For a variety of reasons, travel medicine in Britain is a responsibility nobody wants. As a result, many travelers go abroad ill 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 travelers, 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 tropical Diseases hospital when they come home. But it is notoriously difficult to get everybody to 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 travelers' diarrhea in Turkey, or to take the time to spell out preventive measures travelers could take. 'The NHS consultant finds it difficult to define travelers' health,' says Ron Behrens, the only NHS consultant in travel and tropical medicine 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 a grey Tropical Diseases in London area, and opinion is split. 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 is linked to travel there is rarely any information about where those afflicted went, what they ate, how they behaved, or which vaccinations they had. This shortage of hard facts and figures makes it difficult to give detailed advice to people, information that might even save their lives. A recent leader in the British Medical Journal argued: 'Travel medicine will emerge as a credible discipline only if the risks encountered by travelers and the relative benefits of public health interventions are well defined in terms of their relative occurrence, distribution and control.' Exactly how much money is wasted by poor travel advice? The real figure is anybody's guess, but it could easily run into millions. Behrens gives one example. Britain spends more than fl million each year just on cholera vaccines that often don't work and so give people a false sense of security. 'Information on the prevention and treatment of all forms of diarrhea would be a better priority,' he says. Travel medicine in Britain is________.