Australia has high standards of hygiene, and there are few exceptional health hazards – at least in terms of disease. No vaccination certificates are required unless you’ve come from a yellow-fever zone within the past week. Standards in Australia’s hospitals are also very high, and medical costs are reasonable in comparison to Europe and the US.
The national healthcare scheme, Medicare, offers a reciprocal arrangement – free essential healthcare – for citizens of the UK, Ireland, New Zealand, Italy, Belgium, Malta, Finland, the Netherlands, Norway and Sweden. This free treatment is limited to medically necessary treatment in public hospitals and casualty departments (though the ambulance ride to get you there isn’t covered); at GPs, you pay upfront (about Aus$50 minimum), with two-thirds of your fee reimbursed by Medicare (does not apply to citizens of New Zealand and Ireland), or fill in a bulk bill form and the doctor bills Medicare directly (so you don’t pay anything). For more details visit whttp://www.medicareaustralia.gov.au.
Reimbursements are collected from a Medicare Centre by presenting your doctor’s bill together with a Medicare Card, available from any Medicare Centre. It’s advisable to obtain one if you are eligible and staying in Australia for a while, particularly if on extended working holidays. Applicants need to bring a passport and their home country National Health documents. Dental treatment is not included: if you find yourself in need of dental treatment in one of the larger cities, try the dental hospital, where dental students may treat you cheaply or for free.
Australia’s biggest health issue is one of its chief attractions: sunshine. You’d think by now every visitor would be aware that a sunny day in London, Toronto or even Miami is not the same as one in Cairns, and that Australian ultraviolet rays are far more damaging. Apparently not – most visitors still get burned at some point, so extra care is needed.
Two out of three Australians are likely to develop skin cancer in their lifetime, the world’s highest incidence rate. About five percent of these will develop potentially fatal melanomas, and about 1800 die each year. Looking at the ravaged complexions of some older Australians (who had prolonged exposure before there was an awareness of skin cancer) should be enough to make you use lashings of the highest-factor sun block (SPF 35+), sold just about everywhere.
Sunscreen should not be used on babies less than six months old: instead, keep them out of direct sunlight. The war paint on the noses of surfers and small children is actually zinc cream; the thick, sticky waterproof cream provides a total blockout and is particularly useful when applied to protruding parts of the body, such as noses and shoulders.
Australians are now fully aware of the sun’s dangers, and you’re constantly reminded to “Slip, Slop, Slap”, an old government-approved catchphrase reminding Aussies to slip on a T-shirt, slop on some sun block and slap on a hat – still sound advice. Pay attention to any moles on your body: if you notice any changes, either during or after your trip, see a doctor; cancerous melanomas are generally easily removed if caught early. To prevent headaches – and cataracts in the long term – wear sunglasses; look for “UV block” ratings when you buy a pair.
The sun can also cause heat exhaustion and sunstroke, so as well as covering up, stay in the shade if you can. Drink plenty of liquids: on hot days when walking, experts advise drinking a litre of water an hour. Alcohol and sun don’t mix well; remember that more than one cold beer will dehydrate you.
Mosquitoes are spread countrywide, and, while malaria is not endemic, in the tropical north there are outbreaks of Ross River fever and dengue fever, chronically debilitating viruses transmitted by mosquito bite that are potentially fatal to children and the elderly. Outbreaks of Ross River fever, which is most common in coastal marshy areas of the Northern Territory, Queensland and north Western Australia but can occur as far south as Southern Australia, are reason enough not to be too blasé about mozzie bites.
The danger from other wildlife is much over-rated. Snake and spider bites are central to the perilous Outback myth, and crocodile and shark attacks are widely publicized, but all are extremely rare.
To minimize danger from saltwater crocodiles (which actually range far inland;) keep your distance. If you’re camping in the bush within 100km of the northern coast between Broome (WA) and Rockhampton (QLD), make sure your tent is at least 50m from waterholes or creeks, don’t collect water at the same spot every day or leave any rubbish out, and always seek local advice before pitching camp. Four-wheel drivers should take extra care when walking creeks prior to driving across.
Snakes almost always try to avoid people – you’ll probably never even see one. They’re more likely to be active in hot weather, when you should be more careful, and keep an eye open in open patches of woodland or scrub in the morning, when they often sunbathe. Treat snakes with respect and you’re unlikely to be bitten: most bites occur when people try to catch or kill them. Wear boots and long trousers when hiking through undergrowth, collect firewood carefully, and, in the event of a confrontation, back off. Sea snakes sometimes find divers intriguing, wrapping themselves around limbs or staring into masks, but they’re seldom aggressive. If bitten by a snake, use a crepe bandage to bind the entire limb firmly and splint it as if for a sprain; this slows the distribution of venom into the lymphatic system. Don’t clean the bite area (venom around the bite can identify the species, making treatment easier), and don’t slash the bite or apply a tourniquet. Treat all bites as serious and always seek immediate medical attention, but remember: not all snakes are venomous, not all venomous snakes inject a lethal dose of venom every time they bite, and death from snakebite is rare.
Two spiders whose bites can be fatal are the funnel-web, a black, stocky creature found in the Sydney area, and the small redback, a relative of the notorious black widow of the Americas, usually found in dark, dry locations all over Australia (ie outdoor toilets, among shrubs, under rocks and timber logs), although they are less common in colder regions like Tasmania. Both are prolific in January and February, when there is the greatest danger of bites. Treat funnel-web bites as for snakebites, and apply ice to redback wounds to relieve pain; if bitten by either, get to a hospital – antivenins are available. Other spiders, centipedes, scorpions and ants can deliver painful wounds but only cause health problems if you have allergies.
Ticks, mites and leeches are the bane of bushwalkers, though gaiters or repellent sprayed over shoes and leggings will help keep these pests away. Ticks are venomous – they produce the most toxins during feeding in spring – and attach themselves to long grass and bushes, latching on to passing animals that brush past. The most common complaint is discomfort and allergic reactions. However, the paralysis tick, a native of Australia, can be found from Cairns to Lakes Entrance and is life-threatening. This tick is very common and regularly causes paralysis in dogs and cats.
Check yourself over after a hike: look for local stinging and swelling (usually just inside the hairline) and you’ll find either a tiny black dot or a pea-sized animal attached, depending on which species has bitten you. Use fine-pointed tweezers and grasp it as close to the skin as possible, and gently pull the tick out, trying to avoid squeezing the animal’s body, which will inject more venom. Seek medical attention if you are not successful. A lot of bushwalkers advocate dabbing kerosene, alcohol or insect repellent on the ticks before pulling them out, but official medical advice warns against it – this will cause the ticks to inject more toxins into the host’s body.
Mites cause an infuriating rash known as “scrub itch” wherever your clothes are tightest, such as around the hips and ankles. Unfortunately, there’s not much you can do except take antihistamines and wait a day or two for the itching to stop. Leeches are gruesome but harmless: insect repellent, fire or salt gets them off the skin, or twirl them gently with a fingertip until they let go, then flick them off. Bites may bleed heavily for some time.
More serious is the threat from various jellyfish (aka “stingers”) in coastal tropical waters in summer. Unfortunately, both the tiny irukandji and saucer-sized box jellyfish are virtually invisible in water. Irukandji have initially painless stings, but their venom causes “irukandji syndrome”, which can be fatal. Its symptoms are somewhat similar to those of decompression illness: elevated heart rate and increased blood pressure; and in addition, excruciating pain, anxiety and an overwhelming sense of doom and dread. Box jellyfish stings leave permanent red weals, and the venom can cause rapid unconsciousness and even kill by paralyzing the heart muscles. Treat stinger victims by dousing the sting area (front and back) with liberal amounts of vinegar – which you may find in small stands on affected beaches, such as North Queensland. Never rub with sand or towels, or attempt to remove tentacles from the skin – both could trigger the release of more venom; apply mouth-to-mouth resuscitation if needed, and get the victim to hospital for treatment. Whatever the locals are doing, don’t risk swimming anywhere on tropical beaches during stinger season (roughly Oct–May) – tiny irukandji can pass through the nets designed to stop box jellyfish.
Better known as a Portugese Man o’War, bluebottle jellyfish (or “bluies”) are widespread. They deliver a severe searing sting and a rash for an hour or so, but are only dangerous if you are allergic to the venom. Quickly wash off any tentacles stuck to the skin.
Other health hazards
In the hot and humid north, tropical ear, a painful fungal infection of the ear canal, is an issue. Treatment is with ear drops, and if you think you might be susceptible, use them after getting wet regardless.
Although you’re very unlikely to find yourself in the path of a raging bushfire, it helps to know how to survive one. If you’re in a car, don’t attempt to drive through smoke but park at the side of the road in the clearest spot, put on your headlights, wind up the windows and close the air vents. Although it seems to go against common sense – and your natural instincts – it’s safer to stay inside the car. Lie on the floor and cover all exposed skin with a blanket or any covering at hand. The car won’t explode or catch on fire, and a fast-moving wildfire will pass quickly overhead. If you smell or see smoke and fire while walking, find a cleared rocky outcrop or an open space: if you’re trapped in the path of the fire and the terrain and time permits, dig a shallow trench – in any event, lie face down and cover all exposed skin.