Once one of our friends came to us by boat in Indonesia, on an island in the Komodo archipelago. A local attraction is the Lizard Monitor, a carnivorous lizard up to three meters long that also runs faster than humans. They don't usually attack people, but the tour guides say you have to be careful with them and don't get distracted in their presence. After a long walk around the island, our friend came out unscathed after many close encounters with monitor lizards, and when she tried to jump into the tender, she fell off the wooden pier, blanding unsuccessfully on a colony of sea acorns, also called "dog teeth", receiving three deep cuts on his thighs.
The place is uninhabited, the nearest hospital, if you can call it a building with three rooms, five dirty beds and some kind of medicine, was three hours on a motor boat, which we also did not have. Luckily, our friend, her husband is a surgeon, and he gave her twenty-three stitches right on the boat. As always, fortunately, needles, threads, clamps, needle holders, surgical gloves, sterile bandages, syringes, disinfectants and anesthetics were on board. All this has happened over the years since I left Italy, and every timethese things caught my eye, I wondered if we were too hard working or too pessimistic.
It was the most serious injury in many years, but we had others.
Once in the Caribbean, we caught a barracuda, she fought hard and the whole cockpit was covered in slime. While trying to put the fish in the bucket, Carlo slipped and broke his leg.
This time, I used a wooden kitchen spatula to fix the fracture, wrapping the spatula and foot with a thick layer of foam rubber, and securing everything with packing tape. Three weeks later, when X-rays were available, the foot was fine.
There were many different small problems: burns, ulcers, renal colic, colds, which we always solved with the help of the means available on board.
In addition to accidents and incidents, various health problems can occur during a long boat trip and you must be prepared to deal with them, or at least provide first aid, before the doctor thinks you can do it.Различные заболевания
On a boat, the first illness, although rarely reaching dangerous levels, is seasickness. Anyone who suffers from this knows that she is always lying in wait, ready to return as soon as the boat is out of the sea, which makes the first days of sailing dreadful.
If the journey is long and the crew is small, you need to try to block it in the bud, or better yet, warn. But the most important thing is to overcome it.
Remedies range from patches that release scopolamine to bracelets that apply pressure to the appropriate point, special chewing gums and tablets or homeopathic remedies, crusts of bread with anchovy pate, or just drinking a glass of salt water.
Seasickness originates in the inner ear, where the balance organ is located, but manifests itself in the stomach. Eat only light food, do not drink alcohol, be on deck, dress well, lie down or work, all these measures are effective and help to overcome the crisis. The only thing you can be sure of is that after a couple of days the body will get used to the new situation and the seasickness will start to recede until it is completely gone. At least in most cases.
In addition to the usual supplies, we always keep anti-emetics in tablets and ampoules on board, in case of emergency, if someone is suffering from a seasickness crisis more and longer than usual, in order to save a person from dehydration.
Another problem that appears more often than usual on Boas is a digestive problem. Usually it is not permanent crew members who are accustomed to life on the water that suffer, but friends and guests who come on vacation or on a charter. Apparently, this is a problem of our time, judging by television advertising, every third video recommends means of regulation and stimulants for digestion. And people bring them with them: these are some slimy capsules that need to be filled with water the day before use, and bran, and flaxseed oil capsules, and activated carb tablets.lem and glycerin in various forms. And there are no problems. People are aware of their frustrations and take what helps them from home.
Difficulties arise when a person appears who did not have these problems before. A man arrives by boat after several hours of flight, changing time zone, climate, lifestyle and diet. Add to that that you move around a bit while sailing and ninety-nine percent the toilet on board doesn't provide enough privacy, being separated from the rest of the boat by thin partitions, and the skylight suddenly starts to look like a panoramic wind, to sum it all up. no wonder so many begin to sufferfrom constipation. Usually everything is resolved within a few days with the understanding and help of the rest of the crew, but if a person comes across too suspicious who has never experienced this problem before, you should have funds on board to unblock the situation, because when there is even one person, exhausted by the inability to go to the toilet, he can poison the cruise for everyone else. In order to establish peace and tranquility on board, I had to steal a glycerin mini leaf from a tourist center in the Maldives, exchangetake coal tablets for flour on a Swiss sailboat and ship the bran to Australia. Don't wait until you believe!
Otherwise, on a boat, you need to be prepared for anything from the most serious, from a blow to the head by a boomer or an attack of appendicitis to a cold and cough, not excluding tooth decay. And the first-aid kit must be chosen so as to best withstand the worst misfortunes.
It should be remembered that during a long passage the boat plunges into an almost sterile environment, where infections usually do not occur, but the protective functions of the immune system, which are not in demand for a long time, gradually weaken.
An example of what happened to Mauro Mancini and Ambrogio Fogar, who drifted on a raft for sixty days after their sailboat Surprise sank. While they were on the raft, although they were very weak, they did not get sick in any way. After the two of them aboard the ship that rescued them, they both developed pneumonia. It is likely that the infection was present on board in a non-aggressive form, but they no longer had protective immunity. They were treated with antibiotics, but Mancini's body, weakened by the long stay on the raft, could not survive the illness due tofood intake and age.
This is, of course, an extreme case, but in preparation it is better to remember the worst options, and then state that they were needlessly worried.
The first aid kit should take into account the age of the crew members, the state of health of each person, the presence of children on board, and whether scuba diving is foreseen.
In the appendix to this book, we have compiled a list of medicines and medical supplies that should be kept on board. Naturally, it must be adapted to the number of crew members and the type of navigation. There are many medicines and materials, they are decent and take up a lot of space and, in addition, they have an expiration date. Unfortunately, when they are needed, they must be available and you must have them on board.
Even if the first aid kit has been chosen to withstand all the crew's possible problems, it always happens that a good portion of the drug is used to treat other people you meet along the way. If sailing takes place in undeveloped countries or in places far from major centers, it often happens that you are responding to requests for help.
It is not an easy task to treat the inhabitants of distant places, suffering from illnesses, perhaps different from ours, with difficulties in communicating the ignorance of the language. In such cases, you should try your best, remembering that you are dealing with people who have never taken drugs and therefore have a faster and more powerful effect on them than on us.
On an atoll in Melanesia, I cut an abscess on a fisherman's finger and treated it with an antibiotic ointment. The next day, the opening of the abscess was absolutely clean and the wound began to heal. Naturally, from that day we were guaranteed bananas and fresh fish, as well as a line of patients who went to the boat for treatment.
Once on the coast of the Red Sea, old men with cataract eyes came to us, and in order not to disappoint them, I gave them eye drops, it was a pity to look at them. Another time a Muslim fisherman wanted me to heal his wife from a distance. He let out inhuman screams and spat on the ground to show me how it breaks!
At Lamaler in Indonesia, I even complimented myself. The villagers are nice, polite people, except for one annoying person who kept asking us for something. And not that he asked for something valuable, just give him all the time to deceive others. One day he asked us to come home to heal his wife. He poured us huge cups of coffee and then proceeded to explain that the woman had a heartbeat. I was very scared and asked the woman exactly what she was feeling.
- Sometimes it suddenly starts to beat strongly, even when I sleep.
- Good. Don't drink more coffee. If you're thirsty, drink only warm water!
A week later, a pleased husband brought us eggs and assured us that his wife had recovered! However, I advised him to continue the treatment.
Remember that the side effects for these people are also more harmful than for us. Therefore, it is better to give them medication in much smaller doses than recommended. Of course, there are illnesses or wounds that you feel powerless over, and you can only thank Heaven that you were lucky to be born in a country with an advanced and affordable medicine, I hope for a long time.
There is a medical publication where you can go to your doctor or medical institution, which lists all the vaccines that are mandatory and recommended for different countries of the world. Although boat travel is less risky than land travel, you should still follow the standards recommended by health authorities and common sense. In third world countries, care must be taken with water, dairy products and raw vegetables, which are usually doused with sewage. Has smIf you want to get vaccinated against viral hepatitis, they are for type A and type B. However, you first need to do a blood test to find out if there are antibodies to this disease in the blood. In this case, no vaccination is required because you are already immune, possibly due to a hepatitis infection that did not cause jaundice and went unnoticed.
The same with malaria. Traveling and living on a boat risks being bitten by an infectious mosquito less than on land. The mosquito Anopheles, which carries malaria, is only active for a few hours at sunset. They do not fly at anchor a hundred meters from the coast and in the wind, and if this happens, it is enough to wear a long-sleeved T-shirt and long trousers in twilight. In order to infect the mosquito that bit you, you must have bitten the patient shortly before. Therefore, in sparsely populated areas, the risk of infection is very low. Although alwaysbe minimal risk. Unfortunately, there are no vaccinations against malaria.
When crossing the Pacific, there is a risk of malaria from New Caledonia to the Salomon Islands and Papua New Guinea, which then reappears in Indonesia after passing through the Torres Strait. And after crossing the Indian Ocean, he is here again, along the entire coast of East Africa, from Kenya to Tanzania and Mozambique and on to the Comoros and Madagascar.
This means that those who decide to resort to prevention must take large doses of potent drugs for several months, which can also have serious consequences for the liver and vision.
Given the low risk of infection while living on a boat, it is better not to resort to any prevention, avoid going ashore during dangerous hours, dress appropriately at this time and use locally purchased repellents, as they are more oily and will not evaporate immediately with sweat . like those available from us.
And yet you should have everything you need to treat malaria on your boat: lariam, malarone or fansidar, depending on which part of the world you are in. Malaria presents with a range of symptoms such as fever, chills, and pain in the bones and joints. To make sure that the diagnosis is necessary for a quick and painless blood test, it is carried out in any third world hospital. In countries with an increased risk of malaria, it is always possible to find commercially available drugs for the local type of disease. In some countries onWe already have a kit containing the test needed to diagnose malaria and the pills to treat it.
Most of the boats that go on a long voyage are aimed at the southern seas, that is, the tropical zone. The water of these seas can create problems. The Mediterranean is now considered polluted, but I remember when I was little and someone got hurt on the beach, the usual phrase was:
- Go wash yourself in the sea. The sea will heal you.
This practice is not at all suitable in tropical seas. Though not polluted or poisoned... no, that's why the tropical seas are teeming with life. The high temperature of the water promotes the growth of microorganisms, which sometimes make it cloudy and can penetrate even the smallest wound, infecting it. And these infections can have very long recovery periods.
My advice is to apply antibiotic ointment to any wound in a tropical climate and try not to wet it for a few days. After each bath, the wound must be disinfected and the ointment applied again. The chance of infection increases if a cut occurs on the coral. There are also many microorganisms on corals, and a simple scratch can turn into a festering abscess.
Every time there are friends on board, I repeat what I have just explained. Often they consider me a reinsurer, and a person who has only fifteen days of vacation will never stop bathing for two days because of a small cut. And often these people waited for months until the wound healed, and the scar remained for several more years.
We ended up in Indonesia to change course to take our friend to Timor and put him on the first plane to Bali to heal a forgotten wound that turned into phlebitis!
There are a lot of animals in tropical seas. Some of them, very few, are dangerous and you should be able to recognize them. You don't have to think about sharks right away. In all my life, I have only met a man with a scar from a shark bite. It happened in Salomon, in the muddy waters of an enclosed lagoon, and the man we were talking about was preying on American tourists. He had just carried the fish into the boat and was even up to his waist in water when he was attacked by a shark attacked by beating the tormented fish. She attacked a man without distinguishing his size in a dullwater.
Sharks usually keep their distance. They are also afraid of larger animals. A man in the water with his arms outstretched, fins and perhaps a pistol over three meters long and a reef shark reaching a maximum of one and a half meters would not dare to attack him. Otherwise, you need to follow the usual precautions, avoid murky water, do not swim underwater with harpoon fish, be careful when entering and exiting the water.
The really dangerous animals are much smaller and less visible: the Box Jelly Fish (Chironexfleckeri) appears during the rainy season, that is, from November to March, in the waters of Australia. It measures a few centimeters and is barely visible, but its tentacles can be several meters long and covered in microscopic stings that cause very painful burns. The poison they're injecting, a neurotoxin, can be deadly, but now there's an antidote for it. Also living in Australian waters is Hapalochlaena maculosa, a few centimeters long, but with deathflax bite for which there is no antidote yet.
Between the coral boulders in the Indian and Pacific Oceans, you can find Conusgeographus, a clam conidi that, when disturbed, shoots a dart, microscopic but deadly. Luckily, the shot occurs a few minutes after the cone has been moved from its usual location. It is important to be able to recognize it, and if you really want to catch it, immediately close it in a glass jar.
Next, if we want to continue, there are also stone fish, scorpion fish, butterfly fish, but let's not poison the journey that has not yet begun! After all, it's enough to just take precautions, like never walking barefoot on coral or sandy bottoms next to corals where all those poisonous fish hide.
It is also better not to walk barefoot near the villages. The beach is usually a public restroom, and intestinal parasites enter the body through the legs. Here, too, it is better not to wait until you happen to believe! On an Australian boat we met in Vanuatu, one of the kids just got rid of these parasites. The parents said that they watched him weaken and become pale for several months for no apparent reason for several months. They decided to take him to Australia for treatment when a nurse from a local village, concernedthinness of the child, checked his legs and found a site of infection with a parasite that had already occurred several months ago.
“She fed him strange broths,” they said. They dared to entrust her treatment to the boy, and he soon recovered.
Remember that it is impossible to know everything before the trip. But there are illustrated identifiers for dangerous fish and marine animals on sale and there will be as much time as you want to read and study during the passages.
And finally, to paraphrase a Polynesian proverb, usually the external beauty of a fish is inversely proportional to its edibility. Indeed, the brighter and more elegant the fish, the less edible it is.
Throughout the Pacific Ocean and parts of the Caribbean there is a danger of chiguatera. This is a disease that occurs when eating toxic fish.
The main cause of the disease is ciguatoxin, a specific toxin found in algae that normally grows on coral reefs but begins to develop under specific conditions, where corals die. It occurs as a result of human activity that blows up corals with dynamite, creates ports and channels, or is affected by natural forces, cyclones and waves. Fish eating algae accumulate toxins in the body without any harm to themselves. Then predatory fish eat herbivores, and large fish eat small ones in food.chain, as a result of which the toxin accumulates in large fish. And when a person eats one of them, the amount of toxin in which has reached a significant level, the nervous system is affected.
The risk comes only from reef fish, while pelagic fish such as tuna, dorado, kingfish are safe. But on reefs, this phenomenon varies from island to island, from place to place, from one type of fish to another. There is no way to tell if a healthy fish is infected, and because the toxin is resistant to heat and acids, cooking, frying, drying, freezing, or pickling won't help. By eating infected fish cooked in any way, a person is doomed to suffering. The best solution would be not to eat the fish caughton reefs in dangerous areas. But shellfish and crustaceans are safe.
If you still want to eat fish, the risk increases with sample size and decreases if you remove the liver, entrails, eggs, and head, because these parts accumulate more toxin than muscles.
In all the books they write that it is a good precaution to show suspicious fish to the locals, and also to indicate the place where they were caught. This is what we did on Macatea Island, a half-day voyage from Tahiti. We caught a big bass, showed it to the fisherman and pointed out which part of the reef they caught it on.
- No problem, you can eat it. “And we believed, forgetting that it was on Makatei that dynamite was used to blow up a large part of the barrier to allow ships arriving for phosphates to land on the island.
The symptoms appeared a couple of hours after dinner, when we had already chosen anchor and were going to Tahiti. At first it was just heaviness in the stomach and dizziness, then gradually the limbs became more and more difficult to move. We still successfully reached Papeete and did not move for two weeks, completely incapacitated by poisoning. Hands and feet seemed to be filled with lead, any movement was worth superhuman effort, and, in addition, electric shocks were felt upon contact with water.
It was June, it was hot and we were sweating. Unexpected showers constantly doused us from head to toe. To go ashore, we had to get at least wet feet. If you add to this that there is no cure other than drinking more to dilute the toxin and, as a result, peeing often, there was hardly a single day when we did not come into contact with water and did not feel electrical discharges.
The poisoning went away on its own, gradually, gradually, in about a month. We didn't eat fish for a whole year after this incident!
I remembered very late that when I cleaned the fish, it seemed to me that its consistency seemed strange, it was like rubber, I had never seen such a thing in fresh fish before. But who knows! ..
Fortunately, this poisoning, although very unpleasant, is almost never fatal. However, some of the poison remains in the body even after the symptoms disappear, and takes effect again when the next dose of the same toxin is delivered.
Therefore, among the natives, who often deal with these poisonings, there are cases of death due to blockage of the lungs.
For tourists, chiguatera is just a nuisance, no worse than malaria or money; it may happen that the recovery will take longer. But if you have the strength to refuse fish, every time you are on the atolls from the Marquis to the Torres Strait, there should be no risk.
A kit called Cigua-Check has recently been developed that can be used to detect the presence of toxins in fish.
For more information see www.cigua.com or contact Oceanic Test Systems, tel. (808) 531-3017, fax (808) 531-3177Страхование и медицинская помощь в мире
There are many insurance packages that guarantee medical assistance in any part of the world and evacuation to your home country within 48 hours on a special aircraft if it is not possible to provide the necessary treatment on the spot. As a rule, these insurances are very expensive, have a very high deductible and are completely unable to guarantee you assistance in most places where you go on a sailboat, if only because in most cases even contacting the insurance company is not easy.
On the contrary, almost all hospitals in the world will give you cheap or even free. Because now many countries in the world have health care agreements with Italy or Europe, or simply because in a country where the cost of living is low and private medical services are inexpensive.
When we were in Thailand. Carlo suffered an attack of renal colic. At the medical center where he was hospitalized as a day patient, a complete examination was carried out, including radiography using a contrast method, a diagnosis was made and all the necessary medicines were provided for a fee of 30 euros.
In Papeete, I got a free echography because I am a citizen of a European state, since at that time it cost two hundred thousand lire in Italy. In Australia, thanks to an agreement between the local government and ours, Italian citizens can receive free treatment in modern hospitals at a fairly high level; they only need to get something like a local health card. And in places where there are no hospitals, and your insurance company is unlikely to be able to provide you with the promised medical care.
The exception to all this is the United States and several other countries, where medical services are very expensive, even emergency medical care. There, any victim, before they begin to be treated, must confirm their ability to pay. If one of your goals is American shores, you might want to consider health insurance.
On an American boat that we met in Chagos (Indian Ocean) with two young people on board, one of the two seriously injured his knee after falling on a sharp coral. They notified the family in the States by radio, and I don't know by what leverage they managed to get one of the warships from the base on Diego Garcia to come for the wounded. The boy was first treated on the ship, then sent to the military base for x-rays, and his friend got permission three days later to go by boat to the military base to pick him up.
The cost of the medical operation is $16,000 (it is not known how much it costs to deliver), and two teenagers, accustomed to the standards of their country, said that this is not much! And I didn't even have to worry about the payment method. Military doctors simply sent an account to the insurance company.
We asked ourselves many times what would we do if this happened to us!