A couple of weeks ago I asked what readers would like me to write about and we got a few questions, several of them centered around healthcare and what we do about that on the road. Obviously, with six of us, varying in ages from five when we took off traveling and 40 now, healthcare is something that happens while we are moving. So do emergencies, from time to time.

So here is the breakdown of how we make it all work on the road over the long haul:

Insurance

Yes, we have it. We have a traveler’s policy that covers emergency healthcare and things like dental and vision with a $100USD deductible. It doesn’t cover pre-existing conditions or pregnancy. It does cover our gear, trip interruption or protection and expatriation of remains as well as medical evacuation. We know plenty of people who travel without this type of insurance, but we don’t recommend it. One true emergency and you’ll be glad you have it. There are lots of companies out there that offer travel insurance and which is best can hinge on a lot of individual factors. We use World Nomads. We’ve made claims and they’ve paid out with no drama. We’ve been quite happy with their service thus far.

Immunizations

This becomes a hot button issue, I know, and I’m not out to start any big debates or offend anyone. Growing up with a polio affected Daddy, I see things pretty firmly from my position (and yes, I’ve read widely on the anti-vaccine side too). We immunize our kids. We don’t necessarily subscribe to every new vaccine that comes down the pike (we opted out of chicken pox, the flu and the HPV shots, for example) but we do vaccinate for the classics and for the life threatening things.

We also immunize for the regions we travel in. Our kids have the Hep round up, they’ve had typhoid, yellow fever and Japanese encephalitis. We’ve done this both ways, getting the shots before we leave the USA through travel clinics, and getting them “on the ground” in Thailand (JE wasn’t available to us from inside the USA) and we found the “on the ground” route the better way to go, and far cheaper as well!

Doctor Visits

Or dental, or vision, or chiropractor visits; all are necessary from time to time. We’ve found it quite a simple matter, both within the USA and abroad to arrange these visits anywhere that we are going to stay a week or more. I check with my fellow travelers and look for recommendations, and I make use of some of the Dr. rating and recommendation sites out there. If I can find a first hand recommendation from someone I know, that’s my first preference.

I just call ahead, explain our situation and make an appointment. We’ve had dental cleanings and repair work done in Guatemala, Austria & Bali, Indonesia, and the USA. We’ve had vision appointments in the USA, Thailand and Indonesia. We’ve visited a chiropractor in Indiana. We’ve had emergency care in the USA, Guatemala, and Thailand.

Our general recommendation, especially outside of the first world, is to make use of private hospitals and western trained doctors over the public hospitals any time you can.

Almost all of our healthcare we pay for out of pocket as it is generally less than the deductible on our insurance. If it is higher, then we pay out of pocket and file the claim for reimbursement.

Anti-Malarial Pills

This can be another controversial topic. To take them, or not to take them? To take them along as an “after the fact” treatment? To give them to kids? You’ll need to do the research and make your own choices. There are maps on the CDC website that break down recommendations by region.

We take the pills. We’ve never had anyone react badly to them (some people do) and for us, the risk of becoming deathly ill outside of easy reach of medical care (along the Mekong in Laos, for example) is not one we are willing to take when there is an option to avoid it. People do still die of malaria. Lots of them. That being said, we’ve never had to take the pills for more than a couple of months at a time. There are implications for long term use, which bear looking into as well.

It’s also worth mentioning that there are different medications for the different strains of malaria and it’s important that you take the appropriate one. Your travel doctor can sort you out on this front. If you have the luxury of time and you can wait and get the meds from a pharmacy in the country you’re going to, you’ll find that a much cheaper option and you’ll always find the correct meds available in the regions where they are needed.

Preventatives

At the end of the day, we’d just rather not get sick at all. Most of our efforts are focused on prevention (immunizations and anti-malarials are just the tip of the iceberg). We take immunity boosters before we fly or do major overland travel involving chicken busses or other germ laden modes of transportation. We make water kefir and yogurt as we go to keep our guts populated with the right types of bacteria. We take vitamin B to ward off sandflies rather than drench ourselves in insect poisons. We are hand washing fiends and I carry anti-bacterial baby wipes for “washing” fruits and vegetables on the fly. Grapefruit Seed Crush Extract is our favourite treatment for belly problems and will clear things up faster than most of the over the counter meds.

Our Health Kit

We carry an extensive health and first aid kit. It has all of the usual suspects: bandaids to face shields, but it goes a little deeper than that. We’ve learned, over the years, that if you plan to get off of the beaten track you’d better be prepared for emergencies. To that end, we carry several rounds of antibiotics, worm pills, a full needle start and suture kit, inhalers (no one is asthmatic) and a full compliment of over the counter drugs for a variety of emergency treatments, from female conditions, to UTIs, to dehydration and diarrhea. We’ve done our best to leave nothing to chance.

We’ve taken a little criticism on the needle and suture kit front. People have suggested that it’s irresponsible to encourage people to carry medical items they aren’t trained to use, and others have pointed out that there are disposable syringes in even the most back water places now, and that any hospital will have them. Our experience is otherwise. In Guatemala we encountered a hospital that couldn’t deliver the stitches we needed because there wasn’t a suture kit in the entire hospital. Neither were there butterfly bandages. And things were, definitively, not clean. At that moment I realized that given the choice between dirty needle or no needle in a life and death situation with my kids, I’d take dirty every time. But there is no reason to have to make that choice if I will take responsibility for that myself by carrying one of everything. I’m not intending to use the suture kit or the IV start myself, I’m carrying them so that I can supply the appropriately trained person if need be.

What are your approaches to healthcare on the road? Will you share your “secrets?” Do you have any more questions for us? Ask away!