CONTENTS

1 HEALTH 

2 TRAVEL/TRANSPORTATION

3 CRIME

Safety Is Everyone’s Responsibility – Know before you go

This document highlights several risks associated with studying, volunteering and living in India.

The review of risks in this document is limited in scope and reflects VOCATIONAL IMPACT’s current information.

Circumstances may change over time.

Your safety and security is one of VOCATIONAL IMPACT’s top priorities; however, you and your family have a role to play in minimising potential dangers. VOCATIONAL IMPACT cannot monitor your daily personal decisions, choices, or activities any more than is the case in the UK. Therefore, you are expected to participate actively in minimising your risks while in India. Please read and produce a personal safety plan for your time abroad.

VOCATIONAL IMPACT cannot guarantee the safety of participants or ensure that risk will not, at times, be significantly greater than in your home country.

VOCATIONAL IMPACT cannot monitor the daily personal decisions, choices, and activities of individual participants any more than is the case at home.

You are responsible for gathering information about possible risks, and to make final decisions about participation on VOCATIONAL IMPACT’s volunteer programme.

There are many different ways by which individuals judge the safety of places and/or activities. This is a partial list that identifies some of the common hazards associated with particular activities or the environment while studying and living in India (e.g., extreme heat or cold, endemic disease, transportation, crime, violence, political instability, lack of electricity, lack of water, etc.). Consider these hazards and take preventive measures.

Voluntary risks are those associated with activities that students may decide to undertake (e.g., driving a car, swimming, riding a motorcycle, smoking, taking public transportation, abusing drugs/alcohol, etc.).

Involuntary risks are those associated with activities that happen to students that are out of their control (e.g., acts of nature such as fires, floods, tornados, etc., and exposure to contaminants, etc.)

The following resources were used for this report: World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), UK Foreign and Commonwealth Office (FCO), International Intelligent Risk Systems, Inc., Interpol, World Bank, and other university reports and websites.

The Foreign and Commonwealth Office (FCO) provides travel advice by country.

We strongly recommend that students read the section related to their destination prior to departure

https://www.gov.uk/foreign-travel-advice-guide https://www.gov.uk/foreign-travel-advice https://www.gov.uk/foreign-travel-checklist

Over 800,000 British nationals visit India every year. Most visits are trouble-free.

The Indian Ministry of Tourism has a 24 hour multi-lingual telephone helpline on toll free number 1800 111 363 providing visitors to India with information about travel and tourism.

If you’re abroad and you need emergency help from the UK government, contact the nearest British embassy, consulate or high commission.

Before you travel, take out comprehensive travel and medical insurance and read the India specific health information and advice published by the National Travel Health Network and Centre.

HEALTH

The quality of medical care in India varies considerably. Medical care that approaches and occasionally meets Western standards is available in the major population centres, but adequate medical care is usually very limited or unavailable in rural areas. A list of the most commonly used hospitals can be found on the British High Commission website.

If you feel ill or have a medical emergency, contact the volunteer coordinator immediately. Who can recommend a clinic to visit, provide the necessary medical insurance claim forms, and make arrangements with professors if extended absence from volunteering is expected.

Visit your health professional at least 4 to 8 weeks before your trip to check whether you need any vaccinations or other preventive measures. Country specific information and advice is published by the National Travel Health Network and Centre on the TravelHealthPro website and by NHS (Scotland) on the fitfortravel website. Useful information and advice about healthcare abroad is also available on the NHS Choices website.

Mosquito-borne diseases like Dengue Fever occur all year round. There’s been an increase in the number of cases of dengue fever, including in New Delhi.

UK health authorities have classified India as having a risk of Zika virus transmission. For information and advice about the risks associated with Zika virus, visit the National Travel Health Network and Centre website.

Cases of Chikungunya Virus have been confirmed in India, including in New Delhi. You should take steps to avoid being bitten by mosquitoes.

There has been a reported increase in the number of cases of seasonal flu in 2015 – including H1N1 (swine flu). For information and advice, visit the website of the National Travel Health Network and Centre (NaTHNaC) and consult your GP before travel.

For psychiatric illness, specialised treatment may not be available outside major cities.

If you need emergency medical assistance during your trip, dial 102 and ask for an ambulance. You should contact your insurance/medical assistance company promptly if you are referred to a medical facility for treatment.

COVID- 19 / Coronavirus

It is essential you check with the entry requirements ahead of travel, and follow and updates that are required.

We will keep you informed of any changes we see, but it is your responsibility to get the required PCR/vaccine requirements ahead of travel, during your stay and before departure. This is a fast developing part of travel in 2023, please ensure you are up-to-date with your vaccinations.

Vaccine-Preventable Diseases

Vaccine recommendations are based on the best available risk information. The level of risk for vaccine- preventable diseases can change at any time. Make an appointment with a Travel Health Specialist.

Routine (recommended for all travellers) Recommendations or Requirements for Vaccine-Preventable Diseases

Recommended if you are not up-to-date with routine shots including measles-mumps-rubella (MMR) vaccine, diphtheria-tetanus-pertussis vaccine, varicella (chickenpox) vaccine, polio vaccine, and your yearly flu shot.

Hepatitis A (Recommended for most travellers) Recommendations or Requirements for Vaccine-Preventable Diseases

CDC recommends this vaccine because you can get hepatitis A through contaminated food or water in India, regardless of where you eat or stay.

Typhoid (Recommended for most travellers) Recommendations or Requirements for Vaccine-Preventable Diseases

You can get typhoid through contaminated food or water in India. CDC recommends this vaccine for most travellers, especially if you are staying with friends or relatives, visiting smaller cities or rural areas, or if you are an adventurous eater.

Malaria

Prevention requires A, B, C and D: Awareness of risk. Bite avoidance. Chemoprophylaxis (anti-malarial medication). Diagnosis made promptly with early treatment of an infected case.

Malaria remains a major health risk in India as in other parts of the developing world. There are various antimalarial drugs on the market. You are strongly urged to consult with your physician or travel health services before departure about which one to choose.

Risk Assessment

• You could get critically sick, temporarily or permanently.
• Medical complications are a possibility.
• The trip could be cut short because of the possibility of a medical evacuation.
• There is potentially high risk if prophylaxis is not adhered to and personal protective measures are not observed.
• Some volunteers stop malaria prophylaxis because they are afraid of long term adverse effects, conflicting advice, side effects, etc.
• Drugs purchased overseas may not be manufactured according to United Kingdom standards and may not be effective. They also may be dangerous, contain counterfeit medications or contaminants, or be combinations of drugs that are not safe to use.
• Volunteers have become seriously ill with malaria due to in effective adherence to anti-malarial medication and lack of follow up with effective personal protective measures.
• No vaccine is currently available.
• No method can protect completely against the risk for contracting malaria.

Risk Mitigation

• Anti-malarial medications and bug bite avoidance are central components in preventing malaria.
• Prevention of malaria is a complex issue and requires expert advice from travel medicine specialists.
• Recommendations for prevention of malaria must be individualised.
• Visit a doctor (ideally 6-8 weeks) before your trip to get medicines you may need.
• Spray insecticide on walls to kill adult mosquitoes that come inside.
• If you are not staying in well-screened or air-conditioned rooms, use apyrethroid- containing flying-insect spray in living and sleeping areas during evening and nighttime hours.
• Understand behaviours to minimise exposure to mosquitoes (e.g. stay indoors during active biting times, always stay in screened accommodations), barrier clothing (cover as much skin as possible: wear long sleeves, long trousers, socks, shoes/boots and hat. Avoid sandals, and tuck shirts into pants and pant legs into socks.), insecticide- impregnated bed nets, spraying of residence with insecticide, and application of effective insect DEET-containing repellent.
• Take an appropriate antimalarial drug regime exactly as prescribed and carefully following anti-mosquito measures.
• For the best protection against malaria, it is important to continue taking the medication as recommended after leaving the malaria-risk area as indicated by your prescribing doctor. Otherwise, malaria can develop.

Malaria Map: http://www.fitfortravel.nhs.uk/destinations/asia-(east)/india/india-malaria-map.aspx

• Malaria risk is present throughout the year. Risk is highest in north-eastern states including Assam and Orissa.
• In the Andaman and Nicobar islands, Andhra Pradesh, Chhattisgarh, Goa, Gujarat, Madhya Pradesh, Maharashtra and West Bengal risk is not high enough to warrant antimalarial tablets for most travellers, however, it may be considered for certain groups who may be at higher risk (see below under Low risk with additional advice).
• There is low to no risk in parts of the states of Himachel Pradesh, Jammu and Kashmir and Sikkim, and also in the cities of Bangalore, Kolkata, Mumbai, Nagpur, Nasik and Pune.
• High-risk areas: atovaquone/proguanil OR doxycycline OR mefloquine are usually advised.
• Low risk with additional advice: antimalarial tablets are not usually recommended, however, they can be considered for certain travellers who may be at higher risk e.g. longer stay in rural areas, visiting friends or relatives, those with medical conditions, immunosuppression or those without a spleen. Atovaquone/proguanil OR doxycycline OR mefloquine is advised for those at risk.
• Low to no risk: antimalarial tablets are not usually advised
• If you have been travelling in a malarious area and develop a fever seek medical attention promptly. Remember malaria can develop even up to one year after exposure.
• If travelling to high-risk malarious areas, remote from medical facilities, carrying emergency malaria standby medication may be considered.

Dengue Fever

Risk Assessment

• Dengue Fever is prevalent in some parts of the country during certain seasons.
• There is currently no vaccine or other preventive medication for this disease.

Risk Mitigation

• The best protection against this and other insect-borne diseases is to use personal protective measures to prevent mosquito bites.

Rabies

Rabies is found on all continents except Antarctica. Rabies is a preventable and acute viral disease of the central nervous system, most often transmitted through the bite of a rabid animal.

Risk Assessment

• People usually get rabies from the bite of a rabid animal. It is also possible, but quite rare, that people may get rabies if infectious material from a rabid animal, such as saliva, gets directly into their eyes, nose, mouth, or a wound.
• The risk of rabies in an encounter with an animal and the precautions necessary to prevent rabies are the same as they are in the United Kingdom.
• Transmission is through the bite and virus – containing saliva of an infected host.
• Rabies occurs in more than 150 countries.
• Dogs are the source of the majority of human rabies deaths.
• Infection causes thousands of deaths every year, mostly in Asia and Africa.
• No tests are available to diagnose rabies infection in humans before the onset of clinical disease.

Risk Mitigation

• Consult with a healthcare professional during your pre-departure travel consultation.
• Consider getting a rabies vaccine particularly if your activities will put you in contact with animals.
• Budget for out-of-pocket costs for vaccines.
• It is always prudent to avoid approaching any wild or domestic animals.
• Avoid all contact with animals, especially stray dogs and cats.
• Immediate wound cleansing with soap and water after contact with a suspect rabid animal can be life- saving. Flush and wash the wound for a minimum of 15 minutes. Povidone iodine or other substances that kill the rabies virus may also be used at the doctor’s office. Seek medical attention immediately to determine if mediation or anti- rabies vaccine is needed. Immediate local treatment will substantially reduce the risk of rabies.
• Treat any bite from a potentially rabid animal as a medical emergency.

Monkey Bites

Monkey bites have occurred and can transmit rabies and herpes B among other diseases to human victims. Avoid feeding monkeys. If bitten, immediately soak and scrub the bite for at least 15 minutes and seek urgent medical attention.

INSECT PRECAUTIONS

Immunisations and medications may afford protection against some travel-related diseases transmitted by insects such as yellow fever and malaria, but there are many other serious diseases transmitted by insects that require careful avoidance and use of protective measures. If you will be visiting rural areas or engaging in camping, hiking or adventure travel, you are at higher risk of exposure to mosquitoes, ticks, mites, fleas and other disease-carrying insects, but even urban visitors need to take precautions to avoid insect exposure in some areas.

Risk Mitigation

Know the disease risks in the area of travel, the insect that transmits the disease and times of highest activity.

Examples:

• Dengue fever is transmitted by mosquitoes active during the day and usually present in urban areas.
• Sand flies transmit leishmaniasis and are commonly active in forested areas from dusk to dawn. Mosquitoes that transmit malaria are active from dusk to dawn.
• Cover as much skin as possible: wear long sleeves, long trousers, socks, shoes/boots and avoid sandals, and tuck shirts into pants and pant legs into socks.
• Perform body tick checks at the end of the day when travelling in areas with tick-borne diseases.
• Sleep in protected areas with screens or air conditioning or use a permethrin-impregnated sleeping bed net. Ensure there are no tears in the netting and that it is tucked in securely around the bed area. Check and eliminate any mosquitoes from inside rooms and sleeping areas prior to retiring.
• This is especially important in areas with malaria. Insecticide sprays may be used to clear rooms of mosquitoes. Coils should be only used outdoors; avoid using coils that contain DDT. Be aware that many foreign-produced repellents and insecticides are extremely toxic.
• Use an insect repellent that contains DEET (around 35%) on exposed areas of skin and on clothing. Avoid eyes and inhalation of the spray. DEET formulations as high as 50 percent are recommended for both adults and children older than 2 months of age. Repellent products that do not contain DEET are not likely to offer the same degree of protection from mosquito bites as products containing DEET. Other types of repellents have not necessarily been as thoroughly studied as DEET and may not be safer for use on children. The recommendations for DEET use in pregnant women do not differ from those for non- pregnant adults.
• Repellents containing permethrin can be sprayed on clothing, bed nets and camping gear. This is an effective repellent for mosquitoes, ticks and other insects. Permethrin remains effective even with repeated washings.

HIV/AIDS

AIDS represents the late clinical stage of HIV infection. The four ways you can contract HIV are through direct contact with the blood, breast milk, semen, or vaginal fluid of infected persons. In India, many people may be infected yet unaware of their status. Avoid unprotected sexual contact with persons whose HIV infection status is unknown. Be aware of the risks and take all proper precautions.

Risk Assessment

• Both men and women can become infected and can give HIV to someone else. Only certain fluids— blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, and breast milk—from an HIV-infected person can transmit HIV. These fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the bloodstream (from a needle or syringe) for transmission to possibly occur.
• HIV infection is preventable. Factors to consider in assessing risk include the extent of direct contact with blood or other potentially infectious secretions and the extent of sexual contact with potentially infected persons or with persons whose HIV infection status is unknown.
• In countries with high rates of HIV infection, many persons without these risk factors may be infected and be unaware of their status.

HIV cannot be spread in the following ways:

• Shaking hands, hugging or casual kissing
• Coughs or sneezes, sweat or tears
• Mosquitoes, toilet seats, door knob, drinking fountain
• Eating food prepared or handled by an infected person
• Everyday contact with HIV-infected persons at school, work, home or anywhere else
• There is no vaccine to prevent HIV infection.
• There is no cure for AIDS. Risk Mitigation

Understand STD concepts and risks for HIV transmission.

Discuss non-blood alternatives with your physician before departure during the VOCATIONAL IMPACT health clearance appointment. When medically prudent, avoid use of unscreened blood-clotting factor concentrates or concentrates of uncertain purity. If transfusion is necessary, the blood should be tested, if possible, for HIV antibody by appropriately trained laboratory technicians using a reliable test. If you have insulin-dependent diabetes, hemophilia, or other conditions that necessitate routine or frequent injections, carry a supply of syringes, needles, and disinfectant swabs (e.g., alcohol wipes) sufficient to last your entire stay abroad. Before travelling, request documentation of the medical necessity for travelling with these items (e.g., a doctor’s letter) in case official inspection personnel at ports of departure/entry question their need.

Exercise caution at all times to avoid serious accidents or injuries that could require a blood transfusion, as the local blood supply cannot be guaranteed safe.

To avoid transmission through sex, the only sure way is not to have anal, vaginal or oral sexual intercourse or to have sex only with someone who is not infected and who has sex only with you. Latex condoms, when used consistently and correctly, are highly effective in preventing sexual transmission of HIV.

Exercise appropriate precautions if engaging in activities that expose you to risk of infection

• Do not impair your judgement with drugs or alcohol.
• Do not share needles or any devices that can break the skin. That includes needles for tattoos, piercings, and acupuncture.
• If you receive medical or dental care, make sure the equipment is disinfected or sanitised.
• Even though no vaccine is available to prevent infection with HIV, all Indian universities have thorough protocol for handling possible HIV exposure or infection.
• If you have unprotected sex or suspect you may have been exposed to HIV through a medical incident or procedure, consult the volunteer coordinate on site.
• Do not delay as the first 72 hours are critical.

Risk Mitigation

• Do not risk exposure through new sexual contacts. If you cannot abstain, condoms can provide some protection. Condoms are available at many local pharmacies. Women can use a female condom.
• Avoid any behaviour that allows HIV-infected fluids–blood, semen, vaginal secretions–into your body.
• Don’t impair your judgement with drugs or alcohol.
• Tell your sexual partner if you have HIV.
• If you have unprotected sex, consult the volunteer coordinator for post exposure treatment options.

Air Pollution

Excessive air pollution is caused by industrial and transportation emissions, and is at its worst during the winter months. If you have asthma, other respiratory illnesses, or heart disease, consult a health care provider prior to travel and carry sufficient medications.

Severe air pollution is a major hazard to public health in Delhi, and a serious concern in many Indian cities. Children, the elderly and those with pre-existing medical conditions may be especially affected. You can follow further advice at the WHO website

MEDICAL FACILITIES

Medical services in India are provided by the central government, local institutions, missionary institutions (private- non-profit agencies), and a relatively small number of private-for-profit practitioners.

Risk Assessment

• Medical facilities are plentiful in the main cities and limited else where in the country.
• Most doctors and hospitals will expect payment in cash. Medical facilities may be below international standards, outside of the main cities.
• Emergency facilities are extremely limited. In the event of a serious illness or accident, medical evacuation to a destination with suitable facilities would be necessary.
• Ambulance service is basic or unavailable in India. Several hospitals operate ambulance services, but the service can provide transportation and only the most basic of medical care.
• You can get seriously sick and require hospitalisation.
• Medical supplies (including staff) maybe short.
• As water and electricity supply are sometimes erratic, the hospital maybe affected by water and electricity shortages.
• Health facilities are directly affected by shortages of electricity which render equipment nonfunctional and make it difficult to keep vaccines, samples, and medications at the appropriate temperature.
• Congested roads and limited fleets affect the status of ambulance services.
• There are differing cultural expectations in India. The role of family and friends is stronger and depended upon in the hospital system. For example, bringing meals and comfort items such as fresh water and clean clothes is considered the role of the family and friends.

Risk Mitigation

• All volunteers should have adequate travel insurance that covers emergency medical evacuation, as authorised by a doctor, from India to the UK or to a country with suitable facilities.
• Be prepared for the inevitable cultural differences in medical services. If you will need a particular type of medical care, find out in advance whether such care is available, and budget accordingly, as payment will be required upfront.
• Laws governing availability of medications vary widely. Prescription medications are often not available in the needed formulations or strengths. If you take prescription medication, bring an adequate supply through the end of your stay, provided the medication is legal in India.
• If you have diabetes, or other chronic conditions, consult carefully with a physician in the UK or your country of residence before departure. For example, some medical devices, such as insulin pumps, may not be available. If you require these devices, take extras. In addition, certain formulations of drugs, such as insulin, may not be available. Be aware of alternative substitute formulations. There are instances where “type A” of insulin is available locally, but, not “type B” or “type C”.
• If you need to keep medicine/medical equipment refrigerated, access to a freezer/refrigerator for some medical equipment/medication may be difficult as electricity is sporadic throughout India.
• Complete all routine and required medical exams before coming and obtain all required and recommended immunisation.
• Follow through about vaccine recommendations with a travel health professional before departure.

Medical facilities are limited, particularly outside the main cities. Travellers should carry a supply of any needed prescription medicines, along with copies of the prescriptions, including the generic name for the drugs, and a supply of preferred over-the-counter medications.

Prescription Medications

If you take prescription medication, carry an adequate supply to last through your stay. Do not mail medication to India.

A wide range of prescription and over-the-counter medications are available from chemist shops (i.e., drug stores) in India. In some cases, however, the quality and reliability of the medications may be questionable. If you are on any prescription medication, secure a supply in advance of your trip. The laws governing the sale of prescription medications in India are as strict as in the United Kingdom.

However, observance of these laws is sporadic at best. If you are in need of a medication for which you have a legitimate prescription from home, you can probably get an inexpensive version of it at most chemists in India. However, improper use of drugs for which you have no prescription or legitimate medical need will be considered equivalent to the use of illegal drugs and will have similar consequences.

FOOD/WATER SAFETY

Consider all fresh produce contaminated.

Serious infections caused by parasites, viruses, and bacteria are common in India. As in many developing countries, standards for hygiene and public health are not the same as those found in developed countries. Of particular concern are water- and food-borne diseases. The risk of contracting such ailments can be significantly reduced by observing some simple rules.

The quality of water in India is poor. Sewage and hazardous waste have been found to be polluting the water supply in most areas. Laws enacted to prevent water pollution are not enforced and there is little or no oversight over companies or industries responsible for the pollution. Drink only bottled water; it is cheap and readily available. Hot drinks such as tea and coffee are generally safe, as are most bottled soft drinks. Be careful, however, about ice cubes in any cold beverages such as juice or soft drinks. The cubes may be made from unfiltered tap water. For residential use, high quality water purifiers such as the Aquaguard system can be purchased and installed. Exercise caution when buying food or water while travelling by train. Some vendors at railway stations have been known to sell contaminated water in bottles. Do not buy cheap bottled water; try to buy well recognised brands like Evian or Aquafina.

India’s numerous fresh fruit juice stands are appealing but, like all raw foods taken from street vendors, they are subject to contamination and may be dangerous to your health.

All raw fruits and vegetables should be peeled, cooked, or thoroughly cleaned and soaked for 15 minutes in disinfectant solution before eating. All foods should be thoroughly cooked. Try to eat in establishments that use safe procedures during food preparation. Restaurants and other food handlers are not subject to health regulations. Meat is often not refrigerated and may cause illness despite cooking.

Risk Assessment

• A high risk of traveller’s diarrhea exists throughout the country, including in deluxe accommodations in major cities. Food and beverage precautions are essential to reduce the likelihood of illness. Diarrhea may be accompanied by nausea, vomiting, and/or fever. Immunocompromised individuals, including those with HIV/AIDS are particularly susceptible to foodborne diseases.
• Tap water and ice in India may be contaminated.
• Cholera and other potentially life-threatening food and water borne illnesses are present. Seek medical advice if you run high fever, have blood or mucus in your stool, or experience any of the cholera related symptoms.

Risk Mitigation

• Avoid becoming dehydrated. Drink only boiled, treated or bottled water, weak tea, soups or other safe fluids. Avoid any drinks that tend to remove more water from the body, including coffee, overly sweetened drinks, some medicinal teas and alcohol.
• Consult with your doctor or travel clinic specialist pre-departure about medications you can take for self- treatment.
• Pharmacies stock or hydration packets at are a reasonable price.
• Wash your hands often and always before handling and consuming foods. Use alcohol-based hand sanitizer if soap and water are not available. It’s a good idea to always keep some with you when you travel.
• Make sure your food has been thoroughly cooked and remains steaming hot. Avoid cooked foods that are no longer piping hot.
• Eat in well-established, clean restaurants and eat only well-cooked food that is served hot.
• Avoid raw vegetables and salads as they may be contaminated.
• Avoid buffets. Cooked foods that have been left at room temperature are a major risk for food borne illness.
• Avoid uncooked food, apart from fruits and vegetables that can be peeled or shelled. Do not eat raw or undercooked meat or fish. Some types of fish may contain poisonous biotoxins even when cooked. Barracuda in particular should never be eaten. Other fish that may contain toxins include red snapper, grouper, amberjack, and sea bass.
• Avoid buying food from street vendors. According to the World Health Organisation, the hygienic aspects of food vending are a major concern for local food control officers.
• Do not drink tap water unless it has been boiled, filtered, or chemically disinfected.
• Do not drink unbottled beverages or drinks with ice. Bottled water is the safer choice for drinking water but always check the seal to ensure it has not been tampered with local water supplies are limited and contaminated with raw sewage, pesticides, and industrial waste.
• Avoid unpasteurised milk and any products that might have been made from unpasteurised milk, suchasice cream.
• Brush your teeth with purified or bottled water.

HEAT AND SUN-RELATED ILLNESSES

Risk Assessment

• Dehydration and heat stroke are two very common heat-related diseases that can be life-threatening if left untreated.
• When a person becomes so sick with fever, diarrhea, or vomiting, or if an individual is overexposed to the sun and not drinking enough water, dehydration occurs. This is caused when the body loses water content and essential body salts, such as sodium, potassium, calcium bicarbonate, and phosphate.
• Expect excessive sweating in India. This increases susceptibility to dehydration, especially the chronic type. Chronic dehydration makes you feel weak, tired, and lightheaded and increases your risk of developing kidney stones.

Risk Mitigation

• Increase your daily fluid intake to compensate. At least 2 liters of fluids each day are essential.
• Recognise the symptoms of heat exhaustion: nausea, abdominal pain, dizziness, headache, confusion, poor coordination, and thirst. Stop activity, move into a cool room, elevate feet and legs, and sip fluids, to gradually return the body to a normal temperature.
• Contact the volunteer coordinator and local staff and seek medical attention for any of these marked symptoms, or those persisting beyond a few minutes.
• Eat and drink regularly, wear loose and lightweight clothing, and limit physical activity during high temperatures.
• If you are outside for many hours in heat, eat salty snacks and drink water to stay hydrated and replace salt lost through sweating.

ILLICIT DRUGS

Alcohol

The legal drinking age in Delhi and much of India is high by American standards, normally 25. Some states, such as Gujerat, are entirely dry. Although, as in many areas, carding and enforcement of the strict regulations on the purchase and consumption of alcohol may be lax, you can get into serious trouble if caught in violation of the laws. Public drunkenness or rowdiness is considered offensive and can result in disciplinary action, including expulsion from the program.

As with alcohol, the laws banning the use of illegal drugs are strict but enforcement may be lax. Do not take the apparent availability of illegal street drugs as an invitation to experiment with them. The medical and legal consequences for abuse can be severe; drugs can be impure and highly toxic, and the police are hard on foreigners who are caught in possession of banned drugs. Long jail sentences for drug violations are the norm. You do not want to run afoul of the Indian police and penal system.

• Illicit drugs are becoming a concern for the local authorities because of the increasing availability and variety.
• The possession of, distribution, or use of drugs is a crime in India.
• The unlawful possession, use, or distribution of drugs by volunteers on the project site is prohibited. Anyone found in possession of or using such drugs on site will be severely dealt with and suspended from the programme, in addition to facing criminal charges.

Risk Assessment

• Penalties for drug offences, including possession, are severe in India and may carry mandatory prison sentences.
• Buying, selling, consuming marijuana is illegal in India. If you are travelling with prohibited narcotic drugs (cannabis; easy to purchase and popular to smoke, morphine, heroin, valium, cocaine, etc.), without a prescription, you would be committing an offence under Indian law.
• When volunteers are in an environment where they perceive an easier way to get away with smoking marijuana in public, for example, they may become lax and irresponsible about their choice to smoke and where to smoke it.
• The UK Embassy or VOCATIONAL IMPACT will not be able to assist a student arrested on drug charges.

Risk Mitigation

• Act responsibly.
• VOCATIONAL IMPACT expects volunteers to conduct themselves in a lawful manner at all times.
• Violation of country laws exposes the student to criminal charges and/or arrest.

SEXUAL VIOLENCE

Western women continue to report frightening incidents of physical harassment by groups of men (known as “Eve-teasing”). While India is generally safe for foreign visitors, rape is the country’s fastest growing crime according to Indian authorities. Although most victims have been local residents, recent sexual attacks against female visitors in tourist areas underscore the fact that foreign women are also at risk and should exercise vigilance.

Observe stringent security precautions:

Avoid using public transport after dark without the company of known and trustworthy companions.

Restrict evening entertainment to well-known venues.

Avoid walking in isolated areas alone at any time of day.

Ensure hotel room numbers remain confidential and insist the doors of hotel rooms have chains, deadlocks, and spy-holes.

Hire reliable cars and drivers and avoid travelling alone in hired taxis, especially after dark. It is preferable to obtain taxis from hotels rather than hailing them on the street.

Call 100 for police assistance if you face a threatening situation.

Risk Mitigation

• Do not travel alone in India
• Practice risk reduction techniques. Do not assume that it cannot happen to you. Practise the buddy system when going out so you can alert your buddy if you feel threatened or uncomfortable in a situation. Stay alert.
• Tell a roommate or friend about your travel or event plans.
• Research local resources and learn how to summon help in an emergency.
• Always have the VOCATIONAL IMPACT emergency number with you.
• Follow the RAINN (Rape, Abuse & Incest National Network) Safety Tips, https://www.rainn.org/articles/safety- tips-traveling

TRAVEL/TRANSPORTATION

Although travel in many parts of India is relatively safe, there are areas considered dangerous. The Foreign and Commonwealth Office (FCO) advise against all travel in the immediate vicinity of the border with Pakistan, other than at Wagah.

The FCO advise against all travel to Manipur and against all but essential travel to Imphal, the state capital of Manipur. See Local travel

The FCO advises against all travel to Jammu and Kashmir with the exception of (i) travel within the city Jammu, (ii) travel by air to the city of Jammu, (iii) travel within the region of Ladakh. The FCO advises against all but essential travel to the city of Srinagar and travel between the cities of Jammu and Srinagar on the Jammu-Srinagar national highway. The tourist destinations of Phalgam, Gulmarg and Sonamarg fall within the areas to which the FCO advises against all travel. See Local travel and Terrorism

Following clashes in Darjeeling with the police on 12 June 2017, the Gorkha Janmukti Morcha (GJM) called for a strike and indefinite shutdown of government offices. Further protests followed and most hotels are now shut. If you’re planning to travel in the Darjeeling hills, follow local news and advice of the local authorities, and consult your travel company.

Terrorists are very likely to try to carry out attacks in India. Recent attacks have targeted public places including those visited by foreigners. There have been recent media reports suggesting Daesh (formerly referred to as ISIL) interest in attacking targets in India. There may be an increased threat to places visited by British nationals such as religious sites, markets, festival venues and beaches. You should be vigilant at this time, monitor local media and take all precautions for your safety.

If you’re travelling in or through Srinagar you should remain vigilant, avoid protests or large gatherings, follow the advice of the local authorities and your travel company and monitor the curfew restrictions in place and the local media. Srinagar Airport is currently open as is the road leading to Srinagar Airport. Take all precautions for your safety. If you’re travelling with a tour operator you should keep in touch with them and contact them for further information on arrangements they may be making for you to leave the area. Due to the accessibility and current unrest the level of consular assistance that the British High Commission can provide in Jammu & Kashmir is extremely limited.

Restricted Travel Areas by the Indian Government

Certain parts of India are designated as “restricted areas” by the Indian government and require special advance permission to visit. Avoid these areas, which currently include:

• The state of Mizoram
• The state of Manipur
• The state of Arunachal Pradesh
• The state of Nagaland
• The state of Sikkim
• Portions of the state of Himachal Pradesh near the Chinese border
• Portions of the state of Uttarakhand (Uttaranchal) near the Chinese border
• Portions of the state of Rajasthan near the Pakistani border
• Portions of the state of Jammu & Kashmir near the Line of Control with Pakistan and certain portions of Ladakh
• The Andaman & Nicobar Islands
• The Union Territory of the Laccadives Islands (Lakshadweep)
• The Tibetan colony in Mundgod, Karnataka

Travel to India-Pakistan Border

Avoid travel to areas within ten kilometres of the border between India and Pakistan. Both India and Pakistan maintain a strong military presence on both sides of the border.

Political violence and Terrorism

Terrorism is a global threat and is a significant concern for authorities in India. Separatist militants, Maoist rebels, and Islamist extremists are responsible for violence in various parts of the country. The perceived threat to foreigners is low. Typical terror targets include markets, trains, train stations, religious sites, and other busy locations. Many groups use high explosives, meaning that casualties are often very high when bombs explode in crowded areas.

Communal tensions, increased militancy, and warnings about potential attacks often increase just before key national holidays, major religious observances, and significant anniversary dates. Major terrorist attacks typically lead to subsequent security crackdowns that can exacerbate communal tensions and encourage civil unrest. The government might also issue non-specific warnings about additional attacks and increase the alert status of security forces in various parts of the country after major bombings. Numerous, disruptive bomb threats may follow high-profile attacks.

Caste Tensions

Caste conflict is another longstanding problem that can generate significant unrest. India’s complex caste system of social hierarchy has contributed to historical discrimination, although post-independence laws are designed to prevent it. In recent years, specific groups have staged regional shutdowns to press demands for caste status that would grant them more civil service jobs and reserved positions at higher education institutions. These agitations typically involve only one group, but they invariably cause tensions with other castes, especially those that already enjoy reservation status.

Natural Disasters and Threats

Parts of northern India are highly susceptible to earthquakes. Regions of highest risk, ranked 5 on a scale of 1 to 5, include areas around Srinagar, Himachal Pradesh, Rishikesh, and Dehra Dun; the northern parts of Punjab; northwest Gujarat; northern Bihar; and the entire northeast. Ranked 4 (high damage risk) is an area that sweeps along the north through Jammu and Kashmir, Eastern Punjab, Haryana, Northern Uttar Pradesh, central Bihar, and the northern parts of West Bengal. New Delhi is located in zone 4. Severe flooding is common in Bihar, Assam, and Orissa.

Stampedes

Stampedes at public events in India are common as large numbers of people crowd into congested areas. Panic can spread quickly.

Road travel

Travel by road in India is dangerous. India leads the world in traffic-related deaths. Take security precautions when using public transportation in India.

Car and motorbike accidents are one of the biggest causes of injury and death overseas. Several British nationals die each year on Indian roads. If possible, avoid travelling at night. Always travel in a well-maintained vehicle with seatbelts. If you travel by motorbike, wear a helmet and proper footwear.

Do not keep valuables in waist packs, as thieves will assume they contain cash or other valuables and may attempt to snatch them. Carry loose items, such as cameras, maps, snacks, and purses, in a securable bag, and hold it in front of you, not behind. Exercise extreme caution when crossing streets—even in marked pedestrian areas—and try to use only cars that have seat belts. Seat belts are not common in taxis. Helmets should always be worn on motorcycles.

Sea travel

Tourist boats and other small crafts rarely carry life-saving equipment. Although piracy has not so far affected India’s territorial waters, it poses a significant threat in parts of the Indian Ocean, especially for shipping/mariners that don’t take appropriate precautions or follow agreed shipping industry best practice guidelines. Mariners should be vigilant.

Bus Travel

The use of public buses in North India is not recommended. Women should avoid using local buses at night due to an increase in rapes. Travel at night is particularly hazardous. Buses, patronised by hundreds of millions of Indians, are convenient in that they serve almost every city of any size. However, they are usually driven fast, recklessly, and without consideration for the rules of the road. Accidents are quite common.

OCEAN SAFETY

Visitors should exercise caution when swimming in open waters along the Indian coastline, particularly during the monsoon season. Every year, several people in Goa, Mumbai, Puri (Orissa), and other areas drown due to the strong undertow. It is important for visitors to heed warnings posted or advised at beaches and avoid swimming in the ocean during the monsoon season. Trained lifeguards are rarely available along beaches.

Risk Assessment

• If visiting India’s expansive coastline, be mindful of the possible presence of sharks when swimming or engaging in water sports.
• Accidents can occur when swimming in the ocean or walking/climbing on shore areas that are not designated lifeguard-patrolled beaches.
• Visitors from the UK and elsewhere have drowned when swimming in coastal waters, where strong riptides and wave patterns can change unexpectedly and overwhelm even excellent swimmers.

Risk Mitigation

• Swim only in designated swimming areas. Obey lifeguards and warning flags on beaches.
• Practise safe boating—follow all boating safety laws, do not drink alcohol if driving a boat, and always

wear a life jacket.

• Do not dive into shallow water.
• Do not swim in freshwater in developing areas or where sanitation is poor.
• Avoid swallowing water when swimming. Untreated water can carry parasites can cause illness and

infection.

• To prevent infections, wear shoes on beaches where there may be animal waste.

Rail travel

Trains are safer than buses, but train accidents still occur more frequently in India than in other countries.

Don’t accept food or drinks from strangers. There have been reports of travellers being drugged and robbed on trains often on overnight journeys. Take particular care of your passport and valuables when boarding and while on the train. Avoid individuals at railway stations offering tickets and tours.

Air travel

In December 2014 SpiceJet, India’s fourth biggest airline, cancelled over 400 flights and grounded their planes. Although SpiceJet have resumed operations there may be further disruptions and cancellations. Check the SpiceJet website for updates.

Additional security measures have been implemented at airports across the country. If you’re travelling through an airport you should allow additional time to complete check-in and security as you and your baggage may be required to undergo random x-rays and baggage checks.

Pedestrian Travel

Risk Assessment

• Sidewalks are often lacking.
• Where sidewalks exist, they are often taken over by vendors and parked vehicles, forcing pedestrians onto the streets.
• Pedestrians frequently jaywalk.
• Few intersections have pedestrian crossings.
• Some sidewalks have large open storm drains.
• Pedestrians account for 43% of road crash fatalities.
• Pedestrians DO NOT have the right of way.

Risk Mitigations

• Cross streets at corners. DO NOT jaywalk.
• Make sure you are seen.
• If sidewalks are not available, walk facing traffic on the edge of the road, as far from the travel lane as possible.
• Carry a flashlight when walking in the dark.
• When crossing, use all of your senses and don’t use your cell phone for calls and texting.

CRIME

Petty Theft

Petty crime is common, especially theft of personal property. Pickpockets can be very adept and have been known to cut women’s purse straps or slit the bottom of purses without their knowledge. Maintaining awareness of your surroundings and practising good personal security is important.

Theft of passports is quite common, particularly in major tourist areas, on overnight trains, and at airports and train stations. Train travellers are urged to lock their sleeping compartments and take valuables with them when leaving their berths. Air travellers are advised to carefully watch their bags in the arrival and departure areas outside of airports. Violent crime, especially directed against foreigners, has traditionally been uncommon; however in recent

years there has been a modest increase. As Westerners purchasing power is comparatively large, travellers also should exercise modesty and caution in their financial dealings in India to reduce the chance of being a target for robbery or other crime.

Gangs and criminal elements operate in major cities and have sometimes targeted unsuspecting businessmen and their family members for kidnapping.

Scams

Scam artists often prey on visitors in major airports, train stations, and tourist sites by creating a distraction. Taxi drivers and others, including train porters, may solicit travellers with offers of cheap transportation and/or hotels. Once travellers accept the initial deal, scam artists may disclose “necessary” transfers to the domestic airport, disproportionately expensive hotel rooms, unwanted “tours,” and unwelcome “purchases,” and may even threaten travellers when they refuse to pay. Some vendors sell rugs or other expensive items that may not be of the quality promised. Travellers should deal only with reputable businesses and should not relinquish credit cards or money unless they are certain that goods being shipped to them are the goods they purchased. If a deal sounds too good to be true, it is best avoided. Most Indian states have official tourism bureaus to handle traveller complaints.

Be aware of a number of other scams that have been perpetrated against foreign travellers, particularly in Goa, Jaipur, and Agra. The scams generally target younger travellers with deals to make money by privately transporting gems or gold (both of which can result in arrest) or by delivering expensive carpets abroad, supposedly while avoiding customs duties. The scam artists describe profits that can be made upon delivery of the goods, and require the traveller to pay a “deposit” as part of the transaction.

Criminal Penalties

While in a foreign country, a UK citizen are subject to that country’s laws and regulations, which sometimes differ significantly from those in the United Kingdom and may not afford the protections available to the individual under UK law. Penalties for breaking the law can be more severe than in the United Kingdom for similar offences. Persons violating Indian laws, even unknowingly, may be expelled, arrested, or imprisoned.

For example, certain comments or gestures towards women, Indian national symbols, or religion that are legal in the United Kingdom may be considered a criminal violation in India, subjecting the accused to possible fines or imprisonment. Furthermore, since the police may arrest anyone who is accused of committing a crime (even if the allegation is frivolous in nature), the Indian criminal justice system is often used to escalate personal disagreements into criminal charges. This practice has been increasingly exploited by dissatisfied business partners, contractors, estranged spouses, or other persons with whom the UK citizen has a disagreement, occasionally resulting in the incarceration of UK citizens pending resolution of their disputes. At the very least, such circumstances can delay the UK citizen’s timely departure from India, and may result in an unintended long- term stay in the country.

Police response

Report the loss or theft of your passport immediately to the local police and the nearest British embassy or consulate. Likewise, if you are the victim of a crime while abroad, report to local police and the nearest British embassy or consulate for assistance.

The embassy/consulate staff can assist you in finding appropriate medical care, contacting family members or friends, and explaining how to obtain funds. Although the investigation and prosecution of the crime is solely the responsibility of local authorities, consular officers can help you to understand the local criminal justice process and find an attorney if needed.

Victims of a crime, including loss or theft of a passport, should obtain a copy of the police report (called an “FIR” or “First Information Report”) from local police when they report the incident. A copy of this report is helpful for insurance purposes in replacing lost valuables.

The Indian government requires the FIR in order to obtain an exit visa to leave India when passports are lost or stolen. Local authorities generally are unable to take any meaningful action without the filing of a police report.

The local equivalent to the 999 emergency line in India is 100.

An additional emergency number, 112, can be accessed from mobile phones.

Risk Mitigation

• Be vigilant at all times and never venture out alone.
• If you are victim of crime, contact the VOCATIONAL IMPACT in-country contact immediately.
• Use the buddy system; go in groups. Walking alone anywhere, especially in remote areas, is not advised. Should you feel in any way at risk, proceed to a location (e.g. police, shopping centre or service station) where help is available.
• Pay close attention to your personal security at all times and monitor the media for information about possible new safety or security risks.
• If confronted by would-be assailants or police, remain calm and compliant. There have been several incidents where people have resisted trying to hang on to their purse/bag, or it was perceived as resistance and they were seriously injured.
• Exercise caution and monitor developments that might affect safety in India because of the risk of criminal activity.
• Stay in well-lit areas, walk midpoint between curbs and buildings, away from alleys, entries and bushes.
• Carry only necessary credit cards and money; you will not need your airline ticket with you at all times until your scheduled return flight. Keep valuable property e.g. your passport, laptop, electronics, etc., under lock and key. Do not carry or flash excessive amounts of money.
• If you are followed, act suspicious. Keep looking behind you and you may discourage the follower.
• Never hitchhike.
• Ensure that others know of your where abouts. Pay attention; be aware of your surroundings, especially in crowded streets and shopping/market areas.
• Avoid uncontrolled crowds.
• Look like you know where you are going; do not wander in to unknown areas.
• Do not accept lifts from strangers. Be cautious about strangers, especially those who attempt to quickly be friend you. Do not accept food, drinks, or rides from strangers. Trust your instincts. If you feel uncomfortable in any place or situation, leave it.
• Plan the safest route to your destination and use it, keeping to well-lit busy areas.
• Keep a vigilant eye on your bags and other property.
• Carry your money in several locations on your person, not just in your safety wallet and consider carrying a “fake wallet” that holds a small amount of cash.
• Limit purchases or cash advances using your credit cards, as credit card fraud is a serious problem. Do not allow anyone to take your credit card out of your sight.
• Protect your mobile phone.
• Avoid areas known for crime. When in doubt, ask your local representative for advice. Ignore attempts by locals to provoke an argument. Change the topic of discussion and, if possible, remove yourself from the situation.

SECURITY AT THE VOLUNTEER ACCOMMODATION

You will stay with a local family during your programme. This houses other volunteers and this is where you will sleep and eat. You will be responsible to keep you belongings safe during your stay. The local programme representative contacts and emergency contacts are on the walls. Please make note of these immediately and write them down on a piece of paper to have with you at all times.

Risk Mitigation

• Lock doors and windows at all times; including while asleep. Keep doors locked, even if you are away for a few minutes. Remember that most losses occur during the day.
• Do not answer the door to anyone after a certain time at night. Avoid the services of errand boys, who can monitor information and provide it to accomplices.
• Ask to change locks if robbed.
• Avoid isolated footpaths and shortcuts.
• Walk in pairs, groups, and in well-lit areas; use the buddy system as much as possible.
• Conspicuous displays of wealth are inappropriate and endanger the safety of all.
• If at any time you are threatened at knife or gunpoint, do not resist or act in a confrontational manner.
• Do not entertain hawkers
• Keep emergency phone numbers in your phone and in a secure place.
• Use the peepholes in residence doors (if available) before permitting entry to anyone. If the peephole is broken or missing, use the windows, or request their name and purpose.
• There are unemployed youths who perform personal services for volunteers such as washing clothes etc. We encourage you not to use them
• If you return to your residence and suspect that it has been illegally entered, do not enter. Speak to the programme volunteer coordinator
• If someone you don’t know tries to enter a building behind you, or asks to go past the door with you for any reason, say NO.
• A significant proportion of incidents involving foreign volunteers originate from “friendships” made through cursory contacts in town. Do not give out personal information, i.e., house location, home address details, telephone numbers etc. unnecessarily.
• Keep all your belongings out of sight
• Close all the windows before departure
• Never let anyone in that is not an official partner of the organisation.

GENDER AND PERSONAL IDENTITY ISSUES

The number one concern for lesbian, bisexual, transgender and straight travellers, and their families, is staying safe while travelling.

Risk Assessment

• Indian law criminalises’ unnatural carnal knowledge’. If consenting adults are caught engaging in such acts, they can receive up to 3 years imprisonment according to Section 104 of the Criminal Code (Amendment) Act of 2003.
• Lesbians and gays face wide spread discrimination, as well as police harassment and extortion attempts.
• There is a minimum misdemeanor charge for homosexual activity.
• There is a small gay community.
• There is a lot of stigma towards gay men and lesbians living in India. A large portion of Indian society does not accept that such activity exists.
• A gay social life exists, mostly in the form of house parties, and a few queer-friendly clubs, but there are risks.

Risk Mitigation

• Inform yourself. Research tolerance levels and laws for every country that you visit. Homosexuality is illegal in almost every African country. Remember that legal recognition and social acceptance may not be at the same level.
• Be careful and be safe. Social media sites are often used for entrapment in some countries, so when using a social media network to meet friends or locals.

Relationships

Public interactions between men and women are usually much more restrained and segregated in India than in the UK. For the most part, Indian students do not get together in mixed groups. Men usually do not speak to women unless they are well acquainted, nor do they ask to be introduced to a woman. Western men should never touch women, even casually, because it is likely to be misunderstood. At most social gatherings, except in the larger cities, expect formal or informal segregation of the sexes. It is generally unacceptable for men and women to live together, and dating is not part of the Indian lifestyle. In modern Delhi some young people are breaking away from this tradition.

Women

There are many exceptions to generalisations about women in India, like all generalisations about the country. In urbanised Indian society, there are many women who are as independent and forthright as their Western counterparts, and many Indians have come to accept and even admire the position of Western women. In general, however, the quality traditionally most admired in Indian women is modesty.

As an European woman, especially if unmarried, be aware that your appearance and behaviour may be misinterpreted. Sexual harassment has been reported by a number of women who have studied or lived in India. Living alone or travelling alone is unusual. Inviting a man home or smoking or drinking in public may be considered inappropriate behaviour, and talking freely to men who are strangers may be considered an invitation for advances.

To avoid sexual harassment, carefully consider the implications of your dress, comments, and actions. It is advisable to talk to and observe Indian women in their daily activities. Avoid crowded buses and other confined public places. In addition, it is best not to attend dances or expect to date. If you find yourself in an uncomfortable or threatening situation, leave the situation and seek support from others. You may wish to take a self-defence class before departure; most UC campuses have classes available.

Many women report that they are less harassed and attract fewer stares if they wear Indian, rather than American, dress. When wearing Western attire, especially in rural areas, it is best to create a modest impression by wearing a head covering, long-sleeve blouses, and skirts below the knee. Do not wear shorts, halters, or revealing attire in public. When invited to a place where you might have to sit on the floor, consider wearing pants, a full skirt, or Indian dress.

Men

You will find few taboos or limitations in India. However, be aware of some of the issues and restrictions facing female friends, and be sensitive and supportive. Also, be aware of how your behaviour toward women may be misinterpreted. For example, if you are overly or inappropriately friendly with an Indian woman, her and her family may see it as dating and have certain expectations for the relationship.