Health

DESTINATIONS vietnam health-29

TRAVEL TIPS

Health

Temperatures in Vietnam can get extremely high; drink plenty of bottled water and use common sense to avoid dehydration, heatstroke, and sunstroke. Dengue fever and malaria are risks isolated to areas in the Central Highlands—if you're not taking a prophylaxis, make sure to use mosquito repellent. Most of Vietnam is quite humid; keep a close eye on small cuts and scrapes as they can easily get infected.

Using sunscreen is recommended, especially in the south or on the coast. Sunscreen is sold in more upscale pharmacies and in stores featuring imported products. Pharmacies are plentiful and well stocked.

Food & Drink

Street food is one of the more authentic ways to enjoy the Vietnam experience and is usually clean and tasty. If you do decide to indulge in frequent street dining, keep in mind the risk of parasitic infection from eating improperly handled meat. The major health risk in Vietnam is traveler's diarrhea, caused by eating contaminated fruit or vegetables or drinking contaminated water. Drink only bottled water, or water that has been boiled for several minutes, even when brushing your teeth. It's recommended you avoid eating unpeeled fruit and uncooked vegetables or those you suspect have been washed in unboiled water. Mild cases may respond to Imodium (known generically as loperamide) or Pepto-Bismol, both of which can be purchased over the counter. Drink plenty of purified water or tea—ginger (gung) is a good folk remedy. In severe cases, rehydrate yourself with a salt-sugar solution (½ teaspoon salt [muoi] and 4 tablespoons sugar [duong] per quart of water); if symptoms persist or worsen, seek medical assistance.

Medical Care

International clinics and hospitals in major cities offer the highest quality care but also cost more. Local hospitals are not up to the standards of Thailand, Hong Kong, or Singapore, but they are decent and occasionally employ doctors who have been trained overseas. The language barrier is an issue in local hospitals, although some doctors can speak English and French.

Hospitals and pharmacies are often undersupplied and out-of-date. Only a handful of Vietnamese doctors have top-quality Western training. Foreign insurance is not accepted in local hospitals, so you should expect to pay immediately in cash on completion of treatment. The larger hospitals in Hanoi and Ho Chi Minh City, Hue and Danang have experience treating foreigners (mainly due to motorcycle accidents, the biggest cause of injury or death of Westerners in Vietnam). Blood supply is a serious problem in Vietnam: the nation's blood banks are small and, say Western doctors, insufficiently screened.

Foreign-run medical clinics provide basic treatment, 24-hour on-call services and can arrange for emergency medical evacuation to better hospitals in other countries in the region—Medevac planes dedicated to Vietnam are on standby in Singapore. Embassies have duty officers on call to assist with logistics. If you get sick outside Hanoi or Ho Chi Minh City, get yourself to those cities as soon as possible.

Local hospitals can perform some serious emergency operations, but these hospitals are understaffed and aftercare is poor or nonexistent. If possible, it’s best to avoid these hospitals altogether, but if you do end up in one, contact your embassy immediately and they will assist if you need to be evacuated to another hospital.

Medical Insurance and Assistance

Consider buying trip insurance with medical-only coverage. Neither Medicare nor some private insurers cover medical expenses anywhere outside of the United States. Medical-only policies typically reimburse you for medical care (excluding that related to pre-existing conditions) and hospitalization abroad, and provide for evacuation. You still have to pay the bills and await reimbursement from the insurer, though.

Another option is to sign up with a medical-evacuation assistance company. A membership in one of these companies gets you doctor referrals, emergency evacuation or repatriation, 24-hour hotlines for medical consultation, and other assistance. International SOS Assistance Emergency and AirMed International provide evacuation services and medical referrals. MedjetAssist offers medical evacuation.

Medical Assistance Companies

AirMed International. www.airmed.com.

International SOS Assistance Emergency. www.internationalsos.com.

MedjetAssist. 800/527–7478; www.medjetassist.com.

Medical-Only Insurers

International Medical Group. 800/628–4664; www.imglobal.com.

International SOS. www.internationalsos.com.

Wallach & Company. 800/237–6615; 540/687–3166; www.wallach.com.

Shots and Medications

Tetanus-diphtheria and polio vaccinations should be up-to-date—if you haven't been immunized since childhood, consider bolstering your tetanus and polio vaccinations. If you have never contracted measles, mumps, or rubella, you should also be immunized against them. Also note: immunizations for hepatitis A and typhoid fever are advised. According to the Centers for Disease Control and Prevention (CDC), there is a risk of contracting malaria only in rural areas of Vietnam, except in the Red River delta and the coastal plain north of Nha Trang, which are safe. The CDC recommends taking mefloquine (brand name Larium) for malaria. Dengue fever occurs in Vietnam, but the risk is small except during periods of epidemic-size transmission; there is no vaccine to prevent it. Therefore, you should take precautions against mosquito bites. Malaria- and dengue-bearing mosquitoes bite at dusk and at night. No matter where you go, it's a good idea to protect yourself from mosquito-borne illnesses with a good insect repellent containing DEET, and if you're in susceptible regions, use aerosol insecticides indoors, wear clothing that covers the body, and bring mosquito nets.

If you're staying for a month or more and are traveling to rural areas, you should be vaccinated against Japanese encephalitis; for six months or more, against hepatitis B as well. Some of these vaccinations require staggered treatments, so plan ahead.

Bringing a first-aid kit with antacids, antidiarrheal, cold medicine, Band-Aids, antiseptics, aspirin, and other items you may need is a good idea. Also, know your blood type and bring enough medication to last the entire trip; you may be able to get common prescription drugs in Vietnam, but don't count on their availability or their quality. Just in case, however, have your doctor write you a prescription using the drug's generic name, because brand names vary from country to country.

Health Information

National Centers for Disease Control & Prevention. 877/394–8747; www.cdc.gov/travel.

World Health Organization. www.who.int.

Over-the-Counter Remedies

Pharmacies are almost as common as tea stalls in Vietnam, and many pharmacists in major cities speak English. Look for a shop with a green sign that reads Nha Thuoc. These usually stock painkillers (such as Panadol); eye-, nose-, and eardrops (such as Polydexa); cold remedies (such as Tiffy); and various antibiotics—for which no prescription is needed in Vietnam. Remember to check the expiration date when buying any sort of medication.

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