How to prepare for sickness on foreign trips

A Thai vendor cooks noodles in Bangkok. Getting sick from local water and raw fruits and vegetables can taint a trip and possibly require expensive treatment.
A Thai vendor cooks noodles in Bangkok. Getting sick from local water and raw fruits and vegetables can taint a trip and possibly require expensive treatment. (SAKCHAI LALIT / Associated Press)
Posted: April 15, 2013

Before leaving on a trip, most travelers prepare for what they imagine as the worst-case scenarios: rain, sunburn, boredom. The remedies for these potential inconveniences are simple: Pack a slicker, a bottle of sunscreen, and a heavily downloaded Kindle, then slam the suitcase shut.

But sometimes the setback is more serious than a lobster-red nose. What couldit be? Food poisoning, a broken limb, a deep laceration, typhoid, dengue fever, malaria. And what can fix you? Proper medical care, no matter the continent, country, city or mountain village.

Depending on the malady, you could self-medicate with the proper pills, lotions, bandages, and rest. But when the illness exceeds your CVS medical training, you'll need to seek professional attention. A scary concept in an alien land, but done right, the experience can be painless.

To ease the ouch of mind, body, and budget, we sought advice from travel medical experts on how to navigate international health-care systems as foreign and chaotic as Bangkok's street-food scene.

Insurance

On the comments page of InsureMyTrip.com, a travel insurance aggregator, travelers gush about how travel medical insurance gave them "peace of mind." In the first 100 of 1,466 responses, not a single person related a negative story involving an injury or a claim. Nor did anyone complain about wasting money for an unused service.

"There's the ease, and then there's the cost control," said Bruce Kirby, president of the U.S. Travel Insurance Association. "The premiums are so small because the occurrences are so small."

When you travel without insurance, you have to pay for all medical expenses out of pocket - sometimes up front, in cash. In the case of an evacuation, which can cost several thousand dollars, those pockets had better be coal-mine deep. Travelers with insurance, by comparison, don't have to worry about smashing the piggy bank for massive expenditures. Depending on the plan, the company will dip into its own coffers and cover your bills like a generous benefactor.

To determine whether you're a good candidate for travel medical insurance, Peter Evans, executive vice president of InsureMyTrip.com, suggests that you first check your U.S. medical insurance. If your plan covers health incidents abroad, including evacuations, then skip to the next section of this article. If it doesn't, keep reading.

When choosing a plan, you need to factor in such variables as your destination (remote and rural or modern and urban), planned activities (strolling or scuba diving), and your age and personal health, specifically any pre-existing conditions. You can also choose between single- and multi-trip coverage.

For the most basic plan, the cost will equal your daily Starbucks coffee-and-scone fix - from $3 to $8 a day. For example, Evans, who's 52, calculated that for a three-week international trip, he would spend $58 on a plan that would pay up to $50,000 in emergency medical protection and up to $500,000 for an evacuation.

Apparently, peace of mind is a bargain.

"It's probably one of the most unsettling things to be ill in a foreign country," said Phyllis Kozarsky, a travel health consultant for the Centers for Disease Control and Prevention, "and there's nothing sadder than being in dire straits and having to pay $50,000 to $100,000 for medical care."

Kozarsky has experienced the discomfort of ailing abroad and the disappointment of a ruined trip. Soon after arriving in India in 1987, she succumbed to illness and had to fly home for treatment.

"I did everything wrong that you could imagine," said the professor of medicine and infectious diseases at Emory University in Atlanta.

Physician friends of her Indian sponsor family diagnosed her symptoms as pneumonia, diarrhea, dehydration, and an unconfirmed case of Legionnaire's disease. Kozarsky did not have supplemental travel health insurance, but she had connections, which absolved her from the quest for outside medical care.

The flip side: When you buy insurance, you gain connections.

In addition to easing the financial strain, travel medical insurance pairs the patient with an assistance company that will provide support from the first distress call to the final discharge. The advocate offers such invaluable guidance as pointing the patient to a reputable hospital and facilitating treatment by corresponding with the attending physicians.

Finding medical help

You need to be well-informed about where to go for medical help and what treatment you're receiving. And maybe learn a few phrases in the native language, such as, "Is this going to hurt?"

For starters, travelers should tap into the fairy godmother resources offering medical guidance. For example, the Joint Commission, a nonprofit organization that certifies health-care facilities in the United States, has expanded to international hospitals and institutions. Its list covers countries from Austria to Yemen, with Brazil, China, Kazakhstan, Mauritius, and many other destinations in between.

For more than 50 years, the International Association for Medical Assistance to Travellers has been on a mission "to coordinate an international network of qualified doctors and mental health practitioners committed to providing the highest standards of medical care to travellers." Italian physician Vincenzo Marcolongo was inspired to create the organization after he assisted a distressed Canadian in Rome. The group provides a growing database of more than 400 clinics in 120 countries that agree to treat any member (free to join; donation much appreciated) for a set fee of $100 per office visit and $170 for a night call.

"We visit the doctors and have close relationships with them," said IAMAT president Assunta Uffer-Marcolongo, the founder's wife. "The traveler knows that he will not be overcharged."

Health-care systems vary tremendously worldwide, as do hospital cultures. Despite the diversity in systems, some universal tips apply.

Americans can often find familiar care at hospitals affiliated with universities, such as Johns Hopkins, or U.S. health-care centers, such as Harvard Health. Or look for places that cater to expats, business travelers, or medical tourists.

Kirby suggests contacting the U.S. Embassy for recommendations or asking a hotel concierge working at an international chain.


To comment, e-mail TravelTalk@phillynews.com.

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