Post Christmas 2008, with chest infection and sore throat constraining me to a night indoors, my mind was set on looking for flights to South Africa. A dream had been hatched, along with my wife Jules, to go on safari. The experience would be a great teaching resource for Jules and it would feed my obsession with photography - this was no normal safari, but a dedicated, photographic safari. The difference? very early starts to capture the best light, essential for the best photos. For me, this meant getting up at 04:30hrs each morning to do my physio and nebs, as our group of 5 had to assemble by 05:45hrs, ready to leave camp and get out into the wilds of the Kruger National Park.
Early morning starts were a reservation I had about joining a photographic safari. I don't take sunrise photos at home, as physio and cold, damp air puts pay to that. There were other things to consider too, before signing the booking form, paying up and booking flights - i.e. Would the accommodation at camp have electricity and clean water to hand? Imperative, for using and cleaning nebulisers and wiping clean and flushing my PEG. Would we eat properly, given that we'd be spending 12 hours a day, away from camp in the field, photographing? From the gastro aspect, how often and how easy would it be to get to loos? And what about doing nebs on the plane? Added to this was the issue of luggage and transportation of medication. I'd already 
be loaded down with my baggage allowance limit with photography equipment and I'd never consider allowing my medication to leave my eyesight at any time. An email and telephone call to Virgin Atlantic specialist assistance department set the ball rolling and they came up trumps, providing great help, to ensure I'd get my meds to and from South Africa without a hitch. In the Kruger Park, where we travelled between 4 different camps, my meds were reliably and safely transported for me from camp to camp, but we'd got to know 
the family running the trip, so had utmost trust in them and their baggage handling. Virgin were equally helpful and allowed me to carry camera equipment and all medication on board the flight.
Any fears I had about going on safari with CF were allayed. The safari trip leader answered all my emailed questions and was true to his word - camps had reliable electricity and water supplies, we ate like kings, with packed breakfast and lunch whilst out and about, then had a proper meal under the stars at night, so two weeks without overnight PEG feed was overcome on such a good diet. We had occasional loo stops at the few rest camps, though on one occasion Stu, our leader, suggested crouching behind a bush - we declined on grounds of safety, let alone the embarrassment for the women!
We chose August 2009 for our safari, a comfortable time to go, with temperatures during the day reaching mid-20s, though the mornings were cool, like a British autumn. The downside was the increased amount of dust on tracks in the Kruger, a bane to both lungs and lenses.. I covered my head with a blanket when other vehicles passed us.
It was the tail end of winter there in the southern hemisphere and it got dark by 6pm. Towards the end of our trip, temperatures rose to 36-38 degrees C, but we were well covered in the open-sided, roofed photo-safari truck. Salt tablets were becoming more and more necessary as the temperatures rose and we kept up our fluids. On two days, we returned to camp midday, as the animals were all sheltering from the sweltering heat and so became too difficult to photograph well. This gave me time to rest briefly - it's tiring being out in the heat and fresh air 12hrs a day, for 12 days. We took the chance on these two days to use the open-air swimming pool, but with my PEG I was a bit concerned about how clean the water was, particularly as the water wasn't chlorinated; all was well though and at least it provided me with good exercise, given the limited opportunities for this over a fortnight on safari. The dry, warm air and light breeze, as we moved across the Kruger in the jeep, felt great for my lungs, in contrast to the damp, cold air on return to the UK. I took hypertonic saline with me, rather than DNase, as the camps only had outdoor fridges, which in the event were raided each day by baboons and monkeys! The last thing you want is baboons and monkeys over-dosing on DNase! ;-)
At nights, around the camp we awoke to hyaenas whooping and the occasional lion's roar. We awoke to upturned bins outside, as baboons and monkeys had been on the rampage overnight! Once out of camp, with cameras set, we captured amazing sights of the Big 5, leopard, lion, rhino, buffalo and elephant and much more besides, though it did mean patiently waiting at times for an hour or two, cameras ready. Photographing at eye level proved difficult and uncomfortable, immediately after lunch, lying on my belly with my PEG mini button, squashed into the ground! A Cheetah, stalking and chasing impala, was perhaps the highlight and along with experiencing all the other animals we saw, it made it worth the not inconsiderable effort to prepare for this trip and endure the vaccinations and anti-malarials whilst also on IVs - actually, the antimalarial 'Malerone' was excellent, in causing absolutely no side-effects, to be fair. We took our anti-malarial tablet each night with evening meal; obviously in my case just adding it to all the other oral meds at meal times, which helped ensure I didn't forget to take it. The Park Ranger was impressed by the number of CF medications lined up at meal times, but on this same evening I'd almost lost my evening's Creon to the Vervet Monkeys, regularly on the look out for extra titbits and anything else they could steal.
Thanks must go to the CF Team at Heartlands for their part in helping keep me in shape for the trip. The two-week course of prophylactic IVs was a godsend for peace of mind, it helped ensure I did not cough at a critical photographic moment and the IVs helped ensure I did not get to use my holiday medical insurance. The paperwork completed by members of the CF team, to ensure the international flight went to plan, was really appreciated! Thank you Elaine and Dr Whitehouse on this aspect! And thanks to Chris Evans on getting my IVs started!
The insurance company I used was All-Clear Travel Insurance. They were very clear about what constituted a 'planned' admission to hospital and dealt with any questions I'd had. I had had a single hospital admission in the 12 months prior to the safari,( as well as the usual home IVs), so it was important that they could verify that this was a planned admission and so quote fairly and accurately on that basis and cover my wife too on the policy, in the event that I had a 'flare-up' when abroad in South Africa.
I hope this account gives some useful insight into travelling further afield with CF and the implications of travelling to a different climate. What this trip taught me was the importance of planning ahead meticulously, reading the small-print in the insurance documents, asking all your questions well in advance of travelling, liaising with the CF team in good time regarding fitness to fly paperwork and then hopefully you'll have a successful, stress-free holiday.
I do appreciate how lucky I've been to stay well enough and in work long enough to pay for and embark on such a trip - thanks then, to the CF team for helping to ensure the stability in my CF over the months and years, necessary for such an 'expedition'.
