Just as my taxi pulled up to take me to the airport, I looked at my phone to see the missed call. It was my specialist, leaving me a message at the ungodly hour of 7am.
“We just got the results of your biopsy,” he said. “I’d like you to give me a call back. It’s urgent.”
It was the kind of message that would make anyone’s heart drop into their stomach, but for me, there was an extra reason for panic: I was living in Australia and my condition (pre-cancerous cells on my cervix) was pre-existing. Any follow-up appointments and care, such as the LEEP procedure that I would eventually need, would come directly out of my own pocket.
Whenever we talk about “emergencies abroad,” we tend to think about the unavoidable and unexpected. As the coordinator for a volunteer-sending organization, I dealt with everything from volunteers being hospitalized due to gastro-intestinal ailments (“What are they doing over there? Licking their hands?” one of my co-workers would joke in frustration), to a volunteer pricking her finger on a needle at an HIV/AIDS clinic. In my short-lived career staffing high school grad trips, it was a similar tale: A passenger who dislocated his shoulder (while drunk), one who stepped on a sea urchin (while drunk), one who walked across broken glass (while drunk) . . . you get the idea.
However, since moving abroad, I’ve learned that medical upsets abroad aren’t always sudden. For many, they’re the result of pre-existing conditions. But having a pre-existing or chronic condition shouldn’t stop you from working, studying, volunteering or adventuring abroad.
“You can travel with a medical problem, it’s just making sure you’ve taken precautions and know what to do in case something does happen,” says Robin Ingle, CEO of Ingle International.
Here’s what you need to know before you get on the plane.
Always declare your pre-existing condition
Even if your condition is stable, you will need to declare it and your medical history when you’re taking out your insurance policy. Otherwise, you risk voiding the policy entirely.
Tullia Marcolongo, executive director of IAMAT (International Association for Medical Assistance to Travellers), gives the example of an asthmatic patient that rolls their ankle.
“If you haven’t declared that you have asthma, you will not be covered for that broken ankle—even though it’s not related to your pre-existing condition,” she explains.
Ask your insurer if they will your cover pre-existing condition
As with any big travel-related purchase, you should shop around and get a minimum of three quotes on insurance. “Take time, ask questions and get answers in writing,” says Ingle.
You can also inquire if there’s any coverage for your pre-existing condition. These are typically excluded in standard policies, but it’s sometimes possible to buy a “waiver” that will override the policy’s exclusion. “You have to read the fine print—I can’t stress that enough,” says Marcolongo.
Do your research before you depart
Your family doctor or specialist with be the one most familiar with your condition, and whether you’ll be fit for travel—or fit for the type of travel that you’d like to do. However, the research doesn’t end there. Check with your destination country’s embassy to ensure your medication isn’t restricted, which may be the case if you take a narcotic or psychotropic. Marcolongo also recommends finding out whether your medication is available abroad and the cost associated with it. Diabetics, for one, may find that insulin is substantially more expensive elsewhere.
In addition to finding a local doctor on the ground who specializes in your condition, my experience in Australia taught me that it’s also helpful to understand how another country’s healthcare system works. Is it public, private or two-tiered? The set-up will affect how healthcare is delivered, and in many developing countries, this also means that the standard of care may not be what you’re used to.
“Medical treatment isn’t delivered the same globally,” says Ingle. “In certain countries they may have limited services—you may have to be air evacuated out. For example, even in Cuba, which has good physicians, they don’t have high-end medical services.”
Learning to advocate for yourself in the context of the country's culture is also critical. In my case, I asked enough questions to determine that although I needed minor surgery, it could safely wait until I was back home in Canada. Being armed with the right information saved me thousands of dollars, and gave me peace of mind.
Bring your medical records and pack your medication with care
“We recommend bringing paper records, because if your phone dies you may not have access to them in an emergency,” says Marcolongo. A clinical medical record should outline your condition, medications (including the generic names) and doctors.
Always pack your medication in your carry-on luggage, in its original packaging. This isn’t just so it doesn’t get lost, but to preserve its efficacy. (Luggage holds can fluctuate in extreme temperatures, which can adversely affect your medication.) You should also bring an extra supply, in case it gets stolen, lost or in case you have to unexpectedly stay in the country longer than planned.
Remember: When there’s a will, there’s a way
“You don’t think that people who need a weekly or monthly dialysis or blood transfusions will go on a trip, but they do,” says Ingle.
Days after a trip to Mount Everest base camp, adventure journalist Christophe Noel learned he had Type 1 diabetes. “I was scared to leave the house," he says of the months following his diagnosis.
But an invitation to trek in Peru’s Cordillera Blanca mountain range changed everything.
“Once diagnosed with T1D, I thought that it was over. Instead, I seem to do more, go farther, and take much bigger risks while venturing far into the wild,” he says.
Bigger risks has including founding a non-profit, Clean Drink Adventures, which has delivered water purification systems to 10,000 people in remote Nepal villages.
“When I was too scared to leave the couch, everything was impossible. In the last three years as I learned how to work with my condition, I have realized anything is possible. The one setback I can't survive is giving up,” says Noel. “Diabetes commands respect. But that should not keep anyone, anywhere, from doing what they want to do.”
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