You’re traveling or living abroad and then it happens – you get sick! I’m not talking about coming down with a cold from the aircon on the plane – although, granted, that’s very annoying. I mean actually ill.
Being sick isn’t fun anywhere, but it takes different proportions when you’re in another country where you might not know the language very well and aren’t quite sure how the health system works. Because, well, hospitals are not the first thing we read up on when we gather information for our next trip, right?
I have had different cases (and degrees) of being sick while abroad and though I would compile a list of lessons I learned from my experiences, in the hope they’ll be helpful to some of you reading this.
Let me start with telling you about the times I had to seek medical attention when I was abroad, 1) to give you actual examples and 2) to show that I am in no way an expert on all things travel health insurance and emergency cases.
A torn ACL in England
While doing my master’s at the University of Manchester, I joined the women’s rugby team. I wasn’t new to rugby (I had in fact played for 9 years by then), and had never had bigger injuries than a torn-up leg or a sprained ankle. But after just one month, during a normal Saturday morning practice, I took a sidestep and snap, my knee locked. The pain was immense and I couldn’t move my knee at all. I didn’t take it seriously enough then to go to the hospital right away, which I probably should have. I had had knee problems for years before.
On Monday, I finally limped to my GP only to be told I could have an appointment with a specialist in eight (!) weeks. I went to the walk-in center at the hospital only to be turned away with a pack of ibuprofen. Long story short, it took the doctors two months to figure out I had a torn ACL (that’s the anterior cruciate ligament). If I ever wanted to play rugby or any other competitive sports again, I would need reconstructive surgery, so I decided to go for it. But some surgeons refused to operate me because of a bleeding disorder I have, and others suggested I could do perfectly fine with just one ligament.
In the end, I decided to have surgery back home in Germany because I wasn’t getting any further in the UK. I finally got my new ligament in April after eight strenuous months.
Typhoid and a mysterious stomach bug in Zambia
This is by far the most extensive “illness” I have faced so far. In fact, today, 11 months later, I am still dealing with it.
It all started with extreme dizziness and muscle aches in my second month in Zambia. Thinking I had caught Malaria, I went to get my blood tested.
At the second hospital I visited (we will get to this later in this post), I was tested positive for typhoid. I didn’t have high fever yet, and typhoid can take a really ugly turn, so I was lucky that it was caught early. But with what I thought would cure me started a series of events that would have a severe impact on my health and every-day life for a long time after. I got prescribed antibiotics, but reacted badly to them so I went back and got different ones, along with a bunch of pills that were supposed to help me with the stomach pains and cramps I was now feeling. Long story short, the antibiotics (this is an assumption and couldn’t be confirmed) messed up my stomach and gastric system. As the typhoid didn’t go away quickly and I had also caught a UTI, I was put on more and more antibiotics. I got a severe gastritis and couldn’t eat anything other than mashed potato and soft carrots for three weeks. I had random fever outbreaks and constant severe cramps and pain in the lower abdomen. In total, I visited eight different doctors at five different hospitals, I had nine blood tests for everything from Malaria to STDs that revealed no results or hints at what might be wrong with me. The doctors were clueless. It was a nightmare. I was about to go home, but I had one month left in Zambia, and I had made a home for myself, so since I wasn’t in immediate danger, I decided to wait.
Further tests in Germany yielded no results either. I still have semi-severe digestive problems and have also taken tests in Guatemala. I will probably have to continue the investigation when I am back home next year.
What I learned
These are only two examples and in both cases I was lucky in many ways. In the UK, I was very close to home and could go back anytime. I was covered by National Health Care there, which is a nightmare in northern England, but I didn’t have to pay a cent. In Zambia, since I interned with a government-related organization, I had access to embassy doctors and in emergency had the option to get flown out to South Africa for special treatment. I was, considering the circumstances, pretty safe and I understand not everyone has that luck when they are abroad. If I had an emergency in Guatemala now (knock on wood), all I could hope for is that Guatemalan doctors would do the right thing.
Still, I think I learned some valuable lessons that can be applied in many cases when you get sick abroad:
Mandatory: get travel insurance!
This is an absolute must. You might think it’s money you could spend better otherwise, but trust me, it is worth every cent. It’s unlike me to be a complete pessimist, but let me play the devil’s advocate here: what if something happens and you are not covered by insurance? You might run into some serious problems that will have you paying off debt for a long time. So let’s not even run that risk! In Zambia I accumulated a bill of around $800 over time, and I sure was glad to get that money back!
Have all necessary numbers at hand
Your travel insurance will typically have an emergency number in their policy in case you have to go to the hospital. Make sure you save it in your phone and keep the number in your wallet as well. I also always look up my country’s embassy number. I have never had to use it, but you’ll also never regret having saved it.
Get multiple opinions
The first doctor I visited in Zambia only tested me for Malaria and a UTI, not for typhoid. Since a urine test can show a multitude of infections in your body, she simply diagnosed me with a UTI. She didn’t catch the typhoid because I did not have the typical high fever yet. Only because a UTI seemed weird and asymptomatic to me, I went to a second hospital and was diagnosed with typhoid because the doctor there had a hunch. Even though the antibiotics messed me up, they still prevented me from ending up in a hospital room with an IV like I have seen it with some of my university mates after coming back from Uganda. Trust your gut and get a second opinion!
Try to get the best treatment available
I am all for living like the locals and trying to stick out as little as possible. But if you are really sick, don’t take any chances. If you are in a country where you know public health services aren’t entirely trustworthy and are covered by insurance, seek a private hospital. Ask around for opinions on which one to go to – private doesn’t always mean high quality either.
Try to stay calm
This is a hard one. The month I was diagnosed with typhoid, I had just started a month of house-sitting and was all alone in a relatively strange country to me. Honestly, it was hard not to feel a bit freaked out. When I had such bad cramps and fever a few months later and all I wanted to do was cry, I was luckily in a house-share with a bunch of very caring new friends. I also realized that I was probably better off being treated for typhoid in Zambia than in Germany, since it is a very common virus to catch there and doctors are experienced, while at home they wouldn’t have been. Just because you are in a foreign, or maybe developing country, doesn’t mean that medical services will also be bad. I am contradicting point 2 here a little, but it really depends on the situation. You will be able to assess it best.
Trust your gut
Again – I’m a big believer in trusting your gut. When I thought something was wrong with me, I had typhoid. When I thought I had bed bugs, I did had bed bugs. And so on. So, if you feel like it is time to go home and get treated there, do it. I sat it out much longer than I should have in Zambia, and this may have made things worse for me. I am incredibly glad I took the decision to go home for my ACL surgery after I realized things weren’t moving on for me. It sucks to take a break from your trip or end it early, but your health always comes first. Try to remember that.
Keep your loved ones informed
You might not want to worry anyone, but you should try to keep your closer circle of family and friends up to date. They will want to know what’s going on with you, and in case of emergency, also have to know where you are and where to make the appropriate calls. Most of all, especially if you are by yourself, they can give you moral support, even from a distance (thank you social media and Skype!).
Don’t let it stop you from traveling!
Don’t let the fear of possible diseases in other countries stop you from going. In Central America, the risk of catching dengue or chikungunya is very high (so high that my flatmate recently caught it). I’m still here and so far, I’m good. If I catch it, that’ll suck but I’ll get through it. In Zambia I learned that with access to medication (which you have the privilege of), you’ll be cured in a few days and will feel no more than a strong flu. Just be careful with hygiene and don’t drink tap water ever (seriously, don’t risk it). Watch out for salads and raw vegetables when you’re not sure if they’ve been washed with purified water. But also don’t be paranoid the entire time! It’s not worth it to have it ruin your trip.
With this post I am in no way trying to scare or worry you about your next stay abroad. But these things happen – at home and abroad, and it’s better to be a little prepared.
Have you ever gotten sick abroad? What was your experience?