Other World Doctoring… Tips For Surviving A Foreign Situation
Having been down with a nasty case of the flu this week, trying hard to avoid a trip to the local hospital for intravenous rehydration fluids, I’ve had lots (and Lots) of time to reminisce about medical care I have received around the world. Some great and some rather sketchy to be honest.
Expats and travelers always have to take the potential occurrence into mind, and learn how to prepare for the worst.
When I was working for Exxon in Houston, all the exploration teams were sent abroad with kits that included “rehydration salts” for just such experiences. Things that local folks can eat and drink, and be just fine, don’t always agree with non-acclimated systems of travelers. One never knows…
Being an international company, Exxon had plenty of diversity among its exploration teams. One of my favorite “personalities” was Anatoly, a Russian born and trained doctor of geophysics. He was well-trained but not so open to outside ways.
In his thick Russian-accented English, Anatoly kept telling me, “I don’t need rehydration salts. I have Wodka.” No matter how much I tried to explain the DEhydration effects of vodka (Wodka) he was staunchly in favor of vodka as his curative of choice. As for me, I was ever so glad to have had them on my first trip to Baku.
I traveled to Baku via Turkey (Ex-Pat Living: Fear of Flying?) and while I had never had a reaction to Turkish food at home, street food proved my undoing. Arriving in Baku, after a miserable flight (which must have grossed out every passenger in first class) I was so dehydrated and unable to keep anything down that I ended up at the local expat clinic where I was given sachets of activated charcoal to be shaken into bottled water and drunk down.
Looking at the black swirling granules, I couldn’t imagine which was more disgusting, the problem or the cure. But drink I did, and within a day or so I was able to eat again. Then I could keep the rehydration salts down and get back to normal.
Thank goodness for British docs in foreign lands!
When You’re On The Local System
When my local taxi driver was involved in an accident, he ended up in the hospital in Baku. Another driver ran a red light… a not-uncommon occurrence. Trying to watch for pedestrians is a full-time job and often results in follow-on incidents as you’ll see in this video. (Traffic is a whole other post… disregard the Russian captions, you’ll get the idea.)
As this was early after the collapse of the former Soviet Union, everyone was one their own- no supplies, no money, no systems.
Mammed was helpful to me from the first day we met outside the RamStore. He recognized a foreigner but never tried to take advantage. I asked for his advice for buying furniture and he took me to all the places locals go and negotiated local prices for me (or maybe higher than local, but lower than expat prices?).
When I was buying furniture for my office he saw a tv stand that he commented on. At the end of our day we went back to that particular shop and I asked him to go get that tv stand. He was a bit puzzled, knowing that I didn’t need one, but he negotiated a good price for it. Then we took it to his wife as an anniversary gift. Serendipity, I suppose, but I became good friends with them.
When I didn’t see him for a day or two at our local meeting spot, I inquired and found out about the accident, and which hospital he had been taken to.
When I went to visit him, it was quite a shock. It was my first time inside a non-American hospital, and what a difference post-Soviet medicine was.
His wife had to bring clean sheets each day, along with his meals. The family had to pay up front for clean bandages as well. In addition with all that they had to pay so far, they also were told that they need to pay 5 “Shirvans” (each one being 10,000 manats, or about $2USD) for antibiotics. Given the surroundings, that seemed to be a given.
I asked what had happened and found out that he had a compound fracture of his right arm- his driving arm (his shifting arm)- which meant he was going to be without income for quite a while.
Even though in the Soviet system everyone had “страхование” or state provided insurance, this was not that system anymore and people were scrambling to figure it all out.
I gave the doctor the 5 Shirvans and asked them to make sure Mammed received the medicine and care that he needed. That may have been the wrong thing to do, since it opened the door to graft and corruption, but at the time it seemed like the right alternative.
Common Language, Uncommon Meds
When I was in Ireland, my allergies got the best of me and I needed meds in short order to be able to enjoy this visit with my daughter.
One of the things I have learned about travels across the globe, is that the language of science is a wonderful thing. Obviously we aren’t going to find our favorite “brand names” far from home, no matter where we are from, but… you can find common products based on the ingredient listings.
I learned early on when my daughter was growing up with asthma and allergies that I needed to be able to read labels. That bit of learning served me well when I began traveling.
In Ireland, I was in need of pseudoephedrine and acetaminophen to feel comfortable on our long bus journey around the Emerald Isle.
Stopping at a mall so the kids could buy supplies and souvenirs might seem like an unlikely place for a chemist, but I managed to find one. By comparing box labels, I also managed to come up with a combination of products that had what I needed. Journey salvaged!
What To Do With An Uncommon Language?
In Spain, I was not in my element. Not many folks on the Costa Brava spoke Russian or Turkish, my two strong languages. I had studied Spanish for the required years in high school more than a few years ago but it was slow going.
When my husband came down with the flu I knew what I needed to do.
A Life Lesson I learned through lots of travel was to identify important symbols early on in my travel.
In Spain chemists (drug stores, apteks) generally have a bright green neon plus sign or cross above the entrance. In America ambulances and emergency entrances are marked with a red one. I had noted a green sign down a side street of one village we were driving in and convinced my husband to stop- not an easy task on a good day, and nigh unto impossible when the man doesn’t feel well.
Even though the products were in Spanish and all “generic”- meaning no pictures or brand names- I could read the labels and generally identify the ingredients I wanted.
In a new development (still in Beta testing) there is a helpful website you may find valuable in your travels. It’s called http://www.drugs.com/international/
“The Drugs.com International Drug Name Database contains information about medications found in 185 countries around the world. The database contains more than 40,000 medication names marketed outside the USA and is presented in multiple languages.”
I found, for example, that if I was looking to find Paracetamol, which I can get in UK English based countries, I would need to find acetominophen in the US, and vice versa. Knowing this makes reading labels easier, even in a foreign language as drug names translate nearly intact though into a new alphabet you may need to sound out each letter sound to understand the word- the chemist can be of help with this too.
Why Don’t We Have This At Home?
Maintaining health while travelling is important, and most seasoned travelers know to carry prescriptions along with their meds. Sometimes though you happen across a minor miracle in these offbeat places.
A Turkish friend (truly, an angel) found me hugging the porcelain throne one week and knew immediately what to do. He sent out to the local aptek for some Ercefuryl (to restore the intestine flora). If I could buy stock in the company that makes this, I guarantee I would.
Apparently, I’m not alone in this view…
You can diminish the chances of suffering from diarrhea by making sure your intestines are in top shape prior to your departure. A few pills of Ercefuryl usually is all it takes. If you have sensitive intestines, avoid too greasy and/or spicy food during your stay, dairy products and some of Istanbul’s street food. You also want to make sure that your (minced) meat is cooked thoroughly.
If you do get diarrhea, a combination of the medicines Ercefuryl (to restore the intestine flora) and Immodium (to stop excessive visits to the bathroom) should solve the inconvenience in a day or two. Don’t forget to read the respective medicines’ instructions carefully before taking them! Also, drink a lot of water (to prevent dehydration) and stick to (toasted) bread and yoghurt for the time being. Another trick that may help with cramps is a glass of flat coke (room temperature).http://www.wittistanbul.com/magazine/istanbul-health-tips-while-youre-there/
I found in the Drugs.com link that Ercefuryl is marketed in a number of interesting countries, but not in the US. However, now that I know its ingredient, maybe I can try my third world tricks here at home. I just wish I had thought of this a few days ago… uh, on second thought, I was a little preoccupied.
Another Life Lesson
When I was in Baku and needed medical care in the form of surgery, I was lucky to have contacts that could help me. Local practices were just not going to do in this case.
I made a call one afternoon and the next morning I booked myself on a flight to Istanbul to check into the International Hospital at 10:30am.
By 12:30, after consultation with my English-speaking doctor, I was in the operating room with a group of nurses who didn’t speak English, but were very good at sign language.
I made it through the surgery and was in my room sleeping off the anaesthesia until about 4:00pm in the most luxurious hospital bed ever… down comforter, down pillow. I never wanted to leave. Really.
However, this hospital was no hotel so leave I did- walking back to my hotel across the street, not completely sure of where I was, but sufficiently compos mentis to get me back to my room in one piece (no Russian traffic issues there!).
For travelers and expats who may not be so lucky to have well-connected contacts in your travel area, the services of companies like International SOS may be of help. International SOS was a favorite of the expat community in Baku and it has locations world-wide so it may offer you some peace of mind as well.
If I were traveling around the world, a medical insurance policy might be just the ticket. I had to pay more than $3,000USD out-of-pocket for my surgery in Turkey- a bargain by US standards (with a doctor trained in New Jersey, no less) but still a big hit if you’re on vacation and watching your budget.
A year-long policy for me and my husband today with multiple locations, and catastrophic coverage plus would be slightly more than $1,700USD- it would have paid that back twice over for my one medical event. Something to keep in mind if you’re traveling to high risk places or you have medical needs.
So these are a few of the Life Lessons I learned- important ones when the life I had to save may have been my own! You may find these of value on your next trip abroad. Let me know where you’re traveling and what preparations you make. You never know whose life you may be saving!