Health & Insurance

What to Do If You Get Sick Away from Home -- The best and most modern hospitals can be found in Quito and Guayaquil. Most other major cities and towns will have a hospital or two. Your home country's embassy or consulate can provide a list of area doctors who speak English. If you get sick, consider asking your hotel staff or concierge to recommend a local doctor -- even his or her own.

You may have to pay all medical costs upfront and be reimbursed later. Medicare and Medicaid do not provide coverage for medical costs outside the U.S. Before leaving home, find out what medical services your health insurance covers. To protect yourself, consider buying medical travel insurance.

Very few health insurance plans pay for medical evacuation back to the U.S. (which can cost $10,000 and up). A number of companies offer medical evacuation services anywhere in the world. If you're ever hospitalized more than 150 miles from home, MedjetAssist (tel. 800/527-7478; www.medjetassistance.com) will pick you up and fly you to the hospital of your choice virtually anywhere in the world in a medically equipped and staffed aircraft 24 hours day, 7 days a week. Annual memberships are $225 individual, $350 family; you can also purchase short-term memberships.

U.K. nationals will need a European Health Insurance Card (EHIC) to receive free or reduced-costs health benefits during a visit to a European Economic Area (EEA) country (European Union countries plus Iceland, Liechtenstein, and Norway) or Switzerland. The European Health Insurance Card replaces the E111 form, which is no longer valid. For advice, ask at your local post office or see www.dh.gov.uk/travellers.

If you suffer from a chronic illness, consult your doctor before your departure. Pack prescription medications in your carry-on luggage, and carry them in their original containers, with pharmacy labels -- otherwise they won't make it through airport security. Carry the generic name of prescription medicines, in case a local pharmacist is unfamiliar with the brand name.

Common Ailments

Dietary Red Flags -- Travelers to Ecuador should be very careful about contracting food-borne illnesses. Always drink bottled water. Avoid beverages with ice unless you are sure that the water for the ice has been previously boiled. Be very careful about eating food purchased from street vendors. Some travelers swear by taking supplements such as super bromelain, which helps aid in the digestion of parasites; consult your doctor to find out whether this is a good option for you. In the event you experience any intestinal woe, staying well-hydrated is the most important step. Be sure to drink plenty of bottled water, as well as some electrolyte-enhanced sports drinks, if possible.

High-Altitude Hazards -- Of concern in areas of high altitude is altitude sickness. Common symptoms include headaches, nausea, sleeplessness, and a tendency to tire easily. The most common remedies include taking it easy, abstaining from alcohol, and drinking lots of bottled water. To help alleviate these symptoms, you can also take the drug acetazolamide (Diamox); consult your doctor for more information.

Tropical Sun -- Limit your exposure to the sun, especially during the first few days of your trip and, thereafter, from 11am to 2pm. Use a sunscreen with a high protection factor, and apply it liberally. Remember that children need more protection than adults do. Don't be deceived by cool weather or cloud cover. I've been foolish enough to think I didn't need sunscreen on a severely overcast day, and paid the price with a painful sunburn.

Malaria -- Fortunately, since mosquitoes can't live at high altitudes, malaria is not a risk in Quito, Cuenca, Baños, or Otavalo. Although located at sea level, there's no malaria risk in the Galápagos, either. But because there is a small risk of malaria for travelers who plan on spending time in the jungle areas of El Oriente or the Pacific lowlands, the CDC recommends that you protect yourself by taking the drugs mefloquine, doxycycline, or Malarone. Insect repellent is probably your best protection against malaria.

Staying Safe

Robberies and pickpocketing are the greatest problem facing most tourists to Ecuador. Crowded markets, public buses, and busy urban areas are the prime haunts of criminals and pickpockets. Never carry a lot of cash or wear very valuable jewelry. Men should avoid having a wallet in their back pants pocket. A woman should keep a tight grip on her purse. (Keep it tucked under your arm.) Thieves also target gold chains, cameras and video cameras, prominent jewelry, and nice sunglasses. Be sure not to leave valuables exposed or unattended in your hotel room.

Rental cars generally stick out, and they are easily spotted by thieves. Don't ever leave anything of value in a car parked on the street. Also be wary of solicitous strangers who stop to help you change a tire or bring you to a service station. Although most are truly good Samaritans, there have been reports of thieves preying on roadside breakdowns. Public intercity buses are also frequent targets of stealthy thieves. Never check your bags into the hold of a bus if you can avoid it. If this can't be avoided, when the bus makes a stop, keep your eye on what leaves the hold. If you put your bags in an overhead rack, be sure you can see the bags at all times. Try not to fall asleep during the trip.

The Ecuadorian indigenous people are very uneasy about having their picture taken. Many, in the more touristy areas, have parlayed this into a means of earning a few dollars, by charging to have their picture taken. In the more remote and rural areas, a rude or disrespectful foreign shutterbug can earn the strong and sometimes vocal disdain of the local population. Always ask permission before taking photographs of people.

Political gatherings to protest current economic and social conditions are not uncommon. The most common form of this is the blockading of roads and highways. There's really little you can do to avoid this, though a fair amount of patience and some compassion will ease the bother and lower your stress levels. Many of these protests and blockades are announced in advance in the newspapers. If you have an important flight or connection, and you have a long ride to the airport, ask your hotel to check on any alerts, and be sure to leave plenty of time for your drive to the airport.

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Note: This information was accurate when it was published, but can change without notice. Please be sure to confirm all rates and details directly with the companies in question before planning your trip.

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				Frommer's Ecuador, 1st Edition Author: Eliot Greenspan Pub Date: August 06, 2007 Price: $22.99				Related Titles: Frommer's Argentina, 1st Edition Frommer's Brazil, 4th Edition Frommer's Buenos Aires, 2nd Edition