Advances in Tourism Research series publishes monographs and edited volumes comprising the latest research findings, written and edited by leading researchers working in the wider field of tourism studies. Development of Tourism Safety and Security in the Kingdom of Saudi Arabia 249 Jeff Wilks and Faisal Al-Mubarak.
List of Tables
Contributors
David Grant is Professor of Law and Director of the Travel Law Centre, Northumbria University, UK. Jeff Wilks, PhD, is a professor of tourism and director of the Center for Tourism and Risk Management at the University of Queensland, Australia.
Dedication
Acknowledgments
This huge increase in the movement of people changed the nature of tourism from early on. While a number of recent shocks suggest that the tourism industry is experiencing turbulent times, it is pleasing to see that this book focuses on positive responses and stories of success in providing quality service.
Preface
INTRODUCTION
Current Issues in Tourist Health, Safety and Security
Introduction
Delivering Quality Service
One of the difficulties in establishing health, safety and security within tourism is that the roles of the staff required are very different from those of ordinary tourism staff. This is why the Communications or Marketing Manager in many tourism organizations is the default crisis management person - it is an "extra" consideration, with assumptions that day-to-day operations will take care of security and that external agencies such as the police will always be available in a crisis.
Identifying Current Issues
Some are experts in tourism (e.g. the WTO); others have expertise in specific areas of activity rather than an industry. A good example of the latter is the International Strategy for Disaster Reduction (ISDR) which provides global leadership in mitigating all types of natural and man-made disasters (http://www.unisdr.org/) (see Chapter 9) . .
Sources of Health, Safety and Security Risk in Tourism
Many tourists are not aware that the drug laws of the host country are applicable, not those of the tourist's nationality. The benefit of the WTO framework for identifying sources of risk is that it shows where tourism is exposed to threats.
A Risk Management Approach
The first step in the risk management process is focused on the environment in which any tourism organization or destination operates. The second step in the risk management process is to identify the risks to be managed.
Genuine Partnerships
It is now widely accepted that a whole-of-government approach is needed in this area. Tourism needs to engage the other areas of government that have specialized expertise in health, safety and especially security to form real partnerships.
The Structure of this Book
HEALTH
Travel Medicine and Tourist Health
Morbidity and Mortality of Travellers
A study published by Baker, Hargarten and Guptill (1992) analyzed deaths of Americans abroad (nearly 5,000 per year) and concluded that most Americans who die overseas do so in developed countries of Western Europe and the causes of death are similar. to the USA Moreover, deaths of Americans in less developed countries are not from infections and tropical diseases, but are mainly from chronic diseases, injuries, drownings, suicides and murders.
Defining Travel Medicine
Similarly, studies of deaths among Australian, Canadian, American and Swiss travelers abroad found that cardiovascular disease, accidents and injuries were among the most common causes of death abroad (Baker et al., 1992; MacPherson et al., 2000; Prociv, 1995; Steffen, 1991).
International Developments in Travel Medicine and Tourist Health
Regional travel medicine associations have also flourished, such as the Asia Pacific Travel Health Association, which holds biennial conferences on travel medicine and tourist health in the Asia Pacific region, in the two years leading up to the ISTM annual conference. Other international travel medicine and tourist health programs are listed elsewhere (ISTM, 2004).
Other Sources of Health Advice
Although there is still relatively little research on the health of travel advice provided by the travel industry, shortcomings have been noted in brochures provided by travel agencies. Deficiencies in travel agents' knowledge and advice to travelers regarding their health during travel have also been noted (Lobel, Campbell, Papaioanou, & Huong, 1987; Lobel et al., 1990; Malcolm, 1996).
Infectious Hazards of Travel
However, antimalarials that do not have a preerythrocytic effect on the liver stages of the malaria parasite, such as doxycycline and mefloquine, should be continued for up to 4 weeks thereafter. The two most important arbovirus diseases for travelers are dengue fever and Japanese encephalitis (JE), as people have been traveling to more remote areas where these diseases are endemic in recent years.
Prevention of Infectious Diseases through Vaccination
Arboviral diseases There are many arboviral diseases that can impact travelers and about two thirds of the world's population live in areas infected with yellow fever and dengue vectors, mainly Aedes aegypti mosquitoes. There are a number of other infectious diseases, such as hepatitis B, JE and rabies, that can affect travelers to certain destinations or result from the nature of their travel, which are vaccine preventable (see Table 2.1).
Non-Infectious Hazards of Travel
It would be prudent to vaccinate travelers against food- and water-borne diseases such as hepatitis A, typhoid, and polio (Zuckerman, 2002), and to use other measures to combat these diseases. The development of combination vaccines such as hepatitis A plus typhoid and hepatitis A plus B has greatly reduced the number of injections required (Zuckerman, 2002).
Issues in Aviation Medicine
Travel Advisories
Travel Insurance
Summary
Immunogenicity and protective efficacy of the current inactivated Japanese encephalitis vaccine against different strains of Japanese encephalitis virus. Leggat (Eds), Proceedings of the Fifth Annual Scientific Meeting of the Australian College of Tropical Medicine, Bali, Indonesia, 28 June.
Travel Insurance and Aeromedical Evacuation
Aspects of travel accidents usually NOT covered by appropriate travel insurance Pre-existing medical conditions. It is possible that routine illnesses may also be excluded by the travel insurance.
Appeals Procedures
Travelers should also be aware that laws describing controlled substances may differ from those in their own country. Even then, there may be language and financial barriers that may need to be overcome.
Aeromedical Evacuation
Preferably, the aircraft should be equipped with a glider or similar transfer device to facilitate the transfer of the patient to the air ambulance. It will be necessary to arrange for a public ambulance to meet the aircraft and assist in the transfer of the patient.
Conclusion
All relevant medical records must accompany the patient and preferably be electronically downloaded or faxed to the admitting medical team prior to departure. A written summary of all events during the transfer should also be provided to the receiving medical team (proforma can be used).
Tourism and SARS
History and Epidemiology
In addition, persons involved in the wildlife trade in Guangdong had a higher seroprevalence of SARS CoV than unrelated controls (Guan et al., 2003). Intensive shoe leather epidemiology has clearly demonstrated that transmission is almost exclusively person-to-person, through direct inhalation droplets, hand contamination and fomites (Seto et al., 2003).
Travel, Tourism and SARS
Impact of SARS on Tourism
Some conferences and conventions scheduled for Toronto were canceled and production of at least one film was moved out of the city. The results of the Canadian study, "Economic Impact of SARS on Tourism in Seven Selected Member Economies of the APEC Region" can be found at www.apecsec.org.sg.
Measures at International Borders
WTTC estimates of the economic impact of SARS are available at www.wttc.org. the Mainland and Hong Kong SAR) and Singapore indicate that no cases of SARS were detected by thermal scanning among more than 35 million international travelers scanned on entry during the SARS epidemic. Due to the lack of internationally accepted standards for the development and maintenance of passenger manifests, excessive delays occurred in obtaining the manifests from various airlines (St John et al., 2005).
Transmission of SARS on Airplanes
SARS Information for Travellers
To minimize the possibility of infection, close contact with large numbers of people should be avoided, and visits to hospitals with an ongoing SARS epidemic should be strongly discouraged. No one who has had contact with a known SARS case, whether in a SARS-affected area or elsewhere, should cross an international border for 10 days after the last contact, provided they remain asymptomatic.
SARS and Travel Medicine
Travelers are strongly advised to be vaccinated against influenza, and the rationale for this should be explained to them: although the influenza vaccine does not protect against SARS, it will minimize episodes of febrile illness and therefore reduce the number of misdiagnoses and lower the overall incidence of SARS-mimicking illnesses (Wilder- Smith & Ang, 2003). Furthermore, it will reduce the risk of a febrile episode, which may be picked up by airport screening and lead to delays at the airport or even quarantine.
Outlook
Epidemiological determinants of the spread of severe acute respiratory syndrome in Hong Kong. The role of influenza vaccine in healthcare workers during the severe acute respiratory syndrome.
Local Health Impacts of Tourism
Global Perspective
Pearce (1981) analyzed daily holiday diaries (n⫽96) of tourists visiting one of two tropical islands. It found that about 30% of tourists reported medical (or viral) symptoms (cold, nausea, stomach upset, diarrhea) and over 50% recorded an injury (or environmental shock), such as stings, bites and sunburn.
Local Community
Finally, Nicol, Wilks and Wood (1996) assessed foreign tourists and interstate tourists admitted to one of seven hospitals in Queensland. A general overview of research on the health of tourism in Australia can therefore only conclude that a fairly high percentage of reported ill health and a very high percentage of treated injuries could have been prevented.
Local Health Services
The Study
While clients from the host community comprised the most severe illness category (see Table 5.4), the overall results were not statistically significant (χ2 ⫽ 7.2, df ⫽ 3, p⫽0.06 NS). A χ2 test showed that there was an overall statistically significant difference in cell frequencies in Table 5.5 (χ2⫽73.3, df ⫽1, p⬍0.05).
Summary of the Study Findings
Tourist Ill-Health: The Local Community
For example, Cossar (2003) reports that the average cost per travel-related inpatient admitted to infectious disease wards in Glasgow in 1998/99 was £2136. Until we develop a system that allows discrete identification of tourists receiving treatment, we may never be able to accurately estimate the cost of tourism health services.
Disseminating the Information
Over the years, various studies have provided some limited insight into the financial costs involved. This figure was then extrapolated to calculate a theoretical total for UK hospitalization costs from travel-related admissions.
Tourist Attributes
Research on Australians traveling overseas has shown the negative impact that poor health has on the tourist experience, although in most cases the tourist illness has been reported as mild and somewhat self-limiting. Grayson and McNeil (1988), and Jackson, White, and Schmierer (1993) reported that 21% of a sample of Melbourne tourists indicated that poor health was the primary reason for their worst tourist experience.
Who Should Take Responsibility for Tourist Health?
Unfortunately, tourists did not attribute the causes of preventable ill health during travel to internal/personal factors, but rather attributed the causes to external factors (host society, tourism industry, accident, fate).
Tourist Ill-Health: The Emerging Public Health Problem
Conclusions
It is therefore important that all stakeholders work together to ensure that the health care needs of tourists are met. Paper presented at the 27th Annual Conference of the Public Health Association of Australia, Cairns, 24-27 September.
SAFETY AND SECURITY
Terrorism and Tourism
Israeli scholar Rafael Raymond Bar-On has documented terrorist attacks against the tourism industry for more than 30 years. His list shows that terrorist attacks against the tourism industry have occurred all over the world (Bar-On, 2001).
An Overview of Terrorism and Tourism
For example, tourism is based on a sense of openness; it is by nature the opposite of xenophobia, a celebration of diversity. Terrorists and tourism professionals are aware of the fact that tourism is a voluntary activity.
The Post September 11 Paradigm and Air Travel
People who work in the industry are not only trained to deal with unusual behavior, but accept such behavior as a form of good customer service. Changes in regulations such as plastic versus metal knives have also caused a higher level of anomic behavior on the part of the traveling public.
Cruises
Air travel has always tended to lower some people's natural levels of inhibitions. Issues from rude behavior to excessive consumption of alcoholic beverages to bizarre sexual behavior have long been a part of air travel.
Places of Lodging
Predicting Vulnerability
As a prediction when referring to mass tourism, there may be a relationship between these following factors and a tourism center's propensity to become a target. These answers to these questions then simply provide a stochastic model that can be used as a guide.
Risk and Crisis Planning
Although there is no one way to predict which areas of tourism may be targets, the following may be helpful. The greater the number of positive answers to these questions, the greater the potential for a major terrorist attack.
Visitor Risk Analyses
Visitor Safety Support Structures
Develop a working relationship between local security professionals and various components of the visitor industry. Tourism professionals must also consider whether their plans meet the needs of the people they serve.
Crime and Tourism
It is often easier to simply forget about the crime than to find a police station and spend a day filing reports. Due to under-reporting and the fact that some crimes are committed through their own hands or aid, there is no way of knowing how many visitors are actually victims of a tourism crime.
Tourism Crimes Typologies and Definitions
This tendency to experiment is one of the reasons why young men, especially between the ages of 18 and 30, often become victims of tourist crime. Tourist sites, such as large theme parks, must be aware of the fact that they are targets of thugs who may try to take advantage of the day's receipts.
Classical Tourism Crimes
In reality, the thief may be less interested in the actual credit card than the credit card number. The goal of credit card thieves is to steal credit cards and use them as quickly as possible.
Casinos and Crime
In the case of a specific type of tourism crime, namely the relationship between casino tourism and crime, the situation is even more difficult to define. The Biloxi crime rate due to casinos was about the same as the rest of the state experienced.
Current Issues in Travel and Tourism Law
Hurricanes
The passenger would therefore be left uncompensated by the airline for the delay - whether at the beginning or end of the holiday. The first is that, in the case of contracts, the defendant can be sued in the courts of the country where the contract is to be performed (Article 5).
Food Poisoning
This provides that the organizer is liable to the consumer "for the proper performance of the obligations under the contract, regardless of whether such obligations are to be performed by [the organizer]. Longmore LJ pointed out that regulation 15 does not deal with improper performance of the holiday.
Deep-Vein Thrombosis (DVT)
In the cases covered by Article 17, the provisions of the preceding paragraph also apply. The provisions of the European Convention have no bearing on the interpretation of international conventions such as the Warsaw Convention on Air Transport.
Terrorism
For example, as a general rule, courts will apply the law of the country where the attack took place. As a general rule, the courts will apply the law of the country in which the illegal act took place.
Natural Disaster Management
What are Natural Disasters and How do They Wreak Their Effects?
The occurrence of natural disasters has increased in recent years (Figure 9.2), especially those in the hydrometeorological category, which includes floods and tidal waves, storms, drought and related disasters such as dust storms and fires, landslides and avalanches. The dramatic increase in the occurrence of disasters (Figures 9.1 and 9.2) has been accompanied by a similar increase in their average annual economic cost.
Management Approaches to Disasters
Warning systems and communication channels in the event of a disaster are mentioned in Table 9.2 as part of the mobilization phase. Establishing a well thought out communication network is a major role of the Disaster Management Team.
The Tourism Industry Subset
One of the key characteristics of the tourism industry is its desire to advertise safe (albeit exciting) and reliable (good weather guaranteed; there will always be snow) tourist experiences. Understanding and listening to the environment, on which tourism depends and from which the tourist derives many pleasures, is a key component in mitigating the consequences of a disaster.
Tourist Gut Reaction: Food Safety and Hygiene Issues
Japan, which is poisonous if not properly prepared, causes death from tetradotoxin; or cassava, which contains a toxin that can turn into cyanide in the human body if not properly prepared; however, in general, eating food during a tourist experience is not thought of as a potentially life-threatening activity and is usually presented as a soft cultural experience. In addition, it can take up to 3 days or longer after eating contaminated food for signs of illness to appear, so it is often difficult to pinpoint the cause of the problem.
Extent of the Problem of Food-Borne Illness in Tourism
Added to this increased exposure is the general acceptance that the incidence of foodborne illness is increasing. The total burden of foodborne disease in Australia is estimated to be around $4 to $7 billion each year (Tambling, 1999).
What’s in Our Food?
Bacteria live all around us - in the air, soil, water, on plants, animals and food and on our bodies. The US Food and Drug Administration (FDA) also identifies this foodborne pathogen as the most common bacterial cause of diarrhea in the US, resulting in 1-6 million illnesses each year.
What’s Happening in Australia?
To answer the question of implementing basic food safety practices, it is useful to revisit food preparation sites. In the future, studies will be conducted to determine the effect of these Standards on food safety practices.
What’s Happening in Some Other Parts of the World
The results revealed that respondents were quite aware of food safety but had misconceptions about important aspects of cooking, storage and general handling. For example reprocessing or disposal of food if the minimum temperature is not met.
Being an Active Agent in Prevention — “Boil it, Cook it, Peel it or Forget it”
Tourist Injury
Tourist safety research conducted to date has been largely non-strategic, meaning that the studies reported in the literature on tourism, sport and recreation, medicine and safety have been partial in nature and independent of each other, part of an ongoing of a research program with long-term goals related to the prevention of tourism injuries in a specific industrial sector or destination. An exception to this is the adventure and recreational tourism safety research these authors conducted over several years in New Zealand and more recently in Scotland, where they attempted to identify the starting point of visitor injuries and understand their causes using primary and secondary data sources.
Adventure Tourism Safety in New Zealand
A survey of 142 New Zealand adventure tourism operators (Bentley, Page, & Laird, 2001b) allowed analysis of client injuries and their primary causes among a wider range of commercial adventure activities. Operators reported risk factors for adventure tourism client injuries to include a wide range of client, equipment, environmental and organizational factors.
The 2003 New Zealand and Scotland Adventure Tourism Safety Experience Survey
The most commonly reported activities provided by New Zealand operators were: scenic flights (15%), kayaking (14%), mountain guiding (6%), white water rafting (6%) and horse riding (6%). Other frequently reported hazards in New Zealand included striking an object (30%), falling from a height (26%) and drowning or non-fatal submersion (18%).
Discussion and Conclusions
It seems likely that this will happen soon through the use of similar methodologies to those used so far in the New Zealand and Scottish studies. Risk Management in Adventure Tourism Operations: A Review of Legal Case History and Potential for Litigation.
ADVENTURE
Risk Management in Outdoor Adventure Tourism
Outdoor Adventures are a Special Type of Tourism
Participants in outdoor adventure tourism activities are aware of, enthralled and often challenged by the natural environment. It is therefore the responsibility of the adventure tourism operator to provide and facilitate a Table 12.1: Examples of common adventure.
Trends Promoting Outdoor Adventures
Adventure as Both a Special Interest and Mass Tourist Product
Not surprisingly, operations targeting special interest markets can have a longer duration and represent a relatively high objective level of risk. Compared to mass market adventures, the operator that caters to special interest markets may require customers to have existing skills and previous training in the activity (Morgan, Moore, & Mansell, 2000).
The Outdoor Adventure Experience
Examples of special interest markets include corporate groups racing performance yachts and experienced divers on shipwreck night tours. Despite the diversity in adventure activities and clientele, the fundamental concept of adventure will provide similar experiences to both the novice and experienced participants.
Risk Perceptions and Safety
Based on the level of objective inherent risk, outdoor adventure tourism is categorized as soft or hard adventure (e.g., Swarbrooke, Beard, Leckie, & Pomfret, 2003). Regardless of the level of real or objective risk, a primary challenge for adventure tourism managers is ensuring customer safety.
Managing Tourists in Outdoor Adventures
