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Staying Healthy

No vaccinations are necessary to visit Russia, though there have been cases of diphtheria and cholera in provincial areas in recent years, and tuberculosis is a major problem in prisons. Most visitors' biggest health challenges are digestive, either from St. Petersburg's bacteria-ridden water or dubiously prepared street food. Bottled water is cheap and widely available. HIV is a growing problem, and prevention and public information campaigns are sorely inadequate.

Healthy Travels to You -- The following government websites offer up-to-date health-related travel advice.

  • Australia: www.dfat.gov.au/travel
  • Canada: www.hc-sc.gc.ca/index_e.html
  • U.K.: www.dh.gov.uk/policyandguidance/healthadvicefortravellers/fs/en
  • U.S.: www.cdc.gov/travel

General Availability of Healthcare

Soviet healthcare was universal and nearly free, though clinics were chronically short of equipment. State subsidies shriveled in the 1990s and shortages worsened; doctors remain dismally paid and depend heavily on bribes from patients. But competition is slowly emerging, and Moscow and St. Petersburg have several private clinics that offer high-standard care and English-speaking personnel, though at high prices.

Bring any prescriptions with you, and Imodium or other anti-diarrhea medication. All-night pharmacies are common in Moscow and St. Petersburg, and over-the-counter medications are easily available, though generics are rarer. Foreign brands are often of better quality and always more expensive than their Russian equivalents. For the bold, even penicillin and IUDs can be purchased without a prescription.

Contact the International Association for Medical Assistance to Travelers (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) provide 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

Dietary Red Flags -- Moscow's water is potable but can be risky for foreigners. St. Petersburg's water contains the bacteria giardia lamblia and should be avoided (beware of tooth-brushing and iced drinks). Many St. Petersburg hotels have their own water filtration system. Cheap bottled water is widely available. Avoid fried meat pies sold on the street and meat sold outdoors. Vegetarians are finding more and more options in Russia, mainly at restaurants that specialize in Japanese or American cuisine. However, nearly all restaurant soups are made with meat stock, and vegetable side dishes are often prepared in lard. Although Russia has substantial Muslim and Jewish minorities, very few restaurants cater to those with religious dietary restrictions.

Respiratory Illnesses -- Tuberculosis, virtually wiped out by Soviet health campaigns, has resurfaced in recent years, largely among prison populations. The disease is treatable but some strains have grown resistant to standard medicines. Another respiratory challenge is air quality, which is dismal in most Russian cities. Fuel emissions are restricted but the restrictions are barely enforced.

Extreme Weather Exposure -- Though Russia is no doubt a cold place, most travelers do not spend enough time outdoors in the winter to risk hypothermia or its milder cousin, frostbite. Visitors engaging in a lot of outdoor winter activity should carry many layers of clothing and thermoses of warm liquid.

What To Do If You Get Sick Away From Home

Any foreign consulate can provide you with a list of area doctors who speak English. If you get sick, 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. Finding doctors or all-night pharmacies can be hard in Moscow and St. Petersburg if you know no Russian, and is much easier with a Russian helper or hotel concierge. You will pay as you go no matter where you seek help, and prices can vary from a few dollars in a public clinic for emergency care to hundreds of dollars in a private one. Foreigners are sometimes charged more just because they are assumed to have more money than Russians.

For travel abroad, 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.

If you suffer from a chronic illness, consult your doctor before your departure. For conditions like epilepsy, diabetes, or heart problems, wear a MedicAlert identification tag (tel. 888/633-4298; www.medicalert.org), which will immediately alert doctors to your condition and give them access to your records through MedicAlert's 24-hour hot line.

Pack prescription medications in your carry-on luggage, and carry prescription medications in their original containers, with pharmacy labels -- otherwise they won't make it through airport security. Also bring along copies of your prescriptions in case you lose your pills or run out. Don't forget an extra pair of contact lenses or prescription glasses. Carry the generic name of prescription medicines, in case a local pharmacist is unfamiliar with the brand name.

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.