Fun times at the WRHATH&TMC

On Monday of this week I went for my first appointment at the Winnipeg Regional Health Authority Travel Health & Tropical Medicine Clinic, where I met with a nurse named Judi, who was really friendly and helpful and laughed at my jokes, so she's ok in my books. Also, the clinic itself is located conveniently close to work, and they have a whole shelf of Rough Guides to peruse while you're waiting around. So far the WRHATH&TMC gets two thumbs up.

My appointment lasted over an hour, and Nurse Judi gave me the rundown on a horror-show of diseases that I need to consider vaccinating against, including the relatively mundane Hepatitis A and B, polio, tetanus, diptheria and rabies, moving to the more exotic yellow fever, typhoid, malaria and meningococcal meningitis, and finishing off with a touch of altitude sickness and the decidedly ferocious-sounding duet of Tickborne and Japanese Encephalitis.

Today I got the booster shot for polio, diptheria and tetanus (thoughtfully provided in just one needle), and my first round of Twinrix, for Hep A/B. I also picked up the oral vaccine for typhoid, and made an appointment for early January to receive another shot of Twinrix, and the Yellow Fever vaccine, and whatever else I decide to go for. Finally, in early June, I'll get my last Twinrix shot just before I jet off.

For a mere $150, I'll likely go ahead with the meningitis vaccine, but I have a decision to make about Japanese Encephalitis. At $120 per dose, and requiring 3 doses, it's not cheap vaccine. The virus that causes JE (as we savvy 'Round The World traveling types call it) is carried in birds and pigs, and transmitted to humans through infected mosquitos, mostly in rural areas, and almost exclusively at night. And what happens to the infected? Here's what Wikipedia says:

Japanese encephalitis has an incubation period of 5 to 15 days and the vast majority of infections are asymptomatic: only 1 in 250 infections develop into encephalitis.

Severe rigors mark the onset of this disease in humans. Fever, headache and malaise are other non-specific symptoms of this disease which may last for a period of between 1 and 6 days. Signs which develop during the acute encephalitic stage include neck rigidity, cachexia, hemiparesis, convulsions and a raised body temperature between 38 and 41 degrees Celsius. Mental retardation developed from this disease usually leads to coma. Mortality of this disease varies but is generally much higher in children. Transplacental spread has been noted. Life-long neurological defects such as deafness, emotional lability and hemiparesis may occur in those who have had central nervous system involvement. In known cases some effects also include, nausea, headache, fever, vomiting and sometimes swelling of the testicles.

Well at least I don't have to worry about swollen testicles.

In all seriousness though, bad JE infections are one of those things that are very very rare, but very very bad if they do happen. My risk of getting infected is really low - I likely won't be in rural areas late at night, and even if I am I'll be taking precautions against mosquito bites anyways, because of the much higher risk of malaria. Nurse Judi said that unless I'm in a rural area hotspot for more than 3-4 weeks, I should be fine. On the other hand, these people decided to go for it. When it comes down to it, $360 isn't much to protect me from lifelong neurological defects.

And then there's biggie: malaria. Malaria kills between one and three million people each year, and there is no vaccine. It's carried by mosquitos, like JE, and is most prevalent in sub-Saharan Africa, where I will be spending some time. It's also in India, Southeast Asia, and South America. Because there's no vaccine, the only thing you can do is limit your exposure to mosquitos, and take anti-malarial medication when you're in a malaria zone. The WRHATH&TMC offers three options, which I would buy here and pack around with me until I hit the M-Zone. Those options are: Malarone, Doxycycline and Mefloquine. Of these, the best choice seems to be Malarone, which is the newest, and has the fewest side effects, and is also (of couse) the most expensive. Anti-malaria meds need to be taken before, during and after any stay in the M-Zone, and Malarone costs about $5.00/day, whereas the other two come in around $5.00/week. I have to think about what to do here, and figure out how much anti-malarial medication I should take with me. It is possible to pick up the stuff while out on the road, but Nurse Judi pointed out that travelers need to be wary of counterfeit drugs when buying overseas.

Nurse Judi also gave me a helpful handout on how to stock a first aid it for world travel, and confirmed my suspicion that it would be a good idea to get and fill a prescription for a broad spectrum antibiotic to have with me, just in case.

As for the budget, Monday's tab breaks down like this:

• Consultation with Nurse Judi: $52.00
• Tetanus/Diptheria/Polio Booster: Free (thank you Manitoba Health)
• Twinrix (Hepatitis A/B), first round: $62.00
• Oral Typhoid Vaccine: $42.00
• Total: $156.00

Still on the menu:

• Another two consultation/visit fees: $42.00
  
• Yellow Fever vaccine: $78.00
• Twinrix, rounds 2 and 3: $114.00
• Meningococcal Meningitis vaccine: $150.00
• Japanese Encephalitis vaccine, 3 rounds: $360.00
• Malarone anti-malarial meds: estimate $300-$500

The total here comes to a staggering $1,100 - $1,300.00 (not including first aid kit supplies) which is close to double what I budgetted, and I thought I was overestimating. Perhaps it makes most sense to spend my money on the good anti-malarials, and consider skipping the JE and meningitis vaccines. Then again, is this any time to cheap out? Opinions are welcome, especially if you actually have experience with any of this stuff.

Gear Picks - Tiny Speaker

Here's another new (maybe even recurring) feature I'm calling "Gear Picks". As you might guess from the title, this will be a post about some item of travel-related gear that I've already purchased, or am considering, or just think is really cool (because I'm really all about the cool gear, especially if it's also TINY, which makes today's offering extra-great).

Behold the X-Mini Capsule Speaker:


Look how tiny it is! It's a little more than 2" across, and about 2-1/2" inches high, and weighs in at a mere 52 grams (1.8 oz.). The trick is that it actually extends upwards expanding an accordion style vacuum chamber that acts like a loudspeaker, giving it much more volume than you'd expect from such a tiny thing. The manufacturer, XM-I, call this the "Bass Expansion System", and say it mimics the resonance of a sub-woofer (a sub-woofer the size of a dust-bunny, but a sub-woofer nonetheless).


The device has USB-rechargeable batteries and separate little retractable cable that plugs into any standard mini headphone jack. Reviews claim it's got surprisingly decent sound quality, though of course it's only in mono. If you can't live without stereo, check out the X-mini's big brother, the X-Minimax.

And here's a little Youtube video about the device that also features some nice Irish accents:

The list price on the website is $29.90 USD for the Mini, and $55.00 for the Minimax, available in black, red and white. I really like having the ability to play music or podcasts from a speaker instead of just from headphones, and I figure an iPod Nano and an X-mini speaker are a bit cheaper and less theft-magnet-y than an iPod Touch. So, X-mini speaker, you're on my list.

This time next year - November 21

Today's exciting "This Time Next Year" destination is Istanbul, Turkey. In fact it's the whole country of Turkey, though I suspect I'll spend most of my time in Istanbul, which I was surprised to learn is actually the third largest city in the world (population 11,372,613 at the time of writing). It's situated on both the European and Asia sides of the Bosphorus Strait, so it's the only city in the world that spans two continents, and it's commonly thought of as an East-meets-West melting pot.

Istanbul is an ancient city - archeological discoveries in the area go back as early as 6500 BC, and the city of Byzantium (the first known name for the city) was established in 667 BC. When the Roman Emperor Constantine the Great made it the capital of the Roman Empire in 330 AD, he changed the name of the city to Walterople (literally "City of Walter"), after his late uncle. Ok, actually he changed it to Constantinople, I suppose because he was the freakin' emperor of Rome and figured he was kind of a big deal. The name Istanbul was apparently in common use in the city from before 1450 or so, but didn't become popular in the west until someone wrote a catchy song about it.


One of the big things to see in Istanbul is the Hagia Sophia a 6th century basilica/mosque/museum that was, until 1520, the largest cathedral ever built. Though it didn't make the grade as one of the New Seven Wonders of the World, it did manage to rank in the top 20, so since I'll be in the city anyways I'll probably wander over there.

Istanbul has a gajillion brilliant historical sites and markets and museums and things, but right now I think the coolest thing going on there is the construction of the Marmaray - the world's deepest undersea immersed tube tunnel - being built underneath the Bosphorus Strait. Once completed it will mean that a passenger could travel by rail all the way from the northern tip of Scotland to Beijing, China. (Said passenger would be well-advised to pack a few sandwiches for such a journey.) It's a fantastic engineering project, though it's been delayed by more than two years because workers unearthed an incredible Byzantine archeological site and have had to trade in their backhoes for those weeny little dental picks and paint brushes. The site they uncovered is the fourth-century-Constantinople port, Portus Theodosiacus, and includes what may be the only Byzantine naval vessel ever discovered.

Also of note is the fact that the placement of the tunnel runs distressingly close (a mere 18 kms) to a big geological fault which scientists calculate has a 77% chance of unleashing a earthquake of 7.7 magnitude or greater in the next thirty years. Perhaps our weary passenger should pack a inflatable dinghy along with his PB&J.

The one thing I won't be rushing out for while in Turkey is Turkish Delight, which has always seemed to me like a waste of calories that could better be expended on chocolate. Also, I suspect I won't be eating much turkey.

If the idea of a trip to Turkey floats your Byzantine naval vessel, I plan to be there between November 18 and December 2, 2009.

Who doesn't love a good sale?

Thank you to Practical Hacks for the heads-up on a big 20% off holiday sale at the Rick Steves Travel Store (on until December 14th). Rick Steves is a well-known travel guide who claims to show people "Europe through the back door" - his catchphrase for getting off the beaten track and seeing real people and places instead of just tourist traps. He runs guided tours, and he writes a popular series of guide books, and he has a radio show, and a podcast that I like, and a tv show that I watch, and he sells travel stuff on his website. What can I say? The guy's definitely covering all the bases. I also like him is because he's another "one bag" zealot.

I've had my eye on a few things from the Rick Steves store, so I'll definitely be placing an order while the sale is on. I'm just hoping to catch it when the Canadian dollar is a bit stronger against the US, so I can spend as little as possible.

Here's what's on my list:

Civita Day Pack - This will be the everyday pack that goes everywhere with me. I imagine it will normally carry the Asus Eee PC, a guidebook, a water bottle, other books, a sweater or jacket, and anything else I might need or pick up in the course of a day touristing around. When I'm in transit between locations I'm hoping it can live sort of rolled up in the top end pocket of the Aeronaut, acting as a bit of padding for the Eee PC too. I'll be getting it in the lovely, low-key "slate" colour. (BTW, more on the Tom Bihn Aeronaut is coming in a future post.)

Silk Sleep Sack - I'm splurging for the silk one because they're lighter, pack up smaller than cotton, and should be more comfortable. (Colour: Sage Green) Here's what Rick has to say about sleep sacks.

Serious budget travelers need a sleep sack. The primary use is for hostels. If you don't have one, you'll rent one each night... the ones you rent can range from straight — jacket tight to crinkly disposable paper versions. A sleep sack has uses beyond hostels. If you'll be sleeping out, the Mediterranean is warm enough without a sleeping bag-but the sack gives you the thin bit of warmth and protection that makes this a realistic option. In Scandinavia, many budget alternatives to hotels rent beds without linen. With your sack you can say "ya sure, ya betcha" and save piles of kroner. Sleeping for free on the train is more comfy and feels much cleaner, if you have your own sack to crawl into. And, in more rugged corners, cheap hotels can come with dirty sheets. More than once, I've been thankful to be cradled in my own sleep sack rather than some questionable sheet in a dumpy hotel. Mountain huts often come with blankets only — washed once a year. While some travelers don't care, I prefer to have the clean linen this sack provides between me and the hut bedding which one German hiker described as "the germs of centuries."

Travel clothesline: This is a must - the whole premise of traveling light is based on being able to do one or two small items of laundry in a sink every night, or every other night. A travel clothesline lets you dry things overnight and wake up to a fresh pair of socks without having to spend hours in a laundromat. Apparently the good ones are made with 3 lengths of surgical-type rubber tubing braided together (as opposed to those shoddy 2-length twisted knock-offs!). The braided design lets you tuck the corners of clothing in between the tubes, thus eliminating the need for clothespins. (And yes, I appreciate the extreme travel-geekness of the fact that I've researched and carefully considered the relative merits of three-stranded-braided vs. two-stranded-twisted travel clotheslines. And that's not even getting into the Great Velcro Loop vs. Suction Cup Debate.)

I'm also considering a new toiletries kit; My current kit is showing its age a bit, and I think I can afford to splurge on this one, along with the handy removable mesh shower caddy that can go right into the shower with me. I'm concerned that even the smaller of the two kits available is still quite large, but for $15.95 USD I may risk it. I'm waffling between the red and the yellow.

All this should add up to about $88 USD, plus about $16 USD for shipping. I figure it'll come to about $120 CDN after exchange, plus there may be taxes and duty and stuff when I pick up the package. All in all though, I think that's a great deal, and much less than I budgeted for the above items.

Now about those suction cups...

Rule Britannia?

Here's a dilemma I've been struggling with: Due to the fact my mother had the foresight to be born in England (thanks, Mom!), I'm actually eligible to claim British citizenship. This would mean I'd be a dual citizen of Canada and Britain, and I'd be able to hold a British passport along with my Canadian one. Because Britain is part of the European Union, having a British passport would make traveling into and out of E.U. countries a complete breeze. In fact, as far as I know I could even live or work in an E.U. country if I felt like it. This all sounds like a very good thing for someone in my position.

So what's the dilemma? Well, there are two:

1. The Cost: Applying for British citizenship currently costs £459.00, and that's just for the actual application itself. That doesn't include the cost of gathering all the properly certified paperwork that's required to accompany the application. It also doesn't include the cost of the passport itself (another $237 USD), or the courier costs, or the passport photos to be taken, or even possible costs associated with getting to a swearing-in ceremony, which is apparently mandatory. (I guess you can't just sign on the dotted line while humming a few bars of "God Save the Queen".) I estimate the whole affair would probably add up to about $1,500.00.

2. The Gut Reaction: I'm not sure why, but the thought of being a citizen of somewhere other than Canada gives me pause. Part of me worries because having citizenship in a country doesn't just mean having rights in that country, it also means having responsibilities. What obligations - legal, moral or otherwise - would I have to Britain if I went down this path? Deeper still, it just feels funny to think about being a citizen of anywhere other than Canada - it feels like a betrayal of the country of my birth.

I don't want to imply that I have anything against Britain - I strongly identify with all things English. I'm not just a WASP by default - I grew up with grand and great-grandparents speaking in an accent, and steak-and-kidney pudding for Sunday dinner (Mmmm!) (No, really!), and Beatrix Potter books. I still have family there. If any country other than Canada could really be home to me, I think it would be England. In a very real sense, they are my people. (This is not to lessen the contribution of the prairie farming stock that make up my Dad's side of the family. I'm also a big fan of Saskatoon pie and have been known to cheer for the Roughriders.)

Friends I've asked about this idea tend to take a purely pragmatic stance - Shorter line-ups! Legal short-term work if you need it! They might change the rules again - do it now while you still can! On a more philosophical level, they've pointed out that we live in an increasingly global society, and being a citizen of an E.U. country might have great benefits for me down the road quite apart from the advantage it would be on this trip.

So what do you think? I'd be interested to hear other opinions on the subject. Leave me a comment and give me something to think about.

This time next year - November 7

This week Winnipeg set a new record for the warmest temperature reached on November 3rd, breaking the old record set in 1905. On Monday the temperature went up to 19° Celsius; when I got up this morning the view from my back door looked like this:


So since winter has arrived as decisively as Barack Obama, I think today is a good day to introduce a little (hopefully) recurring feature I've been thinking about called "This time next year..." (posts like this will be labeled TTNY in the tag cloud). It's something I've been using to keep myself a bit more motivated. I've got a widget on my iGoogle homepage that shows me the weather in Winnipeg and whatever other location(s) I choose, so I've been viewing the place where I think I'll be in one year's time. Of course the schedule is all just theory at this point, but I still think this is pretty good motivation:


Today's "This time next year" location is Athens, Greece. Exciting! I imagine Greece will feature boatloads of history, crystal blue Aegean seas, and enough olives, feta cheese, lamb and ouzo to sink the Argo. (How appropriate that I'm currently working on a production of "Medea".) Greece would also be an excellent place for friends to meet up with me for a little R&R on the beaches of a Greek Island. I'm serious - think about it! I plan to be in Greece around November 3 - 17, 2009.

Even more exciting is that this time next year I hope to be running the Athens Marathon (I think it will be on Sunday, November 8th, 2009). This is THE marathon... the one that actually starts in the city of Marathon and runs to Athens, theoretically following the route that Pheidippides took to announce the Greek victory over Persia in the Battle of Marathon in 490 BC. (The fact that the legend says he dropped dead after making his announcement is something marathoners like to gloss over).

The modern Athens Marathon actually finishes in the Panathinaiko Stadium, which was built in 566 BC and has been renovated many times since then, most recently for the 2004 Olympic Games when it hosted the finish of the Olympic Marathon. How cool is that? Participants in the Athens Marathon run the last 170 metres of the course in a stadium built out of white marble that's 2,574 years old.


And that thought, my friends, is enough to get me through a snowy Friday afternoon in November, in Winnipeg.