Travel often brings us face-to-face with contrasts. Sometimes it’s the scenery, the shift from arid bushveld to lush coastline in a single day. At other times, it’s cultural, such as the way a meal is served or how greetings are exchanged. And then there are those moments when the difference lies in something as practical, yet deeply personal, as the cost of healthcare.

This past week, we experienced one of those moments in Komatipoort, South Africa, a small but busy town that hugs the border with Mozambique. Our mission wasn’t to stock up on souvenirs or local crafts but to tackle something far more essential: filling prescriptions that will carry us through the next year of our travels.

When the pharmacist tallied up the total, ZAR 29,000, or US $ 1,629, my heart skipped a beat. It felt like such an enormous sum, handed over in one swipe. The stack of neatly packed boxes and bottles was daunting, filling up three big plastic bags. But then, as the shock subsided, we reminded ourselves of the bigger picture. This was a year’s worth of peace of mind, a year’s worth of uninterrupted health, and a year’s worth of freedom from worrying about whether or not we’d be able to find what we needed in the next country.

When compared to the United States, the difference is almost laughable. The same medications were available there, even with insurance, but would have cost several times what we paid. Since we don’t live in the US, there was no sense in buying a pharmacy plan when we could only get three months of drugs at any given time due to insurance restrictions.

In the U.S., prescriptions are a monthly reminder of how expensive it is to stay well, with bills that keep piling up, appointment fees added on, and insurance companies deciding what is or isn’t “covered.” Here in South Africa, we paid upfront, yes, but we walked away knowing the next twelve months are accounted for, at a fraction of the American cost. What felt at first like a fortune suddenly seemed more like a bargain.

There’s a psychological comfort in that. As travelers, we live with a certain level of uncertainty. Where will we be next month? Will the Wi-Fi be strong enough to stay connected? Will we find a place to stay that feels like home? Those unknowns are part of the adventure, but health is different. Health is the foundation upon which all those adventures are built. Knowing we have what we need neatly tucked away in our luggage allows us to embrace the journey with less worry and more joy.

I thought about how many people in the U.S. don’t have that option. Even retirees, who should be able to enjoy their later years without constant financial strain, often find themselves paying shocking amounts for the medications they need. It’s one of the strange ironies of our travels that moving through countries where people sometimes have less materially, we often find greater accessibility when it comes to healthcare. South Africa may not be perfect, but the availability and affordability of medication is a lifeline not just for locals but also for travelers like us.

Of course, spending ZAR 29,000 in one go isn’t something to brush off lightly. It was a big line item in our travel budget, and I’ll admit we were a little shocked.. But when you consider what that figure represents, the decision made itself. It isn’t just a transaction; it’s an investment in our ability to keep going, to keep saying yes to new places and new experiences without the nagging worry of running out of something vital.

There’s also a strange sense of gratitude that comes with moments like this. Gratitude for the pharmacists who took the time to patiently gather everything we needed. Gratitude for the fact that South Africa’s system makes it possible to buy in bulk. And gratitude that, as nomads, we’ve learned to adapt to different systems, to figure out what works and what doesn’t as we cross borders.

Doc Theo wrote us prescriptions for several preventive medications in case we become ill on the upcoming cruises, including Tamiflu, Prednisone, respiratory drugs, and various antibiotics suitable for norovirus or the cruise flu/cough. If we’re lucky, we won’t need to use some of these. Also, he explained we can WhatsApp him if we need guidance on which ot these we should take, leaving us with tremendous comfort with the concept of our “doctor-traveling-with-us.”

Walking out of that pharmacy, bags in hand, I couldn’t help but feel lighter, even if the luggage itself was a bit heavier. It wasn’t just about the medicine. It was about knowing that we’d taken care of ourselves in a way that allows us to keep chasing the life we’ve chosen. The freedom of the open road, the constant stream of wildlife outside our door in Marloth Park, and the endless discovery of new places —all of it — is sustained by these practical decisions made quietly in a small town like Komatipoort.

Yes, ZAR 29,000 is a significant amount of money. But it bought us more than pills and prescriptions. It brought us reassurance, continuity, and the ability to keep moving forward without pause. And when weighed against the alternative, the spiraling costs and stress of the American healthcare system, it feels less like an expense and more like a gift.

Travel teaches us to value experiences over possessions, but it also teaches us to recognize the worth of what drives us forward. This time, it wasn’t a spectacular view or a cultural encounter that left the biggest impression. It was a simple transaction at a pharmacy counter, reminding us once again that sometimes the greatest luxuries are not material, but the peace of mind that allows us to continue our journey through the world.

Today, at 4:00 pm, we’re meeting Rita, Gerhard, and Inge at Amazing River View for river watching, sunset viewing, and dinner.

Be well.

Photo from ten years ago today, September 7, 2015: