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    Health Recommendations for tourists visiting Guatemala The success of your vacation depends not only on the organizer, but also on you! Bring a positive attitude and be prepared to be flexible. Here are some suggestions that might make your trip safer and more comfortable.

    Place your name and address on the outside and inside of every piece of luggage. Aim to travel light; however here are some recommendations of items to bring with you: If you need one bring a small one with you.

    Make sure your electrical devices are compatible. Film, batteries, memory cards, supplies for contact lenses and shaving devices are all more expensive in Guatemala, and sometimes difficult to find. Bring as much as you think you will need, to avoid wasting valuable time on tour searching for it. Familiarize yourself with your camera before your trip, to avoid frustrations or missing out on good shots during the early days.

    Shampoo in hotels is usually quite strong. If you have a sensitive scalp, you might like to bring your own shampoo with you. Pack a couple of plastic bags to transport wet clothes, trash or coffee that you might purchase Guatemalan coffee is world famous.

    It can be useful to pack an extra bag for carrying back additional purchases. While on the trip remember to carry some bottled water with you to avoid dehydration. You should also carry some sunscreen, sunglasses, a hat, mosquito repellent and the business card of the hotel you are staying at. A small calculator might be also useful, as well as a small dictionary Back to the top Mobile Phone Operators in Guatemala Before traveling, contact your local operator and make sure that your mobile phone is compatible with the technology of our networks and find out the agreements they might have for roaming form Guatemala.

    If your local operator works with this company, you will have good reception in all cities and most of the rural areas. Technology and carrier frequency ranges: It has good reception in all cities and among all suppliers it has the widest reception in the rural areas. As it has not as good a reception in the rural area as other operators, it might not be the best choice if you are travelling deep into out in the rural area, but it has a very good reception in the department capitals and all main commercial cities.

    You can also just buy a SIM card of any of the mentioned providers and put it in your phone, but make sure you phone is not blocked to be used only with a specific card and provider, and that it uses the frequencies mentioned above. However, if you prefer to use your roaming, let your main contact know you are travelling abroad.

    They will appreciate it when they see their phone bill next month. If you will be travelling in altitudes higher than m such as Antigua, Panajachel and Guatemala City you will probably need a light jacket or sweater for the evenings.

    In altitude above m Chichicastenango, Quetzaltenango, Huehuetenango it can become chilly after sunset, so a jacket is recommended. During the daytime, it is likely to be warm in all regions of Guatemala.

    However, during the months of December and January in the highlands it can sometimes be cold, even during the day. It is advisable therefore to dress in layers. In the hotter, more humid lowland regions you will be more comfortable in light cotton clothing. Guatemalans tend to dress modestly and conservatively. Likewise, neutral colors are preferable, especially whilst on nature trails.

    Moreover, when visiting Mayan temples, you will find that the staircases leading to the top are rather steep, and therefore modest shorts or light trousers are the more practical option. During the rainy season in Guatemala, which stretches from May to October, heavy rain showers occur daily for a short time.

    Regular umbrellas are not very suitable for these downpours; so either carry a large one or a raincoat. Comfortable walking shoes or tennis shoes are suitable for most regions and towns. Sandals with a strap around the ankle to prevent you from slipping are especially good for the warmer regions, beaches and places where you might get wet.

    However for health reasons, closed shoes are more suitable for areas such as markets where the ground may be dirty. Slippers or thongs are useful for hotel rooms to avoid walking directly on carpets or on cold tiled floors.

    Back to the top Money Check which costs are already included in your tour package and be aware of which payments you will still need to make following arrival. For safety reasons however, avoid depending entirely on cash. Bring only what you will need for the first couple of days and take advantage of banks at the airport to obtain local currencies, especially if you are arriving during the Weekend.

    Never trade currencies with street vendors. Due to the fact that Guatemalan banks offer poor exchange rates for Euros or Mexican Pesos, and hardly accept other currencies, it is advisable to carry US dollars.

    During your trip, limit money exchanges to banks and hotel front desks. Contact your credit card company before you leave on your trip.

    Credit cards are accepted in most hotels and quality restaurants, but only in more up-market stores. You can find ATMs in the main cities. In rural areas it will be difficult to use credit cards, so carry local currency in low denomination bills. This also applies if you want to purchase something from street vendors or in markets. Never keep your credit cards, personal documents and cash in the same place.

    Most stores have fixed pricing, but it is customary to barter in both markets and with street vendors — potentially cutting up to a third off the price of a product. It is advisable to compare prices on similar products with different vendors before you buy however keep in mind that exaggerated bargaining contributes to low paid labor. Due to the number of tourists in some areas you will counter children begging for money.

    As with street vendors there is a risk that you will be followed by more. Any charges by customs police at Guatemalans land-borders are illegal but common. To pass promptly through the customs it is usually necessary to make these payments to the authorities, especially on the border crossings from Guatemala to Honduras or El Salvador. Back to the top Tips Tipping for particular services is customary in Guatemala as in other countries. There are no hard and fast rules regarding how much to tip a person.

    It will depend on a number of factors, such as the quality of service given, or the effort involved in delivering the service. Ultimately it is up to you to decide how much to tip, but you may find these guidelines for group travelers helpful.

    This may or may not already be included in your bill so check it before paying. Porters in hotels and airports usually get one American dollar per bag or two per room. Some lodges and hotels are located in rugged natural environments; meaning porters have to carry the luggage for a longer distance or up a hill.

    Here it is appropriate to tip more, in accordance with the effort exerted. When taking photographs, please act respectfully and ask permission before photographing someone. Remember, that individuals that you see in markets or on the road are simply living their daily lives — and are most certainly not actors performing for tourists!

    They may feel uncomfortable having their picture taken — just as you might if you noticed strangers taking photos of you. If you ask to take a photo of someone they may request a donation of a few quetzals, usually in between Q. Remember however that these are just guidelines. It is up to you if, and how much you want to tip.

    One of the most practical and comfortable ways of tipping your tour guides is to leave the tip in an envelope, including a note or business card if desired. This will enable you to express your gratitude for their services smoothly, avoiding, avoiding any awkward or clumsy moments.

    Back to the top Safety Use the same common sense travelling in Guatemala that you would at home.

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    Be especially cautious in areas such as crowded markets, bus stations, elevators, crowded tourist sites, festivals and the outskirts of cities.

    Only approach police officers wearing uniform and carrying identification. It is advisable that you purchase travel insurance that includes medical assistance.

    Make sure that you know the names of the hospitals in Guatemala City that your insurance will cover, and carry always your insurance ID and phone number so that the company may be contacted in emergencies.

    Independent travel in Guatemala is not advisable. When travelling with a group, make sure the person who meets you is the tour operator representative. Ideally, get his or her name and phone number before departure. Make a note of the emergency phone numbers of your bank, credit card company, embassy and consulate, and bring them with you. Also note down the name and contact details of a relative or friend that could be contacted in case of an emergency.

    Try not to bring anything that you feel would be irreplaceable. If you are renting a car, check it before signing an agreement and familiarize yourself with driving local laws.

    If you are driving to in rural areas, check road conditions first as you might need a 4-wheel drive. Make sure your tank is always full and filled with the correct fuel. If the national police arrive, it is recommended that you tip them immediately upon their arrival, and ask them for help. Do not move the vehicle.

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    If somebody needs help call the local authorities. If you leave your hotel for a day trip or are departing, keep the room locked and leave the key at the reception. Carry copies of your most important documents and leave the originals in safe pace. Never share your itinerary or travel plans with strangers or any other private information.

    Use only authorized registered taxis. Taxi rates should be negotiated at the beginning of the trip. If you travel by boat make sure there are life jackets on-board. National parks have designated trails which you should follow for your own safety. When visiting volcanoes, private reserves, caves or rivers, go only with a professional guide.

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    Make sure you are informed about the terrain so that you are prepared, and know what precautions to take.
    The landfill activities here only occupy the eastern side of the island, keeping the rest of the island full of untouched flora and fauna. Perfect for the eco-adventurer, interested visitors can book a tour with NEA who conducts guided nature walks. With rich mangrove habitats and a healthy coral population, the island has become a site for nature research with a coral nursery on the island.

    Wait, corals have babies?! Pulau Satumu The Story: The only towering feature that is visible from a distance is the Raffles Lighthouse in shining white. The Lighthouse has been operational since to warn incoming ships at night when they are reaching the shore or shallow waters. Truth be told, a glimpse of this makes me think of Shutter Island. But hey, I'm not saying this is the same thing. The island has restricted access to the public but the Maritime and Port Authority of Singapore organises the Singapore Maritime Week every year.

    It is through this event that the island is open to the public with a guided tour.

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    Visitors get a historical tour of the lighthouse and revel in crystal clear waters by the rocky shore. Coney Island The Story: Nah, this is not the theme park in New York. In fact, a few entrepreneurs had plans to develop the island into the now famous Brooklyn theme park back in Thereafter, the island was a popular picnic ground for locals.

    The Aw brothers of Haw Par Villa also once owned the island and built a mansion which now stands abandoned. Also known as Pulau Serangoon, this island is scheduled to be launched as part of the new Watertown Punggol that is located next to Punggol Waterway. The 45ha area will be made into a commercial and residential site, with half of the island sporting a beach that faces the Johor Strait. So there isn't a ferris wheel or a carnival but it is instead a rustic slice of what could have been.

    The existing evergreens create natural forested walkways in the serenity where bird-watching is strongly recommended. There is also a small stretch of beach with a view of Pulau Ubin in the distance.

    I know what it sounds like Talk about a B-grade Sentosa. Then again, island living could be the next big thing. Walk across the connecting walkway from Punggol Promenade Nature Walk.
    Internet Lily is not your average university student. At 22, Lily has not yet finished her accountancy degree at a private university in Malaysia, but is already living the life of a high-flying finance professional.

    She is being bankrolled by a year-old sugar daddy. Finally, things appear to be going smoothly. When she wraps up her studies in June, she will take a gap year in Europe, basing herself in a posh house in the fashionable London borough of Camden, owned by her sugar daddy, an expat accountant in Singapore. And Lily is far from alone. As of March, The SugarBook hadusers — up from 75, at the beginning of the year — mostly from Malaysia, Singapore, the Philippines and Indonesia.

    Its founder, Darren Chan, hopes to grow that membership toby June, and sees the China, Indonesia and Thailand markets as ripe for expansion. Sugar daddies and mummies range in age from 30 to In Greater China, the website has over 90, active members, mostly female aspiring sugar babies.

    Hong Kong and Macau account for 11, active female members. To boost membership, both platforms are offering free premium accounts to students who register using their university email address, hoping to cash in on struggling students seeking a way to finance their education.

    SeekingArrangement says this has helped entice more than three million students in the US and Europe to sign up. Critics of sugar dating — roughly defined as an older man or woman spending extravagantly on a younger girlfriend or boyfriend in return for a relationship — say it is little different to prostitution, as sugar daddies often expect more than just companionship.

    Blind dating in Beijing This has prompted concerns in conservative Southeast Asian states. Singapore police have vowed to take action if they suspect The SugarBook is being used to exchange money for sex.

    One user of SeekingArrangement has already received a two-year prison term — a year-old married man who had sex with a year-old girl he met on the site. The Malaysian Communications and Multimedia Commission also has threatened legal action if prostitution, blackmail or fraud are suspected.

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    No lip reading in this Tokyo speed dating service Despite these procedures, soliciting sex is rife. This Week in Asia signed up as a sugar baby and sugar mummy on both services for a week and was offered cash for sex on numerous occasions.

    Critics say the power dynamic is inclined heavily towards the sugar daddies — and that sugar babies often become depressed when their relationships turn sour. Many self-harm and some attempt suicide when the lifestyle they are used to ends, says Dr Andrew Mohanraj, deputy president at the Malaysian Mental Health Association. Even those who evade physical harm may sustain psychological scars — among them, an inability to see relationships as anything other than transactional.

    He will just be my husband, right?
    The basic principles of an informed consent are information, comprehension and voluntariness, in accordance with the Belmont Report. Back to Top [H2] What are the regulatory requirements for informed consent? Back to Top [H3] What are the regulatory requirements for informed consent in vulnerable subjects?

    Please refer to the Guidance on Safeguards and Consent Requirements in Vulnerable Subjects for regulatory requirements for informed consent in vulnerable subjects i.

    Back to Top [H4] For clinical trials in minors, must the minor give consent prior to participating in the clinical trial? For clinical trials in minors, the investigator should determine if the minor has sufficient capacity or understanding and intelligence to give consent.

    If the minor subsequently is deemed to have the capacity or understanding and intelligence to give consent during the clinical trial, the minor must be re-consented accordingly.

    Otherwise, the legal guardian of the minor must give consent. Back to Top [H6] For clinical trials in adults lacking capacity where there is a donee for the adult lacking capacity, does the investigator need to ascertain whether the donee has been authorised to give consent for clinical trial participation? If the donee has been granted the power to decide on clinical trial participation, the donee may give consent for the adult lacking capacity.

    If the donee has not been granted the power to decide on clinical trial participation, the donee should not give consent for the adult lacking capacity. Back to Top [H7] For clinical trials in adults lacking capacity where it has been established that the adult child of the adult lacking capacity is the legal representative, is there an order of priority amongst the adult children if the adult lacking capacity has more than one adult child?

    For clinical trials in adults lacking capacity where it has been established that the adult child of the adult lacking capacity is the legal representative, there is no order of priority amongst the adult children if the adult lacking capacity has more than one adult child. However, there should be no objections from the other adult children and any individual s of higher priority to the enrollment of the adult lacking capacity into the clinical trial.

    It would be recommended to give the family of the adult lacking capacity ample time to consider enrollment of the adult lacking capacity into the clinical trial. Back to Top [H8] For clinical trials in adults lacking capacity where it has been established that the adult sibling of the adult lacking capacity is the legal representative, is there an order of priority amongst the adult siblings if the adult lacking capacity has more than one adult sibling? For clinical trials in adults lacking capacity where it has been established that the adult sibling of the adult lacking capacity is the legal representative, there is no order of priority amongst the adult siblings if the adult lacking capacity has more than one adult sibling.

    However, there should be no objections from the other adult siblings and any individual s of higher priority to the enrollment of the adult lacking capacity into the clinical trial. Where feasible, the decision from that adult child should be obtained and documented. Back to Top [H10] What are the elements of an informed consent form? Back to Top [H11] What are the required approvals for the informed consent form prior to use?

    All amendments to the informed consent forms must be submitted to the relevant IRBs prior to use. Substantial amendments to the informed consent forms must be submitted to HSA for review and approval prior to use. Back to Top [H12] Who can obtain informed consent? Informed consent must be obtained by an investigator who is a qualified practitioner and delegated by the Principal Investigator to obtain informed consent.

    A qualified practitioner is a registered medical practitioner under the Medical Registration Act or a registered dentist under the Dental Registration Act.

    It is not acceptable for an investigator who is not a qualified practitioner and other non-investigators e. Back to Top [H13] When should informed consent be obtained from the subject or legal representative if applicable? Informed consent must be obtained from the subject or legal representative if applicable prior to any study procedures. Back to Top [H14] Which version of the informed consent form should be used to consent the subject or legal representative if applicable?

    The version of the informed consent form that has been approved by the IRB and HSA except for administrative changes should be used to consent the subject or legal representative. Back to Top [H15] Where should informed consent be obtained from the subject or legal representative if applicable? Informed consent should be obtained from the subject or legal representative if applicable in a conducive environment without any coercion, duress or undue influence.

    Back to Top [H16] How should the informed consent form be explained to the subject or legal representative if applicable? The language of the informed consent form should be non-exculpatory, non-technical, practical and understandable by the subject or legal representative if applicable. The subject or legal representative if applicable should be given ample time and opportunity to ask questions to consider participation.

    Please refer to Sections 4. Back to Top [H17] How should the informed consent form be completed?

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    The informed consent form should be personally signed and dated by the investigator obtaining informed consent, the subject or legal representative, and the impartial witness if applicable. If there are checkboxes to be completed in the informed consent form, it would be recommended that the checkboxes are personally completed by the subject or legal representative if applicable. The signature of the investigator obtaining informed consent should be consistent with the Signature Sheet.

    Back to Top [H18] Are signature stamps and date stamps acceptable means of signing and dating the informed consent form? Hence, it would not be acceptable for signature stamps and date stamps to be used as a means of signing and dating the informed consent form. Back to Top [H19] If a clinical trial involves recruiting subjects who are mentally competent, but unable to sign or date the informed consent form, how can consent be obtained from such a subject?

    An impartial witness would be required to observe the informed consent process if the subject is mentally competent but unable to sign or date the informed consent form. It would be recommended to develop an informed consent process for such a scenario and submit it to the IRB for review and approval. Back to Top [H20] How can informed consent be obtained from a subject or legal representative if applicable who is unable to read the informed consent form? If the subject or legal representative is unable to read the informed consent form, an impartial witness would be required to be present during the informed consent process.

    By signing the informed consent form, the impartial witness attests that the informed consent had been accurately explained to, apparently understood by, and informed consent freely given by the subject or legal representative if applicable. The subject or legal representative if applicable should sign and personally date the informed consent form, if capable of doing so.

    Please note that the role of an impartial witness is different from a translator, since the translator does not need to attest to the above-mentioned clauses.

    Back to Top [H21] Who can act as an impartial witness? The role of an impartial witness is to attest that the informed consent has been accurately explained to the subject or legal representative, the informed consent has been apparently understood by the subject or legal representative, and the subject or legal representative has voluntarily agreed to participate in the clinical trial.

    There is no regulatory provision regarding who can act as the impartial witness. One should consider whether the person who acts as an impartial witness is independent of the clinical trial and is not influenced by people involved in the clinical trial.

    The possible choices would be either a family member, friend, clinic staff who is not a part of the study teamor a layperson. Whilst it is impractical to get a layperson, the viable options would either be the family member, friend, clinic staff who is not a part of the study team. The choice of an impartial witness should be made in the best interest of the subject. If the subject or legal representative is able to read the informed consent form, a translator would be required to be present during the informed consent process.

    If the subject or legal representative is unable to read the informed consent form, a translator and an impartial witness would be required to be present during the informed consent process. Back to Top [H23] Who can act as a translator? An individual who is adequately qualified or certified in the local language may act as a translator. Information on the translator should be completed in the informed consent form or subject medical records.

    It is acceptable for an impartial witness to act as a translator if the impartial witness is able to fulfil the role of a translator. The following table summarizes when an impartial witness or translator is required during an informed consent process: Subject or Subject's legal representative Investigator.

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