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.