Health Matters
Written by: Lisa Arcella
Drexel University student Jennifer Degnen spent a semester studying and traveling in South America and thought she was well prepared for the trip before she left. But that was before a slip on some rocks changed her mind. "I went hiking with some friends in Peru, slipped and badly twisted my ankle. Before this, I had only ever considered that I could get sick on the food. I had to get money from my parents wired to me before I could be treated, which took hours. Plus I was in pain and didn't even have an aspirin with me. It was a nightmare."
Being well prepared for a foreign study trip takes more than just packing the right clothes and a good translation guide. Levels of sanitation and healthcare differ from country to country. Whether it's a serious disease like SARS or simply an upset stomach, students need to prepare for worst-case scenarios and learn how to avoid them whenever possible-before the departure date.
"Schedule a visit to a travel health clinic or provider at least eight weeks in advance, if possible, to allow time for any needed immunizations," advises Dr. Ben Koppel, Medical Director of MEDEX Assistance Corporation. "The travel-health specialist will provide information specific to the travel area and recommended immunizations, prescribe medications that may be indicated for malaria prevention and recommend actions indicated for disease prevention." Koppel says that many general practitioners may lack the expertise about the country you are visiting and may not stock required or recommended immunizations. Travel clinics will provide these services. But be aware that insurance carriers may consider these as elective services and not cover them.
Do your homework. "Yellow fever immunization is required for entry into some countries. The unvaccinated traveler may be denied entry, vaccinated upon entry or placed in isolation," says Koppel. "The yellow fever immunization must be given at an official yellow fever vaccination center, as designated by health departments. The administering official must have a Uniform Stamp."
Dr. Koppel says it is also important to take a copy of any pertinent health records if you have an ongoing health problem (like asthma for example) in case you require treatment abroad. Don't forget to carry the name and contact information of your home health care provider with you in case of an emergency.
It may seem like simple common sense, but if you have an essential medication, keep it in a carry-on bag, not your suitcase, and remember to take a supply that will last the duration of the trip, since they may be hard to renew abroad. "Take copies of prescriptions, and if any medicines contain narcotics, carry a letter from your physician attesting to your need to take them," says Bart Littlefield, Senior Vice President, Product & Marketing of StudentUniverse.com, a student travel company. "I think the best advice is to first and foremost, use common sense. If something doesn't smell or look right, go with your gut, and avoid it. Don't eat food served from food stalls on the street, make sure to stay hydrated, starting with your flight to your destination and if you are unsure about the local water, skip the ice cubes in your drink and avoid salads (which may be washed with local water)."
Remember to give your body some time to adapt to local foods that may be new to you and be aware that the levels of cleanliness in other countries may be very different from what you are used to. "Remember that not all restaurants follow health code regulations to the letter," says Michael Gallant, a senior at Columbia University and author of Getting the Most From Study Abroad (Natavi Guides). "It's a good idea to avoid sketchy, half-cooked and unidentifiable lumps of meat and other nastiness. Ask local residents for advice on picking decent restaurants, grocery stores, vendors, and markets. After a while, you'll get a sense of what's safe and what will give you salmonella, but in the meantime, play it safe."
Gallant also suggests that you proceed with extra caution if you have food allergies. "Learn the correct translations for all of the foods you're allergic to and ask before you eat," he says. "You might look like an overly picky eater, but better that than spending a week horizontal in the local hospital."
Drinking water is always a concern for travelers. Many countries will have perfectly sanitary, drinkable tap water, but others might not. Do your research beforehand and find out how careful you need to be. In areas where the water may be contaminated, stick to beverages bottled somewhere with better filtering facilities and boil tap water before using it. If you're really roughing it, consider bringing iodine tablets to help sterilize water.
It pays to be prepared, according to Don Hay, the director of intelligence management at iJet, a travel risk management company that provides up to the minute alerts for travelers. "I think you always want to be somewhat skeptical," he explains.
"Be cautious, plan ahead and know what you need to bring with you. Do you need to pack Deet or bring mosquito netting if you are in a more remote place? Research done before any trip always pays dividends, because even the most seasoned travelers can run into unforeseen problems. A few months ago I was in Nicaragua and I know you always drink bottled water and thought I was cautious, but I had a salad that caused some problems later on. Luckily, I had an over-the-counter medication with me to minimize it."
Students need to be prepared for more serious injuries as well, and many travel experts recommend additional health coverage. First, contact your health insurance carrier to determine if your policy will provide coverage in a foreign country. Supplemental insurance may be needed to ensure adequate coverage, including evacuation, if a medical emergency occurs.
Be prepared to pay for services prior to treatment. This is the norm in most countries and your insurance card is likely to be worthless. You may have to submit the foreign bills to your home company for reimbursement. If at all possible, request itemized billings. Also, check your policy for any exclusion such as dangerous activities. This could impact reimbursement of medical emergencies encountered while involved in activities like trekking, motorcycling and scuba diving.
"Medical insurance often includes emergency medical care during your trip as well as hospitalization, intensive care and outpatient services, ground transportation, emergency evacuation, reunion and repatriation or evacuation, and accidental death and dismemberment insurance," says Littlefield.
"Insurance is always a good idea. Before you buy it, be sure your insurance is adequate for your specific travel plans and the activities you like to do."
Helpful websites:
medexassist.com
StudentUniverse.com
ijet.com
Association of International Educators
NAFSA's Section on U.S. Students Abroad
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