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Health care concerns for international travel

Medical care is available throughout the world.  Here, my son gets a cast in Mexico.
Medical care is available throughout the world. Here, my son gets a cast in Mexico.
Nancy Sathre-Vogel

Is fear of a health concern arising holding you back from international travel? You are not alone. For many people, the idea of being far from adequate health care is a major stumbling block preventing them from getting out and about in the world. The good news is that health care concerns don’t have to prevent you from seeing and learning about your planet.

I’ve had a *bit* of experience with health care around the world in my many years spent gallivanting around the planet. My son has had repeated operations to remove infected ingrown toenails and my husband was medivacked to Israel with a heart condition. I had Lasik surgery on my eyes in Taiwan. I broke my hand in Egypt; my son broke his arm in Malaysia. I screwed up my foot in Vietnam. We’ve had traveler’s diarrhea, giardia, amoebas, dengue fever, colds, and flus. And we’ve survived it all – with the help of medical personnel around the world.

In most countries, there are two tiers of health care – public and private. In many places, the same doctors work in both - mornings in the public hospital; evenings in their private clinics. The doctors typically have a fairly high degree of training and are capable of treating most ailments. In my experience, they are willing and ready to refer you to someone else if they do not feel they have the expertise to handle the situation. The difference between public and private is a fine line – the private clinics tend to have better and more complete facilities and better support staff, but are a bit more expensive.

The local people are a great source of information about where to go. Seek out a well-presented professional and ask him where you should go – those are the people who tend to demand the best and know where to find it. If they direct you to the public hospital, go there. If they recommend a private clinic, go there instead. Remember that all those people you find so fascinating need medical care too, and they find it where they live.

In most countries throughout the world, medical care is very affordable. A visit to a doctor will rarely cost more than $20, and frequently significantly less. X-rays or an MRI won’t break the bank. Although we have an insurance policy, health care around the world is typically so affordable that we don’t even bother submitting a claim – it would cost us more in postage and copies than we paid for the doctor in the first place. We maintain our policy only for serious illness or injury.

In general, for fairly routine, run-of-the-mill illnesses, the public health care facility will be just fine. They know what types of bacteria are prevalent in the area, and are current on other illnesses they see a lot of. You’ll be better off having malaria or typhoid or diarrhea treated by a local doctor than back in the USA. The public hospitals also deal with plenty of fractures and know how to set them.

For most of us, that is the extent of our medical care overseas – we don’t experience drastic situations often. But – what if? What if your heart suddenly goes into arrhythmia or your knee suddenly goes out causing excruciating pain? What if you are afflicted by a mystery illness that won’t go away despite numerous visits to local doctors and a course of antibiotics?

You have two approaches to take depending on if the situation is life-threatening or not.

Non-life-threatening: Ask around until you find a specialist. Every country has specialists in nearly every medical specialty imaginable – and they are very easy to get in to see. In the USA, you can wait weeks or months for an appointment with a specialist but in most countries you will be able to get in today. They will even frequently make house calls! It may take a bit of digging to find the specialist, but keep asking everyone – hotel workers, other doctors, or people you meet on the street.

In Mexico, my knee suddenly went out one evening. I was simply walking down the corridor at my hotel when I was struck by the most intense, excruciating pain I had ever felt. My husband helped me into the room and we panicked. What now?

By the next day, I was talking with a knee specialist. Seriously- knees were all he did. He knew knees inside and out and, by simply feeling my knee, told me my knee cap had come out of alignment and it would take about a week for the swelling to go down and the pain to go away. Sure enough – a week later I was back on my bike, pedaling my way back to the USA.

In Colombia, my son needed surgery to remove a severely ingrown and infected toenail. We asked around until we found a foot specialist and allowed her to do the surgery.

In Taiwan, I found a Lasik specialist for my eyes. He performed hundreds of surgeries each week.

When my hip started hurting, I was in the MRI machine within hours. When I nearly collapsed due to an intense headache, I was at the neurologist’s office immediately. Specialists throughout the world are very knowledgeable and much more accessible than they are in the USA.

If you don’t find the right doctor the first time, keep asking around until you find someone you can trust – they are there.

Life-threatening situation: A life-threatening situation is an animal of a whole different color! Whereas with other situations you have time, a life-threatening situation does not offer you that luxury. You need help, and you need it now.

Your approach here is to head for the biggest hospital around. Don’t wait for an ambulance; just get in a taxi and go. The doctors there will most likely know if they can deal with the situation or not – if not, they will start the proceedings to get you evacuated out of the country.

Depending on where you are and exactly what your situation is, your travel insurance company may opt to fly you to better facilities. Be sure you have evacuation insurance! I know – you might be thinking you don’t need it – you are healthy and there is little chance of something major happening. I’ll tell you a story to (hopefully) change your mind!

Many years ago my husband and I went out for a bike ride one day. We were living in Ethiopia at the time and planned to leave in a couple weeks for a bike tour around Tanzania and Malawi. As it happened, we forgot our water bottles at home. I stopped at every village to buy something to drink; my husband left me in the dust and rode hard – he wanted a good training ride.

By the time I got home, my husband had been there for hours. “Nancy,” he said, “Something’s wrong. I can hardly move – I get totally winded just walking across the room.” We were both clueless about what could be happening, so we just left it – he was healthy and strong, after all.

Four days later, he was still getting winded at the slightest exertion. He went to visit a doctor. “It looks like your electrolyte balance is messed up,” the doctor told him. “Take potassium pills, eat bananas, and go get an EKG.”

John took the pills and ate bananas, but didn’t go get the EKG – until the next week. As he waited in line at the clinic, he collapsed to the floor. A taxi rushed him to the clinic, where a doctor examined him and sent him immediately to the emergency room at the hospital. It didn’t take long for the doctors there to determine they needed to send him out of the country – they didn’t have the facilities needed to convert his heart.

By this point, John’s condition was life and death. His heart had not been beating properly for ten days. He was weak and his body didn’t have the oxygen it needed. His heart was beating – but flopping around rather than making good, solid contractions.

I contacted our insurance company, and they began the process of getting an air ambulance flown in – commercial airlines would not accept a heart patient. A while later, John and I got on a plane and arrived in Tel Aviv, Israel where they converted his heart. He walked out of the hospital a healthy man again.

But – here’s the moral of the story: Always get evacuation insurance. The air ambulance that flew from Israel to Ethiopia with five highly trained individuals (pilot, co-pilot, navigator, doctor, nurse) did not come cheaply. That seven-hour flight cost $90,000, and that doesn’t even include the cost of the hospital in Tel Aviv! Without insurance, we would not have been able to afford the flight, and my husband could very well have died that day in Ethiopia.

So what am I trying to say here? I’m saying don’t let fears about medical facilities hold you back from experiencing all our planet has to offer. When was the last time you ended up in the hospital with a serious, life-threatening condition? I would venture to guess it hasn’t happened very often – and chances are good that it won’t. Pick up an insurance policy for just in case, and then don’t even think about it.

Yes, it is likely that you’ll have diarrhea or a cold. You might slip and fall. But for all of those minor illnesses or injuries, local medical care is perfectly adequate no matter where you are – and many times even better than what you would find in the USA. Go! Explore! Discover! The world is waiting.

Nancy Sathre-Vogel is currently cycling from Alaska to Argentina with her husband and twin sons. She is documenting their journey for Guinness World Records at www.familyonbikes.org and also has a column in the Communities to the Washington Times.

 

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