5The New Zealand Tourist and Publicity Department produces a wide range of re- ports on marketing for specific source areas such as Northern Europe, North America, South-east Asia and Japan. These reflect the importance of marketing for tourism in a country which is isolated from many of the major tourism source areas. ‘/bid.

‘D. Shelton, ‘Selling Australia and New Zealand: capitalising on international attention’, Travel and Tourism Analyst, Au- just 1987, pp 29-39. Patterns of package tourism in New Zea-

land are considered in detail in P. Forer and D. Pearce, ‘Spatial patterns of pack- age tourism in New Zealand’, New Zea- land Geographer, Vol 40, No 1 1984, pp 34-43.

Tourist health - taking action

The establishment of an International Tourist Health Association at the end of the Second International Mediterranean Conference on Tourist Health held in Rimini, Italy from 15-18 March 1989 marks an important step forward in concern for consumer protection. The aims of the conference are described by Vincent J. May, Head of Division of Tourism Planning and Development at the Dorset Institute, UK.

Tourism is intended to improve peo- ple’s quality of life and to promote their health by relieving them from the pressures of day-to-day activities. Yet high proportions of UK travellers (sometimes in excess of 50%) are said to be affected by illness during or on their return from holidays. Many of these illnesses are not the most news- worthy, but there must be cause for concern when it is reported that an average of five and a half days are lost as a result of traveller’s diarrhoea. The World Health Organization (WHO) has estimated that 40% of internation- al travellers suffer from diarrhoea, of whom 30% are confined to bed and 40% change their itinerary. The inci- dence of illness among tourists is generally higher than among local populations, and places seasonal pressures on local health-care provi- sion. In extreme and fortunately infre- quent cases, emergency repatriation is needed. This all poses questions for the travel and insurance trades, health professionals and the managers of des- tination areas, broadly:

0 What precautions can be taken by travellers to avoid infectious dis- eases and accidents?

0 How can standards of food safety and water supply in particular be improved?

0 What risks arise from the tourist environment and how can they be reduced? and

0 How can the health care facilities of destinations deal adequately with increased seasonal de- mands?

International conferences investigate

As a result of initiatives taken by Walter Pasini and Italian colleagues to establish an Italian Association for Touristic Medicine with headquarters in Rimini, two International Mediterranean Conferences on Tour- ist Health have been held in 1988 and 1989. The second of these was sup- ported by WHO, WTO, and the Council of Europe, and was organized to define tourist health as a new branch of public health and to identify responsibilities for disease prevention and health promotion in tourists. Key topics included:

0 marine ecology and pollution of the sea in relation to health risks;

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enteric and diarrhoeal diseases as a major problem for tourists; the control of these problems through food safety and environ- mental sanitation; the spread. control and preven- tion of sexually-transmitted dis- eases, and respiratory diseases such as Legionellosis; healthy lifestyles and quality of life both among tourists and host populations; prevention of accidents and emergencies; climate, tourism and health; and information, legislation and health insurance.

The International Tourist Health Association (ITHA) has two main aims. The first of these is to facilitate communication and exchange of in- formation among those engaged in protection and promotion of the health of others, through the improve- ment of the ecological conditions, health safety and hygienic standards of tourist facilities, sites and services. Due regard will be paid to safeguard- ing the health of host populations. The second aim is to create tourist health awareness among individuals, national and international bodies and all sec- tions involved in tourism in both generating and recipient communities,

There is already considerable coop- eration between public health author- ities and major tour operators, but much of the recent media concern with river, lake and beach pollution, with food safety and risks to tourists from the more newsworthy, infectious diseases suggests that many holidays will continue to be marred. Interna- tional concern is expressed in the need to establish the ITHA. It remains to be seen if such international coopera- tion will improve the quality of the tourist experience and enhance the sustainability of many existing tourist destinations.

Vincent J. May Head of Division of Tourism Planning and Development

Dorset institute Wallisdown Road

Poole BH 12 5BB, UK

TOURISM MANAGEMENT December 1989 341