The (almost) 7 D’s of packing defensively
Sometimes when traveling abroad for an aid mission you’ll pass through countries that, while friendly to your country, are not so friendly to deal with. On several occasions aid workers traveling to Thailand have had necessary medical items, such as splints, bandages, medications, etc. seized at customs despite providing the proper documentation. They were told this was to prevent anyone from bypassing the system and selling products within Thailand that will compete with local businesses and go untaxed by the government.
In order to prevent loss on a recent aid mission into Eastern Myanmar that began in Chiang Mai, Thailand, I decided it was best to pack defensively.
This particular aid mission meant traveling to a village in the remote mountainous jungles of the Karen State, Myanmar, and teaching trauma medicine to aspiring Physician Assistants. These PA students would soon be returning to their even more remote villages to become sole medical providers for their friends, neighbors, and the occasional passersby. I used my background as a medic in the Ranger Regiment and an instructor at the Joint Special Operations Medical Training Center to try to cater to the injuries they may face. Put simply: the goal was to prolong the process of death to the point where it meets the process of healing.
There is a distinct lack of medical infrastructure in the Karen State, mostly due to the 70-year civil war that has been fought with Burma/Myanmar. Moves made by the Burmese Government, such as declaring National Parks on Karen land (1), have stifled development and forced many of its inhabitants out of their homes. That, coupled with the unmatched density of landmines in Eastern Myanmar (2), has ensured there are high numbers of injuries that go untreated every year.
This aid mission was entirely crowd funded, despite being in partnership with a global charity. This charity is faith based and tends to exercise faith by going where they’re needed and letting God take care of the money. I followed their example and booked my ticket well before our minimum amount was reached, and I eventually ended up receiving more than I expected, though not until after leaving the United States. Because of the strain on funds at the time and my access to inexpensive (or donated) and somewhat niche equipment, I decided to try to sneak as much as I could manage in my luggage.
The list included:
2 SAM Junctional Tourniquets
2 I-GEL airways
1 Cric kit
1 Laryngoscope set
1 BP cuff
8 halo chest seals
3 Xstat syringes
1 IO devices
8 7.0 ET tubes
5 Nasopharyngeal airways
4 Suction easy
8 14g 3.25” needles
2 Skin staplers
3 SAM splints
4 Celox Gauze
3 Quikclot gauze
3 Chitogauze xr pro
6 emergency trauma bandages
7 CAT Tourniquets
7 SOFT T Wide Tourniquets
4 Trauma Shears
Knowing the difficulties I was likely to face, I came up with a strategy based on the experiences of others, as well as some of my own creative solutions. This is by no means an exhaustive list of ways to beat the system (in a positive way) but it served me well.
If you show up with a militaristic rucksack like an ALICE Pack, whoever is inspecting bags is going to want to take a look inside. I don’t care how good it is for your environment. Don’t attract any more attention than you already do just by being you.
Conversely, if you pack like a pauper you’re probably going to get searched, too. My flight into Thailand originated in Shanghai and thusly was filled with Chinese people. Many of these passengers chose to pack their belongings in rice bags and each one was pulled aside and searched. It’s important to choose a bag that fits in the goldilocks zone between too tacti-cool and too tacti-lame.
Blend in as much as you can, but choose carefully who you try to blend in with. As a nearly 6’ tall white dude in Southeast Asia I will never blend in with the locals. It doesn’t matter if I wear a longyi (3) and cross my arms behind my back while not standing quite so upright. It just isn’t going to happen. But put on some pants from REI, a pair of crocs, and an Eddie Bauer T-shirt and magically I’m a missionary, an aid worker, or a scientist. Blend in with someone you CAN blend in with and is WORTH blending in with. Don’t wear cargo shorts and Nike’s with an elephant T-shirt and convince everyone you’re a dirty American tourist. But I digress…
When embarking on an extended journey into multiple environments you want to make sure you have everything you need. The tendency, at least for me, is to lay everything out in an organized manner so you can easily pan across the vast array of clothing, equipment, food, etc. and convince yourself that you are adequately prepared. Without visually inspecting the contents of my bag I never actually trust that I packed everything. The guessing game of “did I pack it, or did I just pick it up and set it down?” is enough to eat me from the inside out as I lie awake the night before I leave.
After going through the effort of systematically anticipating your needs and gathering the required tools and goods to ensure you’re going to make it through this experience, it’s easy to want to pack like items with like items. Your stack of moisture wicking T shirts neatly folded next to your nylon-based trousers and roughly three times as many socks as you really need fit nicely into your red rolling luggage. The problem is, that kind of organization is easy to pick apart under X-ray. Mix it up. Unfold your shirts. Unfold your pants. Toss them about
randomly. So random you think there must be a pattern to it. Mix your bandages and splints and anything else that may be seized among them so that you can imagine an equal density throughout your bag. A mass of vacuum sealed pressure bandages is bound to get the attention of the X-ray tech who is trying to prevent goods from entering the country.
Innocuous metallic items with unique shapes can do a great job at breaking up the silhouettes. Things like trauma shears may serve you well, however, that was one of the items that had been seized in the past by other medical missionaries traveling through Thailand. What I used instead were carabiners. I packed 6 carabiners along with some 1” webbing for justification throughout my bag to try to break up those silhouettes. The 1” webbing is also a useful tool for patient movement as long as you practice making a harness more than once every two years. You know who you are.
This customs agent is looking for things. Give them something to find. Think about placing highly recognizable items in an easily accessible place in your bag. Depending on the laws surrounding the areas you’re traveling to and through these items may change. There are no major laws surrounding the use or carry of knives in Thailand or Myanmar. I chose to pack a relatively large fixed blade survival knife in my bag. I placed it in an exterior pocket so as to keep it oriented in the most recognizable position. When the bag goes through the X-ray, the customs agent is going to see a large, full tang, serrated knife, with a very large pommel. The ease of identification and the nature of the object are going to draw the eye of the viewer towards that object and away from more subtle items you’re trying to hide.
If you’re going through the UK or a few other countries, then knives are a big no-no. Make sure you know what you can get away with before you try taking something that may be illegal.
As an aside, while going through security in Shanghai on my way back to the states I was able to make it through security with the same large survival knife, despite it being explicitly banned. By displaying some photos on my cell phone of the work I did in the jungle I was able to provide justification for having it. This did NOT prevent every single agent from admiring it. Some American made steel is pretty impressive when all the products you’ve seen in your life are stamped “Made in China.”
If you’re bringing in items with fairly recognizable silhouettes it can be a good idea to find items that look like those items. For example: a vacuum sealed pressure bandage bears a similar size and shape to a vacuum sealed, freeze dried, backpacking meal like those made by Mountain House or Backpacker’s Pantry. Place some of these similar items in plain view near the opening of your bag so it can be easily assumed that the same items lie beneath. A lazy customs agent will likely not go any deeper than that.
If you’re working with a legitimate entity it may be a good idea to have documents in English and the local language granting permission to bring in necessary goods. This absolutely does NOT always work. If the customs agent doesn’t want you to have something, you’re probably not going to keep it. However, if they’re on the fence about it they might give you a pass if you can produce a fancy piece of paper with a letterhead. A watermark doesn’t hurt either.
Do not offer this document until you have to. If you volunteer a permission slip they’ll want to know why you need permission and perhaps go looking where they otherwise would have overlooked. Keep it handy but keep it hidden.
unDergarments (Well the title’s a stretch, but we’ll choose to look past that for now)
This is juvenile. I’m not pretending it isn’t. But, if you have something that is very important to your mission it makes sense to give it a last line of defense. For my medical aid mission based on point of injury trauma management and prolonged field care, the basics of trauma medicine were very important. Sure, you can improvise a tourniquet quite easily. In fact, improvisation was one of the main points I tried to drive home in a rural jungle environment. Improvising a Junctional tourniquet, however, is quite a bit more troublesome. It can still be done, but without good resources it becomes exceedingly difficult. When you’re trying to teach a particular concept through an already challenging practice to people who often don’t understand you, it’s best to limit the areas where it can go wrong.
For that reason, I packed several SOFT-T Wide tourniquets in my underwear compartment. My hope was that any customs agent who went rifling through my stuff to get a tourniquet out of my bags would realize that some of the things he was rifling through would make the juice not worth the squeeze. Luckily, I didn’t have to test this theory. I’m not entirely sure it would have worked but it made me giggle to think about and, after all, in matters of life and death why wouldn’t you play dirty to win?
A blood hound who is tracking you will never lose the scent. You’re not going to beat the hound. You may, however, be able to beat the dog handler. A specialist in that sort of thing once told me a story about betting a dog handler he could beat his hound. After some money was set aside and a handshake he took off running into the woods. He ran in a straight line until he came to a very prominent tree with some space around it. He began to run circles around the tree, small at first and then bigger as he formed a spiral growing around the mighty oak. After a dozen or so laps he continued into the woods and began to loop around to where the wager was set to wait for the dog handler.
The dog never once lost the trail. It ran through the woods with its handler in tow until it reached the large tree. It then began to circle the tree in what appeared to be a search pattern. After several laps around the same tree the handler was convinced his dog was defeated and sheepishly walked out to settle up.
The techniques and principles I’ve listed in this article will not beat an X-ray machine. They may, however, beat the X-ray “handler.” The point of this article is to make your lives easier and help you accomplish your mission. If the rules are black and white, you need to follow them in order to live on to fight another day, so to speak, but if there’s some grey area in there I hope my experience can help.
(1) Myanmar’s Indigenous People Fight ‘fortress’ Conservation . Reuters. August 5, 2018. Available at:
(2) Myanmar’s Deadly Mines . The Diplomat. March 10, 2018. Available at:
(3) Photo. Seasite. http://seasite.niu.edu/burmese/Cooler/Intro/Intro_images/Bd04.JPG
Bryce is a former special operations combat medic having served a total of 8 years in the Ranger Regiment and 160th SOAR.