No. 10 I'm Not Puking, You're Puking: How to Handle Illness Overseas

Maldives, China, Paris

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I'm Not Puking, You're Puking: How to Handle Illness Overseas

Before we traveled to Africa for the first time, I wanted to be certain that we could get medical care if we needed it. I called our insurance provider, paced around the kitchen, and grilled the representative, Lauren.

“So, if we need to go to the hospital in South Africa, it’s covered?”

“Yes,” Lauren said. “You’ll have to pay out of pocket and file for reimbursement when you get back to the United States.”

“But it’s covered.”

“Yes. Cigna will reimburse you.”

“What if my plane crashes and I need to be air lifted out of the bush? They’ll cover that?”

“Yes.”

“What if my head is crushed by an elephant and I need to be flown back to the United States to have it inflated and reattached?”

“Yes.”

I still wasn’t convinced. For weeks, I had visions of receiving a three-million-dollar medical bill and trying to argue, “…but Lauren said...”

Thankfully, we didn’t have to put the insurance to the test in Africa, but it begs the question of how to handle illness when you travel abroad.

1. Before you leave, call your health insurance provider to discuss what is and is not covered on your policy when you are traveling outside the United States. Ask what is required for proof of treatment in order to be reimbursed.

There was the time that I got nauseous in a Chinese airport right before a flight. That’s very unusual for me. I have an iron stomach. What goes down does not come up again. I’ve only vomited three times in my life, and that day I was on the verge of a fourth.

The situation was so precarious that when my daughter, Faith, sat down five seats away from me, the minute vibrations felt in my chair nearly sent me over the edge. We had medication for nausea—in the suitcase in the belly of the airplane.

Tim set out to try to find medicine. In the stores, predictably, he couldn’t read the labels. As he continued to search, he discovered what he hoped to be a pharmacy. Two young men stood behind a counter in an otherwise unadorned, empty room. They did not speak English.

Google doesn’t work in China. So before we left the United States, Tim downloaded a translation app for Mandarin Chinese. Not the paid version where you can type in useful phrases in an emergency. The free version that only allowed one word at a time.

Tim typed, “Sick,” into his phone and held it up.

The young man took out his mobile and typed back in his own translation app, “You?”

Tim typed, “Wife.”

“Pregnant?”

Tim shook his head no. “Nausea.”

The young man opened a large cabinet and took out a bottle. He shook two white pills into a tiny square envelope. His mobile translation read, “If no work go hospital.”

Tim squatted down by my knees. “Here’s the thing,” he said. “These pills may or may not make you feel better. I have no idea what they are.”

It wasn’t like he’d bought them on the street. I presumed the man who distributed them was a professional. A professional what—nurse, doctor, pharmacist, plumber—I didn’t know. I decided to take them because I couldn’t get on the plane otherwise.

For thirty minutes, I closed my eyes and sat preternaturally still. Whether the pills were a placebo or actual chemicals, the nausea dissipated in time to board the plane. And I kept the envelope because it was cute.

2. If the medical situation is inconvenient but not urgent, consult the local pharmacist. Pharmacists in Europe and Canada (and apparently China) are trained and allowed to prescribe medicine, including antibiotics, for common or prevalent problems.

Another time in the Maldives, Tim lost most of the hearing in one ear. I figured it was swimmer’s ear. Sun Siyam Iru Fushi, the island resort where we were staying, had a resident physician who took a look.

When Tim and our son, Aidan, returned to our bungalow, Tim explained how the doctor flushed his ear out with warm water to dislodge an overgrown and particularly stubborn chunk of earwax.

“It was as big as a crouton,” Aidan said with genuine awe for his father’s wax-production capabilities. Tim’s ear wasn’t infected, thankfully, and we resumed our vacation after a bill of about one hundred US dollars. I was pleasantly surprised by the fee, considering that half a gallon of water cost twenty-eight dollars.

3. For minor medical situations, don’t be afraid to use a local doctor. Make certain to get a receipt with details of the reason for the visit, the treatment provided, and the fee charged—on letterhead if possible, for your records.

The most serious medical situation we encountered while traveling was in Paris. Faith was about seven and had picked up a gastrointestinal bug. For two days, nothing she ate or drank would stay in her stomach. Fearing she would become dangerously dehydrated, the whole family piled into a taxi and went to a pediatric hospital in the 15th arrondissement.

The emergency room was practically empty. We were seen right away. The staff was at a loss for how to bill us. We had done a home exchange with a French family who was, at that moment, on a hike with my mother in the United States. I gave the hospital our local address.

The doctor came into the triage room and took Faith’s vitals. In broken English, she asked if Faith had been running a fever.

“Yes, 101 degrees,” I said. She frowned and shook her head.

“She needs it in Celsius,” Tim said. He opened the calculator on his telephone. “I think the conversion formula is…” He started punching numbers. “…a hundred and one minus thirty-two, times nine over five.” He showed the answer to the doctor.

She shook her head gravely, “Non.”

“Okay, okay,” Tim said. “I must have done it backwards. Hang on.” He refigured the problem and showed the new results. The doctor’s face cleared, and she recorded the number. Later, Tim said he’d told the doctor that Faith had a fever of 255 degrees.

The doctor prescribed flat Coke for Faith’s stomach and walked to the vending machine to buy one for her. Faith thought it was the best medicine ever since I never let the kids drink soda. Say what you want about socialized medicine, that hospital was the best ER experience we’ve ever had.

The bill went to the Paris apartment a few weeks later, and we weren’t there to collect it. I have no idea what happened, but we never paid it.

4. I’m not suggesting you dodge your hospital bills. What I am suggesting is that you carry your medical history with you. We didn’t need them in this particular case, but if we had, obtaining them from the US could have been a very lengthy process that could have slowed down treatment.

   Download your records to a thumb drive and travel with it. In the event of a medical emergency, especially if you have pre-existing health conditions, you can quickly make that information available to the hospital staff and speed up the process of deciding how to best care for you.

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If your health care company won’t cover you when you’re out of the US, consider Travel Medical insurance or travel insurance with a medical rider. Typically, travel insurance costs about 5-10% of the price of your trip, depending upon the selected level of coverage. Click here for a list of the best travel medical insurances.

Safe travel my friends!

Eileen

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I’m pleased to announce the publication of three photographs from my travels in Italy and Ireland last summer in the Spring issue of Glassworks Magazine.

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