Ethics Challenges: Health, Safety and Accessibility in International Travel and Tourism

William L. Richter and Linda K. Richter explore ethical dimensions of accessible travel for people with disabilities, citing trends, issues, and strategies for public administrators to deal with these concerns. Internet publication URL:

by: Linda K. Richter, and William L. Richter

Enormous increases in international travel by public sector employees and others, along with incidents of terrorism, accidents, and disease, raise a variety of ethical issues not normally covered in the training of public personnel administrators or in the standard administrative ethics course. Issues of accessibility for individuals with disabilities may be familiar to personnel administrators and students of ethics, but take on vast new dimensions when those individuals travel abroad. Travel-related ethics issues involved in health, safety, and accessibility may include identification of individual and institutional responsibilities, informed consent, contingency planning, emergency response mechanisms, fairness, and equal treatment.

This study provides an overview of trends and issues, explores their ethical dimensions, and identifies relevant strategies to prepare public administrators to deal appropriately with these concerns. The study treats both tourist and educational travel abroad, and considers risks to host societies as well as to travelers.

Governmental agencies, professional associations, and other institutions have sought to develop effective responses to health, safety, and accessibility challenges arising from rapidly-expanding international travel. The U.S. State Department, the Centers for Disease Control, and the World Health Organization are valuable sources of public safety information, but political considerations sometimes undermine accuracy and credibility. Health and safety guidelines, vulnerability assessments, and other ethics strategies will help institutions and administrators to deal with future challenges, but the key task is for administrators at all levels to become more aware of the issues surrounding this, the world's largest industry.

Public personnel both in the U.S. and abroad are faced with an ethical crisis they scarcely recognize: what to do about international tourism. In 1998 more than 600 million people traveled internationally, a figure that is expected to soar to 1.6 billion by 2020. 1 That kind of growth will put intense pressures on governmental personnel to cope with a wide range of health, security, and accessibility issues. This article explores the ethical dimensions of challenges facing the public sector at an levels, not the least of which is the very reluctance of public officials to acknowledge negative problems from tourism.

Most nations consider domestic and international tourism to be an important part of their economies with pro-growth efforts expected to be supported by both the public and private sector. Even the United States, which makes a virtue out of the private sector and often a scapegoat out of the public sector, by 1985 had 43 federal agencies dealing in some way with tourism. 2 Every state and all major cities along with hundreds of smaller communities are making elaborate efforts to boost economic growth through tourism. Indeed, tourism is one of the few public sector areas that has not been downsized. 3

Public sector employees not only boost, manage, budget, monitor, and administer tourist attractions, but they also administer the licensing, taxing, and zoning through which tourism is developed and maintained. Those same employees are also tourists themselves-- dependent at home and abroad on the policies that support their health and safety. Terrorism, accidents, disease, and accessibility problems may be increasing with tourism growth, but not all these threats are borne by the tourists. Balancing visitor and community needs grows more and more difficult. Host populations, local health, transport, and criminal justice facilities may also be taxed by the health-related issues exacerbated by tourism.

What is needed? A new level of coordination and commitment by public bodies ranging from the local level to the World Health Organization are essential for meeting the challenge. Yet, there is little evidence of the necessary political will to confront the problems associated with the rapid expansion of tourism. No one builds a career squelching tourism; little credit is given to exposing new problems so that they might be prevented.

Still, it is critical that students of public administration and government employees learn to recognize and confront the host of ethical issues not typically covered in the training of public administrators or in the standard ethics course. In the U.S., for example, issues of accessibility for individuals with disabilities are covered in training about the Americans with Disabilities Act, but not considered generally are U.S. government personnel, tourists, or other travelers going abroad.

Ethical issues involved in health, safety, and accessibility for travelers include: identification of individual and institutional responsibilities, informed consent, contingency planning, emergency response mechanisms, issues of fairness, and what constitutes equal treatment.

In Part I of this article the range of issues and trends confronting public personnel will be addressed, while in Part 11 specific ethical dimensions of these issues will be examined. In Part III the evolving efforts to deal with these issues are discussed and recommendations made about how to improve the protection of the traveler and the host destination.

Part 1: Overview

International travel is not a new phenomenon. The arrival of widebodied jets in the 1960s democratized travel by making it more affordable. The decolonization of Asia and Africa plus the Cold War also meant increasing numbers of embassies, consulates, and transnational corporations that governments needed to keep secure. Thus, what was once the Grand Tour for the select few became a mass movement of government personnel, business people, tourists, and students- all of concern to their home and host countries.

Health and safety issues are also not new issues in travel. Within a week of the 1912 sinking of the Titanic, policies were passed around the world mandating adequate lifeboats on ocean liners and calling for international monitoring of icebergs. The international community can make ethical judgments to save lives when the attention of the world is clearly focused on the problem.

The 1917-1918 influenza epidemic also served as a cautionary tale of how the movement of travelers B in this case primarily soldiers B could unleash deadly terror on civilian populations and their unprepared governments. Between 20 and 30 million people died, far more than from World War I fighting. 4

Accessibility for people with disabilities is a relatively new issue and, except in a few nations, has been scarcely addressed. These issues are certain to become more serious and will raise increasingly difficult ethical dilemmas. Whereas travel was once considered a private decision, it is now ringed by government policies on access, promotion, safety, immigration, customs, disease control, and even foreign policy Tourism trends will dramatically accelerate ethical issues for public administrators in all these policy areas.

The first concern is the enormous growth in travel, for which public administrators and policy makers are simply not prepared. More than a 300 percent increase in international travel is expected by 2020. Already over two million people cross international boundaries every day. Domestic tourism will be several times that amount! 5 Crowding exacerbates a desire to get away from it all; so, at the same time tourism is becoming more urban, it is also radically changing once remote settings.

The U.S. national parks are an example. Parking rather than the park itself is becoming the preoccupation of park service personnel. Is this simply a changing role to which personnel must adapt as they encourage access and participation in the once wild parks? Or should employees resist by banning cars or rationing access as a way to protect the larger public interest in preserving a national resource and keeping the quality of the experience special? Cost-benefit analysis does not prepare the administrator adequately for protecting either the longterm integrity of the resource or measuring the quality of the experience unlimited access provides. What other values need to be weighed? A second concern is the global booming senior market. "...according to the UN, the number of senior citizens in the year 2025 will be 1,100,000,000 B almost double the number estimated for the year 2000 and five times the 1950 figure.... Throughout the world we are witnessing 'double demographic aging'... a phenomenon in which a longer life span, together with the record decline in birth rates, produces demographic growth rates very close to zero, and in some cases, negative growth..." 6

In the U.S. seniors are 25 percent of the population but control 70 percent of the wealth. They also have disproportionate political clout. Yet their propensity to travel creates extra safety and health concerns, especially when they venture abroad. 7 These concerns are beginning to impact global decision-making bodies. The United Nations declared 1994 the International Year of the Elderly. There is a growing awareness that "a central requirement of any social programme is the principle of the right to useful and worthwhile activity for all. This means that government must draft and implement active policies for training, leisure, and social integration." 8 Currently, little if anything is being done to prepare public sector personnel for participating in tourism development that targets the special needs -particularly health needs-of this group.

Deregulation, privatization, increased industry competitiveness, and the speed of world travel have encouraged pressures to cut corners on safety, especially in terms of food preparation and sanitation. Today, food poisoning and medical emergencies are a far greater threat than crime or terrorism. A study done by the British Consumers Association revealed that 15 percent of their members had been sick on vacation. Sixty to 75 percent experienced illness when visiting developing nations. 9 These percentages are probably similar for other travelers. The pillows or blankets on planes often harbor lice, mosquitos, fungi, viruses, and germs as the plane moves through airport after airport before getting a thorough cleaning. Dengue fever, TB, hantavirus, malaria, and other diseases are carried around the globe in hours. 10 Public officials are often faced with increasingly lax policy standards at a time of reduced vigilance by the private sector. Public pressures may also reduce safety: Immigration, agricultural inspectors, and customs officials are sometimes upbraided by U.S. Department of Commerce personnel and members of Congress for their slow handling of inbound planes and ships. The critics remind employees that they must facilitate tourism to boost it. The visitor or returning citizen must not be harassed or delayed. The conscientious employee may be urged to lighten up."

Many ships and planes simply register in countries where restrictions are looser. Allowing the whistle on potential hazards for the traveling public or the host destination is often not an option. Increasingly, concerns are voiced even in the tourist industry press. The World Health Organization, criticized for timidity in the face of member resistance, is also beginning to act. Increasingly, the link between a potential for bioterrorism or even accidental spread of infectious disease has gradually encouraged greater global NGO and public sector cooperation. 12 These trends have highlighted a growing awareness that tourism B once and still promoted as a boon to one's health and the salvation of many a community's tax base B may be a mixed blessing at best.

Part II: Ethical Dimensions

In this section the ethical dilemmas public officials face vis a vis these tourism trends are explored. One has already been alluded to: the political pressure to facilitate tourism in the name of economic development over "red tape" that may include protection of both tourist and nontourist. just as community, state, and national officials are loath to assess the politically useful industry in terms of its costs rather than merely its tax receipts, they also oftentimes lack the political will or the contingency planning effort needed to prevent major problems.

Often the "rational" decision for local bureaucrats is to acquiesce to local demand, though they may foresee a larger, long-term threat to the public interest. Cost-benefit analysis tends to discount the future threat over the present advantage. 13

The importance of tourism economically and politically has shifted the bureaucrat's constituency to a few economic interests and favors the tourist over the general citizenry. For example, tourist resorts may lack adequate sewage facilities. In the short run, the tourist may be spared dysentery by drinking bottled water. In the long run, however, the communities and villages surrounding the resort may experience polluted wells, unsafe beaches, and a decline in the local fishing industry.

If the public sector seeks to enforce tough standards in the design phase, its inspectors may be bribed or the dangers belittled and the advantages of economic development oversold. Later the resort or attraction may have its own local clout sufficient to control planning. Even when a major health hazard exists as with the medical waste washed up on New Jersey's beaches a few years ago or even where disease and political instability threaten, public officials generally do not dissuade tourists from coming. One of the few exceptions, and that possible only because of the government's authoritarian control, occurred when Marshall Tito, President of Yugoslavia, closed his country's borders in 1975 and forbade travel among towns, successfully "burning out" a smallpox epidemic. 14

More commonly, public sector tourism organizations promote tourism as being good for the health and a "stressbuster." Some even wink at prostitution by advertising "a fresh peach on every beach" and "Try a Virgin... island." Even where prostitution is prosecuted, which is far from every place it is illegal, there is usually a double standard that leads to prosecution of the prostitute but not the one buying the sexual services. 15 In an era dominated by the AIDS epidemic, such public sector marketing is a disgrace.

Nor are children adequately protected from pedophiles B some of whom actually tour as groups exploiting children. This is a serious problem in many countries, but it is particularly difficult to control in developing countries where low civil service salaries encourage bribery. 16

A second ethical problem is the distribution of police and judicial services. Affluent travelers are often afforded more protection than nontourists. Some cities have special patrols in the tourist belt. Sentences may be harsher for crimes against tourists. Is this consistent with equal justice? Many would argue it isn't. "Those who have less in life should have more in law," argued former Philippine President, Ramon Magsaysay.

Others, however, note the special vulnerability of tourists, often unfamiliar with the destination, its language, signage, money, traffic patterns, or customs. Moreover, on vacation people are more apt to be careless or behave more recklessly than at home. All of these behaviors set them up for criminals. Hawaii and several other states have taken special efforts to fly tourists back to their state in order to testify against alleged criminals. Enforcement officials say this is necessary to protect tourism and keep tourists from being targeted because they are transients. The motives may not be altogether altruistic, but they might fit John Rawls' dictum on justice, which includes treating everyone equally, except in those instances where the most vulnerable would benefit from unequal treatment. 17

A third ethical issue for public sector personnel has both domestic and international dimensions. National, state, and local officials seldom if ever warn in-bound tourists of health, safety, or accessibility issues.

Though an extraordinarily violent nation with extremely expensive health care, the U.S. and its communities are careful only to accentuate the positive. Nor is this practice unusual. The Philippines still includes in its brochures information about areas the unwary would discover were in the midst of a civil war. 18 It is left to the Internet and private guidebooks to provide cautionary advice to the domestic or international tourist. 19 As an example, Fielding's Guide to Dangerous Places found that Florida was far more dangerous for Europeans (42 percent affected) than North Africa, Turkey, California, and Kenya, combined. 20 On the other hand, governments are not nearly so loath to warn about other countries. Keeping tourism at home obviously supports a nation's balance of payments, but it is more than that. Developed nations, especially the U.S., Japan and the U.K., are quick to note areas of risk, often with a range of foreign office bulletins ranging from advisories to "don't go" to absolute prohibitions on travel.

The latter are sometimes more political than strictly cautionary. This leads to the dilemma: Should travelers' health and security advisories serve foreign and economic policy? Or does a lack of candor sacrifice government credibility on future, perhaps more important, issues?21 For those who read the warnings and don't go abroad, credibility may be the issue. But for those who go to places where genuine risks are not acknowledged, tourist safety is jeopardized. Isn't government's first responsibility-to protect its citizens -being overshadowed by political convenience? Or does the larger national interest dictate that health and security threats from friendly nations be treated differently from those from unfriendly ones?

For example, some countries with good records on tourist health and safety like Iran and Libya are nations to which U.S. travel is either forbidden or called "extremely dangerous." Meanwhile, Guatemala-- where rapes of students in broad daylight and banditry are frequent-- has only a mild U.S. advisory Critics have charged that the U.S. having brokered the Guatemalan civil war truce and being lobbied by investors who have massively increased holdings-did not want to protect tourists as much as the Guatemalan economy. Similar considerations appear to have influenced the "watering down" of advisories about Egypt, one of the three top recipients of U.S. aid, and about Mexico, whose bailout needed tourism for repayment. In general, however, most experts concede that the warnings are generally warranted. Now posted by U.S. Consular Affairs on the Internet as well as available from the State Department, the advisories have a global impact. 22

Japan has been historically even more protective of its traveling citizens. The national economy of some nations has been hurt by a simple announcement from the Japanese government detailing some health or security threat abroad. Japanese citizens respecting the credibility of the government advisories followed the recommendations immediately. Public sector employees need training in thinking through their responsibility to their profession, to the institutions involved in making health and security advisories, and to the larger public interest. Pressures from superiors and constituents may pull the employee in different directions. Few important issues are clearcut. Here, Albert Hirschman's classic Exit, Voice and Loyalty may be helpful in suggesting options and consequences. 23 Institutionalized channels like the U.S. Department of State's dissent channel, offer opportunity for responsible and confidential debate. 24

A fourth ethical dilemma concerns both tourist and non-tourist health and safety. Is it ethical to be reducing health requirements world-wide in the name of facilitating tourism at a time of increased vulnerability to infectious disease? For example, the few nations now barring visitors who test positive for HIV are in violation of World Health Organization (WHO) guidelines, which require less and less scrutiny of incoming tourists.

How does WHO come to be in such a sorry state... ? WHO does not operate according to its own definition of health. WHO is slavishly in thrall to its member states. Appropriate respect for rational sovereignty has been overtaken by blind obeisance... e.g., the desire to avoid embarrassment that an epidemic is underway. 25

Accidents are another major source of injuries and fatalities for travelers. The July 1999 canyoning deaths of 19 adventurers in the Alps, and the numerous fatalities that have accompanied the commercialization of Mt. Everest treks have raised additional ethical questions. Should there be tighter controls on popular but potentially dangerous activities? If so, how much of the burden of filling in the details of such policy will fall to civil servants?

Inadequate signage is another significant contributor to accidents. The use of international signage that communicates through pictures rather than a specific language is widespread in Europe, Australia, and New Zealand, but more scarce in the United States B where foreign visitors have far more accidents in the U.S. than citizens B and rare in developing countries. The World Travel Organization (WTO) has urged member nations to increase international signage. 26

The whole literature on bureaucratic discretion details the scope for and the extreme care public employees need to take in making "street level" decisions. 27 Requiring more safety measures to be taken or insisting on more experience from those participating on so-called "adventure tours" is a possible approach, but others may argue that the doctrine of caveat emptor relieves the government of responsibility for their safety. 28 Becoming more proactive on behalf of tourist and non-tourist health and safety, however, is fraught with controversy whether at the local public health office or at the international level. Many people have a visceral distrust of government. Also, there are often legitimate needs to go slow, to build consensus, to protect investments, and to avoid "crying wolf" and thereby destroying citizen confidence.

But, we are in a more litigious political environment in many countries. Thus, even if the population is unenthusiastic about some expenditures for health, safety, and accessibility, that same public may expect government to fulfill its core role of keeping them safe. Public sector training that emphasizes thinking through long and short term considerations, doing contingency planning and generally seeking to put in place cooperative internal and international mechanisms to deal with such crises is vital.

International Educational Travel   29

Individual tourism is governed by consumer law and government policies, but public educational institutions have additional ethical issues surrounding their international student services and study abroad programs for their own citizens. Such situations are only beginning to be addressed.

International educational travel is complicated by the fact that the students are typically 18-22 -at the prime time in their lives for risktaking behavior. They may be going to countries with unfamiliar laws and customs. Sexual freedom varies markedly around the world. The prospect of running afoul of drug, drinking, or other laws needs to be addressed as the laws differ greatly in severity.

Because international students often bring financial as well as educational and cultural benefits, universities in many countries are increasingly involved in recruitment of such students. International study opportunities are seen as an important dimension of a student's career. Exchanges, study tours, international internships and community service projects abroad are some ways in which universities structure college credit and travel-sometimes with established procedures and appropriate supervision, sometimes merely with eager faculty and a tour company.

Some recent statistics illustrate the magnitude of the issue. Over the past decade the numbers of Americans studying abroad have doubled, from 48,483 in 1985-86 to 99,448 in 1996-97. Most of that growth has occurred in the 1990s. Such students are only about a fifth of the 480,000 foreign students to the United States, but American interest is mushrooming. From the mid 1980s to the mid 1990s, foreign enrollments in the United States increased by about 40 percent, while American students abroad increased by 105 percent. American student travel abroad has also become much more diverse. In the mid 1980s nearly 80 percent of all travel was to Europe; by 1996-97 that percentage had dropped to 64 percent. Travel to Latin America had more than doubled and other, predominantly developing nations were increasing their share. In many cases, the geographic diversification has left students exposed to greater risks and their supervisors unprepared for coping with the sheer variety of threats to health and safety. 30

Economic competition, recruiting, and a genuine belief in the educational value of such opportunities keep educators committed to their expansion. The United States is not the only country dealing with these issues. In Australia, New Zealand, and throughout Europe, the practice of student travel is well ahead of the U.S. pace. In many of these societies, vacations are longer and government policies subsidize the travel of youth and workers. Still, consideration of ethical and legal issues of such travel has been slow to keep pace.

The first key issue is quality control. In many places, there is no litmus test or set of standards for the myriad of existing programs nor set requirements for the faculty leading tours. Is the emphasis on increasing numbers coming at the expense of adequate preparation of those traveling internationally? This may be in terms of language preparation or more basic screening. On what basis are students and faculty refused the right to participate? What are the criteria, the processes, and the responsibilities by which specific individuals are given institutional authorization to lead groups abroad?

Are there any screening requirements in addition to academic criteria that can assess the mental health or emotional maturity of participants? If not, shouldn't there be? Some students and faculty are subject to crippling depression when put in entirely new surroundings even without language and customs barriers.

Are there any screening requirements in addition to academic criteria that can assess the mental health or emotional maturity of participants? If not, shouldn't there be? Some students and faculty are subject to crippling depression when put in entirely new surroundings even without language and customs barriers.

Secondly, this raises the dilemma of privacy versus the institution's need to know. To what extent is obtaining information on a student's or faculty member's mental and physical condition itself an invasion of privacy? What legal information is appropriate?

A third issue has to do with the nature and type of orientation, if any, offered to or required of those going abroad. Are students made aware of the health and safety risks of excess drinking abroad, accidents in unfamiliar settings, the penalties for illicit drugs, restrictions on women and the political situation into which they are going?

Finally, should national or institutional policies acknowledge or explicitly waive responsibility for warning travelers of health and security risks? How can institutions protect themselves, their students and their faculty?

Accessibility Issues

Reasonable accommodations for people with disabilities constitute still another set of ethical issues for government personnel serving outside the country and students seeking an international study or work experience. The United States has gone further than any other nation in providing access to transport, accommodations, and attractions for people with disabilities thanks to the Americans with Disabilities ACt. 31 Yet issues of fairness remain.

Should special needs students have separate but comparable opportunities or is there a value for people with disabilities and able-bodied people to travel together? Should all trips enjoying official government or university sponsorship be accessible for people with disabilities even if it means that groups cannot go some places or that additional costs would be involved? Should individuals with disabilities be subsidized in order to equalize their opportunities?

Or should a more utilitarian approach be adopted arguing for the greatest good for the greatest number? Should students with disabilities pay the differential in travel costs for sign language, braille information, wheelchair accessible sites, or personal attendants?

Currently there is no clear legal standard for making such decisions. Rather individual universities are making decisions based on their own resources and notions of fairness. Two private universities, for example, responded to this issue in quite different ways. When Kalen Feeney, a deaf student, applied to go to London on one of Willamette University's study abroad programs, the university paid for an interpreter, even though that meant over $10,000 in additional university costs. The College of St. Scholastica opted not to provide a sign language interpreter for one of its students wanting to go to Ireland. 32

These and other cases raise several ethical questions of fairness and distributive justice, of utilitarian or Rawlsian notions of decisionmaking. There is also the question of whether administrators should pursue defensive or proactive strategies with respect to accessibility issues. While U.S. courts have not applied domestic ADA requirements to university study abroad programs, coordinators of the program must still wrestle with their responsibilities to make such experiences available to all students. In other countries, the dialogue about these issues has scarcely begun.

And then there's the question of gender and sexual orientation. Should universities only establish international exchanges with countries having comparable non-discrimination policies? Or, does that defeat the advantage of study and research abroad which is to experience countries with different values?

These issues by no means exhaust the travel-related ethical problems with which public sector personnel must grapple. However, they suggest the breadth of concerns with respect to health, safety, and accessibility that must be confronted. In Part III we will examine what is being done to address some of these issues.

Part III: From Issues to Initiatives

In this article the authors have argued that there is an unusual but enormous threat to public health, security, and accessibility from the huge growth and multiple facets of travel and tourism. Deregulation, privatization, heightened competition for tourists of all types, and a sharp increase in the proclivity and ability to travel combine to make tourism and other forms of travel a stew of ethical problems for the public administrator.

These can be challenging for public sector training to address. Still, there are mechanisms that could potentially deal with these issues. At the most general level, there are Codes of Ethics. The International Personnel Management Association (IPMA), the American Society for Public Administration (ASPA), and the International City/County Management Association (ICMA) are but a few of the professional societies that address in their Codes of Ethics broad guidance that could be applicable to travel and tourism.

These Codes of Ethics include general advice on avoiding conflicts of interest, abusing the public trust, and serving the public fairly and compassionately. However, nowhere is the public sector employee charged with responsibility for recognizing and coping with the complexity of issues that surround tourism and the public interest. Too often, it is simply assumed that more tourism is desirable. If, as we have seen, health, safety@ and accessibility issues are neglected, travel and tourism may threaten the public interest.

The tourism industry has begun to recognize this. Efforts are underway to develop a Global Code of Ethics for the industry. 33 However, it is not clear whether the tourism sector will recognize that the various components of the world's largest industry must be partners with the public sector in not only creating sustainable tourism, but also in maintaining healthy, safe, and accessible destinations.

Several codes of ethics for travelers have been developed, which are excellent in encouraging responsible behavior by tourists. These evidence concern for host peoples' customs, feelings, and economic condition, but they do not address health, security, and accessibility issues. Nor are there, to our knowledge, any codes by host destinations except perhaps in the area of consumer protection in terms of tours, accommodations, and purchases.

The World Health Organization's performance remains a critical gap in developing a coordinated strategy. It was founded at a time of very little international travel, much smaller global populations, and when many infectious diseases now plaguing the planet were unknown. Since 1976, over thirty new infectious diseases have been identified, but out-of-date monitoring and disclosure mechanisms at WHO failed to alert the member nations.

Approaching its half century, these challenges of organizational identity and continued relevance confront the World Health Organization. However, the key issue is not how WHO will respond but whether it will respond at all. The existing leadership of WHO has adopted a fortress mentality, fighting bitterly to sustain the status quo and meanwhile allowing good will and opportunities for revitalisation to slip away. The Organization is demonstrably off-course-untrue to itself and consequently suffering from both a myriad of internal ailments and a loss of the intellectual coherence that is essential for global health leadership .... 34

In 1999 new guidelines and information were released by WHO amidst signs that a health crisis looms, but it remains to be seen if member nations will act to avert a disaster. They failed to do so with the AIDS epidemic, which afforded much more time for coordinated responses than Ebola, Rift Fever, the Marburg Virus, and viral pneumonia Will. 35 These emerging health threats are symptomatic of many of the new challenges raised by increased globalization, and they require comprehensive, sustained policy responses....

... A network of this sort need not be built entirely from scratch. For example, the WHO has recently established a global surveillance network, called WHONET, linking microbiology labs around the world to a central database... 36

The U.S. Centers for Disease Control and health counterparts throughout the world provide immense quantities Of data, but each nation processes information through the prism of its own national interest. The traveling public and the host society are not necessarily protected in the process, since few nations have the political will to warn non-citizens and thereby risk decreasing tourism.

Moreover, in a federal system like the United States, linkages from the Centers for Disease Control down to local public health offices may be routine, but incomplete and underutilized. Enormous outbreaks of E. coli infections in the United States in the summer of 1999 were possible because of gaps between the Environmental Protection Agency and local jurisdictions in monitoring the water supply. In one case, more than a thousand people were sickened and several died from contaminated water at a state fair. Because the fair was not a permanent attraction, regulations did not require the kind of scrutiny that was obviously necessary. 37 How many circuses, fairs, and exhibitions fall through the screening process in even a developed country? How many may die on pilgrimages throughout the world?

In developing nations, information, monitoring, and sanctions are even more erratic and problematic, because the public sector lacks the capacity to implement policies even if a consensus existed on what needed to be done. Such countries are particularly reluctant to work with bodies such as the WHO or international carriers by attempting to document outbreaks of infectious disease. Why raise fears the nation cannot address and at the same time discourage the tourism so vital for foreign exchange? 38

The World Bank has once more signaled an intention to get back into making loans for tourism development, largely halted in the 1980s. It will be important to see that new development provides a healthier and more accessible infrastructure for the host societies and not merely the tourism enclaves for the affluent outsider that too often characterized past World Bank tourism aid.

In the foreseeable future, the Internet and the private sector will provide the vast bulk of information about travel and tourism, albeit without any quality control for accuracy There are, however, more encouraging consequences of the cyber-revolution. A large global e-mail network, The Program to Monitor Emerging Diseases (PROMED), was initiated in 1993 by doctors who on their own are monitoring health conditions within their borders. Today, there are more than 10,000 subscribers in 130 countries. 39 There are also modest signs that protecting their citizens against the traveling public or lapses in security abroad is becoming an increased responsibility of governments. In September 1999, for example, the United States Department of State listed specific nations unlikely to be Y2K compliant by January 1, 2000, and while not urging travelers to avoid such countries, it served notice to the traveling public of anticipated problems. Other nations are expected to follow suit. 40

Sanitation scores on cruise ships, spraying of airplanes, and strict controls on agricultural products and animals are some of the current efforts being made to shield the travelers and the destinations from some of the effects of tourism. But even these modest steps are bitterly resisted by many in the tourist industry and among the general public. Some of the most potentially effective efforts are underway at public universities, which have started to develop policies to cope with student and faculty travel. One of the first steps taken was to develop professional organizations for those charged with providing services to international students. One of the earliest was the National Association of Foreign Student Advisors, now known as "NAFSA: Association of International Educators." Originally formed in the late 1940s to encourage ethical standards and professional conduct among educators providing foreign student advising, the association now encompasses study abroad advisors, admissions officers, and other international education officials as well, each within an organized section.

In the 1970s, however, as many institutions sought to develop universitywide coordination and oversight of their international programs, NAFSA opted not to create a section for all-university international administrators. A parallel organization was therefore established, the Association of International Education Administrators (AIEA). These are but two of several professional organizations formed to provide guidance and support in the broad field of international education. The responses of these and other associations to ethical challenges parallel those of public sector professional organizations, like IPMA, ASPA, and ICMA.

Codes and Guidelines

One strategy for protecting the health, safety, and other interests of students learning outside their home countries, has been to develop codes and/or guidelines for their behavior, their home institutions, and/or their host institutions. There are at least two recent examples: In 1997, the American Association of Collegiate Registrars and Admissions Officers (AACRAO) developed a "Bill of Rights and Responsibilities for International Students and Institutions." Except for one brief reference to insurance (Article I, Section 8: "International Students have the right to services and information that support their unique needs as international students, such as counseling on immigration regulations, cultural adjustment, orientation to the host institution, and information on insurance and taxes."), there is no mention of health, safety, or accessibility or related issues. 41

In May 1997, NAFSA, AIEA, and the Council on International Educational Exchange (CIEE), formed a joint task force to formulate a set of health and safety guidelines for institutions that sponsor study abroad programs, and then to seek endorsement by major study abroad organizations and universities. The preliminary guidelines were revised, then reviewed at professional meetings in 1998. By early 1999, the discussion had moved from what should be in the guidelines to how they should be implemented. 42

The current document, "Responsible Study Abroad: Health and Safety Guidelines," has three substantive sections: (A) Guidelines for Program Sponsors (listing 14 responsibilities of sponsors); (B) Responsibilities of Participants (12 items); and (C) Recommendations to Parents/ Guardians/Families (6 items). Health and safety issues are central to this document. There is no mention of accessibility as a concern. This document seems to be having real impact; it remains a lively part of professional dialogue and the subject of serious implementation efforts at many universities and in study abroad organizations.

Information Management

A second ethical strategy pursued in international education might be identified as parallel to the openness or disclosure strategy familiar to public administrators. 43 Many of the recommended ways of dealing with health, safety, and accessibility issues with respect to student travel involve providing participants and others with appropriate and accurate information. For example, the U.S. Department of State, in addition to its advisories and country background information, referred to earlier, has an excellent "Tips for Students" page that in turn provides linkages to several other valuable sites. 44

The "Bill of Rights and Responsibilities" identifies several types of information that individual international students and their institutions have a right to acquire and/or a responsibility to provide. Many of the study abroad health and safety guidelines focus on providing accurate and timely information. 45

Mobility International USA (MIUSA) has set up a network of several organizations and institutions to assist universities and individuals to locate and develop accessible study abroad opportunities. Under a 1995 grant from the U.S. Information Agency, USIA, Mobility International established a clearinghouse on Disability and Exchange, a collaborative effort involving itself, USIA and 16 other international exchange and disability-related organizations. 46

It is important to also communicate the limits of responsibility, i.e., to inform participants of those things which the institution or the sponsor cannot be expected to provide. Waivers, signed by the participants, are a common way of dealing with this, but programs should not simply see waivers as a way of protecting themselves and their institution from lawsuits. 47

Organizational Assessment and Contingency Planning

The first of the Guidelines for Program Sponsors indicates that they should "Conduct periodic assessments of health and safety conditions for the program, and develop and maintain emergency preparedness processes and a crisis response plan."48 Several of the other guidelines focus on specific areas of preparedness. This strategy echoes the "ethics inventories," "vulnerability assessments," and other mechanisms found in much of the administrative ethics literature. 49 Individual universities have established emergency response teams and crisis guidelines specific to their own institutions and programs. The University of Georgia, for instance, has a web site with Y2K advice for students abroad. 50

Training and Education

Professional associations such as NAFSA and AIEA, and some universities, provide training for practitioners who deal with ethical challenges associated with international travel. 51 Because of the rapid growth of travel and tourism as an area of public and private enterprise, however, and because of the tendency of many people not to regard travel and tourism as a serious subject of concern, there is a tremendous need for both pre-service and in-service ethics training for administrators.

As with the public sector in general, a major incentive for training administrators, offering orientation programs, and developing contingency planning has been the liability of the educational institutions. The last 25 years have seen a transition from the general immunity from lawsuits of public officials to qualified immunity to personal liability of public personnel in a variety of situations. A duty of care is expected and required. Failure to fulfill one's obligations to provide such care may stem from inadequate hiring, training, supervision, retention or from a variety of situations that may endanger the traveler or others. 52 The health, safety and accessibility issues touched on in this article represent areas of increased vulnerability for public employees. Even in the absence of legal pressure, important strides have been taken with respect to accessibility. While it is important to acknowledge the progress being made, however, it is critical also to recognize how much needs to be done in training public sector employees generally to understand and deal with the ethical dimensions of travel-related health, safety, and accessibility concerns. As with most ethical issues, there is, unfortunately, no neat and tidy formula to apply. The law may be pegged too low or worded too loosely to protect the public interest.

Training employees in the anticipation of problems, prevention of obvious sources of danger, orientation of travelers to their new environments, and better surveillance and monitoring between and across levels of governmental responsibility can help to establish a record of care and due diligence. But often inadequate staff and resources may force tough choices as to which clienteles- the tourists or the general public-to monitor most closely.

Failure to protect the public can lead to a backlash against such travel in general and toward outsiders in particular. Tourism is an incredibly easy industry to sabotage, for there are always alternative destinations. 53 Public personnel attention to the ethics surrounding health, safety and accessibility issues in tourism can do much toward protecting the public and the "health" of this, the world's largest industry.


1 WTO News, May 1997, p. 1.

2 Richter, Linda K., "State-Sponsored Tourism Development: A Growth Field for Public Administration," Public Administration Review, Vol. 45, No. 6, November-December 1985, pp. 832-839.

3 Richter, Linda K., and William L. Richter, "Tourism Development: Public Sector Careers for the 21st Century," paper presented at the American Society for Public Administration annual meeting, Indianapolis, March 23-27,1985.

4 Crosby, Alfred., America's Forgotten Pandemic. The Influenza Epidemic of 1918 (Cambridge: Cambridge University Press, 1990).

5 WTO News, May,1997, p. 1.

6 "Third International Conference on Senior Tourism," brochure, 1999.

7 Travel Smart, Nov. 15, 1997:1, 8; Dec. 15, 1998, p. 16.

8 "Third International Conference on Senior Tourism," brochure, 1999.

9 Pelton, Robert Young, Coskun Aral, and Wink Dulles, Fielding's The World's Most Dangerous Places, Third Edition (Redondo Beach, CA: Fielding Worldwide, 1998), p. 7.

10 "The Coming Plagues," World Press Review, November 1998.

11 Personal observation by Linda Richter as member of National Travel and Tourism Advisory Board, Washington, D.C., 1990-1994,

12 Richter, Linda K., "Health Issues in International Tourism: Policy Prescriptions for the 21st Century," a paper presented at the International Academy for the Study of Tourism Meeting in Zagreb, Croatia, June 27-july 3, 1999.

13 Peters, Guy, American Public Policy, Fifth Edition (New York: Chatham House, 1999), pp. 421-436.

14 Preston, Robert, "The Demon in the Freezer," The New Yorker, July 12, 1999, pp. 44-61.

15 Richter, Linda K., The Politics of Tourism in Asia (Honolulu: University of Hawaii Press, 1989).

16 ECPAT Newsletter, Vol. XII, No. 1, February, 1999, Philippines, p. 11.

17 Rawls, John, A Theory of Justice (Cambridge, MA: Harvard University Press, 1971).

18 Richter, Linda K., Land Reform and Tourism Development: Policy-Making in the Philippines (Cambridge, MA: Schenkman, 1982).

19 Pirages, Dennis, and Paul Runci, "Ecological Interdependence and the Spread of Infectious Diseases," in Maryann K. Cusimano, ed., Beyond Sovereignty (New York: St. Martin, 2000), pp. 173- 194.

20 Pelton, Aral, and Dulles, Fielding's The World's Most Dangerous Places, p. 9.

21 Bok, Sissela, Lying: Moral Choice in Public and Private Life (New York; Vintage, 1979); Bok, Sissela, Secrets: On the Ethics of Concealment and Revelation (New York: Vintage, 1984).

22 Tidwell, Michael, "Who Can You Trust?," Travel Weekly, May, 1998, pp. 46, 49-51.

23 Hirschman, Albert, Exit, Voice, Loyalty (Cambridge, MA: Harvard University Press, 1977).

24 "Channels for Dialogue in the State Department," in William L. Richter, Frances Burke, and Jameson W. Doig, eds., Combating Corruption/Encouraging Ethics: A Sourcebook for Public Service Ethics (Washington, D.C.: American Society for Public Administration, 1990), pp. 224-228.

25 "Fortress WHO: Breaking the Ramparts for Health's Sake," Lancet, No. 8944, January 28,1995, pp. 203-204.

26 WTO News, February-March, 1999, p. 12.

27 Michael Lipsky, Street Level Bureaucrats (New York: Russell Sage Foundation, 1980).

28 Fielding's The World's Most Dangerous Places, Third Edition.

29 While the scope of this article does not allow space for discussion of faculty activities abroad- including research, consulting, lecturing, participation in international conferences, and other-it is helpful to note that they are a sizeable component of university international travel. Some of the issues discussed here with respect to students apply to faculty as well. Similarly, some of the observations concerning hosting international students apply to exchange faculty and visiting international scholars.

30 Davis, Todd M., ed., Open Doors, 1997-98: Report on International Educational Exchange (New York: Institute of International Education, 1998), pp. 89-90.

31 Travel Smart, December 5, 1998, p. 16.

32 Amy Magaro Rubin, "Students with Disabilities Press Colleges to Help Them Take Part in Foreign Study," The Chronicle of Higher Education, September 27, 1996, p. A47.

33 "Ethics and Internet to Highlight General Assembly," WTO News, July-AugustSeptember, 1999, p. 15.

34 Lancet, 1995, p. 203.

35 "Fortress WHO: Breaking the Ramparts for Health's Sake," Lancet, No. 8944, January 28, 1995, p. 202.

36 Pirages, Dennis, and Paul Rund, "Ecological Interdependence and the Spread of Infectious Diseases," in Maryann K. Cusimano, ed., Beyond Sovereignty (New York: St. Martin, 2000), p. 189.

37 "E. Coli Outbreak Leads to Lawsuit," Kansas City Star, September 19,1999, p. A15.

38 Pirages, Dennis, and Paul Runci, "Ecological Interdependence and the Spread of Infectious Diseases," in Maryann K. Cusimano, ed., Beyond Sovereignty (New York: St. Martin, 2000), pp. 173-194.

39 Morse, Stephen, "Too Close for Our Own Good," Washington Post, November 30,1997, as cited in Pirages and Runci, in Cusimani, ed., Beyond Sovereignty, p. 189.

40 Kansas City Star, September 21, 1999.

41 "Bill of Rights and Responsibilities for International Students and Institutions," available from AACRO, One Dupont Circle, NW, Washington, DC 20036.

42 Discussion sessions at annual meetings of the Association of International Education Administrators, Monterrey, CA, February 20,1998, and Merida, Mexico, February 12, 1999.

43 Richter, William L., Frances Burke, and Jameson W, Doig, eds., Combating Corruption/Encouraging Ethics: A Sourcebook for Public Service Ethics (Washington, D.C.: American Society for Public Administration, 1990), pp. 217-246.

44 info.html. For the WHO and CDC web sites, see and, respectively

45 For example: (A. 2.) "Program sponsors should provide health and safety information for prospective participants... ;" (A. 3.) "Provide clear information concerning aspects of home campus services and conditions that cannot be replicated at overseas locations;" (A. 4.) "Provide orientation to participants prior to the program;" (A. 10.) "Communicate applicable codes of conduct and the consequences of noncompliance to participants." "Responsible Study Abroad: Health and Safety Guidelines," photocopy

46 Amy Magaro Rubin, "Students with Disabilities Press Colleges to Help Them Take Part in Foreign Study," The Chronicle of Higher Education, September 27,1996, p. A48. Mobility International's list of member organizations in their Roundtable Consortium may be found on their web page at

47 Richard C. Kast, "Liability Issues: In Loco Parentis and the Reasonable Person," International Educator (Fall 1997/Wmter 1998), pp. 27-32.

48 "Responsible Study Abroad: Health and Safety Guidelines," paragraph A.8.

49 See, for instance, Eileen Seidman, "Vulnerability Assessment: A Three-Letter Word," The Bureaucrat, Vol. 12, No. 1 (Spring, 1983), pp. 32-34; reprinted in Richter, Burke, and Doig, eds., Combating Corruption/Encouraging Ethics: A Sourcebook for Public Service Ethics (Washington, D.C.: American Society for Public Administration, 1990), pp. 161-164


51 The Health and Safety Guidelines urge universities to "Provide appropriate and ongoing health and safety training for program directors and staff, including guidelines with respect to intervention and referral, and working within the limitations of their own competencies.' Responsible Study Abroad: Health and Safety Guidelines, paragraph A.9.

52 Walter, Robert J. "Public Employers' Potential Liability from Negligence in Hiring Decisions," Public Administration Review, Vol. 52, No. 5, 491-495.

53 Richter, Linda K., "After Political Turmoil: The Lessons of Rebuilding Tourism in Three Asian Countries," Journal of Tourism Research, Vol. 38, No. 1 (August 1999), 41-46.


Linda K. Richter 
2383 Grandview Terrace
Manhattan, KS 66502-3729

Linda V, Richter is Professor of Political Science at Kansas State University and author of numerous books and articles on tourism policy. Linda coordinates political science internships, including international internships.

William K. Richter
2383 Grandview Terrace
Manhattan, KS 66502-3729

William K. Richter is Professor of Political Science and Associate Provost for International Programs at Kansas State University He co-edited Combating Corruption/Encouraging Ethics (1990). Both approach these issues as practitioners as well as academicians. William Richter directs K-State's Office of International Programs which has responsibility for the university's study abroad programs. (Copyright International Personnel Management Association Winter 1999)

Reprinted with permission of Public Personnel Management
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