Before our first extended trip, when we were still living in Connecticut, Marcia and I visited the foreign travel clinic at our local city health department. We brought our itinerary and got all the required and recommended shots for the countries we planned to visit. Even though we no longer live in that area, this clinic keeps an ongoing record for us, which allows us to call and find out which vaccinations need to be updated. We do this before every trip abroad. We also maintain our own records, including keeping track of minor ailments, which helps us know when problems may be recurring more often than they should.
Additionally, we research medications, such as antimalarial drugs—which are recommended by the CDC for many of the places we travel to—and antibiotics for stomach ailments and other maladies. We discuss our options with doctors, other travelers, and, in some cases, contact the drug companies themselves with questions. Because our trips are for long periods, it is important to know about the long-term effects of certain medications. We also carry some herbal and holistic remedies, generally as preventives, and I take medication for treating high blood pressure and high cholesterol, which are available in many countries without a prescription.
Both Marcia and I, at one time or another, have been sick in a foreign country. Our first recourse is our own first aid kit. If that's not sufficient, we look for professional help. The guidebooks we use, such as Lonely Planet and Rough Guides, offer information about treatment centers where English is spoken, and American embassies have lists of doctors, though they don't make specific recommendations. Hostels and hotels can usually recommend doctors in the immediate area, and fellow travelers who have had local medical care can also be good sources of information.
Every time we have medical treatment in another country, we experience some trepidation. But this is emotional, not based on the actual care we have received around the world. While we certainly have a few, shall we say, "colorful" stories about health care we've received abroad, and, admittedly, some of the places where we were treated lacked the U.S.'s sanitation standards, in almost every instance the care we had was mostly professional and usually curative. It's important to keep in mind that local doctors are familiar with the local diseases and the treatment for them.
Some of our best travel stories are about the myriad health providers we have encountered, from the dentist who filled a cavity for Marcia in a luxury high-rise in Jakarta for $135, to the doctor in India who treated her for an allergic reaction to a wasp sting for $1, to the top-notch dentist in South Africa who performed root canals and intensive periodontal work on me that would have cost thousands of dollars in the States, for just a few hundred dollars.
While medical care in Third World countries is usually inexpensive, we decided we shouldn't do without evacuation insurance, which covers the cost of being airlifted to the nearest suitable hospital—or back to the United States—in the event of a medical emergency. American Jewish World Service (AJWS), the agency for which we've done the most volunteer work, always pays for this when we are on assignment for them, and we make sure we have it when traveling on our own as well. It is literally a lifesaver if you ever have the occasion to use it.
In 2000 we did use it. We were on an AJWS volunteer assignment in Kanchipurim, India, when, in the middle of the night, Marcia woke with what she thought could be a detached retina. (It actually turned out to be torn.) She went down to the lobby and got the desk clerk to connect her with an international operator. She called the 24-hour emergency number of the evacuation insurance company and talked to a doctor somewhere in Hong Kong. He felt Marcia should be airlifted out of India immediately and got the ball rolling. At first he was going to send us to Bangkok, where he knew of an excellent eye hospital, then called back because he had second thoughts about traffic there and how much time it might take to get from the airport to the hospital. He made new arrangements for us in Singapore and arranged for a car to pick us up at our hotel in the morning. In addition, seats on a nonstop flight were arranged for us and when we arrived in Singapore, an ambulance, driver, and attendant were waiting to take us directly to see the doctor. It was truly extraordinary service.
The bottom line for us is that we want to travel off the beaten path. We try to take precautions and be sensitive to the fact that we are both 69 years old. We have the usual aches and pains (especially me with arthritis, high blood pressure, and high cholesterol) but fortunately nothing yet that can hold us down.
Food and Drink
Our first rule is to always drink bottled water, unless our guidebook specifically states the water is safe. We also avoid ice, unless it's made with purified water, and use only bottled water to brush our teeth.
Eating is a bit more complicated. Good food is important to us, and in our opinion the tastiest fare is often in marketplaces and street stalls, and we prefer to eat where the locals eat. We look for food stalls that are busy and that have a fast turnover. In warm countries, where there usually isn't refrigeration, we don't eat anything that has been sitting around. We always look first at the people running the place or preparing the food. If they look clean and efficient, we look at the food, the pots and pans, and the level of cleanliness. If we're comfortable with what we see, we eat.
One of the things we like in these settings is that dishes and utensils are not involved. In India and Southeast Asia, food is often served on banana leaves, or something similar, and you use your fingers. (Even the sit-down restaurants in many of these countries are like this, with a bank of sinks at the door for hand washing before and after a meal.) It's actually a point of pride for us to be able to eat stews and curries with our fingers. When we first did this, with considerable difficulty, years ago in Malaysia, we couldn't take our eyes off a group of Muslim women in white burkas eating in this manner without getting a single stain on their clothes.
Sharing meals with new friends can be somewhat of a balancing act between not wanting to be rude and not wanting to get sick. Because we so frequently go to places not visited by many tourists, people often stop us on the street to talk. Conversation leads to invitations for tea or a meal in the most basic homes. We sit with our hosts and take out our water bottles, explaining that our stomachs have not yet made the adjustment to local food, but that still, we want to visit with them and chat. Sometimes we accept tea, but ask that the water be boiled for several minutes. In situations where we've felt safe, such as during homestays and at weddings, we've had some of our most delicious and memorable meals.
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