These health tips are based on experiences from my previous Sar-El tours and have personally helped me. It is my hope that some of the tips will prepare you for an enjoyable and unique experience while in the program.
Health care in Israel is at a high western standard, but many IDF army bases are in isolated areas with limited available medical care. We volunteers must discuss our medical problems with our physicians, and our VFI Ambassadors when applying to the program.
Listed below are some health tips to consider.
FITNESS: An exercise program can reduce the risk of chronic disease and help with a weight reduction program. I have found that walking 30 minutes a day helps in meeting the demands of the daily work schedule of the Sar-El program. You may want to think about walking, swimming, bicycling, or jogging, and about strength training before entering the program. You should be on an exercise program as part of a daily routine, and comfortable with it before leaving for a Sar-El program. Assigned jobs on the base can include light or heavy lifting, or standing for long periods of time. We can take breaks, rest periods, and if necessary, check with our Madricha about changing to a more suitable job. If you are on medications, check with your doctor before starting your exercise program. Particularly for older volunteers, the physical activity of the program, traveling, and changes in diet and climate may have serious consequences.
IMMUNIZATIONS: Israel does not require any immunizations for entering the country. I found it wise to obtain an annual flu shot. A tetanus vaccine every ten years is recommended. A vaccination for pneumonia should be considered for volunteers 65 years and older, with chronic cardiopulmonary conditions and/or smokers. Vaccinations should be obtained at least 4-6 weeks before leaving for the program.
MEDICATIONS: Keep prescription medications in original containers in carry-on-luggage. I take more medication that I expect to use on the trip. Take a list with you of your medications including non-prescription medications, such as aspirin and vitamins. We should discuss with our doctors about packing antibiotics for traveler’s diarrhea, respiratory infections, or any other infection we may be at risk for. On most IDF bases volunteers do not have access to refrigerators and those that are available are not of a standard to store medications. Volunteers with any condition which requires refrigerated medication will not be able to join the program. (See VFI Medical Information Form about medications requiring refrigeration). Wear a Medical Information Bracelet for allergies or for any special medical condition you may have such as diabetes. Older volunteers may take more medications than any other age group and are often at a higher risk for adverse drug reactions. A volunteer should not start a new medication just before starting the Sar-El program. I write down and take with me a daily schedule for taking my medications and keep it with my VFI papers. It is also wise to have a dental check-up before entering the program.
PACKING: VFI has a packing list on their website. Also, Ruth Mastron firstname.lastname@example.org has an excellent packing list with photos. A first aid kit for minor medical problems may include: Tylenol, Band-Aids, antihistamines, cough and cold medications, medicine for motion sickness, antibacterial cream, anti-diarrheal tablets, and sunscreen with a SPF of at least 15. Check with your doctor about any other special items that you may need. I pack my prescriptions for medications and for eyeglasses, and papers for VFI in my carry on luggage.
HEALTH INSURANCE: It is a requirement for the Sar-El program. Medicare will not cover the volunteer in Israel. Be sure to check your current policy if a travel clause is included. You may need to purchase suitable travel insurance.
TRAVELING: Wear comfortable clothes, and wear comfortable shoes that slip on and off for airport security and for removal during your flight. For long flights to Israel I suggest wearing support stockings. El-Al Airline has a list of exercises to use during the flight and how often to perform them, usually every hour, to prevent deep vein thrombosis in the legs. The cabin air has a low humidity, and one may develop dehydration. During the flight, drink plenty of liquids such as water and fruit juices.
JET LAG: VFI volunteers will travel across multiple time zones to reach Israel. I have experienced jet lag with symptoms of daytime fatigue and staying awake. Because of jet lag, which is temporary, your body’s internal clock wakes you during the night, and makes you drowsy during the day. Symptoms will be worse and last longer the more time zones you have crossed, and especially if traveling in an easterly direction. Jet lag usually doesn’t require treatment, but check with your doctor about using sleep medications or melatonin during the flight or afterwards. On arriving in Israel I try to be outside in the afternoon and combine this with exercise such as walking. Other things to do include getting plenty of rest before the trip and staying hydrated during and after the flight. I try to sleep on the plane if it is nighttime in Israel, and once in Israel I try not to sleep until the local nighttime. I have found arriving in Israel at least two days before joining the Sar-El program allows me to be more alert for the program.
COMMON COLD: One of the most frequent medical problems the volunteer may bring with them or contact during the program is a cold. Because we may be crowded together in our sleeping quarters, the virus causing the cold or even GI problems can spread easily among the group. For treatment drink lots of fluids, rest may help, take a break from the work schedule on the base, and avoid contact with other volunteers. You should seek medical attention if there is a high fever, breathing problems or no improvement within a few days. There are many over-the-counter remedies for a cold. Consult with a pharmacist or a doctor before combining various cold medications with prescription drugs.
GASTROENTERITIS (GI): GI symptoms include nausea, vomiting, diarrhea or fever. Contact from another person or from food poisoning can cause gastroenteritis. You should rest and not become dehydrated. Seek medical advice with vomiting, severe diarrhea lasting more than 1-2 days, dehydration getting worse, high persistent fever or severe abdominal pain. Tap water in Israel is safe to drink and the food on the army base is safe to eat, but be careful of food from street vendors. There is a tremendous variety of cuisines and food eaten in Israel. Meals on IDF bases are kosher army food and may not be what you are used to. On weekends away from the base, you will have a selection of places to eat: restaurants and cafes, food stands and in Israeli homes if invited by Israeli relatives, or by Israeli friends. Fresh fruit and dried foods can be purchased in open markets or local grocery stores which can be cheaper than eating at restaurants. Fruit can be saved from lunch on the base for an afternoon snack. I take energy bars to use as an in-between snack.
CONSTIPATION: It can be a problem during the program and can be caused by less exercise, poor fluid intake and not enough fiber-rich food. If a high fiber diet, fluids and exercise are not enough, fiber supplements, stimulants and stool softeners may be helpful.
BACK PAIN: We are sometimes given jobs on the base that entail physical activity that we are not use to doing at home. To alleviate the problem, tell your Madricha if your job is more than you can handle. Also it may help to take breaks from the job for periods of rest and for stretching. For sore muscles, you may want to take nonprescription pain relievers. Also, learn to lift properly, wear proper shoes (see program handbook) and as noted above, an adequate exercise program at home before joining the program will be helpful.
HEAT EXHAUSTION: Israel has many hot days, and many of the job assignments require us to be outside. Drink plenty of water during the work period, wear a wide-brimmed hat, wear light-colored and loose fitting clothing and use sun screen. Older adults are more vulnerable to heat because it takes more time to adjust to the heat. Volunteers on certain medications for cardiovascular conditions, medications for psychiatric conditions and medications for diabetes are at an increased risk for a heat-related illness. Check with your doctor to see if your health conditions will be affected by working outside in the sun. You may want to volunteer for a time when there is cooler weather in Israel and for a job where the volunteer can be inside a building.
SLEEP DISORDERS: Volunteers using CPAP(continuous positive airway pressure) machines for treatment of obstructive sleep apnea should bring machines that can be used for international travel. The CPAP machine should not be a disturbance to other volunteers in a multiple bunk room. A back up battery must accompany the CPAP machine in case of a power shortage. If the CPAP machine is a disturbance to other volunteers, the volunteer may be asked to leave the program. The volunteer with a CPAP machine should be comfortable wearing the mask and make any necessary adjustments before leaving for Israel. Volunteers who snore need to bring ear plugs for their roommates. Be sure consult with VFI/Sar-EL personnel and/or your doctor regarding questions about one’s sleep disorder before joining the program.
DIABETES: A number of volunteers who come to Israel have diabetes which is managed by diet and/or medications. The American Diabetes Association has an online site with information for diabetics who will be travelling. The volunteer should review this information. Before leaving for Israel see your doctor for a medical exam to make sure your diabetes is under control, and have a letter explaining what you need to do for your diabetes, and have a prescription for insulin and/or pills. Volunteers with diabetes should carry snacks and glucose tablets for emergency sugar sources at all times.
The volunteer with diabetes requiring insulin should consider where diabetic supplies including insulin will be stored while on a Sar-El program. Insulin stored in very hot or very cold temperatures may lose its strength. As noted above, adequate refrigeration is not available to the volunteer on every base. The diabetic volunteer who does require refrigeration for his/her diabetic supplies will not be able to join the program.
Be sure to have more than enough diabetic medication in case of an emergency, and the diabetic volunteer should wear a medical ID bracelet or necklace that shows the volunteer has diabetes. Since one will be on long flights, exposed to different activities, and have meals on IDF bases that may not fit your usual diabetic diet, test the blood sugar more often than usual. Diabetics should stay hydrated, treat dry skin and skin cuts, follow daily foot care regimen and bring comfortable shoes and socks.
It is my hope that these health tips will help volunteers have a happy, healthy and rewarding Sar-El journey.
By Wesley C. Walker, M.D.