What’s Holding Back Happiness In Russia?

February 8th, 2010 by Chrissy Donovan

If you are a regular reader, you know we’ve been hunting for happiness. But sometimes on our travels, if we look closely, we gain insights into deeply rooted cultural sources of unhappiness.

We recently introduced our Healthy Planet Index, a ranking of 141 countries that is based on a measure called happy life years—a combination of life expectancy and satisfaction with life.   For instance, in Costa Rica, life expectancy in 2005 was 78.5 years and satisfaction with life (on a scale of 0 to 10) was 8.5; we used these figures to create a Happy Life index value of 66.7, which tops the Healthy Planet Index. 

As we reviewed the results, one country that caught our eye is Russia.  With 38.1 happy life years, Russia ranks 91st.  Russia is 75th when our 141 countries are ranked by happiness and 97th when they are ranked by life expectancy.  The question is, what problems are behind these low figures?         

The answers are numerous.  A substandard system of medical care, the prevalence of tuberculosis (a disease of poverty) and overindulgence in alcohol are some of the bigger pieces to the puzzle.  Let’s take a closer look at alcohol.  Everyone knows the stereotype that Russians are heavy drinkers.  We did some research to see how much truth is in this generalization.  First, we’ll give you the numbers.  According to the World Health Organization in 2003, 10.3 liters of pure alcohol were consumed by each Russian person over the age of 15.  10.3 liters of pure alcohol translates into 580 shots (1.5 oz. drinks) of 80 proof vodka (and yes, we chose vodka because we‘re talking about Russia).  That’s an average of 1.6 shots per day.  It should be said that 10.3 liters was not the highest figure for a country in 2003.  In Ireland, which was at the top of the list, the average was 13.6 liters.  Russia is not the only place where lots of alcohol is consumed.  On the other hand, the situation in Russia is said to be even worse than the official numbers portray because of the large black market for alcohol.           

There is more to the story than these raw numbers, and it’s something visitors to Russia should heed:  alcohol in Russia is often consumed more dangerously than in other countries.  History books, newspapers, Russian officials and ordinary Russians all say the same thing:  Russians tend to drink in binges.  And, of course, they tend to drink vodka, a highly distilled alcohol.  This is the Russian way of drinking.  And it is the kind of drinking that can kill in the span of a night.   Bootleg alcohol that has toxic ingredients is not an uncommon thing in Russia.   All of these circumstances add up to a high rate of death due to alcohol poisoning in Russia.        

That’s nothing to take lightly; however, it’s the smaller, more sensational side of the story.  Much of the self-destruction from over-drinking takes more time to show.  We’re talking about heart disease, alcoholism, cancer, violence, weakened immune systems, lost days of work, to name a few.  These ills are the larger villains.

The bottom line? Russia’s problems with alcohol are real, not just stereotypical.   Russia is certainly not the only country that faces a struggle with booze (hint hint Western world). But misery with company is still misery.

Photo info:  http://www.flickr.com/photos/atbaker/ / CC BY 2.0
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Thin Air Way Up There: Take the Risks Seriously

February 5th, 2010 by Frank Gillingham, MD

If you are planning a mountain climbing, hiking, skiing or snowboarding trip, you may have your sights set on a high altitude destination such as the Peruvian Andes or the ski resorts of Colorado.  These destinations carry with them the thrill of a tingling physical challenge as well as the risk of developing altitude sickness (also known as mountain sickness).

Altitude sickness results from your body’s decreasing ability to absorb the oxygen necessary to convert nutrients to energy because of the thinning of the air as you ascend.   This change results in symptoms that can hit anyone regardless of his fitness level.  In fact, it often strikes younger, more fit members of climbing expeditions and may be less common in those over the age of 50. Tolerance to high altitude varies tremendously between individuals, and can vary from trip to trip for the same individual, though cold weather seems to worsen the effects.

Anyone with chronic medical conditions or a history of asthma, lung or heart problems should discuss travel to a high altitude destination with a physician well in advance of travel. Individuals who suffer from the following chronic medical conditions should never travel to high altitude destinations:

  • Chronic Obstructive Lung Disease (including Emphysema and Chronic Bronchitis)
  • Congestive Heart Failure
  • Sickle Cell Anemia
  • Pulmonary Hypertension

It is common for those visiting a high altitude destination to breathe more frequently and experience increased heart rate and pulse. Dryness of the skin and mucous membranes occurs, as does a minor headache. These are normal characteristics of a body adapting to high altitude.

Severe symptoms such as these, occurring within the first 36 hours at altitude could be indicators of the onset of altitude sickness:  

  • Extreme increase in breathing frequency, with shortness of breath and/or cough
  • Very rapid heart rate with palpitations, chest discomfort or a perception of pulses in the neck and head
  • Severe headache
  • Nausea and/or vomiting
  • Fatigue and sleeplessness

Severe cases of altitude sickness can result in death, so it should be taken seriously. Mild symptoms of altitude sickness can be treated with rest at a stable altitude and acetaminophen or other analgesic (pain medicine).  If symptoms persist for more than 24 hours, seek medical attention. If possible locate a physician who is experienced in high altitude medicine.  Descent to a lower altitude is crucial. Never ascend if your symptoms are getting worse.  Some physicians will prescribe medications such as dexamethasone and/or nifedipine prophylactically for travelers to high altitudes, but this practice is controversial. 

To avoid altitude sickness, allow your body time to adapt to the thinning air, stay hydrated and follow all the normal safe-travel tips.  Food poisoning, jet lag and other situations manageable at regular altitudes will be much worse in high altitudes.

Don’t be up in the air about taking care of yourself; make sure you are grounded with good information and preparation.  Otherwise, you may be grounded longer than you planned.

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Vaccination Recommendations for Travelers

February 5th, 2010 by Frank Gillingham, MD

In a recent Wall Street Journal post, Avoiding Illness on the Road, Dr. Phyllis Kozarsky, a travel health expert for the Centers for Disease Control (CDC), offered some good advice for travelers, particularly business travelers. 

In this piece Dr. Kozrsky correctly to advises those who are travelling overseas to get immunized, even if coincident with departure.  However, nascent travelers should be aware that protection is not immediate. In the case of the hepatitis A and B vaccines, for instance, full immunity cannot be guaranteed for everyone who receives the vaccine for at least one month.  Long lasting immunity requires a second vaccination anywhere from one month to one year after the first. 

According to the CDC, the only vaccine that is required by international health regulations is yellow fever for those travelling to sub-Saharan Africa and tropical South America. The CDC recommends that this vaccine be obtained at least ten days prior to arriving in an area where yellow fever is endemic.  In addition, the vaccine must be administered at an approved center that can provide the vaccinee an authentic “International Certificate of Vaccination”.  The yellow fever vaccine must be repeated at ten year intervals to remain effective.

Meningitis vaccinations are required in for those travelling to the “meningitis belt” across the middle of the African continent and parts of Saudi Arabia.  The vaccine provides protective antibodies after a week to ten days, with immunization lasting only three to five years.  There are vaccines for encephalitis, an infection of the brain, which must also be administered at least a week or two before travel in order to be protective. 

Those travelling abroad should consult with an infectious disease or travel medicine specialist at least one month prior to trip departure to insure adequate protection against infectious diseases.  Destination specific vaccination requirements can also be found on mPassport.com.

Photo info: http://www.flickr.com/photos/darwinwins/ / CC BY-NC-ND 2.0
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Health, Happiness and the Velocity of Life: Connecting the Dots Around the World

January 29th, 2010 by Mike Hartung

Our admittedly desultory investigation of comparative health and happiness around the world (Destination Happiness, Healthy Planet Index, and More Happiness Data) has been joined recently by New York Times columnist Nick Kristoff,  Freakonomics columnist Justin Wolfers and the staff at Glimpse magazine.

I don’t want to suggest that this line of inquiry is gaining urgency; on the contrary, I think the evidence is mounting that a key component of the health and happiness formula is a more leisurely pace of life. While Kristof and Wolfers highlight education and economic development, respectively, as “drivers” of happiness, the simpler, more fundamental factor may have been captured by Glimpse. Reporters polled their readership (students on international programs) to cull the Top 5 Health Tips From Abroad. Four of these tips clearly put the brakes on the American way of life: 1) Get out of the car, 2) Leave more time to eat, 3) Work less, 4) Nap more. And the examples of this lifestyle come from developed countries such as the Netherlands, Greece, Turkey and Spain.

Kristof taps two other important lines of inquiry we will pursue at our own pace: “environmental performance” and the “gender gap”. When we take the time to soak up our surroundings, it would be nice to find clean air, safe water and an abundance of tolerance. We think we’re starting to connect the dots. Do you think we are on the right track?

Photo info:  http://www.flickr.com/photos/48089670@N00/ / CC BY-NC-ND 2.0

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Headed for the slopes?

January 29th, 2010 by Moira Bishop

Does talk of the upcoming winter Olympics have you channeling your inner Lindsey Vonn or Shaun White? Skiing and snowboarding are great winter activities — fun meets fitness.  Regardless of where in the world you decide to visit to participate in these types of winter sports, there are some safety issues to consider:  protect your head and face, keep warm and know your own abilities and your surroundings. 

Protect your head.  Regardless of how well you ski or snowboard, there are other factors on the slopes that could cause a serious fall.  Other skiers, random patches of ice or just dumb luck can knock you down and knock you out. To limit the seriousness of injuries that you could sustain during such a fall, wear a helmet!

Protect your face. While you are outside on a mountain covered in snow, the elements are constantly attacking your skin. The wind and the sun can burn and dry out your face and lips.  Apply sunscreen to your face every few hours and lip balm as often as necessary.  The glare of the sun off the snow can be blinding, so wear sunglasses or goggles with UV protection.

Keep warm.  If you’re a strong skier or snowboarder, you might feel that the extra layers of clothing are cumbersome and limit your free styling ability.  However, frostbite could take you (or your hands or feet) off the slopes permanently.  Warm gloves, hats, long underwear and socks are remarkably thin and warm these days, so if you don’t like bulk, check out your local REI or ski or snowboard shop.  You want the layer of clothing closest to your body to be made of wool, silk or polyester.  These materials will wick the sweat away from your body instead of trapping it on your skin and making you feel colder.  Trails.com provides a realistic plan for layering that you might want to consult while planning what to pack.

Know your own abilities.  While you will likely challenge yourself during your outing, you don’t want to overdo it.  Going from the bunny slope to a black diamond is not safe, nor is it a good idea to leave your snowboarding lesson and immediately go attempt to perfect the Backside 720. Use your head and plan your progression based on realistic advances.   Regardless of how well you can perform in the snow, even the most talented of us can’t call for help while knocked out cold. So don’t ski or snowboard alone. Always go with someone who you can check in with at regular intervals. 

Know your surroundings.  Before you leave for your outing, do a quick survey of local hospitals or urgent care facilities.  If you do need to be taken for medical assistance, you’ll want to know you’re headed for the best treatment available.  (For a global database of hospitals, check out mPassport.com.) 

Have a great trip! Let us know how it goes.

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Mudslides in Machu Picchu

January 26th, 2010 by Moira Bishop

The heaviest rains to hit Peru in the past fifteen years have caused mudslides with serious consequences today — 4 people have been killed and 2,000 tourists have been stranded in and around Machu Picchu.

Reports from our contacts at Pardo Medical Center based in Cusco, Peru indicate that the heavy rain is not letting up and that is causing problems for transportation.  The trains are not running and the Cusco airport is closed until at least tomorrow, so the only way out is by helicopter.  The clinics are open for anyone who can get to them. 

Like many natural disasters, mudslides cannot be predicted.  If you are visiting or planning to visit a mountainous — or even just hilly — region that has recently experienced heavy rainfall or snowmelt, you may want to reconsider your plans.  

Ideally, you will never be in the path of a mudslide, but just in case, it’s a good idea to note these instructions from the Red Cross:

  • Quickly move out of the path of the mudslide or debris flow.  Moving away from the path of the flow to a stable area will reduce your risk.
  • If escape is not possible, curl into a tight ball and protect your head.  A tight ball will provide the best protection for your body.

Though you don’t want to spend time dwelling on worst case scenarios while preparing for vacation, a few minutes of planning can prove to be invaluable.

Photo info: http://www.flickr.com/photos/comprock/ / CC BY-SA 2.0
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Healthy Travel App Rap

January 26th, 2010 by Andy Orr

This post introduces a new weekly feature of the Healthy Travel Blog – App Rap.  Each week we will attempt to post about the latest travel apps that focus on health and safety.  It may not always be easy to find relevant information for this series, but this week is what some call a ‘no-brainer’, and I won’t even talk about the soon-to-be introduced iPad tablet from Apple.

Of course, the Haiti earthquake has been the big news ever since it first hit back on the 12th.  CNN recently reported about a survivor who relied on his iPhone while he was waiting to be rescued.  Aside from a phone’s normal functions, his iPhone had an app from Jive Media called Pocket First Aid & CPR that enabled him to treat his wounds with confidence.  He also used his phone’s alarm to wake him up every twenty minutes, as the app had warned him not to sleep if he was experiencing shock.  While there are other free apps that duplicate some of this information, this one is particularly comprehensive and well worth the $3.99 price.  It even includes the ability to load personal medical details for you and your family members.

In other news, I read about a free app from Dr. Sam Pejham called AsthmaMD.  While the features that allow users to log their asthma attacks, medications, and peak flow meter readings and then send them on to their physician are useful, I was most intrigued by its ability to aggregate data across users.  Because its data is real-time and location-based, this app can become an amazing source of data for asthma researchers.  Sure, it might be cool to receive a location-specific coupon on your phone as you walk past a store, but this app, along the lines of IBM’s “Smarter Planet” initiative, uses this data in much more significant ways.

Finally, in an update to our previous posts on mPassport, HTH Worldwide has launched its second destination, mPassport London.  By the end of March, there will be twenty destinations available!  London is currently free, so please download it, check it out, and let us know what you think.

We will be doing in-depth app reviews in the future, so also send us your favorite, and we will give you our take on it.

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Feeling SAD? Therapeutic options for deep winter blues include travel

January 26th, 2010 by Frank Gillingham, MD

Seasonal Affective Disorder (SAD), better known as “winter depression”, describes people with normal mental health who become depressed during the winter months.  Officially, it is a form of depression that seems to recur annually. The malady appears to be particularly prevalent among college students, many of whom spend long hours during the winter months secluded in poorly lit dormitory rooms or libraries. 

The symptoms of SAD mimic those of clinical depression: excessive fatigue, lack of sleep, a tendency to crave unhealthy foods such as sweets and starches, and even suicidal thoughts.  Academic or work performance may suffer and interest in outside activities or relationships may dwindle.  Occasionally people who experience SAD go on to develop major depressive disorder or even bipolar disorder if left untreated.  The likelihood of developing symptoms seems to increase in those who have also experienced the shock of living abroad in a cold, relatively dark climate, such as the U.K. or Scandinavia. 

It is little wonder that spring break is a popular concept.  By the time February and March come around, people of all ages are desperate for some time in the sun.  However, those who experience SAD can ill afford to wait until the first warm day of spring.  Apart from the usual medications for depression, seasonal affective disorder may respond to light therapy, including sunlight or the placement of bright lights, cognitive behavioral therapy (learning to overcome adverse thoughts or actions through conditioning), melatonin, and even negative air ionization, which involves releasing charged particles into the sleep environment. 

Recognition is the key to early intervention and successful treatment, so if you suspect that you or someone close to you is suffering from SAD, it may be a good time to plan a sunny vacation.   Check out cloud cover probabilities around the world month-by-month with an interactive map from NASA’s Earth Observatory to make sure you maximize your chances of catching the rays you need. Or use the map as a possible predictor of where SAD is most prevalent.

Photo by: http://www.flickr.com/photos/bob_august/ / CC BY-NC-SA 2.0

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Planning a winter road trip?

January 22nd, 2010 by Moira Bishop

Whether you’re planning a road trip in your own car or flying to a cold climate and renting a car this winter, you should assemble a winter emergency kit for your travels. In addition to the possibility of getting snowed in there is also a risk for getting stranded on the road.  Because we live in an area prone to snow and ice, my co-workers offer suggestions on what to keep in your trunk for your daily commute and road trips in the winter:

First Aid Kit/Flashlight/Flares – Include these items in your winter emergency kit, and keep them in your car through the rest of the seasons.

Blankets – You’ll want one if you get stranded in the cold somewhere due to an accident or a break down and your car loses power and can’t provide heat.

Boots, Gloves – These will be handy if you have to get out of the car for ANY reason, like walking to get help or if you drift off the road into a snow bank.

Snow Brush/Ice Scraper– Be prepared for whatever visible evidence of winter sticks to your car.

Shovel – Find one that is easy to store (with a short or retractable handle), you’ll find it useful if you get snowed in or plowed in anywhere.

Rock Salt/Sand/Kitty Litter – Put any of these items behind your tires to create traction to help you get out of slippery situations.

Jumper Cables – These are always a good idea, but are especially valuable in the winter when your battery may succumb to the freezing temperatures.

Portable Battery Charger - This is a step-up from just jumper cables; you can charge your battery without the help of another car.  Some models include an outlet so you can use it to charge your cell phone or other devices.  It’s worth the price because you can also use it to plug in small home appliances indoors if the power goes out.  

Windshield Wiper Fluid – Snow, ice and the dust from salt on the roads can constantly coat your windshield as you’re driving down the road.  Make sure that you have a full reservoir of fluid before you set out on your journey and bring a refill so you never have to worry about limited visibility on the road. 

Food and Drinks – Pack items like granola bars, cookies, or trail mix that won’t be affected by the extreme cold and will provide a fair amount of nourishment if you get stuck somewhere. Keep water in your car as well, it may freeze, but will melt eventually and will help you avoid dehydration.  

Did I forget anything?  Share your tips with us.

Photo by: http://www.flickr.com/photos/genista/ / CC BY-SA 2.0

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Notes from an HTH Physician in Port-au-Prince

January 15th, 2010 by Laura Hilton

Dr. Scott Nelson, a U.S. Board Certified Orthopedic Surgeon and HTH provider, has been practicing in Santo Domingo, Dominican Republic for several years.  In conjunction with CURE International, he is leading a team of Dominican orthopedic surgeons to provide  medical services to victims of the earthquake.  Dr. Nelson and his colleagues arrived in Port-au-Prince January 14th

January 20, 2010

FYI: the aftershock was a big one, but all is still ok with our CURE team!

January 19, 2010

Our team has done 75 surgeries so far at the Hôpital de la Communauté Haitienne. The entire CURE International group, from the headquarters all the way to the team on the ground in Port-au-Prince is organized and working well.

CURE has also facilitated an 18 person team from Texas to work at the Centre Hospitalier du Sacre-Coeur in Port-au-Prince. Due to the concern of aftershocks toppling certain sections of the hospital, additional ORs had to be created. This team divided an open room ER into 3 ORs; literally set up an OR in the hallway and also set up an OR using a radiology room. Overall, this team performed over 300 operations, including 40 amputations and more than 100 cast/splintings in just 48 hours.

Tomorrow and Thursday, CURE will be sending more than 25 medical, anesthesia, nursing and administrative professionals and a substantial amount of donated orthopedic equipment and supplies to further care for the Haitian people.

There are now hundreds of medical volunteers in Port au Prince – many independent, from a wide range of countries, organizations and backgrounds. There are now many medical supplies in at least 3 hospital sites in Port-au-Prince, where most of these volunteers are. There is no centralized coordination mechanism for administering medical care at this point in time – everyone is working together, working hard and doing everything they can.

January 18, 2010

The electric company of the Dominican Republic has donated a generator and a container, which the CURE hospital in Santo Domingo is filling with supplies and clean clothes for Dr. Nelson and the team.

In the last 48 hours, we were able to take the Hôpital de la Communauté Haitienne from an indescribable battlefield state, with almost no doctors and nurses and supplies, 2 ORs not doing surgery, and utter chaos…to over 100 foreign docs and nurses, 7 ORs, an ICU, stocked supply room and life-saving surgery 24 hours around the clock!

January 15, 2010

“The first hospital we visited was not equipped to do orthopedic surgery even under normal conditions. We then went to Hôpital de la Communauté Haitienne, a 75 bed community hospital in Freres near Delma. There are many orthopedic cases filling the parking lot and patio, as everyone is too scared to be inside a building.  We are mobilizing now.”

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