Health & Insurance

Ocean Safety

Because most people coming to Hawaii are unfamiliar with the ocean environment, they're often unaware of the natural hazards it holds. With just a few precautions, detailed below, your ocean experience can be a safe and happy one. An excellent book is All Stings Considered: First Aid and Medical Treatment of Hawaii's Marine Injuries (University of Hawaii Press, 1997) by Craig Thomas and Susan Scott.

Note that sharks are not a big problem in Hawaii; in fact, they appear so infrequently that locals look forward to seeing them. Since records have been kept, starting in 1779, there have been only about 100 shark attacks in Hawaii, of which 40% have been fatal. Most attacks occurred after someone fell into the ocean from the shore or from a boat, and the sharks probably attacked after the person was dead. General rules for avoiding sharks are: Don't swim at sunrise, sunset, or where the water is murky due to stream runoff -- sharks may mistake you for one of their usual meals. And don't swim where there are bloody fish in the water, as sharks become aggressive around blood.

Seasickness -- The waters in Hawaii can range from calm as glass to downright frightening (in storm conditions), and they usually fall somewhere in between. In general, expect rougher conditions in winter than in summer. Some 90% of the population tends toward seasickness. If you've never been out on a boat, or if you've been seasick in the past, you might want to heed the following suggestions:

Everything You've Always Wanted to Know About Sharks -- The Hawaii State Department of Land and Natural Resources has launched a website, www.hawaiisharks.com, with more information than you probably wanted to know about sharks. The site covers the biology, history, and culture of these carnivores, and provides information on safety and data on shark bites in Hawaii.

Stings -- The most common stings in Hawaii come from jellyfish, particularly Portuguese man-of-war and box jellyfish. Since the poisons they inject are very different, you need to treat each sting differently.

A bluish-purple floating bubble with a long tail, the Portuguese man-of-war causes some 6,500 stings a year on Oahu alone. These stings, although painful and a nuisance, are rarely harmful; fewer than 1 in 1,000 requires medical treatment. The best prevention is to watch for these floating bubbles as you snorkel (look for the hanging tentacles below the surface). Get out of the water if anyone near you spots these jellyfish.

Reactions to stings range from mild burning and reddening to severe welts and blisters. All Stings Considered recommends the following treatment: First, pick off any visible tentacles with a gloved hand, a stick, or anything handy; then rinse the sting with salt- or fresh-water and apply ice to prevent swelling and to help control pain. Avoid folk remedies like vinegar, baking soda, or urinating on the wound, which may actually cause further damage. Most Portuguese man-of-war stings will disappear by themselves within 15 to 20 minutes if you do nothing at all to treat them. Still, be sure to see a doctor if pain persists or a rash or other symptoms develop.

Transparent, square-shaped box jellyfish are nearly impossible to see in the water. Fortunately, they seem to follow a monthly cycle: 8 to 10 days after the full moon, they appear in the waters on the leeward side of each island and hang around for about 3 days. Also, they seem to sting more in the morning hours, when they're on or near the surface.

The stings can cause anything from no visible marks to red, hivelike welts, blisters, and pain lasting from 10 minutes to 8 hours. All Stings Considered recommends the following treatment: First, pour regular household vinegar on the sting; this will stop additional burning. Do not rub the area. Pick off any vinegar-soaked tentacles with a stick. For pain, apply an ice pack. Seek additional medical treatment if you experience shortness of breath, weakness, palpitations, muscle cramps, or any other severe symptoms. Most box jellyfish stings disappear by themselves without any treatment.

Punctures -- Most sea-related punctures come from stepping on or brushing against the needlelike spines of sea urchins (known locally as wana). Be careful when you're in the water; don't put your foot down (even if you have booties or fins on) if you can't clearly see the bottom. Waves can push you into wana in a surge zone in shallow water. The spines can even puncture a wet suit.

A sea-urchin puncture can result in burning, aching, swelling, and discoloration (black or purple) around the area where the spines entered your skin. The best thing to do is to pull any protruding spines out. The body will absorb the spines within 24 hours to 3 weeks, or the remainder of the spines will work themselves out. Again, contrary to popular wisdom, do not urinate or pour vinegar on the embedded spines -- this will not help.

Cuts -- All cuts obtained in the marine environment must be taken seriously, because the high level of bacteria present in the water can quickly cause the cut to become infected. The best way to prevent cuts is to wear a wet suit, gloves, and reef shoes. Never touch coral; not only can you get cut, but you can also damage a living organism that took decades to grow.

The symptoms of a coral cut can range from a slight scratch to severe welts and blisters. All Stings Considered recommends gently pulling the edges of the skin open and removing any embedded coral or grains of sand with tweezers. Next, scrub the cut well with fresh water. If pressing a clean cloth against the wound doesn't stop the bleeding, or the edges of the injury are jagged or gaping, seek medical treatment.

What to Do If You Get Sick Away from Home

If you get sick, consider asking your hotel concierge to recommend a local doctor -- even his or her own. You can also try the emergency room at a local hospital. Many hospitals also have walk-in clinics for emergency cases that are not life-threatening; you may not get immediate attention, but you won't pay the high price of an ER visit.

If you suffer from a chronic illness, consult your doctor before your departure. For conditions like epilepsy, diabetes, or heart problems, wear a MedicAlert identification tag (tel. 888/633-4298; www.medicalert.org), which will immediately alert doctors to your condition and give them access to your records through MedicAlert's 24-hour hot line.

Pack prescription medications in your carry-on luggage and carry them in their original containers, with pharmacy labels -- otherwise they won't make it through airport security. Carry copies of your prescriptions in case you lose your pills or run out. Don't forget an extra pair of contact lenses or prescription glasses.

For domestic trips, most reliable healthcare plans provide coverage if you get sick away from home.

Travel Healthy -- Before you get on the plane, read Healthy Travel by Michael P. Zimring, M.D., and Lisa Iannucci (Basic Health Publications), for excellent information before, during, and after your trip. The book is loaded with great tips on surviving the long flights to Hawaii, the best health products to pack, how to make your trip stress-free, and a few pointers on managing your weight on the trip.

Safety

General Safety -- Although tourist areas are generally safe, visitors should always stay alert, even in laid-back Hawaii (and especially in Waikiki). It's wise to ask the island tourist office if you're in doubt about which neighborhoods are safe. Avoid deserted areas, especially at night. Don't go into any city park at night unless there's an event that attracts crowds -- for example, the Waikiki Shell concerts in Kapiolani Park. Generally speaking, you can feel safe in areas where there are many people and open establishments.

Avoid carrying valuables with you on the street and don't display expensive cameras or electronic equipment. Hold onto your pocketbook and place your billfold in an inside pocket. In theaters, restaurants, and other public places, keep your possessions in sight.

Remember also that hotels are open to the public and that in a large hotel, security may not be able to screen everyone entering. Always lock your room door -- don't assume that once inside your hotel, you're automatically safe.

Driving Safety -- Recently, burglaries of tourist rental cars in hotel parking structures and at beach parking lots have become more common. Park in well-lighted and well-traveled areas if possible. Never leave any packages or valuables visible in the car. If someone attempts to rob you or steal your car, do not try to resist the thief or carjacker -- report the incident to the police department immediately.

Ask your rental agency about personal safety, or request a brochure of traveler safety tips when you pick up your car. Get written directions or a map with the route marked in red showing you how to get to your destination.

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Note: This information was accurate when it was published, but can change without notice. Please be sure to confirm all rates and details directly with the companies in question before planning your trip.

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				Frommer's Honolulu, Waikiki & Oahu, 10th Edition Author: Jeanette Foster Pub Date: November 19, 2007 Price: $17.99				Related Titles: Frommer's Hawaii 2008 Frommer's Hawaii 2009 Frommer's Hawaii with Kids, 2nd Edition