The Traveler
 

Issue: May 2017

An informational bulletin on security, medical, and travel related issues
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Security

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Health
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Travel

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Regional Information

Africa - East Asia - Europe - Near East - South Asia - Western Hemisphere

 

Electronic Device Ban on Specific U.S. - and U.K. - Bound Flights


On March 21, the United States and the United Kingdom announced new security measures prohibiting airline passengers from carrying large electronic devices, including laptop computers, in their carry-on luggage on flights from several Middle Eastern destinations to the US or UK. According to multiple credible, but unconfirmed, media reports, the new security measures were triggered by intelligence that an Al-Qaeda-affiliated terrorist group has developed bombs that can be disguised as batteries for electronic devices. The ban is unlikely to remain in its existing form in the long term, due to its inconsistencies, inconveniences, safety concerns, and questionable effectiveness. However, authorities in the US, UK, and other countries are likely to implement new security screening procedures for large electronic devices that will mitigate the threat behind the electronics ban while still allowing passengers to take their devices onboard with them. 

The measures will effectively prohibit passengers from carrying on any electronic device larger than a smartphone. The US has not specifically identified the maximum size for a smartphone, while the UK has stated that smartphones will only be allowed in carry-on luggage if they are smaller than 16 cm (6.3 inches) long, 9.3 cm (3.7 inches) wide, and 1.5 cm (0.6 inches) deep. For comparison’s sake, an iPhone 7 Plus is 15.8 cm (6.23 inches) long. If travelers have questions about specific items, they should contact their airline before traveling. 

What airports are affected?

The US security measures specifically apply to flights to the US departing from the following airports: 

• Queen Alia International Airport (AMM) in Amman, Jordan 
• Cairo International Airport (CAI) in Cairo, Egypt
• Ataturk International Airport (IST) in Istanbul, Turkey 
• King Abdul-Aziz International Airport (JED) in Jeddah, Saudi Arabia 
• King Khalid International Airport (RUH) in Riyadh, Saudi Arabia
• Kuwait International Airport (KWI) in Kuwait City, Kuwait 
• Mohammed V Airport (CMN) in Casablanca, Morocco
• Hamad International Airport (DOH) in Doha, Qatar 
• Dubai International Airport (DXB) in Dubai, United Arab Emirates
• Abu Dhabi International Airport (AUH) in Abu Dhabi, United Arab Emirates

Outside of Israel, no other airports in the Middle East/North Africa region have direct flights to the US.
The UK security measures apply to all UK-bound flights departing from Egypt, Jordan, Lebanon, Saudi Arabia, Tunisia, and Turkey. Unlike the US measures, the UK measures do not apply to Morocco, Qatar, or the UAE. Tunisia and Lebanon are included on the UK list but not the US list, as these countries have direct flights to the UK, but not the US.

What is the reason for the measures?

The US Department of Homeland Security (DHS) has stated that the new security measures will be implemented because “evaluated intelligence indicates that terrorist groups continue to target commercial aviation, to include smuggling explosive devices in various consumer items.” The DHS has stated the measures were not a response to a specific terrorist plot.

Media reports have suggested that the new measures are related to intelligence that Al-Qaeda in the Arabian Peninsula (AQAP) has developed bombs that can be disguised as batteries for electronic devices. These media reports have not been officially confirmed. AQAP has been responsible for several previous bombmaking innovations, including placing a bomb in an attacker’s underwear in a failed attempt to down a flight from Amsterdam to Detroit in 2009, and placing two bombs in printer cartridges in 2010 in an attempt to attack two US-bound cargo planes. While both of these plots failed, they demonstrate the credibility of reports that AQAP has developed new types of bombs to attack commercial aviation.

After the new measures were initially announced, several media sources and commentators raised the possibility that the new US measures may have been motivated partly by political concerns instead of security concerns. The UK’s adoption of the security measures and subsequent reports of the battery bomb intelligence have indicated that such allegations are likely unfounded.  

When will the new measures take effect and how long will they last?

The US formally notified airlines of the new measures early on Tuesday, March 21, and gave the airlines four days to comply. The UK did not provide a specific deadline in its public announcement for the new measures. Qatar Airways and EgyptAir said they would enforce the new measures starting March 24, while Turkish Airlines and Emirates have said they will do so starting March 25. Other airlines will likely begin enforcing the measures around the same dates. Travelers should contact airlines if they have any questions regarding whether the measures will be in effect for their flights.
The US DHS has stated that the procedures will “remain in place until the threat changes.” The UK has not provided an end date for its increased security measures.

If the reports of AQAP developing battery bombs are true, the new security measures will likely remain in place until security officials can develop new screening methods to detect bombs disguised as batteries in large electronic devices, and implement those methods at existing security checkpoints. At that point, the prohibitions on carrying large electronic devices in carry-on luggage will likely be lifted and replaced with enhanced screening at airport security checkpoints. 

The US or UK may remove individual countries or airports from their respective lists of affected airports and countries if they demonstrate that their security measures are capable of detecting the devices that AQAP has allegedly developed. 

How will the new measures be enforced?

The US and UK will largely leave enforcement in the hands of the affected airlines. Neither the US nor UK conduct security screenings on foreign soil, although the US operates a customs pre-clearance facility at Abu Dhabi International Airport (AUH). 

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Evacuation Types and Common Procedures


There are three primary situations that may call for an evacuation while traveling abroad – a medical emergency, a natural disaster, or a deteriorating security event. Each of these evacuation types may entail a slightly different procedure and planning requirements. Typically, a traveler is either evacuated to the nearest qualified medical facility, known as an in-country evacuation, or is repatriated, returned to his or her country of origin. Less commonly, a situation may require that a traveler is evacuated to a neighboring country. 


The type of evacuation and particular situation also determine who is conducting the evacuation. In countries with adequate emergency response services, such as local law enforcement or emergency medical personnel, these groups will typically carry out evacuations in the event of a medical emergency or natural disaster, and sometimes during dangerous security situations. However, for security-related evacuations, local governments may provide some services but are not to be relied upon, as securing government officials, facilities, or local nationals is often their top priority. 

While a traveler’s embassy or consulate may be able to facilitate an evacuation or help with the process, most governments urge their citizens not to rely solely on them for emergencies or evacuations while abroad. For security evacuations, a traveler’s government may conduct evacuations or provide airlifts from a commercial airport, but their response times and availability is contingent upon the situation.

In more remote locations with inadequate emergency response services, a third-party provider is likely the best option. Third-party evacuation providers employ pilots, emergency medical technicians, physicians, and specially trained security personnel, often military veterans, who are well-versed in conducting emergency evacuations. Their nationality and language proficiency may vary, but most will also speak English. 

Medical Evacuations

Medical emergencies are the most common reason a traveler may require evacuation. Many countries have non-obligatory healthcare, meaning that medical treatment or a patient’s release from the hospital is contingent upon his or her ability to pay for incurred expenses. Different countries take varied approaches to non-obligatory healthcare, and policies regarding the provision of emergency care prior to payment varies not only by country but also by hospital or locale. Even in emergency situations, responders in a country such as Nigeria may not provide treatment until the patient proves his or her ability to pay, which is often accomplished by showing responders a valid insurance card or by having the insurance company send a guarantee of payment. While one hospital may require a guarantee of payment prior to emergency treatment, another hospital may not. As such, knowledge of a destination’s health infrastructure and policies is essential. 
In a country with obligatory healthcare, adequate emergency response services, and qualified medical facilities medical evacuations are typically carried out via ambulance or a hospital’s helicopter, taking the patient to the nearest qualified hospital in timely fashion. In a more remote location, even in some countries with obligatory healthcare, travelers may require proof of the ability to pay or a third-party evacuation provider, and evacuations can often take several hours or more than a day depending on the terrain. 

In the event that there is not a qualified medical facility nearby, evacuation to a neighboring country or repatriation to the traveler’s country of origin may be necessary, often making the medical evacuation procedure more complicated. A traveler will likely need to have his or her travel documents, such as a passport and visa, on hand. If the traveler does not have the required travel documents, the local embassy or consulate may be able to process emergency documents or facilitate travel without documentation. A traveler’s medical condition will often determine how and when he or she returns to the country of origin. This often requires a doctor clearing the patient for travel or having a physician travel with the patient on a commercial airline. Depending on the traveler’s medical condition and proximity to a qualified medical facility, a private airplane equipped with an onboard Intensive Care Unit may be necessary.

Evacuations after Natural Disasters

Evacuations due to natural disasters are generally far more complicated than those for medical emergencies. Natural disasters can put a massive strain on local emergency response services, leaving those who are not in critical condition waiting for hours or days to be evacuated, often making a third-party provider the best option for ensuring a traveler’s safety. In the event of a natural disaster, such as the devastating earthquake in Nepal in 2015, local emergency response teams will deploy to the area, establishing a triage center and evacuation staging area. The medical teams will prioritize patients based on the severity of their injuries and will attempt to instruct others where to go. When a natural disaster compromises the structural integrity of nearby buildings, those who are not in critical condition are often left to wait in temporary camps or tents until they can be evacuated. In the aftermath of the earthquake in Nepal, hundreds of individuals were stranded in temporary camps for days before being evacuated. 

A third-party evacuation provider can often expedite this process and may be able to get the traveler to safety well before local services could. If communication infrastructure is also compromised, local emergency teams will often provide satellite phones or help individuals facilitate private evacuations. Once in contact, the evacuation provider will give the traveler instructions regarding pick-up times and locations or any other pertinent information. The first priority is to get the traveler to a safe location, which may or may not mean returning to his or her country of origin. Injured travelers who require immediate attention will be transported to the nearest qualified medical facility. Those without injuries or with injuries that do not require immediate attention are often transported to a nearby airport or airstrip, where they can then be transported to a hotel to await a commercial flight home.

Security-related Evacuation

Evacuations due to deteriorating security are the most complex and the most likely type of evacuation to require a specialized third-party provider. In the event of civil unrest, military conflict, or terrorism, travelers are often unable to travel to the embassy or commercial airport without compromising their safety. As previously mentioned, a traveler’s embassy or consulate may be able to help facilitate evacuations but should not be relied upon as the only option because security events put a massive strain on their resources. For instance, during the Arab Spring in Egypt, the US State Department provided airlifts for hundreds of US citizens, but even more were left waiting for several days before they could be evacuated. Furthermore, many had to arrange their own travel to the airport or to the embassy, where they were later transported to the airport. 

Embassy personnel or a third-party provider will instruct individuals on the best course of action based on the security situation. This often entails sheltering in place or carefully moving to a secure location. If the provider has security personnel in the area, the stranded individuals will often be taken to a designated safe house until an air evacuation can be made or until secure ground transportation can escort the travelers to an embassy, airport, or other secure location. As with the other types of evacuations, travel documents are typically required to be on hand, though local embassies can often process replacement documents in the event they have been lost, stolen, or left behind in a location where retrieval would be hazardous.
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This Summer, Be on Alert for Insect-Borne Diseases


Bugs such as mosquitoes, ticks, and some flies can spread diseases including the Zika Virus, Dengue, Lyme disease, or Malaria; many of which cannot be prevented or treated with a vaccine or medicine. 

When traveling in the northern hemisphere, spring and summer are the peak seasons for bug bites, therefore extra caution should be used from April to September. When traveling to southern countries, be on alert no matter the season as continued warm and humid weather conditions favor insect population growth.

Before you travel, find out what types of insects are found at your destination and whether they can cause health issues. To help you identify the risk of insect-borne diseases, also known as companion vector-borne diseases (CVBD), the CVBD World Forum created a World Occurrence Map listing the diseases and their vectors for most countries in the world.



To minimize the risk of contracting an insect-borne disease, you should always take protective measures to avoid insect bites and prepare for your trip accordingly:

Ask your doctor if appropriate preventive vaccines and/or medications exist.
Research the peak biting times (e.g. day vs. night) and areas at risk (e.g. indoors vs. outdoors, rural vs. urban) and plan activities and itinerary accordingly.
Use insect repellents that contain DEET for protection against mosquitoes, ticks and other flies (use repellents with up to 50% DEET for adults and up to 30% for children. Do not use DEET-based repellents for babies under two months). Repellents without DEET may protect against mosquitoes but will not be effective against ticks and other bugs.
Spray insect repellent on your clothes, even if your skin is covered. Some insects such as the tsetse fly can bite through clothing.
Cover exposed skin as much as possible by wearing long pants, a long-sleeved shirt and a hat. Tuck your shirt into your pants and your pants into your socks.
Sleep under a mosquito net and cover your children’s stroller with netting.
Use air conditioning and avoid opening windows without screens.
Avoid areas with stagnant water (e.g. lakes, swamps) where mosquitoes are proliferating. 
Avoid walking in wooded and brushy areas with high grass where ticks are most commonly found. 
Check for ticks every day and follow proper instructions for tick removal.

If you are experiencing symptoms such as fever, rash, unusual fatigue, joint or muscle pain, vomiting or diarrhea after being bitten, consult a healthcare provider immediately. If you are currently traveling, call Assist America with your reference number at +1 (609) 921 0868 (international) or +1 (800) 304 4585 (U.S. only) for a medical referral near you.

For more specific information concerning the on-going Zika threat, read our most recent Zika report.

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From the Assist America Case Files


Congestive Heart Failure in Wisconsin


Situation: A member living and working in Abu Dhabi for the last 15 years suffered acute congestive heart failure and chronic respiratory failure while visiting friends and family in the United States

Services Provided: Medical monitoring, medical escort, medical repatriation, hospital claim assistance through ClaimAssist



Diane*, a U.S. professor leaving in the United Arab Emirates for the last 15 years, was visiting friends in Wisconsin when she began feeling very weak and had trouble breathing and moving. She immediately went to the hospital where local doctors diagnosed her with congestive heart failure and chronic respiratory failure. 

Her health insurance provider informed Assist America about her condition and our medical coordinators started monitoring her care and treatment in Wisconsin. After seeing a cardiologist and a pulmonologist, Diane was given medication and it was decided that she would be able to seek further treatments upon her return home. 

Once the local treating physicians cleared Diane for air travel, Assist America worked with travel authorities and airline carriers to get the necessary paperwork and approvals for Diane’s medical repatriation which required installing specific in-flight oxygen support. Once all administrative requirements were fulfilled, Assist America arranged and paid for Diane’s repatriation back to Abu Dhabi with a nurse and a physician and ground transportation at both ends.

Diane was able to return home safely and start pulmonary treatment. When Assist America’s coordinators called Diane to follow-up on her recovery, she advised the trip was very smooth and told our coordinators she was looking forward to getting back to her students at the University. 

*name changed for privacy
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The Best Airport Experiences in the World


With a record number of 3.7 billion passengers flying on commercial airlines in 2016, there is no doubt that airports are an inherent part of travel. Airports all around the world are looking into new ways to attract and satisfy these billions of passengers and improve their experiences as they go through terminals. We selected some of the coolest things you can experience in airports should you spend a few hours waiting for your flight. 

Canine therapy in Denver

Getting to the airport on time, remembering your IDs, dropping off bags, going through security checks, finding your gate… all these aspects of air travel can create anxiety and stress for passengers. Denver’s airport understood that quite well and launched an unexpected stress relief program which we find quite adorable. In late 2015, the airport launched the Canine Airport Therapy Squad, CATS (no pun intended?), which allows passengers to pet and cuddle therapy dogs. Many other airports in the U.S., including airports in Newark, LA and San Francisco, have implemented similar initiatives. 

You can check out Denver’s Canine Squad on the airport's website


 
Gaze at the stars while waiting for your flight in Tokyo

At the Haneda Tokyo Airport, travelers can stop for a coffee, a quick bite to eat or a space-inspired cocktail while gazing at 40 million stars in the café’s planetarium dome. The projections feature constellations from different seasons and programs exclusive to the Haneda Airport. 


 
A lay-over in Singapore feels like a mini resort vacation

Singapore’s Changi airport has received many “Best International Airport” awards thanks to its continuous upgrades and renovation, making the airport a non-stop entertainment hub. Here is a list of some of the activities passengers can experience in the airport: 

12-meter high slide, the tallest slide in Singapore 
Rooftop cactus garden
Butterfly garden, housing over 1,000 tropical butterflies
Two free 24h movie theaters 
Rooftop swimming pool and jacuzzi 
Entertainment deck where passengers can enjoy various video games
And much more!

Our suggestion, if you are stopping in Singapore, you have to get a flight with a few hours layover!
 



Surf before you fly in Munich’s airport

Not many people know this, but despite being many hundreds of miles from the nearest shore, Munich happens to be quite the surfing hotspot, offering one of Europe’s best river waves. Each day, about one hundred surfers take a dip into Munich’s Eisbach River to surf the river’s famous wave.   

Embracing its surf hotspot status, Munich organizes a yearly Surf & Style event which lasts for about 5 to 6 weeks. For the occasion, the world’s biggest man-made wave pool is installed between terminal 1 and terminal 2 and welcomes travelers for free beginners sessions (pre-reservation required).  For more advanced surfers and those who have a few days to spare, a three-day surfing camp with an Urban Surfing Champion is available for only $20. If you would rather stay dry for your flight, you can grab a drink and a seat at the beach bar next to the pool. Finally, the airport also hosts the European Championship of Stationary Wave Riding. The dates for 2017 have not been announced yet, but we will surely keep you posted!


Have you ever been in an airport which offers fun and original activities to passengers? Share your experience with us on Twitter by tagging us
@AssistAmerica and using the hashtag #AirportFun


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Summer Travel: Beat the Most Common Summer Hazards




The summer days are finally upon us: kids will be out of school, work should be slowing down, and the weather will get significantly warmer! As people start to enjoy the outdoors and more adventurous activities, hospitals and urgent care facilities are bracing themselves for the summer, also called by the healthcare industry the “trauma season.” Emergency rooms usually see the number of injuries and trauma double compared to the winter months. The most common causes of injuries during the summer include car accidents, severe sunburn, water-sports, dehydration, heat exhaustion, and falls.
 
Although, everyone should enjoy their summer vacation to the fullest, it is easy to minimize the risks of summer hazards by following preventive tips which will keep you and your family safe and healthy:
 
To avoid dehydration, drink plenty of water or beverages high in electrolytes. Avoid excessive consumption of alcohol and caffeine, as both are considered to be diuretics. Eat fruits and vegetables which contain a lot of water such as grapefruits, peaches, eggplants and spinach.
To avoid sunburn, apply sunscreen containing appropriate level of SPF. Stay in the shade during peak hours (11 a.m. to 4 p.m.), cover your skin and wear a hat if you are exposed. Keep children in the shade as much as possible.
To avoid heat exhaustion and heatstroke, do not engage in physical activities during the hottest hours of the day. Get acclimated to the hot weather by slowly increasing the amount of time you spend outside. Again, hydrate as often as possible.  
To avoid water-related injuries, always be with someone else when engaging in water sports and follow the lifeguard’s instructions. Get acclimated to the difference of temperature between outside and in the water. Do not consume alcoholic beverages prior to water activities.
To minimize the risks of car accidents, make sure all car maintenance is done before departure. Allow plenty of time to arrive at your destination and drive during off-peak hours. Stop every 100 miles or 2 hours and if possible, take turns with a passenger. 

Sometimes, even for the most careful traveler, accidents, illness and injuries cannot be avoided. If you find yourself injured or sick, remember that Assist America is here to help. Simply give us a call at +1 (609) 921-0868 (international) or +1 (800) 304-4585 (U.S. only) and have your reference number ready. 

You can also download our FREE Assist America Mobile App from which you can access your membership details, ID card, list of our services and call our medical coordinators from the tap of a button. Click below to download the app:

Iphone Store
Google Store 

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Regional Information

For the latest, up-to-date information regarding key regions, click on the links below:

Africa

 

East Asia

 

Europe

 

Near East

 

South Asia

 

Western Hemisphere

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For more information, contact Assist America at the number on your membership card, or via e-mail at services@assistamerica.com.
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Other sources:

http://www.itb-berlin.de/media/itb/itb_dl_all/itb_presse_all/World_Travel_Trends_Report_2016_2017.pdf

https://www.cdc.gov/niosh/topics/outdoor/mosquito-borne/default.html

Interested in learning more about Assist America? Please visit us at www.assistamerica.com. Tell a fellow traveler about the newsletter and show them how to subscribe online! Interested in having your organization becoming a member of Assist America? Please e-mail us at sales@assistamerica.com.
The content of this edition of AssistAlert is for informational purposes only and is not intended to replace further investigation or personal observations. If you are planning travel, or are traveling in or proximate to the locations identified in this newsletter, you are encouraged to contact SecurAssist for additional information.


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