ENV3102 Health and Safety Risk Assessment and Management Prepared by Joanna Coleman Reviewed and vetted by: Sorain Ramchunder, Co lecturer ...
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ENV3102
Health and Safety Risk
Assessment and Management
Prepared by
Joanna Coleman
Reviewed and vetted by:
Sorain Ramchunder, Co‐lecturer
Edward Webb, BES Programme Director
Office of Safety Health & Environment
2019
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TABLE OF CONTENTS
INTRODUCTION ............................................................................................................................. 3
A – TRANSFER‐BASED RISKS ........................................................................................................... 5
A1. Air transfer between Singapore and Cebu – JC, SR................................................................. 5
A2. Road transfer between Cebu airport and ferry terminal and Tagbilaran accommodations
and ferry terminal – JC, SR .................................................................................................................. 6
A3. Ferry transfers between Cebu and Tagbilaran City –– JC, SR ................................................. 7
A4. Boat transfers to marine survey sites – JC .............................................................................. 8
A5. Road transfers to various field sites – JC ................................................................................ 9
B – TAGBILARAN CITY BASED RISKS ...............................................................................................10
B1. Accommodations. Dao Diamond Resort – JC .................................................................... 10
B2. Around Tagbilaran City ..................................................................................................... 11
C – SPECIFIC ACTIVITY SITE‐BASED GENERAL RISKS ........................................................................12
C1. Mithi Resort & Spa (MRS); formerly Panglao Island Nature Resort (PINR) – JC ...................... 14
C2. Man Made Forest – JC and SR .................................................................................................. 15
C3. Assisted Natural Regeneration (ANR) site – JC ........................................................................ 16
C4. Habitat Bohol (formerly Simply Butterflies) – JC ..................................................................... 17
C5. Philippine Tarsier Foundation (PTFI) – JC ................................................................................. 18
C6. Bohol Tarsier Conservation Area (BTCA) – JC and SR .............................................................. 19
C7. Loon tour – JC and SR ............................................................................................................... 20
C8. Maribojoc Organic Demo Farm – JC and SR ............................................................................. 21
D – BOHOL BIODIVERSITY COMPLEX‐(BBC) BASED RISK ASSESSMENTS AND MANAGEMENT – JC ..22
D1. BBC‐based accommodations .................................................................................... 25
E – SNORKELING PREPARATION AND IN‐WATER ACTIVITIES – JC ...................................................26
F – MEDICAL RISK ASSESSMENT AND MANAGEMENT....................................................................28
G – RISKS DUE TO INTERACTIONS WITH TERRESTRIAL ANIMALS ....................................................30
H – RISKS DUE TO DANGEROUS MARINE ANIMALS .......................................................................32
I – NATURAL DISASTER RISK ASSESSMENT.....................................................................................35
APPENDIX A – MAPS AND DESCRIPTIONS OF MOST LIKELY ROUTES TO MAIN SITES ......................36
APPENDIX B – SNAKE BITE PREVENTION AND TREATMENT ...........................................................45
APPENDIX C – BEE STING TREATMENT ..........................................................................................46
APPENDIX D ‐ ACCREDITED ANIMAL BITE TREATMENT CENTRES IN BOHOL ...................................47
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INTRODUCTION
This document identifies risks to health and safety and proposes control measures for the BES field
course, ENV 3102 Environmental Challenges: Asian Case Studies II, to be held 16 to 31 May, 2019, on
the island of Bohol, in the Philippines. It was drafted following steps outlined by the Canadian Centre
for Occupational Health and Safety (CCOHS), which describes the aim of the risk assessment process
as: “to remove a hazard or reduce the level of its risk by adding precautions or control measures, as
necessary.” This document also adheres to the guidelines of the NUS Office of Safety, Health and the
Environment (OSHE), in its Trip Safety Guidelines, available here.
Risk assessment for most field activities was conducted through a reconnaissance trip by both
original BES lecturers (Drs J Coleman and J Hastings) to Bohol in April, 2013, when most legs of the
journey were completed and many locations visited – identified by the initials JC and JGH. Later trips
have been conducted by JC (March, 2014, November 2015) to assess more legs and locations – these
are identified by the initials JC. The most recent trip was conducted by JC and Sorain Ramchunder
(SR). However, certain aspects of the trip may not have yet been experienced and properly recced.
These aspects or activities bear no initials, but instead include an explanation for why no recce was
done and list measures taken to minimise risks. In addition, this assessment does not cover risks
associated with activities that participants undertake of their own volition, i.e., during free time.
These risks are not foreseeable. Participants can do as they please during free time, with the
understanding that those activities are at the participants’ own risk and that students must respect
certain rules, including advising staff of their whereabouts and remaining contactable (to be
discussed during intro days). On the last day of the trip (30 May), everyone, including staff, has free
time, so students who choose to undertake activities on that day may not have the support of
staff, should anything happen, and they must be prepared to look after themselves.
To assess risks resulting from interactions with dangerous plants and animals, JC conducted
extensive research to collate information from reliable sources. For information on dangerous
plants, local scientists and institutions were consulted, e.g. Bohol Biodiversity Complex. Below is a
list of sources from which information was garnered, mostly regarding animals. The OSHE Field Trip
Safety Manual further supports the information collected.
Myriapoda: University of Georgia extension website
Bees and wasps: Verywell Health website
Spiders: Patient info website
Marine creatures:
University of Adelaide’s Toxinology website
Australia’s MyDR website
DAN Asia’s website
Erickson et al (1992) The emergency management of moray eel bites. Ann Emerg Med 21, 212‐216.
Thygerson et al (2012) First Aid, CPR and AED Advanced. 6th Ed. Jones & Bartlett Learning, MA.
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HOW TO USE THE RISK ASSESSMENT TABLES
Working out the ‘significance’ of a hazard involves determining the two contributing factors: the (1)
likelihood and (2) severity. Meaning, for any identified hazard, what are the (1) estimated probability
that it will occur and (2) likely consequence if it does occur? Although the precise terms used to rate
likelihood and severity may vary among assessments, good practice dictates that they be clear,
concise and consistent within an assessment and easily understood by the reader.
This assessment consists of a series of tables – one per activity or section of the field trip. Each risk
associated with an activity (leftmost column) is rated according to its likelihood (L; 2nd column) and
severity (S; 3rd column). It is standard practice to implement risk controls (4th column) until controls
for the hazard in the yellow zone (medium risk) are as low as reasonably practicable, or the hazard is
in the green zone (low risk). However, this assessment goes a step further and proposes controls
even for some hazards already in the green zone. Hazards without a colour are too variable in risk
and/or severity to place accurately, but control measures still exist.
This assessment uses these abbreviations and definitions for the likelihood and severity of hazards.
Likelihood Severity
VL = very low Rare: not expected to occur, Negligible; unlikely to cause injury, ill‐health or
but still possible much hassle / stress
L = low Remote: unlikely to occur Minor; injury or ill‐health requiring first‐aid only
under normal circumstances (e.g., minor wounds, bruises, irritation, sprains, ill‐
health with temporary discomfort); hassle / stress
M = moderate Occasional: possible or known Injury requiring medical treatment or ill‐health
to occur leading to disability (includes lacerations, burns,
minor fractures, dermatitis)
H = high Frequent: common Serious injuries or life‐threatening disease
occurrence (includes amputations, major fractures, multiple
injuries, acute poisoning)
VH = very high Almost certain: continual or Catastrophic; fatality, fatal diseases or multiple
repeating experience major injuries
Likelihood VL L M H VH
Severity
VL
L
M
H
VH
In all cases, it is the responsibility of the course coordinator(s) to audit control measures on a regular
basis. This is done annually, and the audit involves reviewing the risk assessment and noting details
of non‐compliances and corrective measures.
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A – TRANSFER‐BASED RISKS
A1. Air transfer between Singapore and Cebu – JC, SR
Risk L S Control measures
Theft or loss of M VL Participants must always mind their belongings (never leave them unattended). In particular, be warned
belongings about: 1walking around while using mobile phones, 2risk of drive‐by bag snatching and pickpocketing in busy
areas, e.g., airports, seaports, 3need to collect baggage promptly upon deplaning.
Medical problem or L VL ‐ VH Participants must tell someone immediately if they feel unwell.
injury Info from medical questionnaires is always on‐hand (all staff have hard & soft copies).
Advise flight crew of serious problems.
Terrorist attack VL VH Course coordinator (JC) monitors political stability both nationally and locally until departure.
Exercise normal vigilance and caution.
Everyone should download the SGSecure mobile app to receive important updates, warnings (will be
received even while overseas).
If an incident happens, RUN, HIDE, TELL and, if you have no other option, fight your way to safety. Comply
with instructions of local authorities and save yourself.
Serious aviation VL VH All travel booked on airlines rated 4 stars or above by http://www.airlineratings.com/.
accident Silk Air (carrier in 2018) has an impeccable safety record and a perfect rating of 7 stars.
Pay attention to all safety info and instructions given by flight crew.
Consumption of alcohol in flight is not allowed.
Motion sickness L L Passengers who suffer from motion sickness should bring relevant medication.
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A2. Road transfer between Cebu airport and ferry terminal and Tagbilaran accommodations and ferry terminal – JC, SR
Risk L S Control measures
Getting left behind L L Keep an eye on the time and be at specified meeting places at designated times.
Participants divided into four groups of 10‐14. Each NUS teaching assistant (TA) is responsible for taking
attendance of one group; one lecturer per vehicle ensures each group is complete before any change in
location.
Participants should carry their mobile phones and have numbers of NUS staff (phone if necessary).
Loss of belongings M VL Participants should make sure they have all their belongings before leaving the vehicle.
Vehicular accident L VL ‐ VH Entire group is transported by two charter buses provided by same local provider in Cebu, and by hotel and
Holy Name University in Tagbilaran. Local provider is responsible for ensuring that (1) vehicles are in good
condition (tires, lights, brakes, etc.) and (2) operators have necessary training.
Drivers of both vehicles must be briefed beforehand to ensure they travel in convoy and at safe speed
(although traffic effectively prevents speeding); NUS staff ensure safe speed maintained.
Each vehicle carries a first aid kit.
Strictly no overloading of passengers or equipment on vehicle(s).
Do not stand on moving vehicle, and wear seat belts, if they are available.
Groups must be able to communicate between vehicles or have pre‐designated meeting points in the event
vehicles become separated.
Vehicle breakdown L VL Phone local taxi service. Delays between flights and ferries are large enough and distances are small enough
to arrange alternate transport.
KEN TAXI (Ken Transportation Inc) (032) 491 4144; (032) 272 1493 – they have mini‐vans.
Also install Android App Micab, which signals all smartphone equipped taxis (104 total as of October 2013)
within 2 km radius. Note, I tried and could not install it.
Motion sickness L L Passengers who suffer from motion sickness should bring relevant medication.
Terrorist attack VL VH All precautions in line with previously identified control measures for this risk (see table A1).
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A3. Ferry transfers between Cebu and Tagbilaran City –– JC, SR
We travel with Ocean Jet, 2Go or Weesam Ferries, which operate modern, fully enclosed Fastcraft vessels, with safety and navigational equipment and well‐
trained crews. JC has traveled on all three companies. Serious incidents involving these companies are extremely rare.
Risk L S Control measures
Accident at sea L VH Ferry only travels during daylight. In May, seas are usually calm, but PH Coast Guard has system of storm
resulting in vessel signals that prohibits ferries from sailing when signal one is raised. For more info, see the memorandum of
sinking or capsizing the Philippine Coast Guard.
Pay attention to all info and instructions given in safety video.
Ferry transfers only by Ocean Jet, Supercat (2Go) and Weesam ferries, none of which overloads its vessels.
Falling when L M Boarding procedure is very safe and orderly.
boarding or Participants must board/disembark single file and not carry more than they feel comfortable with.
disembarking Ferry crew stationed at entrance can provide any necessary assistance.
Medical problem or L L‐H Info from medical questionnaires always on‐hand (all staff have hard & soft copies).
injury Staff include certified wilderness first aid responders.
TAs ensure that well‐stocked first aid kit is always on‐hand and that all know where it is.
Advise boat crew of serious issues.
Seasickness L L Passengers who suffer from motion sickness should bring relevant medication.
Terrorist attack VL VH All precautions in line with previously identified control measures for this risk (see table A1).
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A4. Boat transfers to marine survey sites – JC
Group is transported on a large, well‐maintained outrigger boat provided by Mithi Resort & Spa (MRS). The departure point is the beach. The destinations are
Bingag and Tabalong Marine Sanctuaries, which are very close to shore (< 10‐minute trips).
Risk L S Control measures
Accident at sea L H All crossings are accompanied by NUS staff; MRS does not overload the boat.
resulting in vessel All students are already wearing fully inflated snorkel vests, but lifejackets are also provided.
sinking or capsizing Full briefing will be conducted by boat operator or NUS staff before departure, identifying safety features
on the boats.
Sunburn, almost M‐H Vessel has covered seating (but not dinghy used to transfer passengers at low tide – 1‐2 minute ride).
dehydration or nil Bring 500 mL of water (enough for a 2.5‐hour outing).
heat‐stroke Cover up, wear hats and sunblock and drink water regularly.
Participants should advise someone immediately if they feel unwell (especially faint).
Slipping or falling L M To some extent, measures dependent on boat operator’s own control measures.
on deck or falling Participants fully briefed on safe and out‐of‐bounds areas of boat; heed instructions of crew.
overboard Remain seated whenever boat is in motion and sit evenly on each side of the boat.
Medical problem or L L‐H Info from medical questionnaires always on‐hand (all staff have hard & soft copies).
injury Staff include certified wilderness first aid responders.
One well‐stocked first aid kit accompanies group out on the water, with bottle of vinegar (MRS provides).
Advise crew of any serious medical issues.
Falling when L M Participants wade out (or go by dinghy) to boat and climb small ladder to the deck.
boarding or Board or disembark one at a time.
disembarking Participants must not carry more than they feel comfortable with.
MRS and NUS staff position themselves at top and bottom of ladder to provide any necessary assistance.
Seasickness L L Passengers who suffer from motion sickness should bring relevant medication.9
A5. Road transfers to various field sites – JC
Charter vehicles (bus + van) are hired (HNU and/or Felys Transport) to transport all participants, except when we stay at Bohol Biodiversity Complex (BBC),
which uses its own field vehicles to take us short distances. JC has worked with all providers and driven all the routes (maps in Appendix A). Most distances
are not very large, and we mainly use well‐traveled roads.
Risk Likelihood Severity Control measures
Getting left L L Keep an eye on the time and be at specified meeting places at designated times.
behind Before any change of location…
1. One student per project group ensures all members are present and confirms that to faculty and/or TAs
2. All students count off, while one staff member per vehicle pays attention, and advises main leader
(coordinator/lecturer) that group is complete.
Participants should carry their mobile phones and have numbers of NUS staff (phone if necessary).
Vehicle L H Local providers are responsible for ensuring that (1) vehicles are in good condition (tires, lights, brakes, etc.)
accident and (2) operators have necessary training.
Drivers briefed prior to journey to travel at safe speed, staff to ensure safe speed maintained at all times.
TAs ensure each vehicle has one well‐stocked first aid kit and all know where it is.
Strictly no overloading of passengers or equipment on vehicle(s).
Do not stand on moving vehicle, and wear seat belts, if they are available.
Avoid driving after dark, if possible (exception: trekking and short transfers for night activities at BBC).
Medical L L‐H Staff always keep medical info on‐hand (hard & soft copies); participants must carry photo ID.
problem or Staff include certified wilderness first aid responders.
injury TAs ensure one well‐stocked first aid kit is always on‐hand (per vehicle) and everyone knows where it is.
Advise driver of any issues, go to nearest medical centre if necessary (locations pre‐identified).
Vehicle‐ M L For extended travel outside the city, each vehicle must be contactable (mobile phone), have necessary
breakdown equipment to change wheels and carry flashlight and enough water for the journey.
Theft/loss of M VL Participants should take their belongings with them at the end of each day in the field.
personal articles When articles are purposely left in the vehicle while in the field, one staff member per vehicle reminds driver
to either stay with vehicle or keep doors locked.
Motion sickness L L Passengers who suffer from motion sickness should bring relevant medication.10
B – TAGBILARAN CITY BASED RISKS
B1. Accommodations. Dao Diamond Resort – JC
Well‐maintained; grounds well‐lit at night. Of 99 reviews on Trip Advisor, 81 % are excellent or very good. Our group always loves staying here.
http://www.daodiamond.com
Risk L S Control measures
Falling, tripping M M Walk around sensibly, wear shoes and keep to main footpaths.
or stepping on Alcohol may be consumed, but only in moderation (everyone should know her/his limits).
something sharp Be careful when walking in pool area.
Medical problem M VL ‐ VH Info from medical questionnaires always on‐hand (all staff have hard & soft copies).
or injury Staff include certified wilderness first aid responders.
Ensure well‐stocked first aid kit is always on‐hand and everyone knows where it is.
Emergency L H HNU Medical Centre 1.2 km away, phone emergency services (117), advise NUS staff and front desk.
evacuation
Fire L H Absolutely no smoking indoors.
All participants to be briefed on resort’s emergency procedures, exits and fire extinguishers.
Emergency meeting point is designated upon arrival and communicated to all participants.
Theft L VL Note: nobody on Trip Advisor has reported problems with theft, we have never had issues.
All passports collected by NUS TAs upon arrival at hotel and then stored in front desk safe.
Participants should lock their rooms and not leave valuables unattended.
Drowning in L VH Be careful when walking in pool area.
pool Use of pool is at participants’ own risk because no lifeguard is on duty.
Food‐ or water‐ L L‐M Highly unlikely considering quality of food served here. However…
borne illness Only drink bottled or purified water (provided ad libitum).
Take general precautions to avoid food‐borne illness, e.g., only eat food at the proper temperature, avoid
certain foods, etc. – all info that is easily available online (participants should inform themselves)
Allergic reaction L L ‐ VH Hotel knows about pre‐disclosed allergies, but participants must inquire if uncertain about ingredients.
Terrorist attack VL VH All precautions in line with previously identified control measures for this risk (see table A1).11
B2. Around Tagbilaran City
Outside programmed activities, participants may go out unsupervised. It is not possible to recce free‐time activities. To minimise risk, students must travel in
groups of at least three, preferably with at least one male. There will also be an IN‐OUT book at the Dao Diamond front desk. Before going out unsupervised,
students must complete it (who, where, when), and they must carry a mobile phone (with numbers of staff and the resort, and emergency numbers: mobile
(038) 117 or 117 for medical issues, 116 for the police hotline.
Risk L S Control measures
Vehicular L H Use Dao Diamond’s nightly shuttle if possible – local transport (tricycle, mini‐cab) may be less safe.
accident Wear seat belts, if provided.
Being hit by L VH Road conditions are chaotic, but traffic is not constantly heavy and vehicles drive slowly, so crossing safely is possible.
vehicle Participants are briefed on what to expect while walking around, e.g., road conditions and fact that crosswalks and
traffic lights may not be respected.
Theft / robbery M L Theft (especially snatching bags and phones) accounts for more than half of crimes, followed by robbery. Incidence peaks
in Fiesta month of May. Participants must:
Be vigilant when walking around (especially securing valuables and not texting or talking on mobile phones).
Never walk around with passport on their person.
Never risk their lives for the sake of their belongings.
Phone police if necessary: 116 (hotline); +63 38 501 9834; +63 38 411 4982; +63 38 411 4325
Medical problem M L‐H If participants experience any serious problems, they should first phone emergency services (117), and then advise
or injury NUS staff. They should always remain in a group and carry photo ID.
Assault, mugging VL H Violent crime is rare and generally involves acquaintances rather than strangers. Participants must:
or other violent Always be in a group of at least three people – presumably this minimises the risk.
crime Avoid poorly‐lit areas and trust their instincts when dealing with locals.
Phone police if necessary: 116 (hotline); +63 38 501 9834; +63 38 411 4982; +63 38 411 4325.
Getting lost M L Participants should download a map of Tagbilaran, use GPS and have relevant phone numbers.
Falling/tripping M M Roads and sidewalks are very uneven, and some areas are poorly‐lit at night.
Participants should be careful while walking and look where they are stepping.
Terrorist attack VL VH All precautions in line with previously identified control measures for this risk (see table A1).12
C – SPECIFIC ACTIVITY SITE‐BASED GENERAL RISKS
Risk L S Control measures
Falling, tripping, M M Walk around sensibly, wear shoes and keep to main footpaths.
stepping on
something sharp
Medical problem or M L‐H Info from medical questionnaires always on‐hand (all staff have hard & soft copies), and participants must
injury carry photo ID.
Staff include certified wilderness first aid responders.
Ensure well‐stocked first aid kit is always on‐hand and everyone knows where it is.
Advise staff immediately of any serious problems.
Emergency L H Vehicle will remain parked near site being visited, ready for emergency evacuation to closest hospital
evacuation (location identified prior to each trip)/phone 117.
Sunburn, M M‐H Understand the real risk of dehydration, drink 3 L water/day and carry 1.5 L of water.
dehydration or Additional drinking water is on‐hand or available for purchase at all sites.
heat‐stroke Use sunblock, cover up and wear hats.
Participants should advise someone immediately if they feel unwell (especially faint).
Participants poorly L M Staff fully brief participants before activity and check they have the appropriate equipment. Everyone should
equipped or unfit to look out for one another, and advise staff if they notice signs of exhaustion, so activity intensity can be
cope with adjusted according to fitness levels.
conditions
Fire L H Absolutely no smoking.
Emergency meeting point (usually vehicle) is designated upon arrival and communicated to all participants.
In case of fire, everyone should return immediately (and calmly) to emergency meeting point and/or follow
instructions by staff and attraction operators.
Being struck by VL VH Every morning and evening, staff members check the Philippine Atmospheric, Geophysical & Astronomical
lightning or falling Services Administration (PAGASA) website.
tree Field activities cancelled or appropriately curtailed if severe weather is forecasted.
During field activities, sky conditions are periodically monitored, and if thunderheads are forming, then
participants are moved to safe location.13
Becoming lost Almost L Most sites are small, and we are accompanied by locals. Still,
nil Always work in a group; never wander off alone.
Each group has its own TA and/or local guide, so everyone’s whereabouts are known.
At least one person in each group carries a mobile phone, and that it’s always charged and handy.
Within each group and the entire class, establish a designated meeting point (e.g., vehicle) to return to and
wait if anyone does get lost.
Theft/loss of M VL Participants must keep track of their belongings.
belongings
Food‐ or water‐ L M This is unlikely considering the quality of food served to us by our partners. However, in general…
borne illness Only drink bottled or purified water (or drinks made with potable water).
Take general precautions to avoid food‐borne illness (see also table B1).
Terrorist attack VL VH All precautions in line with previously identified control measures for this risk (see table A1).14
C1. Mithi Resort & Spa (MRS); formerly Panglao Island Nature Resort (PINR) – JC
Located in Dauis, 11.6 km (15 min.) from Dao Diamond Resort. Jumping‐off point for marine‐based activities (table A4). Participants also have lunch and
snacks here, use the pool and beach and visit Hinagdanan and Cambagat caves. The compound is gated and guarded. http://www.mithiresort.com/
Risk L S Control measures
Falling, tripping L M The terrain is even and well‐maintained with little to no risk of stepping on something sharp, but the pool area and
or stepping on flagstone pathways tend to get quite slippery. In addition to previously identified precautions:
something sharp Alcohol may be consumed, but only in moderation and after completion of each day’s activities.
Advise staff immediately in case of broken glass.
Be careful when walking in pool area.
When visiting the Barangay Captain’s house in Tabalong for land‐based surveys, there is a staircase leading down
to the beach. It is very slippery – using it is not recommended.
Medical problem M L‐H Closest medical facilities: HNU Medical Centre, < 15 minutes away.
or injury
Theft L VL Participants should keep an eye on their belongings.
Drowning / L VH Be careful when walking in pool area.
becoming Use of pool is at participants’ own risk because no lifeguard is on duty.
injured in pool Note: participants use pool on day 1, to learn and practice giant stride entry, which they will use to enter the water
from the boat. This activity (in the deep end) is supervised by NUS staff, so there is zero risk of drowning. But to
avoid injury do take care to only do the stride entry or jump into the water in the deep end indicated by the cone.
Drowning in VL VH Swimming off the beach is at participants’ own risk because no lifeguard is on duty.
ocean Participants should inform someone if they are going swimming and report when they return.
At low tide, danger is minimal, and it is possible to wade out to islet.
Note: practice transects will be conducted off the beach on day 1, but in water shallow enough to stand.
Food‐ or water‐ L M This is highly unlikely considering the quality of food served to us. So, precautions as previously identified.
borne illness
Slipping and L L Both caves are entered by cement steps / large stones and are well‐maintained. Both caves contain lagoons.
falling in caves Conditions can be slippery.
Participants should hold onto railings / ropes and wear sensible footwear.
Participants are advised not to swim in the lagoons because of pollutants in the water.15
C2. Man Made Forest – JC and SR
Located very close to the town of Bilar, about 35 km (60 min.) from Dao Diamond. 2 km‐long stretch of forest along both sides of HWY. This is a monoculture
of mahogany trees 50‐60 years old. Students conduct vegetation and faunal surveys. The site has a lot of steep slopes, so control measures reflect that. We
have Forester Restituto Piollo and other qualified staff from Bohol Biodiversity Complex accompanying us, so level of supervision is increased.
Risk L S Control measures
Falling, tripping or L‐M L‐H This is a natural site, with roots, steep slopes and other potential hazards that cannot be thoroughly
stepping on ascertained beforehand. In addition to previously identified precautions:
something sharp or Wear hiking boots (footwear with good grip and leg protection) – MANDATORY.
fall resulting in Activities on steep slopes should be avoided, though in our experience, this is not always possible due to
serious injury or the size and topography of the site. Therefore…
fracture - Participants should only work on terrain they can handle themselves on.
- Participants who are not sure‐footed should bring a hiking pole for use on slopes.
- Activity aborted in case of heavy rain.
Becoming lost VL M In addition to previously identified control measures, do not wander off, i.e., stay in general vicinity of the
overall group, even while “using the facilities”.
Medical problem or M L‐H Phone 117/transport to Tagbilaran City.
injury
Pedestrian hit by L VH This site is along a HWY. Traffic generally slows down because of tourists stopping and parking on both sides
vehicle of the road, but extra caution must be taken, e.g., while getting on/off the vehicles, crossing road.
Sunburn, VL M–H Note: risk minimised because site is heavily shaded and much cooler than elsewhere. Wearing a hat is
dehydration or heat‐ unnecessary. Stay hydrated.
stroke
Heavy rain / wind / VL H Highly unlikely because course takes place in dry season, but activity is called off in case of storm warning.
lightning causes tree
fall flood, landslide
Negative interactions VL L–H Note: risk minimised because few animals live here, but general precautions apply (see table G).
with animals16
C3. Assisted Natural Regeneration (ANR) site – JC
Farm of Bill Granert (SWCF), located in San Augustin. About 75 km (1h30 min‐2 hrs) from Dao Diamond. Participants set up experimental plots (ANR and
rainforestation) and revisit ones established by their seniors. ANR activity involves pressing down grass and planting trees. They also do a bird survey. Many
local staff accompany us, so level of supervision is very high.
Risk L S Control measures
Falling, tripping or L‐M L‐H This is a farm, with easy trail to sites, although ground is a bit uneven and there are potential hazards that
stepping on cannot be thoroughly ascertained beforehand. In addition to previously identified precautions:
something sharp or Wear hiking boots (footwear with good grip and leg protection) – MANDATORY.
fall resulting in As much as possible, avoid activities on steep slopes.
serious injury or Participants who are not sure footed may bring a hiking pole for use on slopes.
fracture Activity aborted in case of heavy rain.
Becoming lost L M In addition to previously identified control measures, groups must not wander off, i.e., stay in the general
vicinity of the overall group.
Medical problem or M L‐H Phone 117.
injury
Sunburn, M M–H This site has open areas, and it gets very hot. Hence the morning timing, i.e., to reduce the hazard. Still…
dehydration or heat‐ Understand the real risk of dehydration, drink 3 L water/day and carry 1.5 L of water.
stroke Use sunblock, cover up and wear hats.
Participants should advise someone immediately if they feel unwell (especially faint).
Heavy rain/lightning VL H Bill selects specific sites to minimise risks. If very inclement weather forecast, activity to be called off. This is
causes flooding, highly unlikely because course takes place in dry season.
landslides or tree fall
Negative interactions VL L–H Pay special attention to snakes because this is a natural site. Other measures as described in table G.
with animals
Cutting one’s self or L H ‐ VH Participants use specific techniques associated with ANR, e.g., stamping down weeds with a pressing board,
someone else with a slashing them (using a parang) and planting trees. Be very careful and, especially avoid slashing near other
parang or other tool people when using parang.17
C4. Habitat Bohol (formerly Simply Butterflies) – JC
Located in the town of Bilar, about 3 km (< 5 min.) from Bohol Biodiversity Complex (our departure point). Butterfly breeding and education centre. Students
evaluate conservation and educational value of eco‐tourism attraction, with surveys of visitors and critical analysis of breeding programme.
https://www.facebook.com/HabitatBoholWildlifeAdventure/
Risk L S Control measures
Falling, tripping or VL M The site is small, with paved and dirt paths that are super easy to navigate. So, no special control measures are
stepping on needed beyond those generally prescribed (walk sensibly, wear shoes, etc.)
something sharp
Medical problem or M L‐H First aid on site
injury Doctor lives nearby and could be brought out there.
For very serious case, Habitat Bohol staff to phone ambulance stationed in Bilar, and it would transport
patient to Tagbilaran City.
Being hit by vehicle VL M–H Parking lot is not busy, but this is a remote possibility, especially if students interact with arriving / departing
in parking lot visitors. So be careful while walking around in parking lot, paying attention to vehicles.
Food‐ or water‐ VL M Highly unlikely considering the quality of food served here and the fact that we will only be served ice cream
borne illness (unless we order something else). So, precautions as previously identified.18
C5. Philippine Tarsier Foundation (PTFI) – JC
Located in Corella, about 11 km (15 min.) from Dao Diamond resort or 28 km (40 min.) from Bohol Tarsier Conservation Area – departure point varies
depending on which half of class participants are in. Sanctuary for 20 animals within larger protected secondary forest, research on basic ecology and
behavior of tarsiers conducted here as well as various eco‐tourism and conservation education activities. Students evaluate the conservation and educational
value of eco‐tourism attraction, with surveys of visitors, hiking and interaction with Carlito Pizarras. http://www.tarsierfoundation.org/
Risk L S Control measures
Falling, tripping or M M Footpaths in sanctuary are often muddy and slippery; walk sensibly around the site and keep to main
stepping on footpaths.
something sharp
Medical problem or M L‐H Closest medical facilities: HNU Medical Centre, 8.7 km away.
injury Advise NUS staff and front desk staff, if necessary.
Sustaining M L Tarsier habitat accessed via narrow footpaths with close growing vegetation, so be careful walking around.
scratches and cuts Advise staff of any injuries.
from vegetation
Being struck by VL VH All precautions in line with previously identified control measures for this risk (see table C).
lightning or falling
tree
Hiking to Variable Challenging hike (moderately steep), with fallen leaves (slippery). Besides precautions identified for BBC,
observatory – also participants should note there is a pleasant, sheltered rest stop about halfway up – they can just wait here if
see risks for BBC they feel unable to continue. In case of rain, we will hike the Alameda trail, which is very easy.
(table D) Wear hiking boots (footwear with good grip and leg protection) – MANDATORY.
Being bitten or Almost M Tarsiers are nocturnal and lethargic during the day. They are rarely aggressive toward humans.
scratched by a nil Never touch or approach them too closely (minimum 1 m distance, do not extend hand toward them).
tarsier Advise NUS staff in the event of a bite or scratch (to receive first aid and rabies vaccine).
Being hit by vehicle VL M–H Parking lot is not busy, but this could happen, especially because students interact with other visitors. So be
in parking lot careful while walking around in parking lot, paying attention to vehicles.19
C6. Bohol Tarsier Conservation Area (BTCA) – JC and SR
Located in Bilar, about 38 km (55 min.) from Dao Diamond resort or 28 km (40 min.) from PTFI – departure point varies depending on which half of class
participants are in. Eco‐tourism facility showcasing tarsiers along a walkable trail. Students evaluate the conservation and educational value of eco‐tourism
attraction.
Risk L S Control measures
Falling, tripping or L‐M M The trail is paved, wide and well‐maintained. Walk sensibly around the site and participants will be wearing
stepping on hiking boots anyway (see table C5).
something sharp
Medical problem or M L‐H Phone 117/transport to Tagbilaran City.
injury
Being hit by vehicle in L M‐H Parking lot is somewhat busy, and the risk arises if/when students interact with other visitors. So be careful while
parking lot walking around in parking lot, paying attention to vehicles.
Being bitten or Almost M All precautions in line with previously identified control measures for this risk (see table C5).
scratched by a tarsier nil20
C7. Loon tour – JC and SR
Loon is about 26 km away (25 min.) from Dao Diamond Resort. This is an easy walking tour of the beach to see where the coastline retreated / seabed rose
thereby raising elevation of mangrove area, whose ecology has changed. In addition to faculty and TAs, we are accompanied by Prof Rene Rollon and Ma.
Laurice Jamero.
Risk L S Control measures
Falling, tripping or L‐M M Participants walk on different types of surfaces (pavement, beach). Walk sensibly around, wear sturdy, closed
stepping on shoes and keep to main paths where they exist.
something sharp
Medical problem or M L‐H Closest facility: two hospitals in town of Calape (15 km away); Tagbilaran City is 25 km away.
injury
Pedestrian hit by VL M‐H Except on main HWY, there is little to no traffic, so simply take care when crossing main roads.
vehicle
Risks associated with L M‐H This mangrove area has changed ecologically – it is no longer wet. We do not really walk through it. But should the
mangroves activity change, then exercise general precautions related to mangroves.
Aerial roots are very slippery, steep and arching, and there may be other hazards that cannot be thoroughly
ascertained beforehand. Do not walk on them.
Wet mangroves are good habitats for snakes, which may be wrapped around aerial roots or branches or
basking. Snakes may be well‐camouflaged (e.g., brown snake on brown root; green snake amid green leaves).
Besides exercising precautions outlined in table G, look carefully at aerial roots before clambering over them
and be very careful before placing hands on them.
Wash hands thoroughly after being in a mangrove area to reduce the risk of infection.21
C8. Maribojoc Organic Demo Farm – JC and SR
In Saug Bayacabac, Maribojoc, ≈ 25 minutes from Dao Diamond. http://www.boholtourismph.com/maribojoc‐organic‐demo‐farm/. This farm operates a
programme to train and empower locals, especially women, to grow healthy, organic food with low input of cash. Students receive lunch, a guided tour and
exposure to the training activities, and get to interact with personnel. Farm tour has been recced but not the training activity.
Risk L S Control measures
Falling, tripping or L‐M L‐H This is a farm, easy to navigate, but some trails are narrow with close vegetation, and there are potential hazards
stepping on that cannot be thoroughly ascertained beforehand. In addition to previously identified precautions:
something sharp Wear closed shoes (though this follows activity described in table C7).
or fall resulting in Rubber boots are ideal (for ease of cleaning).
serious injury
Negative L L–H The farm has pigs, cows and poultry. Pigs are properly controlled and contained; poultry and cows are free‐roaming,
interactions with but not aggressive.
animals (being Do not approach animals unless encouraged to do so by farm staff.
bitten, scratched, Participants should not reach their hands toward animals.
pecked, kicked, Do not enter pig pens.
butted, etc.)
Special infection L‐M L – VH There is always a risk from infection in any environment, but farms pose special risk of zoonotic and other diseases
risk associated with the guts of livestock, e.g., E coli 0157, ringworm, brucellosis, cryptosporidiosis, psittacosis, due to
pathogens in animal waste and exposed soil.
Do not touch animals, fencing or manure storage facilities.
Make sure any existing cuts and abrasions are covered with a dressing before the visit.
Participants should have up‐to‐date tetanus vaccines, but any wounds, however minor, sustained during the visit
should be reported to staff.
Clean hands thoroughly after visiting the farm / before consuming food or drink.
Clean shoes at end of visit.22
D – BOHOL BIODIVERSITY COMPLEX‐(BBC) BASED RISK ASSESSMENTS AND MANAGEMENT – JC
Time spent at BBC includes forest trekking, forest surveys (see Manmade Forest), collecting wildlings, tree‐planting, building recovery chamber for wildlings,
working with soil, walking in natural areas (including at night), mist netting bats, spotlighting survey, meeting locals, birdwatching, stream sampling and
maybe swimming and caving (for 2017, caving is a no‐go because proposed caves still have not been deemed safe since the 2013 earthquake). BBC has years
of experience hosting school groups, and staff is putting in place more than reasonable safety measures (see below) to reduce risk.
Risk L S Control measures
Being hit by Almost H There is a gravel road from the main road (Loay Interior Rd) to the complex, and access to the forest and stream
vehicle while nil are on foot along this road. The only vehicles that travel on this road are generally going very slow. Still, be
walking on road careful while walking on the road.
Falling, tripping or L M All precautions in line with previously identified control measures for falls and injuries, esp. table C2, but
stepping on adjusted for the scenario, e.g., proper footwear, use of a walking stick on slopes, using a headlamp at night,
something sharp staying on paths where possible, and surefooted individuals helping others on slopes as needed.
Medical problem M L‐H Info from medical questionnaires always on‐hand (all staff have hard & soft copies), and participants must
or injury carry photo ID.
Staff include certified wilderness first aid responders.
Ensure well‐stocked first aid kit is always on‐hand and everyone knows where it is.
Advise BBC staff immediately of any serious problems.
BBC has Red Cross volunteers on call and ensures Bilar LGU is ready to offer emergency response.
Risks associated L M–H At times, the group travels in vehicles provided by BBC – thus far including a large truck (24 passengers) with
with vehicular side benches in the tailgate and a van. Both were fine. Most journeys are short (< 10 minutes) and often on back
transfer roads, except the one from BBC to Cabacnitan described below. Sites accessed by these vehicles include:
Cabacnitan (15‐minute drive, at speed of approximately 45 kph)
Raja Sikatuna Protected Landscape (RSPL) trekking trailhead and terminus (5‐minute drive, before dawn)
RDJ Resort; accommodation for part of group (5‐minute drive)
Habitat Bohol (5‐minute drive)
Prof Jose Travero’s farm
All control measures as in section A5 to be adopted to the extent possible, recognising that the risk is naturally
minimised in most instances by nature and duration of travel.
Emergency L H BBC staff accompany us on all excursions, so defer to their judgement to deal with this scenario.
evacuation
Sunburn, VL ‐ M M‐H Note risk or sunburn and heat‐stroke virtually nil in most cases because most sites are very well‐shaded, but all23
dehydration or precautions in line with previously identified control measures for this risk (see table C).
heat‐stroke
Being struck by VL VH All precautions in line with previously identified control measures for this risk (see table C).
lightning or falling
tree
Participants L M Staff to fully brief participants prior to start of each activity and check they have the appropriate equipment. Staff
poorly equipped to watch participants carefully for signs of exhaustion and adjust activity intensity according to fitness levels.
or unfit to cope
with conditions
Fire L H ‐ VH Absolutely no smoking in the field.
Participants to be briefed on procedure in case of fire, as per BBC SOP.
Becoming lost VL L Always work in a group; do not wander off alone.
Each group has its own TA and/or local guide, so everyone’s whereabouts are always known.
At least one person in each group carries a mobile phone.
Establish designated meeting point to return to and wait if anyone does get lost.
Theft/loss of M VL Participants reminded to keep track of their belongings.
belongings
Not being able to L M All participants on night walks must have a working headlamp / flashlight (on packing list).
see resulting in a fall Participants to be briefed on night walking before any such activities.
Bites and M M ‐ VH Mist nets attended only by experienced personnel; do not handle bats unsupervised, without proper
stings/disease vaccinations and adherence to bat safety protocol (gloves, glasses, N95, long sleeves, pants, as per JC).
transmission from Both cobra spp. present. Keep to trails as much as possible, carry a stick, wear pants and boots, etc.
bats Red ants – wear pants tucked in long socks.
Stinging caterpillars – wear shirt tucked in pants
Wasps in ground nests – see table G
Otherwise, see table G.24
Being injured by M M Forests contain rattan, among other thorny plants.
thorns or branches While walking in forest, do not grab hold of any plants, except tree trunks and only after checking to
make sure no dangerous animals are on trees.
Understand hiking etiquette, i.e., warn the person behind when pushing aside a branch to pass by, be
observant and point out any dangers to others.
Cutting one’s self or L H ‐ VH During interaction with villagers in Cabacnitan, participants may be offered fresh coconuts, which are cut
someone else with a with a parang. They may be offered the chance to try hacking open a coconut. Those who wish to try this
parang out should be very careful and, avoid slashing other people.
Exposure to toxic L M‐H Numerous plant spp. throughout PH, including Bohol, have toxic parts. Never taste plants (unless told to
plants do so by BBC personnel) and avoid touching face after working outdoors. Also, wear long pants and
sleeves to avoid accidental contact with toxic plants.
Lingatong (stinging hairs) – to be pointed out because it occurs along trails and disturbed areas.
In case of contact, wash skin and clothes as quickly as possible following exposure. Apply wet compress
with baking soda or vinegar or use topical ointment. Avoid scratching.
Dehydration while L H Carry sufficient water for the whole trek (about two hours).
hiking There are plenty of stops, but this is not a race and participants should stop whenever they feel they
need to.
Injury while collecting L M Participants use tools such as pruners, scissors, trowels, etc. Proper procedure is demonstrated by BBC staff
or preparing wildlings – pay attention and follow instructions carefully.
Food‐ or water‐ L M The food served at BBC (nearly all meals) is outstanding, and we have never experienced issues. However,
borne illness the same precautions identified previously (table B1) apply.25
D1. BBC‐based accommodations
We spend a total of 3D/2N at BBC. Because there is no one facility in the area large enough to accommodate the entire group, for the purposes of lodging,
we may split up among three locations: BBC, RDJ Mountain View Resort and dorms at Bohol Island State University (BISU). We have stayed at BBC and RDJ,
but not BISU (has not been recced), but it is literally adjacent to BBC. Also, BBC is upgrading / changing its accommodations and facilities, so we do not know
exactly what to expect. Information here is compiled based on all our observations. There will be at least two staff members at each location.
Risk L S Control measures
Falling, tripping or M M Walk around sensibly, wear shoes and keep to main footpaths.
stepping on something
sharp
Medical problem or M L‐H Info from medical questionnaires always on‐hand (hard and soft copies).
injury Staff include certified wilderness first aid responders.
Ensure well‐stocked first aid kit is always on‐hand and everyone knows where it is.
NUS staff must be able to communicate with each other and BBC staff in case of emergency.
Emergency L H As per each facility’s SOP
evacuation
Fire L H Absolutely no smoking indoors.
All staff and participants to be briefed on the location and use of fire extinguishers.
All participants made aware of the resort’s emergency procedures and exits.
All participants made aware of the emergency meeting point, to be designated upon arrival.
Theft L VL Participants should always lock their rooms when they leave and not leave valuables unattended.
Do not bring passports – leave them at Dao Diamond.
Food‐ or water‐borne L M Risk is nil at RDJ and BISU (no meals taken) and low at BBC given excellent quality of food. However, the same
illness precautions identified previously (table B1) apply.26
E – SNORKELING PREPARATION AND IN‐WATER ACTIVITIES – JC
To minimise risks, JC selected a major tour operator (MRS; see tables A4 and C1) recommended by local contacts, and there is plenty of supervision (minimum of
five staff). To further minimise risks, staff supervisors are good swimmers, only half the students (25 maximum) go out on the water at any one time, and there
are five MPA wardens with us, giving a minimum supervisory ratio of 2.7 : 1.
Risk L S Control measures
Slipping on board M L‐M Move around boat carefully, holding onto the side as necessary while kitting up.
Problems on entry, L M To some extent, measures dependent on boat operator’s own control measures.
e.g., landing on Understand the possibility of boat hitting one’s head when hanging onto the mooring rope.
another swimmer, All participants must check behind them, let others know they are going into the water.
getting hit in head by Giant stride entry (demonstrated by NUS staff and learned on day 1) to be used by all. Wear snorkel vest inflated.
boat, breaking mask Give OK signal before swimming away so next person can enter.
and injuring face, One staff member and one crew member assist person entering the water.
drifting away If waves / current present, link arms with others to avoid drifting away.
Being hit by a boat VL VH To some extent, risk minimised because wardens are keeping watch on water surface.
while snorkelling Always snorkel in pairs and remain in the area designated by staff.
Stop snorkeling every 2‐3 minutes to check location.
Being swept out to VL M The MPAs are very near offshore (people on the beach are visible) and there is almost no current, but participants
sea should abort the snorkel if they encounter strong current.
Lightning strike VL VH If lightning is sighted or emergency whistle is heard, evacuate the water immediately.
Getting lost L L–H Attendance‐taking is much more important with water‐based activities.
Buddy system is employed – never swim alone.
NUS staff double‐check that everyone is always accounted for, especially when leaving.
Everyone taught the distress signal, to be used also if swimmer/pair has drifted too far from the boat to swim
back easily. Participants may also use their whistle to call for help.
Stop snorkeling every 2‐3 minutes to check location.27
Drowning L VH All students complete declaration of swimming ability.
All students must wear a snorkel vest, but inflating it is optional for those who declare they can swim.
Students who declare that they cannot swim must have vest inflated or participate in stationary fish survey
(holding onto floating devices).
Animal sting or bite L M See table H.28
F – MEDICAL RISK ASSESSMENT AND MANAGEMENT
Risk L S Control measures
Dehydration M‐H L‐H Understand the importance of drinking plenty of water, even when not thirsty, aim for 3 L / day in hot weather.
Monitor own fluid intake (should urinate significant amount 3‐4 times / day, pale yellow urine).
Before course, learn to recognise signs of dehydration in self and others, and during trip, take measures to
rehydrate or alert staff as necessary.
- Early signs: dry mouth, thirst, restless/irritable behaviour, headache, mild muscle cramping.
- Moderate dehydration: extreme thirst, flushed face, headache, warm and dry skin, lack of urine production,
dizziness, weakness, cramps in arms and legs.
- Severe dehydration: all above, plus severe cramping, low BP, fainting, convulsions, bloated stomach, lack of
elasticity of skin, rapid deep breathing, fast and weak pulse.
Heat stroke H L‐H Heat stroke: stay hydrated.
and sunburn Understand the risk of sunburn, especially on boats and in the water and open areas. Wearing a hat is
MANDATORY unless advised otherwise. Seek shade when possible. Use high SPF (30+) sunblock and cover up
(rash guard + board shorts / shorty + swim cap in the water, shirts with sleeves and long shorts or pants on land).
Food‐ and H L‐H Only use bottled or filtered water for drinking and brushing teeth.
water‐borne Good personal hygiene is critical to avoid spread of disease when sharing close quarters.
illness Do not consume cooked food > 6 hrs after cooking.
Street food is not recommended.
Cassava, a popular snack in PH, may contain a dangerous dose of cyanide if not prepared properly.
Everyone should seek physician’s advice on proper vaccines.
Infection of H L‐M The risk of secondary infections is greatly increased in the field.
wounds Do not scratch mosquito bites – this is a common cause of secondary infection.
Ensure all wounds, however minor, are washed with clean water and antiseptic or alcohol is applied.
Have wounds assessed daily and report any burgeoning infection to NUS staff.
Understand the dangers of walking around barefoot outdoors.
Ear infections L L‐M The risk of ear infections increases with in‐water activities.
Wash out ears with freshwater after getting out of the sea.
Report any ear problems, however minor, promptly to NUS staff.
Do not go swimming with symptoms of an ear infection, i.e., stop in‐water activities when symptoms appear.
Dengue fever L VH We all live in a nation that has Dengue fever. Apply same precautions (cover up in the day, use mosquito repellent).29
Leptospirosis L M Leptospirosis is present in PH, although prevalence has been decreasing.
Avoid drinking and swimming/wading in potentially contaminated water, especially flood waters
Adopt general measures to avoid water‐borne illnesses described above.
http://www.cdc.gov/leptospirosis/
Schistosomiasis VL M‐H Schistosomiasis is endemic in Bohol.
Avoid swimming/wading in freshwater unless you are told it is safe to do so. Note: in 2014, participants went into a
natural rock pool and none experienced problems – locals perceive risk as nil.
Adopt general measures to avoid water‐borne illness described above.
http://www.sciencedirect.com/science/article/pii/S1201971213003032
http://www.cdc.gov/parasites/schistosomiasis/
Rabies VL VH PH has a problem with rabies. Avoid contact with mammals as in table G.
http://www.wpro.who.int/philippines/areas/communicable_diseases/rabies/continuation_rabies_area_page/en/
http://www.cdc.gov/rabies/
Tetanus L VH Caused by Clostridium tetani, ubiquitous in soil worldwide, infection occurs following wound to the skin.
Participants should consult with physician before the trip to obtain any recommended vaccines.
Hantavirus/ VL L ‐ VH No human cases in PH since 2000, but Arenavirus is endemic to all countries. Avoid contact with rodents.
Arenavirus
Recurrence of L VH All participants must complete pre‐trip medical form and disclose any known allergies and conditions, with details
previous or retained by all staff members on the trip.
existing medical Have a pre‐trip health evaluation.
condition Course coordinator reviews forms and instructs participants with conditions of concern to be evaluated by a
leading to physician and obtain 1authorisation to participate fully or 2explanatory letter about the condition’s implications.
illness/death Participants can sit out from any activity that may pose a risk to their health as a result of a pre‐existing condition.
All medical M L ‐ VH Participants should alert NUS staff if feeling unwell in any way, and problems are evaluated and handled on a case‐
problems by‐case basis.
Serious medical L H All participants have travel insurance, so decision to evacuate should be made by insurer and local medical staff.
problem or
injury requiring
emergency
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