Sunday’s sunset from Jeri and Hans’ third-floor veranda, the last rain-free day.

The following comments are not intended in any manner to substitute for professional medical advice. This post is entirely based on our personal travel experiences regarding preparedness in the event of medical issues or emergencies.  Please seek the care of your medical professionals in regard to your personal healthcare.

Coupling our interest in health and well being with our worldwide travels has been important to us. Many seniors and younger travelers alike choose to address health concerns before traveling. Many others “wing it” hoping for the best, in many cases a poor decision or, simply a lack of a decision at all.

Checking online over the past almost two years, we have discovered a wealth of resources available that may be of assistance, too many to list here.

We’ve found that researching credible medical sites are crucial, not simply the opinions of a few travelers with a good or bad experience, often seeking a place to vent frustrations and unfortunate experiences.

Some of the questions we had and the answers we’ve discovered that have worked for us, that we’d asked ourselves when planning our world travels include and on an ongoing basis:

• Will we get intestinal distress from eating uncooked fruits and vegetables? If so, how does one reduce that risk? Yes, illness is often a result of produce eaten raw. This risk does exist when non-purified water is used to rinse produce, which is then eaten raw, such as lettuce, celery, and fruit. Usually, cooking vegetables destroy most of the bacteria. We rinse all of our produce in a bowl of purified water, replacing the water as needed. Always remain mindful of cross-contamination of washed and unwashed produce. We washed all of our produce immediately before placing it in the refrigerator.  This may reduce shelf life, but our “shelf life” is more important.
• Is it safe to drink the water? Before we arrive at each location we research to determine if the water is safe to drink.If not, we arrange for the property owner to have a several-day supply of purified water awaiting us to ensure we have ample time to get to a grocery store.
• What about brushing our teeth? This is often a cause of illness. We keep small bottles of purified water in the bathroom for wetting the brush, rinsing our mouths after brushing and rinsing our toothbrushes. Daily, we brush with baking soda and then do a full 20-minute coconut oil gargle which kills bacteria in the mouth, spitting it out when done. Once a week we disinfect our toothbrushes (and my contact lens case) in hot boiled purified water.
• What happens if get water into our mouths while taking a shower? Immediately, spit it out and promptly rinse the mouth with mouthwash, and brush our teeth following the above process using purified bottled water.
• Can water be boiled to become safe to use? We don’t recommend this process. Considerable bacteria may remain if the water is not boiled long enough, 15 to 20 minutes, or more. This would only be done in the case of a dire emergency.
• What about washing dishes?  Ideally, we could use purified water to wash dishes.  Unfortunately, the cost of bottled water is prohibitive and if done properly this isn’t necessary. Wash and rinse dishes, pans, and flatware in the hottest cleanest soapy water your hands can take. Drain on a clean cloth. Wipe dishes dry with another clean towel and leave out, not stacked, to further dry on the clean counter to ensure that no water molecules remain.  Wash your hand before handling dishes which we each do so often it’s ridiculous.
• Do we need to take malaria pills or other prophylactic medications while traveling? Taking pills for the prevention of malaria depends on the location of your travels. Check with your local travel clinic for detailed maps and information for every country in the world. Other prophylactic medication? For us, we take a Bifidus Probiotic  (30 billion CFU minimum) supplement daily to keep the balance of good bacteria in the gut.  These may be purchased online or at any quality health store.  Research for a quality brand, most of which require refrigeration for freshness.  We have been taking multiple individual supplements for years.
• What do we do if our luggage is lost or stolen containing all of our daily medications? Do we need to bring along copies of our current prescriptions, written letter explaining the use of medical syringes, if applicable, etc.? Yes! Yes! Yes! We have copies of all of our prescriptions and a doctor’s letter listing all of the supplements we use. Even so, we had trouble boarding a Carnival Ship in Belize (see the posts of April 9th and 10th, 2013 for details of our ordeal).  Also, we carry several Epipen syringes, in the event, we have an allergic reaction (anaphylaxis) to stings from insects or other substances, including a doctor’s letter of authorization.
• Will our insurance pay if we become ill?  Do we need to purchase emergency evacuation insurance?  Is it costly? Every policy is different.  Check with your policy benefit well in advance of travel to determine what will or won’t be paid. Generally, Medicare usually doesn’t pay outside the US, but check on your supplemental policy’s terms and conditions.  Emergency Evacuation insurance is a must if you’re traveling outside your home country unless your regular policy provides this coverage. Check for specific details well in advance of travel.  On its own, emergency evacuation insurance usually is US $200 to US $300 per person for a two-week vacation. Keep in mind, that “travel insurance” and “emergency evacuation insurance may be entirely different from one another; one if in case of cancellation on non-refundable fares, etc. and, the other is for medical purposes. A few policies have both features combined. Check carefully for details.
• Do we need vaccinations to travel abroad?  Again, check with your local travel clinic, a highly valuable resource when planning a trip abroad.  Countries in Africa may require proof of vaccination for Yellow Fever and other communicable diseases.  We keep a copy of our entire vaccination record (we had around 18 separate vaccinations) on the inside flap of our passport holders. We haven’t been asked to produce these records yet , but entry into a country can be refused if not provided.
• How much in advance must we plan for the vaccinations? We both began the vaccination process 6 months in advance of our departure from Minnesota.  Many vaccines require waiting periods between boosters.  Many vaccines may be given at one appointment, which is not detrimental to their efficacy.  The question becomes…how will you tolerate multiple vaccines in one appointment? If dubious, space them out as I did with no side effects.  Many vaccines such as Yellow Fever don’t require a booster for 10 years.
• Did our insurance cover the cost of the vaccinations?  At the time we had the vaccines, both of us were covered under Tom’s policy from work which much to our surprise, paid 100% of the cost.  With the number of vaccines we chose to receive, the total cost would have been over $1500 each.  If you have Medicare or under the new guidelines, this may not be covered. Please check with your company to determine what, if any is now covered.
• Will the tours and excursions in which we plan to partake fit within the confines of our current physical conditions and limitations?  Most tour operators specific the “difficulty level” of each of their tours and excursions.  However, these are often minimized, leaving participants gasping for air and exhausted or perhaps at severe risk.  Read reviews and comments online at travel websites such as Cruise Critic and Trip Advisor.  These comments are often a better resource of “factual” information as opposed to the sales orientated tour companies and cruise lines.
• Did we bring along extra prescription eyeglasses, contact lenses, and supplies, (and hearing aid batteries, if applicable).  What if we lose any of these?  How do we plan to replace them?  We both have our optical prescriptions with us, even if they expire.  In the event of a loss, most prescription eyewear and contacts can be replaced locally or through the mail.  Tom has three pairs of backup prescription eyeglasses and sunglasses. I brought along 24 boxes (6 packs) of contact lenses enough to last three years. I do purchase lens solution at a local pharmacy due to the added weight of the bottles which may be difficult to find in some locations (Belize and Italy).
• If we use any particular medical supplies, what happens if they’re lost or quit working? Although Tom nor I use any particular devices, we suggest bringing a backup in the event of loss or failure.  We do have a thermometer, small blood pressure cuff, emergency suture kit, and emergency dental supplies (dental glue) in the event a crown or filling falls out or dislodges.
• What over the counter medications did we include? We packed Aleve, Tylenol, Tylenol PM, aspirin, Milk of Magnesia and Benadryl, cortisone cream, antihistamine cream, antibacterial cream, and hydrogen peroxide.
• What first aid supplies did we bring? Besides the above comments above, we have Bandaids, bandages, sterile gauze pads, sterile gauze wrap, ace bandage, liquid bandage, and Lidocaine patches.
• Immediately upon arrival,l in a new location, what precautions do we take in the event we become ill or injured? Upon arrival at our new home, we ask the owner/landlord or property manager the location/phone of the best local hospital, medical clinic, physicians, and dentists in the event of any emergency. For example, here in Kenya, we have the phone number of a physician who will make a house call in the event of a non-life-threatening emergency.  Otherwise, there is a hospital within 10 minutes on the main road.

Yes, I know, this stuff is difficult to address. And for many of you who seldom travel it may be boring. But, for those who travel even short distances on a day-long road trip, being away from one’s home base can present challenging health concerns.

Years ago, I was meeting up with a bunch of girlfriends in Mexico for pre-arranged dinner plans. When they hadn’t arrived after a two-hour wait, I tried calling to no response. A day later, I received a call from one of the other friends in the group informing me that the friend had fallen into a hole under a “grate” on the sidewalk resulting in a serious compound fracture of the leg.

The only way to receive quality medical care was to return her to the US immediately.  With her not having emergency evacuation insurance and the requirement of payment in full in advance of the flight with the air ambulance service, the friend had no alternative but to ask family members for their credit card numbers to cover the then cost of US $25,000 when her own card had a US $5000 limit. Can you imagine the stress of returning home facing your own credit card bill, but also that of the cards of family members? That airfare was 30 years ago. Can you imagine how much it would be in this day and age?

This scenario remained stuck in my mind for 2 reasons; one, don’t walk on grates, wooden boards, or any potentially unstable surfaces on roads and sidewalks (in any location). Of course, Tom has adopted this practice also, as we’ve always alerted one another to possible hazards.  And, the second reason, always have an emergency evacuation policy in effect when traveling outside your home country.

Last night, we ventured out to dinner during a massive rainstorm that had started on Monday continuing all the way through today, Wednesday.  As is typical in Diani Beach restaurants, the walk from the taxi drop off area to the restaurant is long and treacherous with uneven steps, many often twice as steep as we’d expect, multiple tripping hazards, slippery surfaces, and the risk of falling tree limbs and coconuts.

Always carrying our LED mini flashlights has proven to be vital to our safety.  Last night, leaving the restaurant in torrential rains and gusty winds, luckily under an umbrella provided by the restaurant, I hung onto Tom for dear life.  If one of us went down, we both were going down. The long, steep outdoor steps were particularly hard to maneuver when their design was inconsistent and there was not a light or handrail at any point.

We both sighed with relief when we found Alfred, our trusty regular taxi driver, waiting for us and quickly jumping out to open the car doors as we handed off the umbrella to the restaurant server who escorted us. We were soaked all the way through to our underwear, but grateful to have made it to the taxi without incident.

No traveler can sit back and make the assumption that they are invincible and exempt from possible injury or illness when traveling.  With all the effort we’ve made, on a few occasions, we’ve fallen prey to unforeseen illness and injury. We can only hope and pray that we’ve exercised more than adequate foresight to guide us through those tough situations.

As they say on a mindless drivel TV show, Big Brother…” expect the unexpected.”  Doing so need not reduce the quality of our experiences or result in needless worrying.  But, preparedness, certainly minimizes the risks enhancing the quality of our experiences.