Medical Considerations of Travel Abroad

Ambulance in West Africa

While our focus has largely been on pure security issues and medical situations are arguably more safety than security focused its still worthy of some mention and its a critical component of personal safety.

It’s safe to say that most travelers and expatriates are far more likely to fall victim to an accident or illness when overseas rather than a violent criminal incident or terrorist attack. For this reason it’s important to be forwarned with knowledge about potential medical hazards at your destination and have some contingency plans.

With a few exceptions its safe to say that most medical care in the developing world does not come close to what most of us are accustomed to in the West. There are some notable exceptions and some places that are known for “medical tourism” where travelers specifically go to receive medical procedures that are more affordable and still considered to be good quality. There are also places where there are western-trained and educated physicians and medical staff although good equipment and facilities may be lacking.

Many places however are lacking in both trained staff and good facilities – particularly in Sub-Saharan Africa and Central Asia. In many of these locations an injury or an infection that could be easily treated at home could be fatal. There may not be an effective emergency medical service and ambulance response may be slow or non-existent. Poor sanitary conditions may also make the local hospital a dangerous place where your condition may get worse, not better.

For these reasons it’s important to have a viable contingency plan for dealing with medical emergencies — from basic prevention potentially up to medical evacuation.

Basic Prevention:

Inoculations: find out what diseases are common at your destination and what inoculations are available for them. Also find out what shots are required and carry a shot card as proof you have received them. Yellow Fever vaccination as an example is required by a number of countries. If you are not vaccinated or cannot prove you are vaccinated by producing a valid shot card some African countries will administer the vaccine to you in the airport under questionable sanitary conditions.

Malaria Prophylaxis: If traveling to a malaria-prone area you should consider whether or not to take an anti-malarial drug such as Malarone or something similar. Regardless you should bring and use insect repellent as well as limiting your outdoor activity and night, wearing long-sleeved shirts, pants, etc. These measures will also protect you against other mosquito-borne diseases like Dengue Fever.

Pack a first aid kit: bring a small first aid kit with bandaids, antiseptic, loperamide/immodium (given the high likelihood of gastrointestinal disorders). Ensure none of the components of your first aid kit are considered prohibited items or controlled drugs at your destination.

Don’t drink the water: or brush your teeth with it. Use bottled water from a trusted source.

Avoid green vegetables, peeled fruit, etc.: avoid salads and other greens unless you are sure of the sanitary conditions during preparation. Avoid fruits and vegetables unless you peel them yourself or wash them yourself with bottled water.

Eat moderate portions: don’t arrive in a new country and gorge yourself on the local chow.
Use hand sanitizer: self explanatory. Keep yourself and your hands in particular as clean as possible.

Wear your seatbelt: that sounds like a no-brainer but the implications of a motor vehicle accident overseas can be much more significant than at home.

Medical Care:

Medical Facilities: try to determine the level, capability and quality of local medical facilities prior to arrival or when you first get there. In many places the best choice is a private clinic. Determine what criteria there is to get treated at the clinic in advance of a problem occurring. In some places there are no acceptable facilities and you will need to be evacuated. Find all this out before a problem occurs.

Payment: many overseas medical facilities will require payment, sometimes in cash, before treatment is rendered. Again — develop a plan for this before the situation arises.

Evacuation: determine how you will get evacuated and to where if your medical condition warrants it.

There are a number of providers that provide emergency medical assistance abroad such as Global Rescue, International SOS, Frontier Medex, TravelMed and others. This is not an endorsement of any of them but they may be worth looking into to address some of these issues.

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