The XXI Commonwealth Games kicks off in the Gold Coast on the 4th April, and New Zealand is sending one of its largest ever Games team away to compete.

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The first ever Games of the Commonwealth Nations – then called the British Empire Games – took place in Canada in 1930. New Zealand sent 22 athletes and 3 officials to these games, compared to around 250 athletes and 200 officials and support staff to the current Games – quite a different medical requirement. New Zealand is one of only six countries to have attended every Games.

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For some sports, the Commonwealth Games is their pinnacle four yearly event, e.g. Netball, Field Hockey and Lawn Bowls. I am privileged to be a part of the health team selected for these Games, it will be my very first, but I’ll be well support by a great group of experienced physiotherapists, GP’s and Sport and Exercise Physicians, including Dr Sarah Beable and Dr Dan Exeter from Axis.

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The large size of the team we are sending to the Gold Coast (at about 450 people it’s larger than the 45 smallest NZ towns) and requires a lot of medical preparation. All athletes need a medical check, which is somewhat easier to achieve with those athletes in a “carded” sport with resources available to access, but a little more challenging to achieve in the large number of athletes from “non-carded” sports. This requires a lot of tail chasing by our medical staff to ensure the athletes are fit to travel and compete. The officials and support staff also require medical assessment and clearance to travel/attend – these people are often older, may have pre-existing medical issues, and can present some of the biggest challenges to the medical team. Prior knowledge of such medical issues, and preparation for the potential complications of those conditions, is essential.

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Along with an even mix of male and female sports, the Commonwealth Games also has the Para-sports fully integrated into the Games programme, which adds further complexity to the medical preparation and delivery. These athletes need appropriate grading requirements completed prior to the Games, along with specific planning around travel and accommodation.

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There are numerous other aspects the medical team is involved with prior to departing for the Games. There is education and advice around protection from the many poisonous and abrasive local critters (fortunately the Australian cricket team will still be in South Africa), but like their cricket team, Australia has a multitude of worthy replacements – crocodiles and sharks, spiders and snakes, Castlemaine XXXX, and Pauline Hanson. The trappings of a night out in the GC after your Games event has finished is high on our list of potential issues, which could become medically related very quickly.

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Other medical team preparations include:

- Assessing for and lodging Therapeutic Use Exemptions for athletes requiring restricted or banned medication for health reasons
- Ensuring up to date vaccination status
- Detailing, ordering and shipping physiotherapy and medical consumables and medicines
- Reiterate the hygiene messages around personal and food safety, early notification to the medical team, potential for isolation. This goes for athletes and staff
- Education around travel hygiene – humidity masks, hand gel, ear plugs and eye mask, own food, water sips regularly

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Our Health Team Leader, Dr Bruce Hamilton, scoped a surfing trip aka "site visit" to the GC months ago to ensure we have a good knowledge of the environment we are entering. This includes contacting the LOC Medical Team (Local Organising Committee). This is really important to get right, because when the proverbial hits the fan, you want the local health team and services to back you up, and help you access the right care and facilities ASAP.

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Prior to departure, it is important for all athletes and staff to have a clear understanding of how they are going to get through a great Games experience, but one that is also busy, noisy, and sometimes stressful. Having a good sleep routine/sleep hygiene – is essential. No screens an hour before bed, and use a blue light filter after dinner for any screens. Knowing activities that can relax/recharge you during the day is also important – that might be doing some exercise, reading a book, or heading to a social setting and watching some sport/engaging in banter – i.e. away from your “work” environment. My personal favourite is nanna naps! Ensuring that your own affairs at home are in order (work, home, kids – yeah right) can reduce the stress of being away from your other commitments and allow you to be more focussed on the important role you are doing – for your country.

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The overall focus of the health team upon arrival is to get set up, and this requires great teamwork, communication and above all, respect, with everyone “mucking in”. This is what I hear our Games teams are renowned for, and I am really looking forward to being part of an awesome event, and to help provide the best platform possible for our athletes to achieve their very best on the world stage.

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