Death and dying abroad: the Canadian experience

BACKGROUND

The objective was to examine the characteristics of international travelers from Canada, who have died while abroad, and to review the health protection and promotion strategies for prevention of adverse health outcomes associated with travel, which may have prevented these deaths.

METHOD

An EpiInfo 6 program was created to analyse all of the Consular reports received in 1995 via the Secure Integrated Global Network, which provides communications and computerization services to the Department of Foreign Affairs and International Trade, Canada. The Consular Management and Operations System was designed to support the delivery of consular services by the Department, and to link Headquarters in Ottawa with missions in other countries, through case management files, including a "Death Abroad" file. The type of data collected included personal demographics (age, gender), date, country, and cause of death.

RESULTS

In 1995, consular services received 309 reports of Canadians dying abroad. Two hundred and twenty deaths were males (71.2%), and 69 were females (22.3%). The average age (56 years) and median age (43 years) were similar for males and females (age range 0.3-86 years). Recorded causes of death were: natural (62.1%), accidents (24.9%), murder (7.8%), and suicide (5.2%). Cardiovascular disease and trauma were the two most commonly specified causes of death.

CONCLUSIONS

At least 36% of the deaths occurring in Canadian travelers would be considered preventable. Pretravel medical interventions for travelers with known preexisting medical problems, may have prevented many more deaths. International travelers need to be aware of the health risks associated with travel. Access to appropriate health risk assessment, prior to exposure, in many cases, would have prevented death abroad.

Arrest and detention in international travelers

BACKGROUND

Our objective was to examine the characteristics of international travelers from Canada who have been arrested or detained while abroad, and to review the health implications of incarceration.

METHOD

An EpiInfo 6 program was created to analyse all of the Consular reports received in 1995 via the Secure Integrated Global Network (SIGNET) which provides communications and computerization services to the Department of Foreign Affairs and International Trade, Canada. The Consular Management and Operations System was designed to support the delivery of consular services by the Department, and to link Headquarters in Ottawa with missions in other countries through case management files, including a "Prisoners" file. Information obtained included personal demographics (age, gender), date, country, and reason for arrest or detention, and outcome of judicial process.

RESULTS

There were 1, 086 arrest or detention reports received from Consular services via SIGNET in 1995. Males outnumbered females 5.6:1. Most individuals arrested were young: 57.5% were less than 40 years, and 79% were less than 50 years. Drug related charges were cited in 33.1% of all cases, with 52.8% of arrested females charged with drug related offenses. The documented conviction rate was 96%. The majority of detained Canadian travelers were held in countries within the Americas (791 cases - 69.2%), with 642 (59.1%) being detained in the USA.

CONCLUSIONS

Arrest and detention is an unusual occurrence for international travelers but relative youth, male gender, and female drug couriers were identifiable risk characteristics. Public awareness campaigns can be targeted to specific population demographics, but all international travelers need to be counseled on the consequences of transgressing laws in foreign countries.