A Journey Back to Paradise

Few of us get to recreate a life changing travel journey! I feel so lucky to have done just that this past week in Thailand. The love of my life swept me away on a 4-month travel adventure in Southeast Asia 26 years ago which led us to marriage and 2 kids. On the eve of celebrating our 24th wedding anniversary, I boarded a plane and traveled 18 hours to meet our daughter in Bangkok to kick off our mother-daughter Southeast Asia adventure for a month, in celebration of her 22nd birthday. The first week of this journey is a replica of the itinerary her dad and I followed, but in a much less primitive way. Hard to believe anyone could ever travel with no cell phone, no public wifi, no GPS, and no Vloggers giving you advise on the do’s and don’ts on your anticipated destinations. We were just armed with our Lonely Planet guidebook for backpackers and a sense of wanderlust. We mapped out our route on public transportation and set out to find our way to the remote islands of Koh Tao and Ko Nang Yuan. Yes – we used a paper map!

After spending 3 days in Bangkok visiting the usual tourist attractions, my daughter and I took a cheap flight, on Air Asia for $56.77US, from Bangkok to Chumpon, a fishing village which is a jumping off point to Koh Tao. The train ride we took years ago is still a popular option for backpackers these days but it really doesn’t make sense to suffer an overnight train for 8-10 hours when you can fly there in 1.5 hour for a few dollars more. 

Transportation systems to these heavenly islands are more well-organized than ever before. We were able to purchase a shuttle ticket from a kiosk at the Chumpon airport and immediately jumped into a minivan scheduled to whist travelers to town. On my previous visit, finding transportation was difficult to say the least and usually at your own risk. Not able to speak Thai meant that we didn’t always know for sure if we were going to end up at our intended destination. The ride my husband and I took with the questionable “taxi” from the Chumpon train station to the pier, via a dirt road in the dark of night, still sends shivers up my spine when I think back. 

After spending an overnight in Chumpon, my daughter and I boarded an early morning ferry boat headed to Koh Tao. I was so excited about the little less than 3-hour ride with toilets onboard. So glad I didn’t have to ride a little wooden fishing boat, and I mean little, with Mr. Dang’s family to the island like my last visit here. I don’t remember how long it took but it felt like a lifetime as I was throwing up the entire time.

The tourist boom on Koh Tao slapped me in the face as soon as we stepped off the ferry boat. Drivers holding name signs of guests they were picking up, tour excursion offices and restaurants lined the street in front of the Maehaad ferry dock. For a moment, I thought we were on the wrong island. Tourist transport and accommodation options are endless these days, unlike our only option back then of staying at Mr. Dang’s cottages because we were able to catch a ride with him. 

My daughter and I stayed at the Sairee Beach Cottage which was reminiscent of the little tiny beach cottages owned and operated by Mr. Dang. There was also a restaurant on the beach but with one big difference – when they made a smoothie, the lights didn’t go dim like it did at Mr. Dang’s.

For better or worst, many things have changed on the islands with the passage of time. As expected, with the ease of access to the islands comes over development in hotels and resorts. There were only a few dive shops 26 years ago as compared to over 80 dive centers now. There are more spas offering cheap massages ($10 US/hour) than I can count on one hand. But the most shocking of all were the changes on the Koh Nang Yuan island, a piece of paradise I have kept in my memory bank as “heaven on earth” all these years. It still has powder white sand on a sand spit but I had to share this beach with many. The newly established fee of 100 baht (approximately $3 US) to enter the island has not deter boatloads of tourists making the very short trip from Koh Tao to Koh Nang Yuan, nor has it helped to keep human trash from the ocean.  

With the popularity of these islands bring greater variety and higher quality of food, especially the western options that we might miss while traveling. The good cup of cafe latte that I was yearning for on my previous visit is now on every restaurant menu on the island.

The old adage of “take the bad with the good” rings true for me on this second trip to Koh Tao and Koh Nang Yuan. They may not be the purist island escape they once were but they will remain on the top of my travel list. In light of posting this blog on Thanksgiving, I want to express how thankful I am for the opportunity to revisit this paradise with my daughter and shared my passion for traveling with her. 


What to expect at your travel clinic appointment

Congratulations – You booked your flight and you’re off on your next adventure! 

Not so fast. Before you leave, take a few simple steps to stay healthy on your trip. By taking the time to understand the health risks at your destination, you’ll keep those around you healthy too. If you’ve never been to a travel clinic, here’s what to expect.

Before you go to a travel clinic

Make an appointment with your family doctor. Your primary healthcare provider and pharmacist may be able to take care of all your travel health needs, including vaccinations. If your doctor doesn’t have expertise in travel health or you need Yellow Fever vaccination, they will refer you to a travel health specialist (for example, Yellow Fever vaccination is only available from certified travel clinics). You can also book an appointment at a travel clinic if you don’t have a family doctor.

Try to book your travel clinic appointment at least 6 weeks before your trip. At busy travel clinics, it may take a week or two to get an appointment. It’s important to book early since many vaccines come in a series and need to be administered according to a specific schedule. Currently, there is also a shortage of Yellow Fever vaccine (expected to last until the end of 2019) so it may take longer to get an appointment.

A travel health specialist will provide medical advice, vaccinations, and medications based on your overall health status and your travel itinerary. They can help you prioritize vaccines if you are short on time or on a limited budget, give you tips about how to avoid common travel-related illnesses, and answer your questions about staying healthy abroad.

Before your travel clinic appointment, make sure to familiarize yourself with the health risks at your destination (our Country Health Advice tool can help). Knowing the risks can help you and your doctor make decisions together about which vaccines and medications are best suited for your trip.

What to bring to your appointment

Bring your immunization records and your detailed itinerary, including travel dates, planned activities, who you’re travelling with, and exactly where you are going – the more specific, the better. This is important because the nurse or doctor’s advice will be tailored to your health needs and the places you’re visiting. Make a list of any health conditions and medications you are taking.

During your appointment

A travel nurse or doctor will ask you detailed questions about your itinerary and your plans for the trip. Common questions include:

  • Where are you going? Which cities, towns, or rural areas are you planning to visit?
  • How long are you travelling for?
  • What is the purpose of your trip? Are you going on vacation, working, studying, volunteering, or visiting friends and relatives?
  • What type of accommodation will you be staying in (such as hotels, hostels, local homes, camping, or on a ship)?
  • What medications are you currently taking?
  • Are you up-to-date with your routine immunizations?

Many travel clinics use travel health information databases to identify local health risks, such as Rabies, Malaria, Dengue, Zika Virus, and other infectious diseases. Based on this information, your travel plans, and health status, your practitioner will identify key health risks you need to be aware of and protected from.

Vaccination is an important part of a travel clinic appointment. This is because many common travel-related illnesses are vaccine preventable. Depending on where you’re going and which vaccinations you’ve had in the past, you may get one, two, or several vaccinations during the same appointment. The majority of travel clinics are licensed to offer the Yellow Fever vaccine, which comes with a proof of vaccination certificate (here is a list of Yellow Fever centres in Canada and the United States). Common travel vaccines include Typhoid, Rabies, Japanese Encephalitis, and Hepatitis Aif not already immune. These vaccines are safe and getting vaccinated will go a long way toward keeping you healthy. However, many illnesses don’t have vaccines. For example, there is currently no Dengue vaccine for travellers. If you’re going to an area with Dengue, your travel health specialist will advise you on how to prevent mosquito bites and when to see a doctor if you suspect that you have Dengue.

Another example is Malaria. There is currently no commercially available vaccine against Malaria but there are antimalarial medications that can be used with bed nets and mosquito bite prevention measures to significantly reduce your risk of infection.

Antimalarial medications can have side effects, but there are several options available (check out our blog Malaria medication: your questions answered for more information). Your health provider can recommend the best option for you based on your health status and your destination.

No matter where you’re travelling, your travel health provider will explain how to choose safe foods and drinks, and how to reduce the risk of Traveller’s Diarrhea and Hepatitis A. The nurse or doctor may give you printed information about other health risks so you can read it at home. They may also recommend travel supplies, like a mosquito bed net if you’re visiting a place with Malaria or Japanese Encephalitis.

It’s important to give your travel health provider detailed information about your travel plans and your health status, particularly your mental health status, so that you can get the most out of your appointment. Some health and mental health conditions can be affected by travel or medication. Your provider can also give you tips and advice on managing your condition abroad and what to do in case you need a refill of your prescription, need to access a local doctor, or have a health emergency since some pre-existing conditions, including mental health, may not be covered by your insurance provider.

A note about fees: Travel clinics charge a fee for the consultation and additional fees for travel vaccines. These fees are not covered by government health plans in Canada and the United States. They may or may not be covered by private insurance. Read our Travel Vaccines on a Budget series for tips on prioritizing vaccines.

After your appointment

Go to a pharmacy to fill prescriptions from your appointment, such as antimalarial medication or antibiotics to treat severe Traveller’s Diarrhea. This is also a good time to assemble your first aid kit and refill other prescription medication.

If a mosquito bed net was recommended for your trip, you can purchase one from travel retailers or outdoor equipment stores. Box-style nets that can be tucked under your mattress offer the best protection because they keep netting (and mosquitoes) away from your skin. Bed nets treated with the insecticide permethrin provide better protection than untreated nets. (Some Canadian travel clinics sell permethrin-treated bed nets but permethrin is not currently available to consumers in Canada.)

Don’t let the precautions discourage you: Using common sense with prevention in mind is the key to a safe and healthy trip. Enjoy!

Source: International Association for Medical Assistance to Travelers