Health & Insurance

Travel Insurance

Check your existing insurance policies and credit card coverage before you buy travel insurance. You may already be covered for lost luggage, cancelled tickets, or medical expenses. The cost of travel insurance varies widely, depending on the cost and length of your trip, your age, your health, and the type of trip you're taking.

Trip-Cancellation Insurance -- Trip-cancellation insurance helps you get your money back if you have to back out of a trip, if you have to go home early, or if your travel supplier goes bankrupt. Allowable reasons for cancellation can range from sickness to natural disasters to a government department declaring your destination unsafe for travel. Insurers usually won't cover vague fears, though, and in 2003 travelers were not given refunds for SARS-related cancellations.

Medical Insurance -- For China, purchase travel insurance that includes an air ambulance or scheduled airline repatriation. Be clear on the terms and conditions -- is repatriation limited to life-threatening illnesses, for instance? While there are advanced facilities staffed by foreign doctors in Beijing, regular Chinese hospitals are to be avoided. They may charge you a substantial bill, which you must pay in cash before you're allowed to leave. If this happens to you, you'll have to wait until you return home to submit your claim, so make sure you have adequate proof of payment.

Lost-Luggage Insurance -- On U.S. domestic flights, checked baggage is covered up to $2,800 per ticketed passenger. On international flights (including U.S. portions of international trips), baggage is limited to approximately $9.07 per pound, up to approximately $635 per checked bag. If you plan to check items more valuable than the standard liability, see if your valuables are covered by your homeowner's policy, or get baggage insurance as part of your comprehensive travel-insurance package. Read the policy carefully -- some valuables are effectively uninsurable, and others have such high excess charges that the insurance is not worth buying.

If your luggage is lost, immediately file a lost-luggage claim at the airport. For most airlines, you must report delayed, damaged, or lost baggage within 4 hours of arrival. The airlines are required to deliver luggage, once found, directly to your house or destination free of charge, although don't expect that necessarily to work with domestic Chinese airlines.

Staying Healthy

Greatest Risks -- The greatest risk to the enjoyment of a holiday in China is one of stomach upsets or more serious illnesses arising from low hygiene standards. Keep your hands frequently washed and away from your mouth. Only eat freshly cooked hot food, and fruit you can peel yourself -- avoid touching the part to be eaten once it's been peeled. Drink only boiled or bottled water. Never drink from the tap. Use bottled water for brushing your teeth.

The second most common cause of discomfort is an upper respiratory tract infection, or common cold, which is caused by heavy pollution. Many standard Western remedies or sources of relief (and occasionally fake versions of these) are available over the counter, but bring a supply of whatever you are used to. If you have sensitive eyes, you may wish to bring an eye bath and solution.

If you regularly take a nonprescription medication, bring a plentiful supply with you and don't rely on finding it in China. Feminine hygiene products such as panty-liners are widely available in Beijing, but tampons are not.

General Availability of Health are -- Should you begin to feel unwell in China, your first contact should be your hotel reception. Many major hotels have doctors on staff who will give a first diagnosis and treatment for minor problems, and who will be aware of the best places to send foreigners for further treatment.

Be very cautious about what is prescribed for you. Doctors are poorly paid, and many earn kickbacks from pharmaceutical companies for prescribing expensive medicines. Antibiotics are handed out like candy; indeed, dangerous and powerful drugs of all kinds can be bought over the counter at pharmacies. In general, the best policy is to stay as far away from Chinese healthcare as possible.

Before You Leave -- Plan well ahead. If you intend merely to visit Beijing, you may not need to bother with some of the inoculations listed below, but take expert advice (not website hearsay) on the latest situation. Some inoculations are expensive, some need multiple shots separated by a month or two, and some should not be given at the same time as others. So start work on this 3 or 4 months before your trip.

For the latest information on infectious diseases and travel risks, and particularly on the constantly changing situation with malaria, consult the World Heath Organization (www.who.int) and the Centers for Disease Control in Atlanta (www.cdc.gov). Note that family doctors are rarely up to date on vaccination requirements, so when looking for advice at home, consult a specialist travel clinic.

To begin with, your standard inoculations, typically for polio, diphtheria, and tetanus, should be up to date. You may also need inoculations against typhoid fever, meningococcal meningitis, cholera, hepatitis A and B, and Japanese B encephalitis. If you will be arriving in mainland China from a country with yellow fever, you may be asked for proof of vaccination, although border health inspections are cursory at best. See also advice on malaria, below.

While You Are There -- Mosquito-borne malaria comes in various forms, and you may need to take two different prophylactic drugs, depending upon the time you travel, whether you venture into rural areas, and where you go. You must begin to take these drugs 1 week before you enter an affected area and for 4 weeks after you leave it, sometimes longer. For a visit to Beijing and other major cities only, prophylaxis is usually unnecessary.

Standard precautions should be taken against exposure to strong summer sun. Its brightness may be dimmed by Beijing's pollution, but the sun's power to burn is undiminished.

The Chinese are phenomenally ignorant about sexually transmitted diseases, which are rife. As with the respiratory disease SARS, the government denied there was any AIDS problem in China until it grew too large to be contained. Estimates of the spread of infection are still highly conservative. Condoms, including Western brands, which should be your first choice, are widely available in Beijing.

Staying Safe

China is one of Asia's safest destinations. As anywhere else, though, you should be cautious of theft in places such as crowded markets, popular tourist sites, bus and railway stations, and airports. Take standard precautions against pickpockets (distribute your valuables around your person and wear a money belt inside your clothes). The main danger of walking the ill-lit streets at night is of falling down an uncovered manhole. There's no need to be concerned about dressing down or not flashing valuables -- it's automatically assumed that all foreigners, even the scruffiest backpackers, are astonishingly rich, and the average Chinese cannot tell a Cartier from any other shiny watch.

Visitors should be cautious of various scams, especially in areas of high tourist traffic, and of Chinese who approach and say in English, "Hello friend! Welcome to China!" or something similar. Scam artists who want to practice their English and suggest moving to some local haunt may leave you with a bill which has two zeros more than it should, and with trouble should you decline to pay. "Art students" are a pest, approaching you with a story about raising funds for a show overseas, but in fact enticing you into a shop where you will be lied to extravagantly about the authenticity, uniqueness, originality, and true cost of various paintings you will be pressured into buying. The man who is foolish enough to accept an invitation from pretty girls to sing karaoke deserves all the hot water in which he will find himself, up to being forced by large, well-muscled gentlemen to visit an ATM and withdraw large sums to pay for services not actually provided.

If you are a victim of theft, make a police report (go to the same addresses given for visa extensions; you are most likely to find an English-speaking policeman there). But don't expect sympathy, cooperation, or action. The purpose is to get a theft report to give to your insurers for compensation.

Harassment of solo female travelers is very rare, but slightly more likely if the traveler appears to be of Chinese descent.

Traffic is a major hazard for the cautious and incautious alike. In mainland China, driving is on the right, at least occasionally. The rules of the road are routinely ignored for the one overriding rule, "I'm bigger than you so get out of my way," and pedestrians are at the bottom of the pecking order. Cyclists come along the sidewalk, and cars mount it right in front of you and park across your path as if you don't exist. Cyclists go in both directions along the bike lane at the side of the road, which is also invaded by cars looking to mount the sidewalk to park. The edges of the main road also usually have cyclists going in both directions. The vehicle drivers are gladiators, competing for any way to move into space ahead, constantly changing lanes and crossing each other's paths. Pedestrians are like matadors pausing between lanes as cars sweep by to either side of them. Pedestrians often edge out into traffic together, causing cars to swerve away from them, often into the paths of oncoming vehicles, until one lane of traffic parts and flows to either side, and the process is repeated for the next lane.

DDealing with Discrimination -- In mainland China, in casual encounters, non-Chinese are treated as something between a cute pet and a bull in a china shop, and sometimes with pitying condescension because they are too stupid to speak Chinese. At sights, Chinese tourists from out of town may ask to have their picture taken with you, which will be fun to show friends in their foreigner-free hometowns. ("Look! Here's me with the Elephant Man!") Unless you are of Chinese descent, your foreignness is constantly thrust in your face with catcalls of "laowai," a not particularly courteous term for foreigner, and a bit like shouting "Chinky" at a Chinese you encounter at home. Mocking, and usually falsetto, calls of "Helloooooo" are not greetings but are similar to saying "Pretty Polly!" to a parrot. Whether acknowledged or not (and all this is best ignored), these calls are usually followed by giggles. But there's little other overt discrimination, other than persistent overcharging wherever it can possibly be arranged. In general, however, once some sort of communication is established, foreigners get better treatment from Chinese, both officials and the general public, than the Chinese give each other. People with darker skin do have a harder time than whites, but those who do not speak Mandarin will probably not notice.