Health and Insurance in Thailand

• Health and Insurance
• Personal Security
• Emergency & Hospitals Numbers

Insurance

If youre unlucky enough to require hospital treatment in Thailand, youll have to foot the bill this alone is reason enough to make sure you have adequate travel cover before you leave. Besides covering medical expenses and emergency flights home, a good specialist travel policy should include insurance against loss and theft of money and personal belongings, and possibly cover for damage to rented motorbikes and cars as well. Most standard policies exclude so-called dangerous sports in Thailand these can mean such activities as scuba-diving, white-water rafting and trekking unless and extra premium is paid.

Before shelling out on a new policy, how ever, its worth checking whether you are already covered. Many bank and charge accounts include some from of travel cover, and insurance is also sometimes included if you pay for your trip with a credit card (though usually only medical or accident cover is provided). Some all-risks home insurance policies cover your possessions against loss or theft when overseas, and many private medical schemes include cover for baggage loss abroad, cancellation or curtailment of your trip and cash replacement as well as sickness or accident. In Canada, provincial health plans usually provide partial cover for medical mishaps overseas, while holders of official student/teacher/youth cards in Canada and the US are entitled to some accident coverage and hospital in-patient benefits. North American students will often find that their student health coverage extends during the vacations and for one term beyond the date last enrolment.

If trouble occurs, make sure you keep all medical bills, and, if possible, contact the insurance company before making any major outlay (for example, on additional convalescence expenses). If you have anything stolen, get a copy of the police report when you notify them of the accident otherwise you wont be able to claim. Note also that very few insurers will arrange on-the-spot payments in the event of a major expense or loss; you will usually be reimbursed only after going home.

Health

Medical Facilities
Medical insurance is advisable when traveling in Thailand. Some policies pay bills direct, while others refund you later. Hospitals in Bangkok, both public and private, are modern, clean, and efficient, although waiting times are longer at public ones. Some doctors are Western-trained and speak good English. Outside the capital the best facilities are in the large towns: Khon Kaen in the northeast, Chiang Mai in the north, or Phuket in the south. Emergency care is available from military hospitals, which treat tourists in emergency cases. For dental or eye care, it is best to seek treatment in Bangkok. The Thai Red Cross on Rama IV Road does not offer medical treatment, but is able to deal with vaccinations and snake bites.

Pharmacies
There is no shortage of well stoked pharmacies in Bangkok there will be several on every main street and shopping mall, and supermarkets will have drugstore kiosks. They are all supplied with up-to-date medications and can dispense antibiotics over the counter without a prescription.

Most pharmacies are open from 8am to 9pm. In the central areas of Bangkok, around Silom and Sukhumvit Roads, a few stay open until 10pm or 11pm. Pharmacy signs are the same all over the country. In small towns pharmacies are less prolific and have fewer supplies. For instance, disposable diapers and tampons can be hard to find in remote areas.

Public Toilets
All hotels and many guest-houses have Western-style flush toilets. In general, paper is erratically supplied. Some toilets have a water spray, which is used instead of toilet paper. In some restaurants and at many major sights, you will encounter the Asian squat toilet. Nearby will be a ladle and a bucket of water, which are used to wash the body and to sluice out the toilet after use. Paper is disposed of in a bin.

Coping with the Heat
Acclimatization to the sometimes oppressive humidity and heat of Thailand can often take longer than expected. In the first few days it is not advisable to exert yourself. Make sure you drink lots of fluids, take plenty of rest in the shade, and avoid being out and about in the midday sun. Once you are acclimatized, dehydration and salt deficiency can still be a problem always keep up a high intake of fluids, especially bottled water, add perhaps add extra salt to food.

Minor fungal infections can occur due to the heat, especially if tight clothing or shoes are worn. Perspiration trapped beneath the skin can cause the itchy rash called prickly heat. The local remedy and prophylactic for this is a talcum powder that contains a tingling cooling agent. Clothing should be loose and light 100 percent cotton is best.

The sun, especially at midday and on the islands, is very powerful; sunscreen and a wide-brimmed hat are indispensable.

First-AID Kit
Although most first-aid items can be obtained from any pharmacy main towns, when traveling to rural areas or quiet islands it is advisable to carry a basic first-aid kit. This should include the following: any personal medication; aspirin or pain killers for fevers and minor aches and pains; an antiseptic for minor cuts and bites; a digestive preparation to soothe upset stomachs; insect repellent; bandages; scissors, tweezers, and a thermometer. Tiger Balm, available at any pharmacist, is Asias miracle cure-all, relieving headaches, muscle pains, and insect bites.

Minor Stomach Upsets
Diarrhea, a common complaint for travelers the world over, is caused by bacteria in food and water.

Should diarrhea occur, eat plain foods for a few days and drink plenty of fluids. It is never wise to drink tap water bottled water is readily available over most of the country. Ice should be fine in main hotels and restaurants, but avoid crushed iced drinks from street vendors. Eating in hotels and good restaurants is generally safe. It is when you venture into the street vendors moveable feasts that the danger of Bangkok belly can arise. Choose food stalls that are poplar with locals, and watch how the dishes are prepared. It can take time for visitors stomachs to adjust to new foods. If your constitution is delicate, stick to unpeeled fruits and well-cooked foods, and eat dishes while they are still hot. Avoid eating spicy dishes on an empty stomach. Fried noodle or rice dishes and noodle soups are usually easy to digest.

Drugs such as Lomotil and Imodium can bring relief to diarrhea, but rehydrating solutions, available at pharmacies, are usually the best remedy. For immediate relief, a single 500 mg dose of the prescription called Ciprofloxacin is effective and safe.

Cuts and Bites
Always take precautions in rural areas: wear boots and long trousers when walking through grassland or forested areas to protect against snakebites and leeches (in the rainy season). Few snakebites are dangerous. If you are bitten, apply and elastic bandage firmly to the bite, keep the limb immobile, and seek immediate medical help.

Jellyfish stings are painful vinegar will soothe the wound. Coral cuts are slow to heal as coral contains a mild poison. Cuts should be treated with an antiseptic to prevent infection. Bandages keep wounds wet so should be used only sparingly.

Insect-Borne Diseases
Seven of Thailands 410 mosquito species carry malaria. Symptoms of the disease include headache, fever, and violent chills. If you experience such symptoms, seek medical advice immediately. Pollution in the main towns and resorts keeps them largely free of malarial mosquitoes. The areas of greatest risk are the Burmese and Cambodian border regions and, to a lesser degree, some rural areas north of Chiang Mai. However, malarial zones are continually changing. For up-to-date information and advice on the most suitable prophylactic drug, call a travel clinic or, in the US, the Thai National Tourist Office, for information on health matters.

Mosquitoes have become resistant to certain malaria tablets. Prevention is by far the best defense against the disease. Malarial mosquitoes are active from sundown till sunrise, during which time you should spray on plenty of repellent, wear long-sleeved clothing in light colors (dark attracts mosquitoes), and use mosquito nets and coils. An-other mosquito-borne disease dengue fever is a risk during the daytime. However, few mosquitoes are infected with the virus, and the symptoms, though intense and unpleasant, are rarely fatal. These include fever, headache, severe joint and muscle pains, and a rash. No preventive treatment or vaccination is available.

In northern Thailand and some rural areas there is a risk of contracting Japanese encephalitis. Spread by night-biting mosquitoes and ticks, the symptoms are headache, fever, chills, and vomiting. Vaccination is advisable if your plans include traveling to rural areas (particularly during the rainy season), or trekking. Should any of the above symptoms occur seek immediate medical help.

As with malaria, the best way to counter the risk of dengue fever and Japanese encephalitis is to try to avoid being bitten in the first place.

People- and Animal- Borne Diseases
Acquired Immune Deficiency Syndrome (AIDS) is spreading fast in Thailand, primarily because of the widespread sex trade, with an alarming 44 percent of prostitutes in Chiang Mai testing HIV positive.

The Thai phrase for condom is thung anaamai Latex condoms are more effective than animal-membrane condoms in preventing disease transmission; to specify latex condoms ask for thung yaang anaamai actually the latter are the only kinds weve ever seen in Thailand. Since the 1970s, when Thai health educator Meechai Viravaidya initiated a vigorous national programme aimed at educating the public about contraception, the most common Thai nickname for condom has been meechai. Good-quality latex condoms are distributed free by offices of the Ministry of Public Health (MPH) throughout the country. One of the better commercial brands available in Thailand is Durex or better yet, but bring along your own favoured brand. Condoms are sold in pharmacists, department stores, hairdressers, even on street markets. Should you need to have and injection at a hospital, try to check that the needle has been sterilized first; this is not always practicable, however, so you might consider carrying your own syringes. Dont even consider getting yourself tattooed in Thailand.

Due to rigorous screening methods, the countrys medical blood supply is now considered safe.

Hepatitis B is also transmitted through bodily fluids. Symptoms include fever, nausea, fatigue, and jaundice, and it can lead to severe liver damage. A prophylactic vaccine is available.

Rabies is carried in the saliva of infected animals and can be passed on by a bite or lick to a wound or scratch. Any bite from a dog, cat, or monkey should be cleaned immediately and checked by a doctor. If rabies is detected, treatment involves a long series of inoculations. A prophylactic vaccine is now available.

Tetanus is a potentially lethal disease transmitted through infected cuts and animal bites. The first symptoms are difficulty in swallowing (tetanus is also known as lockjaw) and muscle stiffness in the neck area, which can lead to convulsions. As with rabies, all wounds should be speedily cleaned and examined by a doctor. Effective vaccinations are available, and a booster is necessary every ten years.

Tuberculosis is prevalent throughout Asia, but the visitor is not at serious risk. Vaccines are available, and unpasteurized dairy products should be avoided, particularly by children.

Bilharzia is contracted from tiny worms that infect some types of freshwater snail. They burrow into the skin and cause a general feeling of sickness followed by abdominal pain. Avoid swimming in untested rivers and lakes.

Food- and Water- Borne Diseases
Dysentery is a severe form of food or water poisoning. Bacillary dysentery characterized by stomach pains, vomiting, and fever is highly contagious but rarely lasts longer than a week. Amebic dysentery has similar symptoms but takes longer to develop. It can recur and cause chronic health problems. Medical help should be sought without delay if you suspect you have either type.

Hepatitis A is passed on in conditions of poor sanitation contaminated water or food and can now be prevented with a vaccine. Symptoms include extreme fatigue, aching, fever, chills, and jaundice. Little can be done to treat the disease beyond rest.

Cholera is a water-borne disease, and symptoms include severe diarrhea, weakness, and cramps. A vaccination is available but is generally considered to be unreliable. Fluid replacement is the most important treatment, while the best prevention is to avoid unsanitary conditions and areas where cholera is present.

Typhoid is transmitted through contaminated water or food, so the same precautions apply. Symptoms are similar to those of flu but quickly accelerate to high fever, weight loss, and severe dehydration. Medical attention is essential as complications such as pneumonia can easily occur. Although a vaccination is available, it is not always reliable.