Preparation Can Save Lives in Health Disasters Abroad

The most frightening medical emergency I’ve encountered abroad involved a young French woman who (as was later diagnosed) was undergoing an appendicitis attack in Afghanistan. And not just anywhere in Afghanistan. Her agony began on a stranded bus in the middle of a desert. (She survived her misadventure, but barely.)

Americans increasingly are seeking out remote places, and at least a few suffer life-threatening illnesses or accidents--sometimes far from adequate medical care or any care at all.

So what can you do to prepare for an emergency? And what do you do if you become a victim?

Assess the hazards of your destination. Are you comfortable with the risks? A car or bus accident is possible anywhere, but in many countries the chances are far greater because of poor roads, unsafe vehicles or reckless drivers. The Bethesda, Md.-based Assn. for Safe International Road Travel (ASIRT), (301) 983-5252, can provide travelers with a report on hazardous road conditions in 60 countries. If pertinent, it also will note where a lack of safety standards makes rental cars or bus travel chancy. A small donation is requested.

Founded in memory of Aron Sobel, a 25-year-old Bethesda medical student killed in a bus accident in Turkey, the nonprofit organization cites Egypt, Kenya, South Korea, Turkey and Morocco as the countries with the most dangerous roads. India might be on the list, but it does not provide statistics.

Under ASIRT’s prompting, the U.S. State Department’s Bureau of Consular Affairs has begun adding road hazard information to the Consular Information Sheets it prepares for each country.

The Consular Information Sheets also describe the quality of medical care available in each country. For these reports, contact the department’s Overseas Citizens Service, (202) 647-5225; automated fax system, (202) 647-3000; or https://travel.state.gov, its site on the Internet.

Pay heed to road hazards. ASIRT offers a number of tips for safe international road travel--for bus passengers, motorists and pedestrians alike. As a bus passenger, be aware that minivans and minibuses have poor safety records in many countries. If a driver is reckless, get off when you can. If you rent a car, insist on seat belts, check the tire tread, ask about the latest inspection of brakes and headlights and avoid night travel in countries with poor safety records or in mountainous areas.

Carry adequate health insurance, and consider buying a medical evacuation policy. If you become ill or are injured abroad, the U.S. Embassy can help you find medical care, but payment is up to you. Evacuating you by air from a remote area to an emergency hospital can cost thousands of dollars.

Before going abroad, find out what medical services your health insurance will cover, warns the State Department, and carry both an insurance policy identity card (proof of your insurance) and a claim form. You may be asked to pay cash up front for treatment. The Social Security Medicare program for senior citizens does not pay for treatment outside the United States, but coverage can be obtained through a Medicare supplement plan offered by the American Assn. of Retired Persons.

Several firms offer medical evacuation insurance, which usually can be purchased on either a per-trip or annual basis. Travel agents sell the insurance, or you can buy it directly from the company. A list of firms is available from the Overseas Citizens Services Office (see above) by fax (the document code is 1019) or on the Internet.

Typical of these travel assistance companies is Worldwide Assistance of Washington, which maintains 25 global medical hotlines. If you become ill or are injured, the company will pay the cost of getting you to a proper emergency facility--whether it’s in a neighboring country or in the United States.

A policy covering only medical evacuation begins at $21 for an individual and is valid for one to eight days. Ask about the emergency medical plans of any adventure tour operator with whom you are considering a trip. If the worst happens, call the nearest U.S. Embassy, or even your credit card company. The embassy can provide a list of local doctors or other medical facilities. Often embassy personnel will take additional steps to assure that Americans get the best medical care. Officials may visit accident victims, they may transport a patient to a better facility and they will make contact with someone at the victim’s home.

Some cards provide overseas travel assistance. My Visa card entitles me to call in an emergency for the names of English-speaking doctors nearby. Before leaving home, I call the member service number on the back of the card and am transferred to the Visa International Service Center. The center gives me the emergency phone number to call in each country I’m visiting.

Times Travel writer Christopher Reynolds is on assignment.