HouseCall 1011

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CONTENTS

COVER STORY:
KATY CALDIS ON HER FIRST TERM

CHECK UP:
WE'RE GOING
ON A SUMMER HOLIDAY

STRAIGHT TALKING ABOUT HIV/AIDS

SUMMER TIME AND THE BURNING IS EASY

FEATURES:
UNLIMITED GP
ACCESS IS HERE!

30 DAY POST- HOSPITALISATION
BENEFIT

REGULAR FEATURE:
HEALTHY MADE EASY

The end of a first term and what a term it's been

- Katy Caldis, CEO

I can scarcely believe that we have come to the end of my first year of term at Fedhealth. It has been such an exhilarating 12 months and a privilege to work with such a passionate and dedicated team of experts.

At the beginning of the year we promised you, our members, that we would make it our business to find ways of making medical aid sustainable and affordable. As we move into 2011, I am delighted that we have indeed managed to expand our Fedhealth range of options to provide far greater differentiation. We now have a range of options that caters for every person at every stage of their life. We have made our affordable options just that - much more affordable without compromising the choice of those members who elect to choose a more comprehensive option with richer benefits. The key is to correctly analyse your needs and select the option that best suits your profile.

In keeping with our commitment to consistently improve on medical aid by providing unique benefits, we have also proudly launched our unlimited GP benefit this year. Members on most options can now look forward to unlimited access to GPs, even once their day-to-day benefits are exhausted. The only condition is that you make use of the expansive Fedhealth GP Network that will be operational from 1 January 2011. This benefit will be available to members on all options except the Hospital Plans, which do not include day-to-day benefits by design. These options are Ultima 200, Maxima Core and Maxima EntryZone. If you family doctor is not part of our network we would encourage him/her to join as this means no co-payments and more extensive benefits for you.

The Scheme will be working closely with contracted GPs and assisting those in the network to practice more cost effectively. GPs will be profiled and encouraged to improve the quality of care delivered and to be the coordinator of care for each patient.

To support this we will be launching a major education and advisory campaign for members, supported by a strong wellness theme early in the new year. In addition we will be making electronic health records available to each of our beneficiaries during the course of 2011 to assist you in understanding and taking accountability for your own health status.

We have also been successful in our pharmacy negotiations and have set up a preferred provider network with fixed dispensing fees. At the end of the day all these measures are designed to help contain costs and keep medical aid affordable.

We are striving for real options and real benefits for members. This is underpinned by a strong wellness drive which permeates everything we do. If we as a group can start making changes in our lives - in how we eat, how we exercise and in our approach to preventative care - we can start to turn around the cycle of disease. In 2011 we will be speaking far more to you about this philosophy and are proud to be kicking off the new year with the sponsorship of South Africa's first International Health Conference. Respected nutritionist, health researcher and author of the critically acclaimed book 'The China Study', Dr Colin Campbell, will be one of the key note speakers at the first Fedhealth International Natural Health Conference ever to be held in South Africa in January 2011.

Dr Campbell is a Professor Emeritus at Cornell University and one of the most respected nutritional biochemists in the world. His message is simple - change your diet and dramatically reduce the risk of cancer, diabetes, heart disease and obesity. He will be joined by Dr Pam Popper, a naturopath, nutritionist and the Executive Director of The Wellness Forum based in Ohio. This conference has been facilitated by Mary-Ann Shearer, the best-selling health-author in the Southern Hemisphere and founder of The Natural Way.

It promises to be a great start to the new year and best of all, we have preferential rates for Fedhealth members.

On that note I would like to thank all of our members for your committed support over the last year and would like to wish you and your families a safe, restful and blessed festive season. If you are travelling please remember to buckle up and drive safely.

Here's to a healthier 2011! ♦

Points of contact

If any of your contact details change, please notify us immediately by contacting the Fedhealth Customer Call Centre on 0860 002 153. Alternatively, your new details can be faxed to 011 671 3647 or e-mailed to update@fedhealth.co.za

Control at your fingertips

Make use of our online facilities
Keep track of your membership and get an in-depth view of your claims history at www.fedhealth.co.za Register today with your name and membership number and have more control and peace of mind. You will also be able to find out more about our benefits and options.

	Unlimited GP access is here!
	At Fedhealth we're constantly looking at ways to improve the affordability and the quality of healthcare provided to members, and are excited to announce the introduction of a Fedhealth General Practitioner (GP) Network as of 1 January 2011. This enhanced benefit will focus on providing you and your beneficiaries with unlimited access to GP consultations, provided you make use of a GP on the Fedhealth GP Network. How it will work is that GP consultations will be paid as per normal from your OHEB and thereafter from your Savings. The difference now is that once your Day-to-Day benefit is depleted and you reach your self-payment gap, GP consultations will continue to be paid unlimited. These consultations will be paid from risk (i.e. as if you have already reached Safety Net) and continue into your Safety Net Benefit, provided a network GP is consulted. This benefit will be available to members on all options except the Hospital Plans, which do not include day-to-day benefits by design. These options are Ultima 200, Maxima Core and Maxima EntryZone. The unlimited GP benefit will apply to the following options: • Ultimax • Ultima 300 OHEB • Maxima Exec (previously Ultima 200 OHEB) • Maxima Plus • Maxima Standard • Maxima Basis The cost savings that you will benefit from are: • Once you have exhausted your OHEB and Savings benefit (during the self-payment gap); all your GP consultations will still be paid provided you consult a network doctor • Once you have exceeded your self-payment gap and the Safety Net Benefit has been reached, any applicable member co-payments will be waivered if a network GP is consulted • Your GP will claim directly from Fedhealth. Please note that this benefit only pertains to the GP consultation fee i.e. does not include medicines costs etc.
A question you may be asking is whether you can still use your current GP even if they are not on the Fedhealth GP Network? The answer is yes; the decision as to whom you choose to see as your GP remains entirely yours and you are welcome to continue making use of any GP of your choice. The consideration to bear in mind is that if a specific GP is not contracted to the Fedhealth GP Network and your Day-to-Day Benefit is depleted (in the self-payment gap) you will be liable for the costs of GP consultations until your Safety Net level is reached. In order to find out whether your GP is contracted to the Fedhealth Network, please visit the Fedhealth website at www.fedhealth.co.za. You will find a link to the GP locator which will assist you in finding out whether your GP is contracted or not. If your GP is not contracted and you would like them to be, please discuss this with your GP. No GP will be excluded from contracting into the Network if they are willing to participate.

30 Day Post-Hospitalisation Benefit
Understanding this benefit The 30 Day Post-Hospitalisation benefit is designed for value added protection after a hospital stay. The Scheme will pay for all post-hospital treatment at 100% of the Fedhealth Rate for 30 days from the date of discharge, with the costs covered from Risk and not from your Savings. This protection ensures that you get the full benefit of completing the correct treatment that a hospital stay may require. Most importantly it also means that the actual time you spend in hospital is minimised and that your day-to-day benefits are protected. For example, after a back operation when you need additional x-rays and physiotherapy, there's great relief in knowing that the hospitalisation, together with the related post-hospitalisation costs (provided they fall within the first 30 days) will all be taken care of. The benefit covers the following range of complications and treatments that may arise: physiotherapy, occupational therapy, speech therapy, X-rays, pathology tests, dieticians, non-routine procedures carried out for suspected complications, and oxygen. Please be aware that certain conditions apply for the benefit to be applicable. The conditions that apply to the benefit: • Members must pre-authorise treatment 48 hours before having the treatment eg. an x-ray • Only treatment as a result of a hospital event will be covered • Only follow up treatment related to the original diagnosis is covered • If the member does not pre-authorise treatment, the claim will be paid from the Day-to-Day benefit or by the member • Authorisation after treatment date will not be considered • The doctor who treated the patient in hospital must request the treatment • This benefit will not apply to any post-hospital treatment after subsequent admissions to hospital for complications from the first admission. What the benefit does NOT cover: • This benefit does not cover post-hospitalisation treatment after the first 30 days from discharge • Routine consultations and investigations for medical follow-up cases • All cases that were treated in a casualty ward and any casualty follow-up treatment • Painkillers, sleeping pills and bandages • Treatment by a chiropractor, aromatherapist, acupuncturist • Dressing of wounds • Medication - this includes all iv and imi injections or antibiotics given in the rooms • Specialists referrals and related requests • Surgical appliances e.g. wheelchairs, braces and crutches • Biokinetics. Please call the Authorisation Centre on 0860 103 951 to obtain authorisation.

Another quality milestone for Fedhealth

Quality has always been the essential ingredient in the Fedhealth experience - not only in terms of the design of benefits and products but also in the level of service excellence delivered to you.

Fedhealth recently scooped the top four awards in the annual ThinkMoney.co.za subscriber's survey (for the second year running) and currently has the highest compliment and lowest complaint ratio over 12 months on the Hello Peter website. Now Pricewaterhouse Coopers has granted ISO 9001:2008 certification to the team responsible for Fedhealth's administration.

The certification is the end result of an extensive 8-month project which involved intensive training, customer research, detailed behind-the-scenes process mapping and evaluation, process improvement, implementation and finally auditing and certification by Pricewaterhouse Coopers.

ISO 9001:2008 is a global quality management standard that assists both product and service organisations achieve standards of quality that are recognised and respected throughout the world. However what distinguishes the ISO 9001:2008 standard is its uncompromising focus on you the member.

The standard is based on the following principles:
• Customer focus
• Leadership
• Involvement at all levels of the business
• Implementing a process orientated approach
• Continuous improvement
• Applying a systemic approach to management
• Instituting a factual approach to decision-making
• Establishing mutually beneficial supplier relationships.

In practice these principles mean that Fedhealth's market-leading standard of customer service will be more efficient, consistent and member friendly. The ISO 9001:2008 certification also means that the Fedhealth administration team is committed to continuous improvement.

All this translates into an enhanced service experience for Fedhealth members.

Get authorisation to avoid a penalty All expenses that are paid from the In-Hospital Benefit must be pre-authorised at least 48 hours before admission to hospital or the procedure taking place, for example an MRI or CT scan. In the event of an emergency admission or emergency treatment in a casualty ward, the Authorisation Centre must be contacted within 2 working days after admission. Contact details of the Authorisation Centre: 0860 103 951 or e-mail details to authorisations.cpt@medscheme.co.za.	Savings available upfront for the year
The following information is required to authorise your treatment: • Membership number • Member or beneficiary date of birth • Reason for admission and applicable tariff codes for the proposed treatment • Date of admission and the proposed date of the operation • The doctor's name, his/ her telephone and practice numbers, if available • Name of the hospital with telephone and practice numbers if available. • For a CT or MRI scan, the name of the radiological practice is also required. Failure to obtain an authorisation number will result in a R1 000 penalty.	The savings account for day-to-day expenses is available upfront in advance for the year. In other words, if your monthly savings account contribution is R100, then the full R1 200 is immediately available to you on 1 January. When a member leaves the Scheme, any advance savings amounts that have been used by the member are payable back to the Scheme within 10 days of the resignation date.

WHAT IS CTI? Computer Telephony Integration From 1 December, the Fedhealth Customer Call Centre will be introducing Computer Telephony Integration. This useful tool allows our call centre agents to identify callers as soon as a call is received. The member enters their membership number before being transferred to a call centre agent. The member’s details are displayed on the agent’s screen at the press of a button when he or she receives the call. This feature allows the agent to greet the member by name and provides a history of any recent activity at a glance. To enjoy speedier service when calling the call centre, please have your membership number available before making the call.

DECEMBER HEALTH CALENDAR
Prevention of injuries month
1	World AIDS Day
3	International Day of Disabled Persons
5	International Volunteers Day
9	World Patient Safety Day
10	International Human Rights Day

Straight talking about HIV/Aids

HIV/AIDS has become one of the most talked about conditions in history, and is no longer just a health issue. Current estimates suggest that around 5.5 million South Africans are infected with the virus. HIV/AIDS poses a significant threat to the development of South Africa as unlike other health conditions, most HIV infections occur in the economically active population (largely in the 20 - 65 age group), which could have serious implications within the country. HIV/AIDS the human aspect With HIV/AIDS we have to remember that there is a human aspect to this virus, that there are people around us living with HIV on a day-to-day basis, who require help and support. There are therapies and treatments that are able to keep people living with the virus healthy and productive for longer than before. Vitamins, good nutrition and exercise can play a critical role in keeping your body strong and healthy. The key is action and information. The first step is to find out whether you have been exposed to HIV and what you can do to stay healthy. Dispelling dangerous misconceptions around HIV/AIDS: • HIV/AIDS is not confined to any particular group (race, sexuality, gender etc) • HIV/AIDS is not a punishment for any wrongdoing • You can't get HIV from mosquito bites, sharing meals, hugging, kissing or drinking from the same cup as an infected person • HIV is not transmitted through sweat, saliva or tears and the only bodily fluids which can transmit it are sexual fluids, blood and breast milk • Having sex with a virgin will NOT cure HIV. The truth around HIV/AIDS: • There is no cure for HIV and the virus will remain in the blood • You can infect others or become infected if you have unprotected sex • You must use condoms correctly to protect yourself and your partner • Once HIV positive, infections such as TB can occur easily because your body cannot fight them • You can lead a normal and healthy life if you are HIV positive • The only way you can tell if you have become infected with HIV is to have an HIV test • AIDS only occurs once the disease has progressed. When a person is HIV positive, the virus attacks their CD4 white blood cells and as it damages these cells and multiplies, their body gets weaker until eventually they get AIDS. This is a slow process and can take up to 10 years if left untreated, but much longer if they receive appropriate and timeous treatment.	AIDS stands for Acquired Immune Deficiency Syndrome. It is the end stage of HIV infection. An HIV positive person is said to have AIDS when: • They have a very low white blood cell count (CD4 count). The amount of HIV in the blood is also usually very high • They succumb to certain other infections as a result of their weakened immune system. These are called opportunistic infections, and can typically include TB, recurrent pneumonia and thrush. Certain cancers, e.g. Kaposi's Sarcoma and dementia may also occur. The chances of HIV passing from mother to child is about 20 - 40% during pregnancy and at the time of birth, the risk of infection increases further if the mother breastfeeds. Unfortunately many women only find out they are HIV positive when they fall pregnant. HIV counselling and testing during pregnancy is encouraged, as it is possible to reduce the risk of mother to child transmission of HIV. You can avoid infection. The first step in prevention is to know your status! Your choices are either to abstain from sex, to be faithful to one partner only or to practice safer sex by wearing a condom. It's also very important to get treatment for any other sexually transmitted infections (STIs) you may pick up as untreated STIs lead to cuts and sores on the sexual organs. This makes it very easy for the HIV to spread from person to person. Getting tested is no longer simply a way of finding out if you're HIV positive or negative, but can give you an opportunity to take stock of your lifestyle and sexual behaviour. Fedhealth has in place a benefit, managed by Aid for AIDS (AfA), which is available to all HIV positive members and their beneficiaries. The two most important messages for you to understand are these: • The HIV benefit managed by Aid for AIDS is available to all who need it, with no extra financial contribution from you, within the normal rules of the Scheme • All you have to do is register on the programme. Early registration on the AfA programme is critical for the best possible management of HIV. By registering before medication is even needed, you will gain access to invaluable support and guidance thus preparing you mentally and emotionally for the journey ahead. You will also be well placed to be introduced to treatment at the right time which is critical for improving the effectiveness of the medicine. If you have any questions about HIV testing and treatment, how to register on the programme or if you'd like confidential advice on the condition, contact Aid for AIDS on 0860 100 646.

We're going on a summer holiday

With the glorious South African summer holidays lying ahead, we're all sure to take in as many beaches, braais and parties, and as much sunshine, swimming and surfing as possible. Keeping the following tips in mind though will make the holiday great fun right through to the end for all HouseCall! readers and their families. Who feels like spending New Year's Eve in a hospital casualty ward anyway?

Catching serious rays
Our sunshine is dangerous, especially between 10am and 4pm. The hole in the ozone layer particularly affects South Africa and Australia. Get into the habit of covering up, wearing sunglasses and hats and don't skimp on high factor sunscreen. First and foremost, skin cancer is a very real danger, and then let's be honest, you really don't want to end up looking like a weathered old lizard by the time you hit 30 or 40 either.

Surf's up!
There are no two ways about it - the sea is dangerous. It might be lovely, cool and inviting, but underneath the surface of the water lurks danger in the form of currents, sudden dips on the ocean floor, rocks, bluebottles and, if you are extremely unlucky, sharks. One wave can knock you over and one current can pull you out to sea. Enjoy the sea, but don't get in over your head. Never swim alone and don't try to show off, the sea is always a much stronger opponent!

Festive-season-fatty
Holidays and weight gain often go together. Have fun by all means, and don't stress too much if you pick up a kilo or two, who doesn't? Just watch out that it doesn't creep up and become more than that. Even regular long walks along the beach can help keep the bulge at bay.

Sun struck?
Our summers are extremely hot and you can get sunburnt. If this does happen, take a cool bath or shower. Put cool compresses on your skin. Take aspirin for pain relief. If any blisters develop, do not break them. If you start shivering, you need to see a doctor, as you could have sunstroke.

Baby light my fire
The sun is not the only thing that can burn you. Braai-fires injure many people every year. Stand well away from them and don't even think of lighting fires with methylated spirit or any other inflammable liquid. Always keep a bucket of water close by. Also remember to throw sand on the coals before leaving them unattended.

Shade those peepers
The ultraviolet rays of the sun could damage your eyes. If you don't have money for expensive sunglasses, wear a hat with a reasonably wide brim, or a sun visor.

Death traps
Never get into a car with a drunk driver. With a drunk driver behind the steering wheel, the car instantly turns into a death trap.

That's how we roll!
Take care when rollerskating or skateboarding and preferably keep off roads that are in use. Wear helmets and knee and elbow pads.

Look mom, no hands
Play by all means, but don't be silly. Don't run around the edges of swimming pools unless you feel like starting the new year with no front teeth, and be careful when swimming in rivers and farm dams.

Ouch! What was that?
Sea sand often contains rusty nails and glass shards. Be mindful of where you walk. If you step on something, make sure you clean the wound properly and if it was anything rusty, you might need a tetanus injection.

Summer lovin' had me a blast...
Holiday romances are great fun, but don't get too involved, as chances are you could end up heart-broken. Enjoy them while they last (remember the rules of safe sex if it gets that far), but don't get your hopes up too high. When we are on holiday, our requirements are also slightly different to what they would normally be.

Don't flip out
Every summer you see large groups of young people driving to beaches on the backs of open bakkies. Hold on tight and don't fool around, falling off at even 10 kilometers per hour could severely injure you.

Have fun, take care and make this holiday one to remember, and not because of your visit to the Intensive Care Unit at the local hospital.

Summer time and the burning is easy

So you know that the sun is dangerous and that you need to take precautions, but it's a mission to go through the whole sunscreen routine at the beach, right? Well it's time you rethink that.

Here are 12 sun-safe tips to save you:
• Self-tan: Treat yourself to a nifty fake tan. Just remember that you need real sunscreen too when you hit the beach!
• Once more, with feeling: If you swim, sweat or towel off, you need to reapply your sunscreen. It's also a good idea to reapply sunscreen throughout the day
• Pucker up: Use a lip balm with sunscreen
• Check the bottle: If you're on medication, check whether it makes you photosensitive. If in doubt, ask your doctor or pharmacist
• Slap on sunscreen: Put on plenty broad-spectrum protection for UVA and UVB rays, at least half an hour before going outside. Use sunscreen with a sun protection factor (SPF) of at least 15. Wear sunscreen in all seasons, even on overcast days
• Be terminally cool: Invest in a good pair of sunglasses. Check that they block both UVA and UVB rays
• Wear a hat: A huge straw affair or a classic Panama say as much about your sense of self-preservation as your sense of style. Pair it with a long-sleeved linen garment
• Know your SPF: Use sunscreen with a sun protection factor (SPF) that's best for your skin type and intended time in the sun. Remember that dark skin can burn, too
• Not just on your nose: Apply it to your ears, hands, feet, neck, the backs of arms and everywhere else that catches the sun without you realising it
• Run for cover: If your shadow is shorter than you are, you're vulnerable to sunburn. Plan your outdoor activities for before 10am or after 4pm
• Don't be fooled by reflection: The sun's harmful rays reflect off water, sand, snow and concrete. Apply sunscreen even when you're under a beach umbrella
• Moisturise: Moisturisers with vitamin E and aloe can help replenish lost moisture. Ask a friend to help.

HEALTHY MADE EASY

Here's to the holidays!
The festive season is almost upon us, so this month's HouseCall! takes a look at tasty variations on some of your holiday favourites, together with two appetising recipes for snacking. A well-deserved holiday is definitely the time to relax and have fun, but be wise about your food choices; nobody wants to start the new year with a serious battle to beat the bulge.

Tasty alternatives to make the summer holidays healthier:
• Instead of fried eggs, have poached or scrambled eggs with smoked salmon
• Instead of a greasy breakfast, have an egg-white-only omelette with mushrooms and grilled tomato
• Instead of hash browns, have mushrooms and tomato
• Instead of steak and chips, have grilled fillet or lean biltong strips with a green salad
• Instead of chips, have baked potato wedges with an avocado and cottage cheese dip
• Instead of crisps, have oven baked sweet potato and beetroot wedges
• Instead of fried chicken, have turkey or ostrich shavings with salad and corn
• Instead of boerewors, have chicken, ostrich or venison wors
• Instead of sausage rolls, have chicken and vegetable kebabs
• Instead of sour cream, have cottage or ricotta cheese on baked potato
• Instead of coconut milk, use lite coconut milk or yoghurt
• Instead of ribs, have chicken, beef or ostrich kebabs
• Instead of fatty dips, have low fat hummus or cottage cheese and avocado dip
• Instead of potato crisps (36% fat), have dried apple chips (0% fat)
• Instead of crisps, have low fat Japanese rice crackers
• Instead of chocolate, have strawberries dipped in chocolate
• Instead of biscuits, have biscotti (homemade without nuts)
• Instead of Pro-Vita, have Ryvita
• Instead of chicken-liver pâté, have low fat aubergine pâté or roast vegetable pâté
• Instead of deep fried samoosas, have spinach in phyllo pastry or baked samoosas
• Instead of hot, sticky puddings, have sorbet and berries, or low fat custard with berries
• Instead of cakes, have pancakes filled with steamed cinnamon and apple slices
• Instead of coffee, have lite ice tea - preferably home-made
• Instead of a milkshake, have low fat fruit smoothies
• Instead of sausage rolls, have mini kebabs
• Instead of ice-cream, have fruit lollies and sorbet
• Instead of rich desserts, have sorbet, ice cold watermelon or fruit kebabs.

Tips to make ordering out healthier:
• Order toasted sandwiches with ham, pastrami or beef, and add mustard
• No mayonnaise fillings on sandwiches, order brown bread or rye without butter or margarine
• Make sure you order a side salad and NO chips
• Make sure you ask for your dressing on the side
• Share a pudding, but better still have fruit salad
• Sushi gets the prize for the best takeout.

Watermelon, Feta, Basil and Pine Nut Salad
45ml fresh basil, sliced
30ml fresh lime juice
A splash extra virgin olive oil
1 kg cubed seedless watermelon
1 tub Woolies Slimmers Choice Danish style feta (0,7g fat per 100g)
Handful pine nuts, lightly toasted (however delicious, pine nuts are very high in fat so use sparingly!)
Mix basil, lime juice and olive oil, season with some salt and pepper, and then add to the rest of the ingredients.

Hummus
1 tin chickpeas, rinsed and drained
Juice of 1 lemon
2 tsp salt
1 tsp milled black pepper
1/2 tsp ground coriander
3 garlic cloves, peeled and crushed (optional)
125ml (half a cup) fat free plain yoghurt or soya yoghurt. Blend together and served chilled.

Be active, don't eat too late and don't drink too much, make healthy choices and don't forget your greens. Lastly, when ordering pizza, remember to halve the cheese and add on the vegetables. Have a blessed and healthy festive season!

Contributed by Amanda Weber of Dietetic Consultancy cell: 083 302 5976 e-mail: dietaw@iburst.co.za

The buzz that bites

The A, B, C and D of malaria

With many of us already planning and even packing for our well deserved holiday it's time to know your A, B, C and D of malaria.

Malaria is a common tropical disease caused by a parasite known as Plasmodium. The infection occurs through a bite by an infected female mosquito, blood transfusion from an infected donor, or use of infected needles by a drug abuser.

There are four types of human malaria:
• Plasmodium falciparum
• Plasmodium vivax
• Plasmodium malariae
• Plasmodium ovale

Depending on the species of mosquito, symptoms can take from 7 to 35 days to start. It can be as long as 6 months or as short as 5 days in patients who acquire it through blood transfusion or needle prick. Symptoms of malaria include tiredness, abrupt chills and fever (39 to 41^oC), which may cause profuse sweating after 2 to 3 hours. Other symptoms include fast pulse, headache, nausea, passing a lot of urine and muscle pains. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs.

The ABCD of malaria prevention according to the World Health Organisation are:
• Awareness of risk
• Bite prevention
• Chemoprophylaxis, and
• Rapid Diagnosis and treatment.

To diagnose malaria, the doctor does a blood test (smear) and the patient may be hospitalised for observation. Malaria can be cured with prescription drugs, but the type of drugs and length of treatment depends on the kind of malaria diagnosed; where the patient was infected; age and the severity of the patient's condition at the start of treatment.

Another concern regarding treatment is that in some parts of the world, the parasites have developed resistance to a number of malaria medications. Early treatment of uncomplicated malaria produces excellent results.

There are two types of prophylaxis:

Suppressive prophylaxis
Chloroquine, Proguanil, Mefloquine, and Doxycycline are suppressive prophylactics. They are only effective at killing the malaria parasite once it has entered the blood stage of its life cycle. It has no effect until the liver stage is complete which is the reason why these prophylactics must continue to be taken for four weeks after leaving the area of risk.

Causal prophylaxis
Causal prophylactics target the blood stages of malaria as well as the initial liver stage. This means that you can stop taking the drug seven days after leaving the risk area. Malarone and Primaquine are the only causal prophylactics in current use.

To prevent malaria, know the risk areas (areas below 1000m altitude) and high-risk times (October to May in Southern Africa). Prophylactic treatment as prescribed by your doctor or travel clinic must be taken prior to travelling. Pregnant women should ideally not expose themselves to the possibility of malaria.

Travellers to any of these areas are advised to apply insect repellent, stay in a well constructed and maintained building and seal doors and windows with screens. If there are no screens, then doors and windows should be kept closed and the inside of dwellings should be sprayed with insecticide at dusk. It's also a good idea to use mosquito proof nets over beds with the edges tucked under the mattress. One can also use insecticide impregnated mosquito mats or coils. Consult your doctor if you have flu-like symptoms up to six months after visiting a high-risk malaria area.

Most malaria deaths are preventable with a little diligence. Ensure your loved ones are protected from malaria by practising care during risky times and before going to risky areas.

Chronic travellers get a head start to the holidays

Members will find that from time to time a need will arise to collect their monthly supply of chronic medication before the due date. Medication, especially higher schedules of medication, is strictly controlled in terms of the act. The Fedhealth system is also designed to assist with the control of these type of transactions and will therefore reject real time claims before the due date. Fedhealth will however relax this rule during November and December 2010 to assist our members who might require medication earlier due to going on vacation etc.

Under normal circumstances during the year the above rule can also be overridden with special motivation. The Scheme will require proof of your travel and proof of a valid current script. In your motivation you will also have to notify the Scheme of the time (number of months) that you will be away.

Resetting your body's travel-clock
What is jet lag?

With many of us about to board flights to visit far off loved ones over the festive season, this month's HouseCall! takes a look at one of the unfortunate downsides of overseas travel. Jet lag should not be confused with the tiredness that you feel after a long journey in a car or after flying north or south for a considerable number of hours. Your body functions are controlled by a "physiological clock" which gets disrupted when you fly from east to west or vice versa to destinations in different time zones. The symptoms experienced when this "physiological clock" is disrupted ("confused") are then referred to as "jet lag".

What are the symptoms?
• Feeling of tiredness during the day upon arrival at your destination
• Listless and unable to perform optimally
• Change in normal bowel activity e.g. constipation
• Insomnia.

The duration of the jet lag would depend on the number of time zones crossed. The symptoms will last one day for every time zone as well as what measures were taken to eliminate these symptoms. Jet lag seems to be more severe when travelling from west to east than east to west. It theoretically would take South Africans who are travelling to Oceanic countries between nine and eleven days to recover from jet lag if precautionary measures are not taken.

Precautions before the flight
• Suitable planning of dietary needs prior to flight
• Adjust sleeping patterns to a new time zone the week prior to a flight, such as the time of rising and going to bed
• Give yourself sufficient time to overcome the symptoms of jet lag before the start of an important event.

Precautions during the flight
• If you are going to arrive at your final destination during the day, you should make every attempt to sleep on the plane. Short-acting sleeping tablets can be prescribed by your doctor and have all been proven to be effective in inducing sleep, yet allowing people to wake up without headaches and alert after four to six hours sleep
• Minimise alcohol intake and avoid coffee or tea
• Eat a high carbohydrate meal prior to retiring that is not large in quantity
• Drink plenty of fluids during flight before retiring.
• Should you arrive at your destination at night, you should refrain from sleeping. Instead do static exercises or walk inside the plane as much as possible.

Precautions upon arrival
• Adjust to the destination's time zone as soon as possible
• Bright light can "advance" your body clock so exposure to sunlight (getting outdoors) instead of getting into bed upon arrival is advised. Best time would be between 11am and 5pm.
• Do not sleep during the day
• Increase fluid intake
• Melatonin capsules taken in the evenings have proved to be useful in some instances.

DISCLAIMER: The opinions, advice and products contained in articles supplied by contributors other than employees of Fedhealth do not necessarily reflect the policy, rules or opinions of Fedhealth Medical Scheme.

TR1965

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