World Scout Jamboree Medical Requirements—Adult
The Jamboree site will be at Kirara-hama, a reclaimed area in Yamaguchi City. The location is in the western part of Honshu, extending about .62 miles from north to south and 1.86 miles from east to west. It is equipped with developed facilities and parks. Over the past five years, the temperature at Yamaguchi City in August has averaged 82 degrees Fahrenheit, with precipitation averaging 6 inches. Since the jamboree site faces the Seto Inland Sea, strong winds sometimes blow. Over the past eight years, the weather from July 31 to August 9 has been mainly sunny, but with occasional showers and cloudy skies. The exciting high-adventure activities, long days, and short nights are in a non-air-conditioned environment. Participants are subject to walking 5 to 10 miles per day and must be capable of walking steadily for an hour without stopping.
All adult participants and staff members will be required to submit a complete and detailed health history, meet immunization requirements, and undergo a thorough physical fitness examination between July 25, 2014, and May 1, 2015. Physical examinations will be by a licensed health-care professional and will be subject to review and evaluation by the jamboree medical service. Failure to complete the fitness examination process by the May 2015 deadline may limit or prohibit jamboree participation. Adult participants and staff members are subject to a medical recheck upon arrival to verify provided information and current fitness. Any adult participant or staff member found medically unfit at any time is subject to being returned home at his or her own expense.
Immunization requirements are based on recommendations of the U.S. Public Health Service. All adult participants and staff members must provide proof of immunization for tetanus within 10 years (five years preferred). In addition, adult participants and staff members must provide verification of the following immunizations since birth: (1) measles, mumps, and rubella (MMR); (2) polio vaccine (oral or injection); (3) diphtheria, pertussis, and tetanus (DPT); and (4) chicken pox. It is recommended that immunizations for hepatitis B (for persons 15 years of age and older) be considered. Any adult participant or staff member who does not have immunizations because of religious beliefs will be required to provide a signed statement and will be subject to a medical check for contagious disease.
Medical Risk Factors for jamboree Participation
For your World Scout Jamboree 2015 experience to be a good one, you need to be aware of physical and mental risk factors that could affect you at the jamboree. Outlined below are risk factors that require special attention, acknowledgment by adult participant or staff member, and verification by the licensed health-care professional performing your fitness examination. These risk factors are based on both BSA experience and the vast expertise of jamboree medical service experts. In the event these conditions are not acknowledged, an adult participant or staff member may be found medically unfit and required to return home at his or her own expense. Please note that the jamboree medical service will not support medical device requirements of adult participants, International Service Team (IST) or Contingent Management Team (CMT) members, and will not support any long-term health needs.
Excessive body weight (obesity):
To have the best experience, adult participants and staff members should be of proportional/normal height and weight. Excessive body weight puts an adult participant or staff member at risk for numerous health problems. One such measure is the body mass index (BMI). You can calculate yours using a tool from the Centers for Disease Control here: http://www.cdc.gov/nccdphp/dnpa/bmi/. Both adult and youth calculators are available. It is recommended that adults have a BMI of less than 30 (obese) for staff positions requiring moderate to high physical exertion. Those with BMIs in excess of 40 (morbidly obese) should reconsider participation until a higher level of fitness is achieved. The medical staff has the right to reject any participant whose physical condition, including BMI, is determined to pose an unreasonable risk.
Cardiac or cardiovascular disease:
Adults who have had any of the following are at risk and should undergo a thorough evaluation before considering participation.
- Angina (chest pain caused by blocked blood vessels or coming from the heart)
- Myocardial infarction (heart attack)
- Heart surgery or heart catheterization (including angioplasty to treat blocked blood vessels, balloon dilation, or stents)
- Stroke or transient ischemic attacks (TIAs)
- Claudication (leg pain with exercise caused by hardening of the arteries)
- Family history of heart disease or a family member who died unexpectedly before age 50
- Smoking and/or excessive weight
Adult participants or IST or CMT members who have congenital heart disease or acquired heart disease such as rheumatic fever, Kawasaki’s disease, or mitral valve prolapse should undergo a thorough exam before considering participation. Adult participants or IST or CMT members with the first seven risk factors should undergo a physician-supervised stress test.
Hypertension (high blood pressure):
Adult participants and staff members should have normal blood pressure (less than 135/85). Persons with significant hypertension should be under treatment, and their condition should be under control in the six months prior to the jamboree. The goal of the treatment should be to lower blood pressure to normal levels. Adult participants or IST or CMT members already on antihypertensive therapy with normal blood pressures should continue treatment and should not choose the time they are at the jamboree to experiment with or change medications. Conditions requiring diuretic therapy to control hypertension could lead to dehydration when coupled with the high heat and nature of the jamboree environment. Blood pressure over 150/95 may result in a medically unfit condition for participation.
Insulin-dependent diabetes mellitus:
Any individual with insulin-dependent diabetes mellitus must be able to self-monitor blood glucose and know how to adjust insulin doses based on these factors. You must know how to give a self-injection and recognize indications of high and low blood sugar. You must bring enough medication, testing supplies, and equipment for your jamboree stay. This includes batteries (without provisions for recharging) both to be brought to and taken from the jamboree (remember Leave No Trace guidelines) for pumps.
An insulin-dependent diabetic who has been newly diagnosed (within six months of the fitness examination) or who has undergone a change in delivery system (e.g., an insulin pump) in the same period should not attempt participation. A diabetic person who has been hospitalized for diabetic ketoacidosis or who has had problems with hypoglycemia in the last year should not participate.
Storage and refrigeration of medications:
Storage of refrigerated medications will be, at a minimum, in the jamboree hospital. The jamboree leadership may identify other locations outside of the jamboree hospital where storage and refrigeration is available, but that has not yet been determined.
Seizure disorder or epilepsy should be well controlled by medications. A minimum of six seizure-free months prior to the fitness examination is considered under control. Adult participants or IST or CMT members with a history of seizures need to limit high-adventure activities (e.g., climbing or rappelling). The jamboree is not a venue to modify maintenance medications.
Acute or severe bronchial asthma under treatment anytime during the past 24 months must be well controlled before participating in the jamboree. Key indicators of well-controlled asthma include:
- The use of an inhaler zero to one time a day
- No need for nighttime treatment with a short-acting bronchodilator. Well-controlled asthma may include the use of long-acting bronchodilators, inhaled steroids, or oral medications such as Singulair.
The following asthma conditions are considered medically unfit:
- Exercise asthma not prevented by medication
- Hospitalization or have gone to the emergency room to treat asthma in the six months before your fitness examination
- Treatment that required oral steroids (prednisone) in the six months before your fitness examination
Adult participants or IST or CMT members must bring adequate and backup supplies of medications and spare inhalers that are current. You must carry your inhaler with you at the jamboree. Not having a proper supply of medication is considered medically unfit.
Adult participants or IST or CMT members with sleeping disorders may experience health risks due to long days and short nights for the duration of the jamboree. Adult participants or IST or CMT members with sleep apnea requiring a CPAP machine should reconsider participation. If considered fit, all equipment (e.g., CPAP machine) must be provided by the adult participant or staff member and be self-contained as there will not be electrical support for the machine. This includes batteries (without provisions for recharging) both to be brought to and taken from the jamboree (remember Leave No Trace guidelines).
Allergies or anaphylaxis:
The outdoor setting of the jamboree has many risks (e.g., wasps, hornets, and other stinging insects) that could trigger anaphylactic reactions in individuals prone to reaction. While it is not an automatic indicator of medical unfitness, adult participants or IST or CMT members who have had an anaphylactic reaction from any cause must contact the Health and Safety Service for review by the jamboree medical service as soon as possible. If declared fit, you will be required to have appropriate treatment with you at all times.
Allergy shots required for maintenance doses are acceptable for persons who have not had an anaphylactic reaction. You must bring all appropriate medications and be able to self-administer them.
The jamboree may not support special dietary needs, including gluten-free foods. Participants with special dietary needs should not assume that there will be opportunities to purchase or acquire foods to meet their individual needs. In the event dietary restrictions present a hazard to a participant which cannot be adequately addressed, they may be sent home from the jamboree at their own expense.
Not having a proper supply of appropriate medication is considered medically unfit.
Ingrown toenails, recent musculoskeletal injuries, and orthopedic surgery:
Every jamboree participant will put a great deal of strain on feet, ankles, and knees by walking 5 to 10 miles per day. Every adult participant or staff member should be able to walk steadily for an hour without rest or rethink their participation. Ingrown toenails should be treated within a month prior to the jamboree. Adult participants or IST or CMT members who have had orthopedic surgery, including arthroscopic surgery, or significant musculoskeletal injuries, including back problems, within six months prior to the fitness exam may find it difficult or impossible to meet the walking requirements.
Fitness exams for these surgeries or injuries must include a release from the surgeon or treating physician in addition to the fitness examiner. An adult participant or staff member wearing a cast on an extremity must have a treating physician release. Medical fitness is still subject to review by the jamboree medical service.
Psychiatric, psychological, and emotional difficulties:
The jamboree is not designed to assist adult participants or IST or CMT members in overcoming psychological or emotional problems and may exacerbate existing conditions. The experience and expertise of the jamboree medical service indicates these problems frequently are magnified, not lessened, when adult participants or IST or CMT members are subjected to the physical and mental challenges of the jamboree.
Any condition must be well controlled without the services of a mental health practitioner. Under no circumstances should medication be stopped before or during the jamboree. Adult participants and staff members are required to bring an appropriate supply of medication for the duration of the jamboree and travel to and from the jamboree. Not having a proper supply of medication is considered medically unfit.
There is no representation or guarantee that there will be accommodations for special needs or disabilities. Jamboree facilities are provided by the host nation and are not subject to the requirements of U.S. laws requiring reasonable accommodations. Participants with needs should not assume that the jamboree will be able to accommodate their individual needs. In the event special needs that cannot be accommodated present a hazard to a participant and cannot be adequately addressed, he participant may be sent home from the jamboree at his or her own expense.
Other risk factors:
Sickle-cell anemia, hemophilia, leukemia, current cancer treatment, and blood-borne pathogens such as hepatitis and HIV provide special challenges to adult participants, IST and CMT members, and the jamboree. To plan for, prepare for, and support any adult participant or IST or CMT member who has any of these medical conditions, an individual evaluation of each situation by the jamboree medical service is required. There may be instances where proper medical support at the jamboree site is impossible. Under such circumstances, participation may be denied.
Any person with a severe physical disability, one of the conditions listed above, or with a reason to believe he or she may be medically unfit for jamboree participation should contact the jamboree medical service as soon as possible by email at Jamboree.Medical@scouting.org.