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Do who choose to go on exotic, far-flung holidays deserve free health advice before they travel? And even if they pay, who ensures that they get good, up-to-date information? Who, for that matter, should collect that information in the first place? For a variety of reasons, travel medicine in Britain is a responsibility nobody wants. As a result, many travellers go abroad prepared to avoid serious disease.

Why is travel medicine so unloved? Partly there's an identity problem. Because it takes an interest in anything that impinges on the health of travellers, this emerging medical specialism invariably cuts across the traditional disciplines. It delves into everything from seasickness, jet lag and the hazards of camels to malaria and plague. But travel medicine has a more serious obstacle to overcome. Travel clinics are meant to tell people how to avoid ending up dead or in a hospital when they come home, but it is notoriously difficult to get anybody pay out money for keeping people healthy.

Travel medicine has also been colonized by commercial interests; the vast majority of travel clinics in Britain are run by airlines or travel companies. And while travel concerns are happy to sell profitable injections, they may be less keen to spread bad news about travellers' diarrhea in Turkey, or to take time to spell out preventive measures travellers could take."The NHS finds it difficult to define travellers' health, says Ron Behrens, the only NHS consultant in travel and director of the travel clinic of the Hospital for Tropical Diseases in London." Should it come within the NHS or should it be paid for? It's Gary area, and opinion is spilt. No one seems to have any responsibility for defining its role, he says.

To compound its low status in the medical hierarchy, travel medicine has to rely on statistics that are patchy at best. In most cases we just don't know how many Britons contract diseases when abroad. And even if a disease linked