The Downside of Paradise

‘I have just escaped from a physician and a fever, which confined me five days to bed … Here be also two physicians … I protested against both those assassins, but what can a helpless wretch do?’

The above excerpts are taken from a letter written by the poet Lord Byron in October 1810, written whilst he was touring the ancient ruins of Peloponnese in southern Greece. He had been suffering from a recurrent fever and shaking (rigors). Writing in this month’s edition of the Journal of the Royal Society of Medicine, Costas Tsiamis suggests that, from Byron’s own descriptions and a knowledge of the area in which he was travelling, it is quite likely that Byron was suffering from malaria. If so, he was fortunate to survive: not necessarily because of the dubious quality of his physicians, but because the disease was poorly understood and no effective treatments had then been identified.

However, two hundred years on, medical science has only brought limited advancement in the treatment of this mosquito-borne infection. According to a report from the World Health Organisation in 2010, 225 million cases of malaria are diagnosed every year and the disease kills almost 800,000 people; accounting for 2% of all worldwide deaths. Clearly, it is not a disease to be taken lightly. Nonetheless, each year thousands of holiday makers from the United Kingdom travel to exotic locations without a thought for the risks to their health; in the case of malaria, failing to take adequate courses of anti-malarial medication, and otherwise neglecting to enquire about vaccinations for other infectious diseases such as typhoid, polio, hepatitis A, yellow fever and rabies. Just because the destination of choice does not make the vaccinations compulsory for entry doesn’t mean you shouldn’t have them. If they are compulsory, it is to protect the inhabitants of the country you are travelling to, not because of that country’s concern for your well-being.

That said, exotic locations do not just bring risks of infection. With an increasing number of older adults taking time out to travel, insurance companies are seeing an astonishing increase in the level of medical expenses claims on travel insurance policies. Figures from the Association of British Insurers indicate that the cost of becoming ill whilst abroad rocketed to £275m in 2010, from a mere £74m in 2004, with the blame being firmly attached to those over 65 years of age.

Of course, holiday makers are not the only ones leaving our shores. Many of those in retirement go in search of greener grass (or at least lower taxes and better weather). Unfortunately, health care is not always of the same standard as in that provided by the NHS in the UK, or may only be available privately and for large fees. According to the British Insurance Brokers’ Association America is, not unexpectedly, the most expensive country for health care, whilst Greece is one of the cheapest. Surprisingly though, according to the Foreign and Commonwealth Office Britons are five times more likely to be hospitalised in Spain than in America.

There is little doubt that Lord Byron’s malaria affected his health for the rest of his life, and he died in 1824 at the age of 36. Of course, today he would be able to obtain advice on malaria prevention and travel vaccinations from physicians better qualified than his imagined ‘assassins’. Happily, your own experience of paradise can have a better outcome than Byron’s, but only with foresight and planning. Whether you are retiring abroad or merely taking a week’s holiday, it pays to discuss your plans with your GP well in advance.

(This article was first published in the Scunthorpe Telegraph, Thursday 1st September 2011)