1. Medical Team

As with the London to Cape Town rally there will be two team doctors and a paramedic:

• Mr Mark Human
• Dr Greg Williams
• Mike ‘Medic’ Johnson (not to be confused with Mike ‘Paparazzo’ Johnson, our official photographer)

Mike is a professional ambulance crewman and motorsport paramedic.

They will each be in one of the sweeper vehicles which follow the participants. These vehicles will also contain a fully trained mechanic, and be fully kitted to deal with both medical and mechanical "breakdowns".

On a journey of some 25 000 kilometres, much of it over difficult terrain, the biggest risk is a road traffic accident.

Due to the delays between the lead car and the sweeper vehicles, our medical support could be hours from any potential incident. Your vehicle could well be the next on scene. Because of this: -

• The emergency service network of the country we are in should be your first port of call in event of an emergency
• Contact details for emergency services in each country will be made available to you on a fact sheet.
• Emergency services will also be aware of our passage.

• All vehicles are required to carry a basic first aid kit and handbook to HERO specifications (see below)
• Each vehicle should have at least one person trained in basic first aid. We are providing an abbreviated first aid course on Friday 10^th August in Cambridge. At least one member of each crew at any one time must either have a first aid certificate issued in their own country, or have attended this course.
• Support crew contact details/procedures will be made available to you.
• All participants will be provided with a necklace identity badge that should be worn at all times in your vehicles, at controls and at official functions.
• The Inca Trail participants will all be covered by personal accident and emergency medical repatriation insurance for up to £50,000. This should be enough to cover repatriation by scheduled commercial flight, but not by private aircraft. Additional cover is available from HERO’s insurers – see separate information sheet.

• Prevention is Better than Cure.
• This trip is highly intensive and both physically and emotionally demanding - make sure you are fit and healthy before we leave.
• Lengthy travel like this weakens your immune system.
• Discuss medical conditions (including altitude) with your General Practitioner and ensure you have sufficient of your regular medication for the entire duration of the trip.
• Carry spare glasses / contact lenses.
• Dental repair kits are also an excellent idea.
• Get "First-Aid Wise".

Specific advice from MASTA (Medical Advisory Services for Travellers Abroad) is as follows: -

• Yellow Fever (live - subcutaneous injection)
• Typhoid (live - oral)
• Hepatitis A ? (intramuscular injection)
• Tetanus +-Diphtheria (booster - injection)

• Polio (live - oral)
• Meningococcal Meningitis

You will be extremely lucky to avoid this completely for the entire duration of the trip. Some general advice may help: -

• Stick to these guidelines on Water/ Food precautions
• Most hotel food should be safe but this is no guarantee, especially away from major cities and in poorer countries such as Bolivia and Peru
• Prefer freshly cooked hot foods
• Beware cold food handled in preparation and cold buffets
• Avoid uncooked egg dishes (e.g. mayonnaise)
• Avoid unbottled drinks and water (or untreated water) including ice in drinks. (Some people prefer to drink their beer/Coke straight from the bottle/can.)
• Use bottled water in your hotel room
• Unpeeled vegetables / fruit and tinned foods, which you have peeled or opened is generally safe.

• Mild diarrhoea is mostly viral and best treated by rehydration - flat Coke is good for this, but take a few sachets of Rehydrat or something similar.
• Blood / mucus in stool should be reported to one of the medics immediately, as should diarrhoea lasting more than 3 days, or more than 6 watery stools in 24 hours, as these probably warrant treatment.
• Remember the Imodium!

• Altitude sickness. Take this one seriously. The rally spends over a week above 10,000ft (3,000m), and goes up to 16,500ft (5,000m - higher than Mont Blanc in the Alps), as well as a couple of shorter spells at altitude. You can negate or minimise the effects by careful preparation over the preceding few days;

• Medication. Your choice really. We advise Diamox (Acetazolamide). It is taken in a 125 mg dose (half a tablet) an hour before bedtime from 24 hours pre-altitude, until we are back beneath 10,000ft. The rally days concerned are:

  - evening of Day 7 (Jujuy) to evening of Day 16 (Huancayo)
  - evening of Day 20 (Arequipa)
  - evening of Day 23 (Calama)

  Side effects are not uncommon and we are currently researching reports of alternatives. Coca tea is widely used in the Andes and has been found by our own advance teams to be beneficial but there is nothing in the medical literature about this.

  We will hold an advice seminar on the evening of Day 5 (Foz do Iguaçu).

• Motion sickness. Many rally navigators suffer from this. Most of those who do take a propriety seasickness remedy such as Stemetil (prochlorperazine 5mg tabs); some people use pressure-point wristbands which are commercially available.
• Hypothermia. The route includes some cold and exposed places. Have warm clothing and a lightweight survival blanket for each person.
• Sunburn/heat stroke. Pack the usual treatments (sunscreen, vaseline, after-sun lotion, etc), as for a holiday in a hot, sunny climate. Note that the sun is much more powerful at altitude - even at moderate temperature.
• Wildlife. Not a great problem. There’s little dangerous wildlife along the route, but don’t touch strange insects, reptiles or animals.

It is compulsory for all vehicles to be equipped with a standard medical kit that must contain at least the following equipment and medication. These kits will be inspected at Scrutineering.

• First Aid equipment
• Disposable gloves
• Gauze/cotton wool swabs
• Antiseptic solution - Savlon/Dettol etc.
• Bandages - crepe and triangular x 4 / safety pins / tape
• Dressings - Band-Aid selection / sterile wound dressings
• Scissors and tweezers
• Thermometer
• Medication
• Antidiarrhoeal - Imodium (Loperamide)
• Analgesics - Codeine + Paracetamol
• Anti-inflammatory - Ibuprofen
• Antihistamines - Piriton (Chlorpheniramine) or Phenergan (Promethazine)
• Antibiotics - Augmentin (Co-amoxiclav) or Ciprofloxacin or Zithromax (Azithromycin)
• Ointment - antibacterial - Bactroban/ Fucidin - antifungal - Daktarin / Clotrimazole

• Do I need to take antimalarials?
  

Malaria treatment is not recommended. Very little of the route passes through areas where malaria is endemic, and most treatments (such as Larium) are of uncertain value.

• Where can I get a first aid kit and medicines to "Inca Trail" specifications?
  

We are preparing both First-aid kits and kits complete with all medicines.These are available from Mike Johnson - see attached order form

MH/ma/26.07.01