General Travel Health

The Most Dangerous Leg of Your Journey.
-- Frank Gillingham, MD

"We should have you on the ground in Boston in 15 to 20 minutes," the pilot announced as the flight attendants collected the last cups and napkins. "And remember: the most dangerous leg of your journey is the ride home from the airport. So buckle up and drive carefully."

That's great advice I received recently from someone who knows a lot about safe travel. While many travelers worry about flying, we take for granted the danger we face whenever we get behind the wheel, or we are in the backseat of a cab. Terrorist attacks, hijackings, unusual bacteria and rare viruses all tend to make more interesting headlines than a cab wreck near some lonely airport. And yet every day travelers are injured or killed in automobile accidents.

Motor vehicle accidents comprise an astounding 25% of all deaths of U.S. travelers abroad¹. It makes sense that when you're driving on unfamiliar roads with a strange rental car, your risk of missing a turn is probably higher than when you are at home. So, please add driving to the long list of tasks you must attend to carefully on your next trip. Listed below are some specific ideas and suggestions - many of which are simple common sense. When it comes to vehicular safety, knowing what to do is the easy part.

• Avoid Distractions. Modern drivers scan radio stations, talk on the phone, read, eat, daydream, stare at billboards and basically seem to train their eyes on every possible place other than on the road ahead. All at 65+ MPH. Let's collectively pinch ourselves and pay better attention to the road.
  
  
• Wear your seatbelt. Even in cabs. They work.
  
  
• Speed, fatigue and alcohol kill. Speed, fatigue and alcohol kill. Easy to remember - hard to follow. Since the typical business trip involves a fair amount of hurrying around in a state of chronic fatigue - not to mention a bottle of wine with clients - we all must be particularly mindful of these risks. Jet lag is never fatal unless mixed with a rental car. Caffeine is no substitute for sleep.
  
  
• Plan your route in advance. Maps are hard to read. Especially when you're cruising along in the left lane of a rain soaked freeway.
  
  
• Beware of dangerous taxi and limousine drivers Use only licensed cabs (you'll need to do some research to figure out what color taxis can be best trusted in your destination). Ask a speedy cab driver to slow down - or order him to stop so you can get out and get in another cab. Use nationally recognized limousine services like Boston Coach if available - they are more likely to screen and train their drivers and maintain their vehicles properly.
  
  
• Beware of rental cars. Sometimes hiring a car and driver is the safest thing to do in an unfamiliar city, especially when you're tired.
  
  
• Avoid Night Driving. Darkness makes driving in an unfamiliar place even more challenging.
  
  
• Avoid Motorcycles and Mopeds. Dangerous, at home or away.
  
  
• Beware of international driving. If you plan to drive while traveling internationally, you face an additional set of challenges. The vehicular fatality rate in most countries exceeds the rate in the U.S. -- in certain countries such as Egypt, Kenya and Turkey, the rate is 10, 20 or even 40 times higher. Rental cars and roads in foreign countries are often not as well maintained as they are in the U.S. You will be unfamiliar with local driving laws and customs and confused by road signs (in some countries traffic laws are truly lacking - or are poorly enforced).
  
  As a start, be sure to research basic driving conditions in foreign countries using the State Department's Consular Information Sheets. These sheets also contain information about the relative safety of public transportation. The Association for Safe International Road Travel provides its individual and corporate members with very detailed reports about road safety in foreign countries. Supplement your own research by checking with your local sponsor or host about the various alternatives - much better to get advice from a local expert than to pick a taxi or a bus based on a free route map or the suggestion of a passer-by.

¹Hargarten SW, Baker TD, Guptill K: Overseas fatalities of United States citizen travelers: An analysis of deaths related to international travel. Annals of Emergency Medicine 20:622, 1991.