Integral to the mission of ATHNA is advocacy for the health and safety of travelers and the advancement of our specialty.
Recently one of our directors, Julie Richards, shared a vlog that depicted travel health care in a somewhat negative light. In response, ATHNA authored a response to that vlog. We encourage you to read both the initial comment and our response on behalf of the role of travel health nurses.
ATHNA's response to Paul Sax
A Different - and Perhaps More Accurate- Perspective from Travel Health Professionals
Where to begin? You certainly raise some valid points in that some travel health resources are for-profit entities that may engage in the unethical practice of providing vaccines, medications, or other services that are not warranted given risks. You also make the point that travel health services are often not covered by health insurance, which is not only very problematic for many travelers but also the communities they impact.
Overall, though, this post does a disservice to patients and to all the committed health care professionals engaged in adhering to appropriate standards of travel health.
Travel health services are found in many types of settings that not only include hospitals, ambulatory care centers, and private travel health clinics, but also college health centers, occupational health units, public health departments, military bases, Visiting Nurses Associations, government offices (e.g., CIA, FBI, U.S. embassies, etc.), pharmacies, and even dental offices. Today travel health is a complex, dynamic specialty that is the focus of multiple professional organizations including The American Travel Health Nurses Association (ATHNA), the American Society of Tropical Medicine and Hygiene (ASTMH) and the multidisciplinary International Society of Travel Medicine (ISTM). In fact, in 2020, after working with ATHNA for seven years, ANA officially recognized Travel Health Nursing as a new nursing specialty.
A broad array of knowledge and skills are mandatory for providing high quality travel health services, including mastery of national and international standards of care (e.g., CDC, WHO), global epidemiology, pre-travel and post-travel assessment of the traveler and the itinerary, vaccinology, behavioral measures for travel-related injury and illness (e.g., preventing vector-borne diseases, rabies, motor vehicle accidents, food and water-borne illnesses, personal safety, recreational hazards, and climate risks. ) Travelers present with a myriad of complexities as well – they may be pregnant, nursing, immunocompromised, suffer from chronic illness or mobility issues. They may be infants or young pediatric patients, immigrants or refugees, VFRs (visiting friends and relatives) , or members of the LGBTQ+ communities that face additional travel challenges.
Moreover, specific itineraries, and climate considerations, and activities (e.g., conducting remote field work, providing medical care abroad, military operations, diving, mountain/rock climbing, spelunking, mission trips, study abroad, rafting), and types of accommodations (e.g., air conditioned, screens only, camping, traveling on a budget) may pose additional health and safety risks apart from the destination. To best prepare the traveler, these important elements of a journey require additional knowledge and resources.
Unfortunately, many health professionals as well as segments of the traveling public do not recognize travel health as the specialty that it is. For those of us working in the field, encouraging travelers to see their “regular doctor” for travel health services is often problematic. Although well-intentioned, it can lead to suboptimal care and really is not appropriate unless the primary care provider makes travel health a significant part of their practice and has the up-to-date knowledge and skills to provide quality care.
In the United States, travel health nurses are actually the first profession here to develop and publish the scope and standards of practice for the specialty. Published by ANA and written in concert with a committed team from ATHNA, this text it describes the “Who, What, When, Where, and Why” of travel health, 17 core competencies necessary for travel health professionals and our personal favorite – an actual code of ethics that providers should adhere to.
Instead of simply accepting the status quo, we would urge you to be a patient advocate and support efforts to make travel health services affordable and accessible to all travelers, provide travelers with the high-quality care everyone deserves, and support all efforts for ethical travel health practice that puts patients before profits.
Sandy Weinberg, RN, BSN, MA, FATHNA
Gail Rosselot, MS, MPH, ANP, BC, FAANP, FFTM, RCPS (Glasg), FISTM, FATHNA
Julie Richards, DNP, MS, MSN, FNP-BC, WHNP-BC, FATHNA
Elaine Rosenblatt, MSN, FNP-BC, FATHNA
Mette Riis, BSN, MSW, FATHNA
Sue Ann McDevitt, RN, BSN, FATHNA, FISTM, AFTM-RCPS (Glasg)
The above serve on the American Travel Health Nurses Association (www.athna.org) Board of Directors