The close working relationships we have with the specialists at the Havenziekenhuis allow the Travel Clinic to provide the necessary logistical support very quickly. An appointment will be made with the relevant specialist as soon as possible - often during a very short stay - so that your employee can receive the appropriate
The Travel Clinic is HKZ and ISO certified.
consultation. In addition, we always try our best to arrange such a specialist appointment for the same day as the medical check-up.
Instant access to tropical doctors Sometimes employees return from overseas with medical complaints. Such persons can count on a direct referral to the Tropics Policlinic. Tests are then carried out to establish whether or not they have a tropical disease. The diagnosis is often made within a day and can lead to immediate treatment or further investigations as appropriate. The Travel Clinic is a general practitioner for the expat family. This means your employees and their families benefit from proper medical attention prior to departure, during their stay abroad and on their return to the Netherlands.
Not only medical risks... Employees of international companies often face more than just medical risks. The Travel Clinic has therefore been working with Expat Preventive, specialists in the field of international security, since 2014. Expat Preventive trains, advises and supports companies before, during and after the posting of their employees abroad by ensuring the following: â€˘ Proper preparation A security policy to manage security risks and enable appropriate response to the consequences of incidents and emergencies. Professional, hands-on safety training with emphasis on behaviour and awareness. Insurance (crisis situations). . â€˘
Good organisation on location Alarm Center for 24/7 emergency assistance. Operational support, and on the spot security assessments. Track & Trace via mobile phone.
â€˘ Debriefing & Aftercare Expat Preventive offers the possibility of monitoring, debriefing and if necessary counselling on return or after an adverse or unpleasant experience.
For more information, please contact the Travel Clinic or visit the website: www.expatpreventive.com
Copyright 2014 Travel Clinic Havenziekenhuis | Text: Sacha text & PR and The Travel Clinic | Design: De Jongens Ronner, Rotterdam Photography: Rick Keus, Travel Clinic and Menno Boermans
Duty of Care The services provided by the Travel Clinic benefit not only your organisation as a whole but also the individual business traveller. If a problem arises with one of your employees abroad the Travel Clinic can help you discharge your Duty of Care towards him or her. The health and welfare of your employees is as much our concern as it is yours.
Benefits for the employee: • Fitness for Duty • A personal approach • Ensuring good health • Motivation • Dutch-speaking doctors • 24/7 accessibility • A medical safety net
Benefits for the employer: • Cost effectiveness • Continuity of operations • Enhanced Corporate Social Responsibility and assistance in discharging your Duty of Care • Advice QHSE • Central control • A reliable partner
For more information about the services offered by the Travel Clinic please contact: Ingrid Rombouts, Manager Travel Clinic Tel: 010 - 404 33 39 firstname.lastname@example.org Maarten Molhoek, Marketing and Communications Tel: 010 - 404 36 03 email@example.com
Travel Clinic Havenziekenhuis Haringvliet 72 3011 TG Rotterdam www.travelclinic.com Havenziekenhuis & Institute for Tropical Diseases Haringvliet 2 3011 TD Rotterdam Tel: 010 - 404 33 00
Health Care Abroad