Staying Healthy

General Availability of Healthcare

In most of Mexico's resort destinations, you can usually find health care that meets U.S. standards. The U.S. Department of State notes that excellent health facilities are available in Mexico City, but training and availability of emergency responders may be below U.S. standards. Care in more remote areas is limited. Standards of medical training, patient care, and business practices vary greatly among medical facilities in beach resorts throughout Mexico. In recent years, some U.S. citizens have complained that certain health-care facilities in beach resorts have taken advantage of them by overcharging or providing unnecessary medical care.

Prescription medicine is broadly available at Mexico pharmacies; however, be aware that you may need a copy of your prescription or to obtain a prescription from a local doctor. This is especially true in the border towns, such as in Tijuana, where many Americans have been crossing into Mexico specifically for the purpose of purchasing lower-priced prescription medicines.

Contact the International Association for Medical Assistance to Travellers (IAMAT; tel. 716/754-4883 or, in Canada, 416/652-0137; www.iamat.org) for tips on travel and health concerns in the countries you're visiting and for lists of local, English-speaking doctors. The United States Centers for Disease Control and Prevention (tel. 800/311-3435; www.cdc.gov) provides up-to-date information on health hazards by region or country, and offers tips on food safety. Travel Health Online (www.tripprep.com), sponsored by a consortium of travel medicine practitioners, may also offer helpful advice on traveling abroad. You can find listings of reliable medical clinics overseas at the International Society of Travel Medicine (www.istm.org).

Common Ailments

Sun Exposure -- Mexico is synonymous with sunshine; most of the country is bathed in intense sunshine most of the year. Avoid excessive exposure, especially in the tropics where UV rays are more dangerous. The hottest months in Mexico are April and May in the south, and July through September along the Pacific Coast, including Baja California. The deserts of northern Mexico are extremely hot in summer.

Dietary Red Flags -- Travelers' diarrhea (locally known as turista, the Spanish word for "tourist") -- persistent diarrhea, often accompanied by fever, nausea, and vomiting -- used to attack many travelers to Mexico. (Some in the U.S. call this "Montezuma's revenge," but you won't hear it called that in Mexico.) Widespread improvements in infrastructure, sanitation, and education have greatly diminished this ailment, especially in well-developed resort areas. Most travelers make a habit of drinking only bottled water, which also helps to protect against unfamiliar bacteria. In resort areas, and generally throughout Mexico, only purified ice is used. If you do come down with this ailment, nothing beats Pepto Bismol, readily available in Mexico. Imodium is also available in Mexico and is used by many travelers for a quick fix. A good high-potency (or "therapeutic") vitamin supplement and even extra vitamin C can help; yogurt is good for healthy digestion.

Since dehydration can quickly become life-threatening, the Public Health Service advises that you be careful to replace fluids and electrolytes (potassium, sodium, and the like) during a bout of diarrhea. Drink Pedialyte, a rehydration solution available at most Mexican pharmacies, or natural fruit juice, such as guava or apple (stay away from orange juice, which has laxative properties), with a pinch of salt added.

The U.S. Public Health Service recommends the following measures for preventing travelers' diarrhea: Drink only purified water (boiled water, canned or bottled beverages, beer, or wine). Choose food carefully. In general, avoid salads (except in first-class restaurants), uncooked vegetables, undercooked protein, and unpasteurized milk or milk products, including cheese. Choose food that is freshly cooked and still hot. Avoid eating food prepared by street vendors. In addition, something as simple as clean hands can go a long way toward preventing turista.

High-Altitude Hazards -- Travelers to certain regions of Mexico occasionally experience elevation sickness, which results from the relative lack of oxygen and the decrease in barometric pressure that characterizes high elevations (more than 1,500m/5,000 ft.). Symptoms include shortness of breath, fatigue, headache, insomnia, and even nausea. Mexico City is at 2,100m (6,720 ft.) above sea level, as are a number of other central and southern cities, such as San Cristóbal de las Casas (even higher than Mexico City). At high elevations, it takes about 10 days to acquire the extra red blood corpuscles you need to adjust to the scarcity of oxygen. To help your body acclimate, drink plenty of fluids, avoid alcohol, and don't overexert yourself during the first few days. If you have heart or lung trouble, consult your doctor before flying above 2,400m (7,872 ft.).

Bugs, Bites & Other Wildlife Concerns -- Mosquitoes and gnats are prevalent along the coast and in the Yucatán lowlands. Repelente contra insectos (insect repellent) is a must, and it's not always available in Mexico. If you'll be in these areas and are prone to bites, bring along a repellent that contains the active ingredient DEET. Avon's Skin So Soft also works extremely well. Another good remedy to keep the mosquitoes away is to mix citronella essential oil with basil, clove, and lavender essential oils. If you're sensitive to bites, pick up some antihistamine cream from a drugstore at home.

Most readers won't ever see an alacrán (scorpion). But if one stings you, go immediately to a doctor. The one lethal scorpion found in some parts of Mexico is the Centruroides, part of the Buthidae family, characterized by a thin body, thick tail, and triangular-shaped sternum. Most deaths from these scorpions result within 24 hours of the sting as a result of respiratory or cardiovascular failure, with children and elderly people most at risk. Scorpions are not aggressive (they don't hunt for prey), but they may sting if touched, especially in their hiding places. In Mexico, you can buy scorpion toxin antidote at any drugstore. It is an injection, and it costs around $25 (£13). This is a good idea if you plan to camp in a remote area, where medical assistance can be several hours away.

Tropical Illnesses -- You shouldn't be overly concerned about tropical diseases if you stay on the normal tourist routes and don't eat street food. However, both dengue fever and cholera have appeared in Mexico in recent years. Talk to your doctor or to a medical specialist in tropical diseases about precautions you should take. You can also get medical bulletins from the U.S. Department of State and the Centers for Disease Control and Prevention. You can protect yourself by taking some simple precautions: Watch what you eat and drink; don't swim in stagnant water (ponds, slow-moving rivers, or wells); and avoid mosquito bites by covering up, using repellent, and sleeping under netting. The most dangerous areas seem to be on Mexico's west coast, away from the big resorts.

Over-the-Counter Drugs in Mexico -- Antibiotics and other drugs that you'd need a prescription to buy in the States are often available over the counter in Mexican pharmacies. Mexican pharmacies also carry a limited selection of common over-the-counter cold, sinus, and allergy remedies.

What to Do If You Get Sick Away from Home

Any English-speaking embassy or consulate staff in Mexico can provide a list of area doctors who speak English. The U.S. Embassy's consular section, for example, keeps a list of reliable English-speaking doctors. If you get sick in Mexico, consider asking your hotel concierge to recommend a local doctor -- even his or her own. You can also try the emergency room at a local hospital or urgent care facility. Many hospitals also have walk-in clinics for emergency cases that are not life-threatening; you may not get immediate attention, but you won't pay emergency room prices.

For travel to Mexico, 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. (that means neither Medicare nor Medicaid reimburses for emergency health care in Mexico, either). 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 more). A number of companies offer global medical evacuation services. If you're ever hospitalized more than 150 miles from home, MedjetAssist (tel. 800/527-7478; www.medjetassist.com) will pick you up and fly you to the hospital of your choice, virtually anywhere, in a medically equipped and staffed aircraft -- 24 hours day, 7 days a week. Annual memberships are $225 (£113) individual, $350 (£175) family; you can also purchase short-term memberships.

It is generally less expensive and more reliable to contract a U.S.-based company for a medical evacuation from Mexico to the U.S. than to contract a Mexican-based company. Contact the consular affairs section of the U.S. Embassy in Mexico City or nearest consulate for suggestions.

Smoke Free Mexico? -- In early 2008, the Mexican president signed into law a nationwide smoking ban in workplaces, public buildings, and public transportation. Under this ground-breaking law, private businesses are only permitted to allow public smoking in enclosed ventilated areas. Hotels may maintain up to 25% of guest rooms for smokers. Violators will face stiff fines, and smokers refusing to comply could receive up to 36-hour jail sentences. Businesses have until October 3, 2008, to create the ventilated smoking areas. It is too early to know how strictly authorities will enforce the law, and its application is likely to be uneven across the country. Despite some uncertainty over how thoroughly the legislation will be followed and enforced, they place Mexico -- where a significant percentage of the population smokes -- at the forefront of efforts to curb smoking and improve public health in Latin America. So before you light up, be sure to ask about the application of local laws in Mexican public places and businesses you visit.