Health on the Road

Many people asked us about medical coverage and how we stayed healthy while traveling.

Before leaving, get your doctor to refer you to a travel clinic at local hospital and bring your itinerary to them. They will prescribe the necessary vaccinations. Evidence of some, such as yellow fever vaccine cards, are necessary to enter a few countries so carry those with your passports. Some vaccines require multiple shots and you have to stagger them. We ended up visiting the hospital five times across two months before leaving the USA.

We found that our standard health plan would cover us while traveling abroad. We could go to any foreign emergency room for critical care and apply later for full reimbursement with a form. In case of chronic care we could be fully reimbursed if we got the care at a “preferred” health service that was on a special list. They would not pay for preventative or acute care at all.

Prescriptions? You can explain the travel period to your doctor and insurer and they will let you get a higher than normal amount of prescription medicine before you leave, so you can carry it along. The travel clinic will also prescribe you malaria pills, a small amount of antibiotic in case of severe diarrhea (did not need), and high altitude drugs (we did not take).

We all went for check-ups and dentist just before leaving. We skipped our 6-month dental cleaning! We pre-scheduled doctor check-ups and dental visits for all for the first 2 weeks upon return.

Thankfully, we never had occasion to need an emergency doctor or dentist visit. We had a precautionary question once that we called home about and resolved over the phone just as if we were still in USA.

We took digital scans of all prescriptions and vaccination records plus a letter from our insurer saying our policies were in force, and we kept a copy on our hard drive.

We also carried a zippered first aid pouch, about the size of a loaf of bread.

Here is what was in the pouch that we actually used:

– Aspirin / Advil / kids chewable Aspirin (#1 of all – needed several refills)

– Anti-itch cream

– Anti-biotic / Neosporin cream

– A box of chewable Dramamine / Bonine motion sickness pills

– About a dozen Band-Aids of miscellaneous sizes

– Electronic thermometer (just rarely and then it ran out of batteries in Africa!)

– About a dozen Claritins and a half-dozen each of Benadryl and Immodium

Gina ended up carrying small portions of all of the above in her purse, which was a frequent resource.

What accounted for 80% of the weight but was never used:

– About 300 more Band-Aids, gauze, scissors, tape, tongue depressors, first aid booklet and other junk they give you in an off-the-shelf first aid kit

– More bottles / boxes of Immodium, Zinc, Benadryl, cold remedy, cough remedy and Airborne

Next time, we will bring the high frequency stuff, fewer band-aids, avoid the cold remedies. It is a great idea to buy the chewable or instant versions of the pills you get since you may not have water at hand. If you get a cold, you won’t die, so just take that as the best moment to learn about local cold remedies. We never found ourselves using the Airborne.

Also in the CVS aisle, we bought four snap-shut plastic toothbrush covers that worked marvelously well and were much more compact than a full toothbrush case. They served to separate toothbrush from hairbrush, all year long.

With so many different bathrooms and pools, perhaps it is not surprising that we encountered athlete’s foot, striking several family members at the same time. This is easily treated with a cream, so carry several tubes of that rather than a big spray can. You want to pick it up in advance and be prepared, because in some countries it is hard to find. You need a tube per person and keep applying it for the full amount of time suggested, so you are completely cured.

Lastly, we used piles and piles of sunscreen, one large bottle of eyeglass spray every six months (which we decanted periodically into a small bottle that we carried everywhere), a dozen eyeglass cloths, a few tubes of lip balm, a small amount of sunburn soothing gel we used maybe four times, and 1-2 bottles of mosquito repellant (only needed it for a few safaris and Galapagos hikes). Remember to pack aerosols in checked luggage – most countries confiscate those if found in carry-ons. We bought $60 of spray sunscreen when leaving London and lost it the next day to airport security!

How about diet? Stay aware of food quality and trust your instincts. When in doubt, stick to cooked foods and fruits that have a discarded peel like orange and banana; brush with bottled water; drink bottled water or canned beverage with no local ice. That said, we were pretty open to eating foods in any restaurant that was busy, provided again that the food was cooked and the water bottled. We also trusted guides and ate salads when they told us a certain restaurant was OK for tourists.

The main dietary concern became gradually clearer as the months progressed – we have gained weight! The food buffets are endless; the exercise opportunities are good for city walks but really bad for cruising and safaris and air travel. A year later I am up “over 5” pounds, which bunches at my waistline distressingly. A slim-down will be in order upon return.

One of the most common mistakes in managing the day is to wait until you are hungry to choose a place for lunch or dinner. By that point everyone is cranky and the bickering gets worse and worse as you hunt for a decent choice. Many countries have windows of time when the restaurants are open, and if you miss that, you will be ruining the meal for sure.

Another common mistake is being too busy to stop for a drink of water. If you skip liquids, someone in the group will eventually feel ill and get headaches or start to bicker, but it will not be obvious why. As a parent you have to keep mental track of this and make sure everyone is drinking, especially during flights and active days.

In Africa, we all took Malarone to prevent malaria. You take one pill before bed so you can sleep through any mild discomforts; we had a few stomach aches but none of the strong dreams that some people report. All in all it was well accepted. The only other Africa health issue on our minds was tick bites – we got these walking in the bush one day in Kenya. The main concern would be tick fever, which we learned can be severe but is thankfully rare. Now we conduct a tick check after every safari. Surprisingly, the level of mosquito activity in June / July has been far lower than we envisioned, because it is a dry season here. Overall, we have been bitten far less here than on say, Martha’s Vineyard.

Russ and Katherine both lost 2 days in London to stomach flu. Carter and Gina both lost a day in India to bad lamb. We all had the occasional digestive complaint at some point, but never so badly that it got in the way.

The bottom line? The most frequent complaint was simply a headache, usually either owing to dehydration, too much reading with dirty glasses, jet lag, or altitude. Aspirin was the main cure we needed and it worked well. Keep your fingers crossed and we will all come home from the year’s adventure healthy and sound!