BMA Consultants and Junior Doctors to Strike in England
North & Central America
On 15 September, the Dominican Republic closed its entire border with Haiti due to an ongoing conflict over the construction of a water channel from a shared river, the Massacre River. The Dominican Republic has accused Haiti of violating a 1929 treaty by building the canal without its consent. On the other hand, Haiti has argued that the canal is necessary to irrigate its farmland and provide drinking water to its people.
The Dominican Republic has said that the border closure will last "as long as necessary" until Haiti agrees to stop construction of the canal. However, it is unclear how long this will take. The border closure includes all land, sea, and air routes.?
The existing State of Emergency (SoE) in El Salvador has been further extended until at least 13 October. The state of emergency was initially declared in March 2022, following a wave of gang-related killings. The government has since extended the state of emergency on several occasions, arguing that it is necessary to continue to crack down on gangs. The state of emergency gives the government additional powers to detain people without a warrant, suspend certain constitutional rights, and increase the military's presence on the streets. Be alert and vigilant about your surroundings. If you are travelling in El Salvador, follow the advice of local authorities.
Hurricane LEE made landfall on Long Island, Nova Scotia, Canada, on 16 September with maximum sustained winds of 70 mph. The storm moved across eastern Canada on Saturday night and Sunday, bringing heavy rains, strong winds, and coastal flooding. In the United States, LEE caused damage in Maine, where a man was killed when a tree limb fell on his vehicle. The storm also caused power outages and flooding in New Hampshire and Massachusetts.
South America
An unusually high number of people with meningitis have been reported in the state of Alagoas, specifically in the capital city of Maceió. Most of the cases (23 out of a total of 29) resided in Maceió. Almost one-third of the infected people (11 cases) have died from their infections. The risk of exposure for the general traveller will vary from place to place, but it may be high in some localities. Travellers to Maceió can reduce the risk of exposure to meningitis by obtaining vaccination against meningitis prior to travelling in the outbreak area.
On 12 October, the fourth "Taking of Lima" protest will be held in the capital city of Lima. The mass protest is being organized by social organizations from 24 regions of Peru. Protesters are demanding the resignation of President Boluarte, the closure of Congress, and the release of former President Pedro Castillo. The protest is expected to be large and disruptive. Organizers, which include trade unions, peasant groups, and indigenous organizations, are calling on people from all over Peru to travel to Lima to participate. There is a risk of violence and transportation disruptions. Travellers to Peru should minimize safety risks by avoiding large gatherings, as they may become violent unexpectedly.
Middle East & Asia Pacific
The state of emergency in Papua New Guinea has been extended until 30 September, due to the ongoing fuel shortages in the country. The emergency was initially declared on 31 July and was set to expire on 30 August. Travel disruptions are expected to continue in Papua New Guinea due to the fuel shortages. Flights may be cancelled or delayed, and public transportation may be limited. Travellers should check with their airline or tour operator before travelling to Papua New Guinea.
People infected with scrub typhus have been reported in the district of Bargarh in Odisha and in the district of Shimla in Himachal Pradesh. At least five people have died from this infectious disease. In Shimla, 295 out of almost 1,000 people who were tested were positive for scrub typhus. The risk of exposure for the general traveller depends on individual activities. This illness is transmitted by the bite of infected mite larvae (an insect).
During the wet season, these insects are usually found in tall grass and other vegetation. If diagnosed early, it can be successfully treated with readily available antibiotics. Travellers can reduce the risk of exposure to scrub typhus by taking all necessary precautions to avoid mite larva (insect) bites, especially if hiking or camping in rural areas. If symptoms develop after mite bites, seek medical care at once.
领英推荐
Overall, in 2023, 301,353 cases of malaria have been reported in the province of Sindh. The first death due to malaria in this province has been reported in the Tharparkar area. In this region, 186 cases of malaria were reported in one day. Malaria infections have also been registered in Karachi.
All travellers to any region where malaria transmission is occurring can reduce their risk of exposure by taking all necessary precautions to avoid mosquito bites, e.g., use mosquito repellent and sleep under insecticide-impregnated bed nets whenever mosquitoes are present. Anti-malaria medication is recommended. Talk to your doctor about which malaria medication you should take.
Europe
British Medical Association (BMA) consultants and junior doctors in England will strike on 19-21 September, demanding better pay and working conditions. A minimum level of care services will be available. After the consultant strike, junior doctors will escalate their strike to a full walkout from 21-23 September which may impact medical and emergency services. Related demonstrations are possible. Patients should check with their healthcare provider to confirm appointments and be prepared for delays and disruptions.
An unusually high number of people infected with tularemia has been reported by the Public Health Agency of Sweden (Folkhalsomyndigheten). So far this year (2023), 208 cases of tularemia have been diagnosed in 14 regions of the country. The most affected areas include the regions of V?sterbotten, G?vleborg, Dalarna, and Norrbotten. The outbreak is expected to increase in the coming weeks, but it is usually limited to specific risk areas.
The average traveller is at low risk of becoming infected with tularemia. In areas where transmission is occurring, hunters, game wardens, trappers, and campers may be at higher risk. Preventive measures include using insect repellent, wearing long pants, rapid removal of ticks, and not disturbing dead animals. Hunters should use face masks when skinning animals that may be infected. There are no safe, available, or approved vaccines against tularemia.
On 18 September, farmers and agricultural processors affiliated with several associations will begin an indefinite nationwide protest to demand the extension of restrictions on the import of agricultural produce from Ukraine. The farmers demand that the ban on imports of wheat, corn, sunflower, and rapeseed from Ukraine be extended and that a new ban be imposed on imports of unrefined oil, dried milk, fresh and frozen fruit and vegetables, meat, live animals, honey, and bee products from Ukraine. The agriculture sector also calls for increased control over the origin, quality, and safety of imported agricultural products.
Additionally, the farmers demand full compensation for increased production costs due to the war in Ukraine to be paid by 30 September, and for aid caps to be removed. To minimize safety risks, avoid areas of large public gatherings or protests. Even events intended to be peaceful can escalate unexpectedly and quickly become violent.
Africa
During the past year (September 2022 - 2023), the National Public Health Ministry (Dire??o Nacional de Saúde Pública) has reported more than 34,300 people infected with cholera. In the past month, the province of Nampula has registered 675 infected people. At least 144 people have died from their infections. Most infected individuals, approximately 75%, do not show any symptoms. However, of those who do exhibit symptoms, only a small proportion develop a severe form of the disease. All travellers can minimize the risk of exposure to this disease. Strictly observe all food and water precautions in any area where there is cholera. If gastrointestinal symptoms (e.g., vomiting and profuse watery diarrhoea) develop while visiting the affected area, travellers should seek medical care at once.
As of 17 September, the death toll from the catastrophic flooding in Libya's eastern city of Derna has risen to 11,300, with another 10,100 people still missing. The floods were caused by Storm Daniel, which hit the country on September 10, causing severe weather conditions, including strong winds and sudden heavy rainfall. Two dams in Derna burst, sweeping away entire neighbourhoods and wrecking homes in multiple coastal towns.
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