Healthy Travel - Vaccines

When Scott, a medical journalist, answered the phone, the stranger on the other end of the line introduced himself as Dan Gooding with the U.S. State Department. It was not good news. Scott's father, a physician volunteering with a medical relief agency, was in a Pakistani hospital, nearly dead from a serious bout with typhoid fever. Although he was a doctor, Scott's father had neglected to avail himself of thetyphoid fever vaccine before departing.

When Scott arrived a couple days later, exhausted and jet lagged, he found his father in a confused state, lodged in a dirty and poorly equipped hospital.

Rather than take further chances with the local facilities, he opted to bring him home immediately. But the airlines balked at releasing the seats on such short notice. Instead, he contracted with a U.S.-based air-ambulance company, which brought a doctor and gleaming Lear Jet practically to his bedside. Back home, his doctors discovered something the Pakistani doctors had missed: an infection of the vertebrae called osteomyelitis. All in all, Scott's father was lucky to be alive, but the bill for the medical evacuation was a staggering $97,000, paid in cash, in advance. Fortunately, Scott's father had purchased a Medi-gap policy that covered overseas medical emergencies, but it was capped at $50,000, leaving a balance of $47,000.

Actually, infectious diseases like typhoid fever are responsible for only 1% of the 6,000 deaths of Americans abroad. About half of these succumb to heart disease and stroke, while all other medical conditions account for another 14%. Accidental injuries, whether from falling off a cliff in Katmandu or getting in a bus wreck in Ankara, account for 22% of fatalities abroad.

Protect yourself from transportation accidents by following the guidelines for safe road travel abroad, below.

In the event of serious illness or accident, the U.S. Embassy or consulate can give valuable advice on doctors and hospitals; the consulate in Peshawar, Pakistan, helped Scott to arrange the air ambulance, for instance. But the government does not provide free medical care or transport home. And Medicare does not pay for such services either.

For all of these reasons, you should purchase a policy that covers foreign medical expenses and emergency travel. The cost for medical coverage alone is typically $50 to $75 per person for a two-week trip. When choosing a policy, keep in mind that medical evacuation costs as much as $20,000 for the Caribbean and Mexico, but can shoot up to $100,000 or more in far-away developing countries. To find a list of companies that provide overseas medical insurance and evacuation services, consult the U.S. State Department's directory.

Be aware that in developing countries, death and injury from road accidents occur at anywhere from 20 to 70 times the rate they do in the United States, Canada and Europe. Follow these precautions whenever possible:

• Travel only in taxis equipped with seat belts, and use them.
• Place all young children in child car seats.
• Before renting a car, inspect the tires, lights, wipers, horn and other safety equipment. Test the brakes and steering once you are under way.
• Do not rent or ride on motorcycles or scooters.
• Don't drive at night, especially between cities.
• Don't drink and drive.
• Ask your travel agent, hotel staff, etc. about the safety and reliability of mass-transit systems such as buses, local trains or trolleys, and subways.