International Medical Must Read Information Before You Go

BY Beth Williams

Getting health care in another country can be an exercise in culture shock. Whether you get a doctor who doesn’t speak English or you don’t understand the procedures in a foreign hospital, getting sick away from the comforts of home can be frightening. Your best approach to deal with an illness or injury while traveling is to prepare for the problem before you depart. It’s important to research your country’s emergency numbers, embassy phone number and address, and local English-speaking doctors and hospitals before your trip.

What to Do

If you are injured or ill, contact a health care provider as soon as possible. Call your regular doctor if you lose or run out of vital medication; he or she may be able to call in a prescription to a local pharmacy. If you are at a hotel and a non-emergency injury or illness occurs, contact the front desk and ask for medical care. The concierge may be able to arrange for a doctor to come to the hotel. For hospital care, take a cab to the local hospital (finding out which hospitals are nearby before your trip facilitates this journey) or call the local emergency number — a good guidebook should have this information.

It is most important to be prepared to deal with a medical emergency if you are traveling with children; if you have an existing medical condition or are traveling with someone who does; or if you will be taking part in potentially dangerous physical activities such as horseback riding, rock climbing or hiking. If you are camping or spending time in a less developed destination, you should also be especially prepared.

How to Be Prepared

Start with the Consular Information Sheets

If you aren’t familiar with the country you’re visiting, the U.S. State Department’s Consular Information Sheets are a good place to start to see what type of medical services will be available to you once you’re there. Select your country and look for “Medical Facilities and Health Information.”  You can also find a list of doctors and hospitals abroad on the U.S. State Department’s Web site. If you’re traveling domestically, contact your insurance company for a list of in-network hospitals and doctors at your destination (you may want to do this a few weeks in advance, as the insurance company might send the list in the mail).

Check Your Insurance

Before you travel, call your health insurance provider to see what coverage, if any, you will have in the destinations you’re visiting. Some insurance companies will not cover injuries or illness outside your home country, while others require that you pay for any treatment up front and then apply for reimbursement after you get home. If you’re not satisfied with the coverage available to you, look into purchasing a travel insurance policy that will cover health care and emergency medical evacuation.

Collect and pack the following health care contact information before you leave and keep a copy with you during your trip:

Write down the following information in your address book, smart phone, journal or itinerary and keep it with you at all times:

  • Your doctor’s office and home phone numbers in case you need a consultation or in the event of an emergency that occurs outside of his or her regular office hours while traveling.
  • HMO/insurance company contact information in case you need to get approval for treatment (don’t forget your insurance card)
  • Travel insurance company contact information, if applicable
  • Embassy contact information for countries in which you are traveling
  • Contact information for a relative or loved one at home, especially if you are traveling alone
  • Be aware of any disease risks in the destination that you are traveling to and get the proper immunizations before you leave.
  • If you are camping or staying in a remote area, pack a first-aid kit. Also, give a copy of your itinerary to someone at home; this way, if something happens to you and you are unable to call for medical help, someone will know where to find you.
  • All of this information should be with your primary identification in your carry-on luggage, wallet, purse or money belt so that, should you be incapacitated, whoever comes to your assistance will find it. If you have serious allergies or a medical condition such as diabetes, be sure to ask your doctor about medical emergency bracelets.

Know the Generic Names of Your Medications

Common brand names at home may not be available or widely known where you are traveling. It’s a good idea to bring along a list of any medications you’re currently taking, but be sure to include the scientific name as well as the brand name (such as atorvastatin calcium for Lipitor or esomeprazole for Nexium).

Knowing the generic/medical names of common medications is also helpful when you’re hunting for over-the-counter remedies in a foreign country. We recommend packing a range of common travel medications in a first-aid kit before you leave, but if you need to replenish your supplies while traveling, keep in mind the following generic medication names:

  • Advil/Motrin/Aleve = ibuprofen
  • Tylenol/Excedrin = acetaminophen
  • Bayer, others = aspirin
  • Benadryl (antihistamine) = diphenhydramine
  • Dramamine = dimenhydrinate
  • Bonine = meclizine
  • Pepto-Bismol = bismuth subsalicylate
  • Antacids = calcium carbonate, aluminum hydroxide or magnesium hydroxide
  • Imodium = loperamide

Locating Doctors and Clinics While Traveling Abroad

The U.S. State Department provides a list of doctors and hospitals abroad. The nearest embassy or consulate in your destination should also have recommendations. Finally, check your guidebook — many include hospital, clinic or doctor recommendations.

Especially at upscale lodgings, ask the hotel concierge for physician recommendations. Some doctors will make “house calls” to your hotel. Alternatively, your best bet may be to contact the nearest medical school, where you will often find English-speaking doctors and students.

While traveling on vacation or for business, you suddenly realize your medications are missing … what do you do? The seriousness of the missing medication depends on your health condition. For some travelers, missing medication is a mild issue but for others it can be life threatening.

The problem is further exacerbated by the varying laws, rules, and regulations governing medications – prescription and otherwise – in all countries.

Unfortunately, if you’re the traveler standing in a foreign hotel room without your prescription medications, there are not a lot of good options.

Before we get started with what to do when your medications go missing, let’s look at how to avoid the problem.

Think about how you would replace your prescription medications when traveling abroad

This is one area that most travelers give very little thought to – what would happen if you lost or has stolen your travel bag that contained your medical prescriptions?  It not like you can simply walk down to your local RiteAid or CVS and get replacements,  Here’s some thoughts you should consider about this subject prior to departure on your overseas trip.

Have a plan of action before you leave

Think about this issue before you go – think that you will loose your prescriptions.  Make a checklist fo traveling with your prescriptions that you keep separate from them.

  1. Always carry drugs and medical equipment, including syringes, needles, catheters, etc., in their original labeled packages – do not put medicines in unmarked containers.
  2. Be prepared to answer questions at the airport and border crossings about the medications you are carrying – have a spare prescription on hand and a doctor’s note, if necessary.
  3. Know how to safely store the medication and check it if it requires refrigeration and use insulated containers during transit (your pharmacist will have container and packaging recommendations).
  4. Unless it requires refrigeration, pack your medication in your carry-on and not your checked bag to minimize loss or theft. If you are traveling with another person, consider splitting the medication for the same reason.
  5. Be prepared with a backup plan if your medication is confiscated. Have an original prescription and a letter from your doctor to facilitate the consultation.
  6. Make sure you have travel medical insurance and check that it will cover lost, stolen, or confiscated medications.

If you have a pre-existing medical condition, it’s wise to carry a letter from your doctor explaining the condition and the medicines used to treat it, for example.

If you are traveling internationally, it may be more difficult to get your medication replaced. The U.S. Food and Drug Administration (FDA) warns travelers that filling their prescriptions abroad may have adverse health consequences.

U.S. consumers who fill their prescriptions abroad have to realize that the name of a drug bought in another country may be identical or similar to the name on their prescriptions back home, but the drug they are given may have a different active ingredient or not be in the same dosage and could cause serious and sometime irreparable harm.

Even with a prescription and cash in hand you could have trouble

Even if you’re prepared with a copy of your prescription and the money to pay for the drugs, many countries do not permit pharmacies to fill prescriptions that originate outside their country.

One solution is to see a local doctor to explain your medical condition to get a new prescription that can be filled locally. If you have a letter from your doctor back home explaining your condition and the medication used to treat it, that will help the local doctor.

Now, let’s look at this very serious travel problem and what you can do to replace your prescription medications.

1. Call someone for help

Travelers who discover their prescription medications are lost or stolen should start by contacting the assistance service company provided in their travel insurance policy. The travel insurance assistance services is the simplest way to get your prescriptions replaced as the service representatives will be able to make the calls to your doctors and pharmacies back home and then advise you how to proceed.

Travelers who are in a foreign country without the benefit of a travel assistance services provider may contact the local embassy in the country they are visiting for help.

Consider having a simple travel medical portfolio which can ensure that you have the information you need – such as your doctor’s contact information, your current prescriptions, your health insurance company contact info – to help yourself too.

2. If your medications were stolen, file a report

If your medications were stolen from your checked luggage, for example, check with your airline and file a report. If your medications were stolen outside the realm of air travel, file a police report.

Be sure to get a copy of the police report – you’ll need it for your travel insurance claim. If your travel medical insurance plan has coverage for the cost of prescription medications, then replacing them maybe covered. If you packed your medications in your checked or carried bags and a bag was stolen, the cost of replacing your prescriptions may be included with your travel or homeowners insurance, but check on this before you leave – all insurance polices are different.

Which medications cause problems at the border?

Two classes of medications – narcotics and psychotropics – are under the purview of international law, which means that any medication that has an effect on the central nervous system will likely be highly regulated. Narcotics have the higher potential of being abused, and psychotropics are used to treat mental disorders.

Some countries also exclude a range of medications used to treat neurological conditions such as epilepsy. Others treat sedating antihistamines as banned substances. A few countries, like the United Arab Emirates, include a range of common medications like contraceptive hormones.

International agreements (sort of) govern the transportation

The International Narcotics Control Board (INCB) is an independent organization responsible for international agreements governing the transportation of medications across borders. Their broad principles concerning travelers intending to carry narcotics and psychotropics are basically:

  • Travelers should be allowed to carry quantities of these substances for personal use for up to one month of travel.
  • Travelers will have a letter and/or prescription from their doctor when traveling with narcotics (but not necessarily for psychotropics).

The INCB also requires countries submit their individual regulations for travelers, but not all have and some are quite vague and even deviate from what the INCB has decided.

The TSA provides helpful information regarding the transportation of medications specifically for travelers with disabilities and medical conditions.

A final word …

The list of tips to solve this critical travel emergency is admittedly short but for the many reasons explained here. It’s a very complicated problem and one that’s not likely to get any easier any time soon.

The following traveler’s health information resources may be able to provide you with additional help in a prescription medication emergency abroad:

  • International Association for Medical Assistance to Travelers (IAMAT) – this organization provides travel health advice and coordinates with an international network of doctors and clinics. Their website includes a directory of fully licensed, English-speaking doctors in 350 cities across 90 countries. This group’s membership is paid on a donation basis, so it’s a good budget option.

  • MedicAlert Foundation’s TravelPlus – the non-profit membership organization that brings us medical identification accessories also has a travel assistance program that offers assistance in locating a doctor overseas, including language translation. This program requires membership.

Additional Contact Information

The following government and private agencies provide valuable health information for travelers going overseas: