Some Good and Ugly of Medical Care Abroad

As I’ve been writing a lot about living abroad, I’ve heard many tales of various medical experiences, both great and poor. My own first big-scale medical experiment abroad was a success, as were several successive experiences which I’ll write about soon, but I’ve had several that weren’t quite so. I’ll get to those, but first another positive tale of medicine abroad.

A dear friend of mine was diagnosed with Hepatitis C. Hep C is fine when it’s asymptomatic, but can greatly damage your liver or kill you in short order if symptomatic. My friend said he must have contracted the disease years back when he was offered a “free” tattoo by a jungle shaman. Who could refuse that? By the time he was diagnosed, a drug cocktail had been developed in the United States; the price tag: $95,000. Yes, indeed. My friend, being the fearless world traveler, knew this treatment had to be available elsewhere. He flew to India and with the list of the cocktail ingredients in hand, sought treatment abroad. The full treatment, including a full liver scan to be sure there was no lasting damage, cost $6,000. That’s right, a savings of almost $90,000! And perhaps he was taken advantage of because when I first shared this story another friend said she had her Hep C cleared for only $2000 USD!

But I’m also not completely naïve to think that medical care is perfect and accessible wherever you might travel. It most certainly is not. Take one of my most frightening experiences to date while traveling in Cambodia. It occurred when Aiden was much younger and I was completing my Masters thesis on Conflict Management and Storytelling in Cambodia. I was spending three months in the country traveling to towns and villages interviewing survivors of the Khmer Rouge. Luckily, Aiden was too young to understand some of the sites we encountered (like the Tuol Sleng Genocide Museum), and just innocent enough to adore the warmth of the people, the relative affordability of big and really fast trucks and toys. His favorite was a go-cart that we would take each evening to a long pathway alongside the Mekong River. He would ride for an hour, encouraging other kids to hitch rides and run after him, before acquiescing to exhaustion and letting me take him home.

Angkor Aiden
Aiden at Angkor Wat

It could have been the pollution, the heat, or a combination of everything. But Aiden had been suffering some kind of respiratory infection. It wasn’t terrible but didn’t seem to leave despite repeated treatment. A visit to the hospital in Pnom Phen left us with advise that the kid would be fine but if he started to have trouble breathing to take him immediately to a hospital. So as we drove to a small jungle town next to the Thai border, I took mental note of a giant hospital building. Just in case. We ate a nice street food dinner and went to bed in our simple hotel room. In the middle of the night I awoke to Aiden’s labored breathing. He sounded like a train rumbling over a track of boulders. I immediately woke my work partner, who then woke our driver. If this was the symptom that was most dangerous then we needed to get him to care – and fast. I gave him a dose of benadryl and we loaded into the car and raced to the hospital. We got to the door, and in the darkness, carrying a limp boy in my arms, I made my way to the front entrance. Which was locked. And there was nothing inside… It was completely empty.

The building, I was to learn later, was a shell, donated to the region by a generous NGO. Yet they didn’t give enough money for the equipment to fill the hospital, or for any staff to actually staff the hospital, or for the electricity to even light the damn hospital. My heart sank and I started to cry, unable to move as I was in shock. Why was I here? Would my son be ok? Would we all die in this godforsaken country? Had I been so selfish as to jeopardize my son’s life because I needed to get a Master’s degree??? What a joke.

We were told there was a doctor in a house nearby, and when we knocked on the door a very annoyed housekeeper answered. I’m not sure she would have opened the door were it not for the boy in my arms, who, for all she could tell, was not even alive. She glanced at him from head to toe and with a huff, opened the door and led us to a waiting room where we stayed for an hour while the doctor was retrieved from his bedroom. The boy was examined and determined to be fine. No need for alarm. He was asleep and breathing as normally as can be expected. Go home, he told us. Get some sleep.

We cut the border trip short and I returned to Phnom Penh for some imaginary idea of better health care. Each of our visits resulted in a dose of antibiotics until finally I stopped taking him. Our last visit was after my son spiked a fever so high the doctors would not let him out until the numbers subsided. We missed our flight out. But I had no confidence in Cambodian health care (where I was told pregnant women in serious medical distress were left to die on clinic steps so as not to increase official numbers on child mortality.)

Despite our no fly order, I took Aiden out of the hospital and booked a next day flight to Thailand. If my son really was so sick then I wanted him in a more civilized medical environment where there were expats and real doctors and hospitals that actually had equipment. My son’s health improved and we enjoyed a week in Thailand before heading home.

This experience changed the way I travel. In fact, it stopped my travels for quite some time, at least until I sensed my son had a stronger immune system. I vowed that any place I visited from here onward had to have an established medical system with competent doctors. Some of my first questions now are about recommended doctors and hospitals. I always have evacuation insurance and I try to carry natural remedies with me wherever I go, especially in areas eager to hand out antibiotics for the smallest sniffle. And I am grateful every day for our good health.

Some of the basics in our First Aid Kit: Antibiotics, Neosporin, aspirin, kid’s acetomenophine, thermometer, band aids, antiseptic, etc. gauze and bandages. Coloidal silver for infections, grapefruit extract, Lots of vitamin C, echinacea, osha, Loquat respiratory syrup, homeopathic flu drops, and a daily general immune booster (for me mushroom extract by Paul Stammets).

meds
Some items I try not to travel without!

I’ve been getting a lot of tests here in Mexico — call it my mid-life baseline test collection — and will detail this experience soon. Follow me here for more!

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