Health and Wellbeing in Spain

If you have any medications you take on a regular basis be sure to bring extra/spares (and carry them in different bags) so if you loose one you have a back-up. Although there are pharmacies across Madrid you may find they do not have your required prescription. Check the expiry date of your medication well before you intend to travel, this enables time to get prescriptions renewed or stock up on medication. 

It is a good idea to think about the times that you take your medications. The flight to Spain may only take a couple of hours, but you need to factor in time difference too, to ensure that you can still take your medication at a certain time each day.

Think Pacific Spain projects are based in Madrid, which has excellent access to healthcare services, including hospitals, urgent care centres and local medical clinics.

Spain has a modern, high-quality emergency healthcare system with ambulance services available throughout the country. If you require an ambulance or emergency assistance, dial 112, the national emergency number. Operators can provide assistance in English if needed.

In the event of an illness or injury, the Think Pacific team will support participants in accessing the most appropriate medical care as quickly as possible. The accompanying college staff will also be informed and involved in line with our safeguarding and welfare procedures. 

The quality of health care in Spain is very similar to the UK and you will find that many of the same procedures followed by health care professionals in the UK will be the same in Spain.

If you need to gain access to healthcare at any point on project, our in-country team will be with you every step of the way on where to go and communicate your health care.

Our projects are intended for students and staff in reasonably good health without potential underlying life threatening illnesses/allergies that may require urgent medical attention.

If you are concerned that a health condition (physical, mental or SEND/ Learning Difficulty) could limit your ability to participate in the programme, please speak with a College Staff Member and/or contact the Further Education Manager on hannah@thinkpacific.com to understand potential challenges and support measures that could be put in place for you.

Make sure you get comprehensive travel insurance and declare all pre-existing conditions to ensure you will be supported with any claims that may arise in Spain.

In Spain if you need to visit a healthcare facility, it is likely that you will need to pay for any treatments and prescriptions upfront – you can then claim on your travel insurance afterwards. Our team will ensure you have the correct medical reports and receipts/ invoices from the healthcare provider before you depart Spain to include in the insurance claim.

Prices are generally very reasonable e.g. a consultation with a doctor is between … Euros which is around £… GBP.

Note – treatments are all priced separately and vary between providers. 

We strongly recommend that all participants obtain comprehensive travel insurance (or ensure they are covered by their college’s group policy) and carry their UK Global Health Insurance Card (GHIC) if eligible, as this may provide access to state healthcare in Spain. However, the GHIC is not a substitute for travel insurance, which should include medical treatment, repatriation and personal belongings.

If you are seriously injured while in Spain, it’s important to seek immediate medical attention to ensure your health and well-being. Our team will support you with this, and ensure you get the medical support you need. We will support you with contacting your insurance provider, and embassy or consulate if needed, and ensure your next of kin are updated with this process if you are not able to inform them yourself. It is important that you carry identification and details of your insurance provider at all times. Once you receive medical attention, follow the advice and treatment plan provided by the healthcare professionals. This may include hospitalisation, surgery, medication, or other necessary treatments.

If it is deemed medically safe to travel and medical evacuation is recommended, your insurance provider or a medical assistance company will typically arrange for your evacuation to your home country. This may involve arranging for a medical escort, arranging an air ambulance, or coordinating your repatriation.

The contraceptive pill is widely used by many women and is low risk for your trip to Spain. There are a couple of things to consider if you are using contraception in Spain, if concerned about anything please contact your doctor. 

Things to consider include:

• Oral contraceptives should be taken at the same time each day. Remember to consider when to take your medication as Spain is in a different timezone to the UK.
• Some pills can increase your risk of developing deep-vein thrombosis (DVT or blood clot) during any travel which is over 4 hours in duration.  You can reduce your risk of this during travel by exercising during your journey and using anti-embolism stockings.
• Most types of antibiotics don’t affect contraception. The antibiotics rifampicin and rifabutin can affect the oral contraceptive pill and reduce the protection from it. If you have to take any antibiotics in Spain, double check this with the doctor prescribing them. 
• Experiencing vomiting and/or severe diarrhoea (having at least 6 to 8 episodes of loose or watery stools (poo) over 24 hours) may interfere with the absorption of your contraceptive pill. Advice on what to do varies depending on the type of pill that you take, please refer to the package insert leaflet for specific instructions for your brand of COCP.

Mild asthma is a common condition we see amongst our participants. Generally if you are able to self manage asthma and haven’t experienced serious attacks then there is no reason why the project should be much different. 

Things to consider include:

• Air travel is generally safe, even for people with medical conditions, so if your asthma is well managed you should have no problems when you’re flying. If you are irritated by recirculated air, or sensitive to perfumes, think about steps you can do to reduce the impact of this on your flight.
• Weather, pollen and altitudes in new locations can affect your asthma symptoms differently –  think about steps you can do to reduce the impact if your symptoms worsen on a project. 
• Projects are moderately physically demanding, and depending on the time of year, heat and humidity may also affect your asthma! If you feel any project activities may trigger your asthma then please highlight this with your leader so you can reduce the amount of physical exertion you involve yourself in!
• Before travelling anywhere, visit your GP or Asthma Nurse for an asthma health check. This is important when flying due to reduced oxygen levels at high altitudes. You can also request an Asthma Action plan to make sure those around you know what to do in case of an Asthma attack.
• Ensure you have back up inhalers/medication in case you lose your inhaler as your prescription may not be available in Spain.

Many people with migraines experience attacks when they travel as it can involve a number of migraine triggers including stress, routine change, environmental changes and dehydration. 

Things to consider include:

• Stress is a very common migraine trigger and is often present when we travel. If travelling makes you feel tense you may feel a migraine attack coming on during the journey or once you’ve arrived. Equally, adjusting to a new environment and being around lots of new people can be stressful so if you need extra support during this adjustment please let your leaders know. If stress is a trigger for you and you feel stressed when you travel, trying relaxation techniques could help you. 
• We know the migraine brain doesn’t like change – you may find changes to your usual routine, whether it’s disturbed sleep or a skipped meal, can trigger a migraine. If you can, planning your journey for the daytime might help as very early starts, late nights or travelling during the night may cause a migraine. It’s also important to make sure you drink plenty of water and eat regularly. If you’re travelling into a new time zone and it changes your meal times significantly, carry some healthy snacks with you. Keep your rescue medication to hand so that if you do feel a migraine attack coming on, you can treat it quickly.
• Changes in atmospheric pressure caused by weather changes can trigger migraines, so if Spain has drastically different weather from the UK, you may be more likely to get a migraine. Additionally, air pressure on aeroplanes may trigger migraine in some people. Dehydration is also common on project and when travelling so make sure you have a bottle of water to hand and drink regularly. Also be sure to have your medication in your cabin bag!

Previous participants with dyslexia haven’t reported any major dyslexia related challenges they’ve encountered on a project. However, this is a completely personal matter and we wanted to note down a couple of things to consider if you do have dyslexia. 

Things to consider include:

• Misreading portals or information can be more common if you are dyslexic, be sure to triple check your forms, the portal and details – or ask a parent/ carer or College Staff member to assist you!
• Sometimes people with dyslexia can find travelling daunting, especially in unfamiliar places. Sometimes reading timetables, schedule numbers and active screens can be more difficult if you are dyslexic, however you will have your College Staff and TP Staff on hand to guide and support you at all times. 
  • Ask questions if you’re unsure – don’t be shy about asking for help along the way!
  • Ensure you have printed copies of all of your documents and request printed versions of any other resources that may be helpful from the College, especially if you use overlay paper.
  • Difficulty with short-term memory is another thing people with dyslexia may encounter, so verbal instructions could be quickly forgotten. If you are finding that you are struggling with the nature of the information sharing on project, let your leaders know so they can support you.

Hay fever is a common allergic condition to pollen which is very common. Most people are able to relieve symptoms with treatment, including antihistamines, which can help to prevent an allergic reaction from occurring and corticosteroids (steroids), which help to reduce inflammation and swelling.

Things to consider include:

• Please be aware that it ‘s very difficult to avoid pollen, especially in Spain where you’ll spend a fair bit of time outdoors or walking between activities. There may be unfamiliar species of flora and fauna that trigger your hay fever so please come prepared with additional medication if you do suffer with hay fever. 
• Your normal prescriptions may not be available in Spain so ensure you have back ups.
• Please see the section on allergies for more general advice on allergies.

The severity of an allergy will depend on the individual. Mild allergies are ones which can be:

• • Self managed with/without medication 
  • Mild allergic reactions do not induce anaphylaxis.
  • Mild allergic reactions have never resulted in hospitalisation or urgent medical treatment.

If you are someone with a mild allergy (as described above) these are often self-managed successfully on project. Please note if you have a more serious allergy e.g. if you are an EpiPen user, someone who experiences allergic reactions that could result in anaphylaxis or hospitalisation then it is vital you inform your project coordinator as soon as possible so we can discuss your allergies and how we may be able to support you in more detail. 

Things to consider include:

• Communication:
  • Air Travel: it is important that airline staff are informed of a food allergy at every opportunity. This is particularly important when checking in at the airport and boarding the flight.
  • Language Barriers: in Spain you may find that language can be a barrier to communicating your allergies. Although most people speak English, the levels of understanding may vary. Think Pacific brief accommodation and restaurants on the dietary and allergy information you provide us with, however, as you will be well aware, communication is essential to safely manage an allergy. It is important to continue taking responsibility for your own needs by sharing information on your allergy in a clear and consistent way in Spain (e.g. e.g. with translation cards, learning key spanish phrases, asking local TP staff for help).
• Diet:
  • During pre-departure briefings, you will be given an insight into the type of food available and to outline that all allergies/ dietaries will be accommodated. If this causes any concerns for you, you may wish to have a chat with a member of the team around more specifics for your allergy and food expectations.
• Medication:
  • Check the expiry date of your medication well before you intend to travel, this enables time to get prescriptions renewed or stock up on allergy medication. Consider the length of your trip and that you may not be able to access the medication you are used to whilst in Spain.

Some people may be prone to getting blocked ears, excessive earwax, other discomforts and sometimes have difficulty hearing. If your symptoms are mild then this should be manageable on project, if symptoms are more severe and you may require additional support please let us know so we can organise a chat. 

Things to consider include:

• • Aeroplane ear is a phenomenon that many people experience when flying. Ears can feel blocked or painful when travelling via air due to pressure changes. If you have pre-existing ear issues then this is something that you should consider ahead of flying.
  • Swimming more than usual in pools or the sea can increase risk of ear infections. Although you are unlikely to spend significant time in water/ doing water-based activities, this may be something you wish to prepare for if you are prone to infections. For example, by avoiding putting your head underwater. This is because wax in the ear can prevent the natural drainage of water from the ear canal, and the warm, moist conditions of the ear canal combined with the wax are ideal conditions for bacteria to grow. You may even wish to go a step further and have your ears checked to make sure they are wax free ahead of departing for Spain!
  • Projects are very socially interactive – if you have mild difficulties hearing that affect your communication it is important to discuss this with us pre-departure but also to communicate with your leaders and others if you have any particular challenges so we can support you, and ensure you are able to engage fully with the project! 

Skin conditions such as eczema and psoriasis may flare up more than usual in the different climate, e.g. you may find you are sweating more in the heat which might irritate your skin, but equally some people find the increase in fresh air and sunshine beneficial for their skin! It will be hard for you to know how your skin might respond to Spain’s climate. 

Things to consider include:

• • For the seasonal hot months, ensure you have sun cream and insect repellant and all year-round take moisturisers, shower gels and shampoos whilst away that suits your skin. It is best to stick to your usual products and try to avoid new skincare products. 
  • Washing powders will be different in Spain, you may wish to bring something from home to hand wash your clothes yourself if you are particularly sensitive. 
  • Consider the type of clothing that may be best whilst you are away. Breathable, natural fabrics like cotton and linen are much kinder to the skin than synthetic materials, especially in hot climates. Long sleeves and long trousers are also a good idea when travelling in the seasonal hot months, where insect bites and mosquitoes are more prominent.
  • Drink plenty of water, in Spain’s hotter months, it is easy to become dehydrated as you need to drink more than usual –  and skin conditions are made worse when the skin is dry!
  • If you are concerned, speak to your doctor about steps you can take or solutions/medications you can bring if you do experience more skin irritation than usual. Be sure to raise this with your leaders. 
  • If you do encounter a skin flare up it is extremely important to avoid itching it and breaking your skin. Open wounds can become easily infected, so if you do break the skin on a rash, clean it regularly and keep it covered until the skin has healed.

Previous participants who have ADHD haven’t reflected that their project was more or less challenging than those who do not have ADHD.

Things to consider: 

• Bringing a watch with the ability to have an alarm. We have found that setting an alarm for activities can be useful.
• Using a notebook or your usual method for note-taking that you find easiest, to ensure you don’t forget key timings, information or instructions, which you can refer back to throughout the day.
• The project will be very structured with some aspects of free time as well as mornings/ evenings – try to create and follow a routine similar to home during these times, ensuring that you carve out time to do these things can help alleviate symptoms.
• Communicate your triggers, support needs and coping strategies with the College Staff or our TP team during pre-departure to ensure that we can best support you to make the most of your project.

Previous physical injuries

• sprains
• concussions
• breaks

You will be experiencing different environments in Spain to what you are used to at home, so you must always be doing dynamic risk assessments and protecting yourself from injury or harm.

If you do get injured, please alert a member of College or TP staff immediately, who can support with First Aid response and ensure you get access to the necessary medical care.

The severity of an allergy will depend on the individual. Severe allergies are ones which:

• Can result in potential loss of life 
• Require the use of an Epi-Pen 
• Include the swelling of airways 

If you have an allergy that is classified as ‘severe’, please provide as much detail as possible to the College and/or to TP about the triggers, symptoms/ immediate effect and emergency response required. 

Pre-Departure steps for you to consider:

• Allergy action plans (written emergency treatment plan) are recommended. These plans are a useful reminder of allergic signs and symptoms, and which medications need to be taken in the case of an allergic reaction. Discuss these with your doctor. 
• Ensure you are transparent with your travel insurance about your allergies to ensure the right plan can be provided so you are covered for any allergy related illness.
• Ensure you have communicated any severe or airborne allergies to the airline to ensure they reduce any risk of anaphylaxis during flight.

Intolerances to foods are classified when either the body can’t properly digest the food that is eaten, or that a particular food might irritate the digestive system.

Food intolerances are something which Think Pacific has been supporting volunteers with since 2009. The most common intolerances are; Gluten and Lactose. However, there are many more that can affect people. If you have a food intolerance, please:

1. Ensure that you have informed the College of this and that is has been passed onto our TP team, including the detail of severity and whether you have to avoid it completely or will self-manage consumption of it.
2. When pre-ordering any meals, please indicate your intolerance again for our team to cross-check the meal will be suitable for your dietary.

If you have a dietary preference that you wish to follow when on project, please ensure that you have referenced this to the College Staff and TP team.

Dietary preferences include but are not exclusive to:

• Vegetarian
• Vegan
• Pescatarian
• Halal
• Specific foods avoided (e.g. no beef or no eggs, due to religious or preference reasons).

Those with Coeliac Disease are unable to eat gluten in any form.

Coeliac disease can be different levels of severity, please ensure that you have outlined this to the College and TP Staff to ensure we can best prepare meals that will not cause illness or discomfort for you:

1. Traces of gluten
2. Cross-contamination
3. Being in the same vicinity of gluten (generally this includes raw versions of the gluten, e.g. bags of flour).

Think Pacific will pass this information over to our in-country team and they will follow the structure as outlined above.

If you have a sensory challenge around food or have experience disordered eating/ an eating disorder, please indicate this to our team to ensure we can help provide meals that you are comfortable with during the project.

Please be as specific as possible about what foods you are happy to eat/ try on the project or are safe foods for you, and which foods must be avoided.

We would recommend that if you do not enjoy or wish to try the foods provided for the 3x meals a day, that it would be worth bringing additional ‘safe foods’ or snacks from home that you are comfortable with, and also budgeting slightly extra spending money for additional meals/ snacks.

During your time in Spain, you will be surrounded by people helping and encouraging you through the highs and lows – from your peer students, to your College Staff, to your Project Leaders. Your College Staff in particular are there to facilitate your project and experience, and are available 24/7 for any pastoral care (physical, mental and emotional support) that you may need.

As you know, Think Pacific projects are challenging and you are undoubtedly going to have tough moments – which could affect ​anyone’s ​mental health or wellbeing. Try to communicate this with your leaders and College Staff if you can. You wouldn’t hesitate to talk to them about your physical health if you were having an issue, so try to treat your mental health exactly the same. Remember the old phrase, ​a problem shared is a problem halved,​ sometimes you might feel better from simply opening up.

If, for any reason, you experience ill health on project then your College Staff are the first port of call. This is any​ sort of ill health – both physical and mental. It is not uncommon for these situations to arise, and hence the standard Think Pacific ill health process is as follows…

1. Make your College Staff aware of what you are experiencing when concerns first arise
2. College Staff will offer any pastoral support that they are able to, with support from TP Staff.
3. If necessary, your leaders or College Staff will escalate the support required to accessing healthcare/ a hospital trip, and discuss your options with you.
4. Your leaders will fill in a medical log documenting the occurrence to ensure that we can track any ill health or wellbeing alongside the College. Whilst in the project environment a 48 hour review period will begin, in which you and your leaders will closely monitor how your health progresses. These records are deleted once your project concludes.
5. If ill health continues or worsens, your College Staff and leaders will discuss the next steps with you. Depending on severity, this could range from having a rest day off project to receiving further professional medical treatment, or being repatriated back to the UK.

IF AT ANY STAGE​ ​you wish to see a Nurse, Doctor or medical professional please make your College Staff and leaders aware, and they will help you receive this treatment as soon as possible. Please remember that although your leaders are with you to support and assist your project and are first-aid trained they are ​not​, however,​ ​medical professionals.

Our aim at Think Pacific is to make mental health and wellbeing something that we talk about just as much as any aspect of our physical health. However, we appreciate that everyone is different, and some people might not feel as comfortable talking about mental health and wellbeing as others. Because of this, we try to make having an open environment something that is part of the very essence of your Think Pacific journey. Our aim is for everyone’s mental health and wellbeing to be something that is constantly upheld, regardless of whether ill mental health is something you have experienced previously or not!