Surfing Overseas

Surfing and other water sports are not without risk, whether undertaken at the local beach or in foreign waters. Always seek advice from locals about rips and currents, submerged rocks, marine stingers and pollution. Caution is better than valour when a long way from decent medical help. Injuries caused through coral or underwater rocks can be very nasty. Make sure you have decent travel medical insurance. The most common injury to surfers is a laceration, either from their own board, someone else’s board, or the ocean floor/reef.

Ensure you maintain hydration while surfing. Take breaks for fluid top ups and snacks. Large meals should be avoided for an hour or so before entering the water. Never surf while under the influence of alcohol or other drugs as your reaction time and orientation will be seriously impaired.

More on Accidents.

Wear a sun protecting rash vest when surfing for long periods. Before entering the water apply a good quality waterproof 50+ blockout to all exposed skin. Zinc cream is useful for the nose and face as it doesn’t run into the eyes. Remember to reapply 50+ sunscreen on leaving the water and every 2 hours. 

Sunburn is caused by overexposure to ultraviolet (UV) light. Just 30 minutes can cause injury. Light skinned and fair headed people are more at risk. The skin may become red and blistered in the acute stage with peeling as it heals. General treatment includes:

• Cold compresses (especially soaked in cold brewed tea) to ease the pain. Apply for 15 minutes.
• Cold moisturising cream for its soothing effect – not oil based products which may retain the heat.
• Analgesia such as paracetamol to reduce the discomfort
• Increase intake of fluids
• Burn creams as indicated
• Loose clothing during the healing process
• Leave the blisters intact as a cover

Apply Aqua Ear or Ear Clear drops to each ear after swimming. This helps evaporate any retained water which may become infected more easily in the tropics. Swimmer’s ear, also known as tropical ear, can be very painful. Some people, including those with “wax build up” are more prone to ear infections. Use Waxol or have your ears syringed prior to travel.

Surfers may also have narrow ear canals after years of cold-water exposure. This is common in surfers from southern Australia.

When out of the water, especially at dusk and dawn, protect yourself with an insect repellent containing 30-35% diethyl toluamide (DEET). When insects are biting wear clothing that covers the arms and legs, particularly the ankles. Clothing impregnated with permethrin will provide extra protection. At night, sleep under a good quality net. It is highly recommended to impregnate bed nets with permethrin if you are staying in “rustic” accommodation in areas where malaria may be an issue. Mosquito-borne diseases such as dengue fever, Chikungunya and Zika are common in many popular surfing areas. These are transmitted by daytime biting mosquitos. Always reduce exposure. For more information see mosquito avoidance measures.

Ciguatera is a special form of poisoning that occurs when the tropical reef fish you eat have ingested algal toxin. Be careful if you are buying fresh fish from local fisherman to cook yourself. Do not eat it if there is any numbness of the hands or stinging sensation after skinning or filleting it. At no times eat red bass, chinaman fish, paddle tail or moray eels. Cooking does not destroy the toxin and you can become seriously ill.

Serious infections (abscesses and blood poisoning) can develop from what at first appears to be a minor abrasion. Waterborne pathogens are commonly found in the surfing environment and neglected wounds can lead to blood sepsis. Assume possible sepsis even in minor abrasions. Hydrogen peroxide can be used to irrigate a wound where contamination with coral, shell or sand particles is suspected. The “foaming” action will help in the removal of tiny particles. A splinter probe can be used to dislodge any visible particles embedded in the wound. Alternatively use a soft, baby, newly opened toothbrush to scrub the wound gently.

Ideally, wounds should be covered and kept dry. Where a rapid return to the water is planned an Opsite dressing or something similar can be applied. Inspect daily for signs of infection: spreading redness with increasing throbbing pain around the original wound or pain in the nearby lymph glands (e.g the groin if the wound is on the foot). Replace the Opsite when it becomes daggy. Try to keep the wound dry.

In tropical climates heat and humidity can complicate wound healing. You must clean and disinfect it well at the time of the injury and not wait until complications arise. Wound infections can develop rapidly - even insect bites, when scratched, can become infected and lead to an ulcer. Pain, swelling, redness and discharge suggest wound infection. The management of a wound in a tropical environment can be found in the Pocketbook on Healthy Travel.  Adventurous surfers should consider taking a Surfers First Aid Kit.

Antibiotics may be required if the wound is red, painful and throbbing. See skin infections.

A variety of jellyfish and other marine creatures are found in warm tropical waters. Wear reef-walkers or old canvas shoes if you are pottering around reefs and don’t pick stuff up with bare hands. 

Stings can range from minor to life-threatening. Use ice-cold packs to relieve pain. If this is ineffective seek medical advice as soon as possible. Heat rather than cold is effective for pain relief in the case of stone fish, sea-urchins and stingray barbs. The barb on a stingray’s tail can inflict fatal injury if it strikes a vital organ or artery and the toxin can be life threatening, as can the toxins of sea urchins, crown of thorns starfish, cone-shells and jellyfish.

Stings by the very dangerous Box Jellyfish (sea wasp) are rare outside Australian waters.

• Apply cold packs to relieve pain.
• Douse with vinegar. If unavailable wash with sea water. Do not rub the area as this releases more toxins from the tentacles.

Seek medical attention as soon as possible.

Ear infections may occur as a result of frequent swimming, diving and or travelling in a high humidity climate. Moisture in the canals after swimming or showering promotes the growth of organisms such as bacteria and fungi. Special kids head bands and ear plugs are available to keep the water out.

Symptoms include:

• initial itchiness followed by an earache
• pain when the earlobe is pulled
• deafness

If infection is suspected stay out of the water until symptoms subside. Antibiotic ear drops such as Sofradex may be indicated and are a useful addition to your kit. Occasionally a “wick” impregnated with an antbiotic ointment needs to be inserted in the canal to reduce the swelling.

Prolonged exposure to salt water or ultraviolet light can cause eyes to become irritated and painful.

Polytears, 4-6 drops may be useful to alleviate symptoms. Always seek medical advice in the event of an eye injury or persistent problems. Stop wearing contact lenses until assessed or better.