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, canceled tickets, or medical expenses. The cost of travel insurance varies widely, depending on the cost and length of your trip, your age, health, and the type of trip you're taking, but expect to pay 5% to 8% of the cost of the vacation itself.

Trip-Cancellation Insurance -- Trip-cancellation insurance will help retrieve your money if you have to back out of a trip or depart early, or if your travel supplier goes bankrupt. Permissable reasons for trip cancellation can range from sickness to natural disasters to the State Department declaring a destination unsafe for travel. (Insurers usually won't cover vague fears, though, as many travelers discovered when they tried to cancel their trips in October 2001.) In this unstable world, trip-cancellation insurance is a good buy if you're purchasing tickets well in advance -- who knows what the state of the world, or of your airline, will be in 9 months? Insurance policy details vary, so read the fine print -- and make sure that your airline or cruise line is on the list of carriers covered in case of bankruptcy. A good resource is "Travel Guard Alerts," a list of companies considered high-risk by Travel Guard International (see website below). Protect yourself further by paying for the insurance with a credit card -- by law, consumers can get their money back on goods and services not received if they report the loss within 60 days after the charge is listed on their credit card statement.

Note: Many tour operators, particularly those offering trips to remote or high-risk areas, include insurance in the total trip cost or can arrange insurance policies through a partnering provider, which is a convenient and often cost-effective way for the traveler to obtain insurance. Make sure the tour company is a reputable one, however, and be aware that some experts suggest you avoid buying insurance from the tour or cruise company you're traveling with. They contend it's more secure to buy from a "third party" than to put all your money in one place.

For more information, contact one of the following recommended insurers: Access America (tel. 866/807-3982; www.accessamerica.com) or Travel Guard International (tel. 800/826-4919; www.travelguard.com).

Medical Insurance -- For travel overseas, most health plans (including Medicare and Medicaid) do not provide coverage, and the ones that do often require you to pay for services upfront and reimburse you only after you return home. Even if your plan does cover overseas treatment, most out-of-country hospitals make you pay your bills upfront, and send you a refund only after you've returned home and filed the necessary paperwork with your insurance company. As a safety net, you may want to buy travel medical insurance, particularly if you're traveling to a remote or high-risk area where emergency evacuation is a possible scenario. If you require additional medical insurance, try MEDEX Assistance (tel. 410/453-6300; www.medexassist.com) or Travel Assistance International (tel. 800/821-2828; www.travelassistance.com; for general information on services, call the company's Worldwide Assistance Services, Inc., at tel. 800/777-8710).

Lost-Luggage Insurance -- On international flights (including U.S. portions of international trips), baggage coverage is limited to approximately $9.07 per pound, up to approximately $635 per checked bag. If you plan to check items more valuable than what's covered by the standard liability, see if your homeowner's policy covers your valuables, get baggage insurance as part of your comprehensive travel-insurance package, or buy Travel Guard's "BagTrak" product. Don't buy insurance at the airport, where it's usually overpriced. Be sure to take any valuables or irreplaceable items with you in your carry-on luggage, because many valuables (including books, money, and electronics) aren't covered by airline policies.

If your luggage is lost, immediately file a lost-luggage claim at the airport, detailing the luggage contents. Most airlines require that you 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.

Staying Healthy

For general information about health issues in South America, log on to the Centers for Disease Control and Prevention's website at www.cdc.gov/travel. In addition to the recommendations below, the CDC advises visitors to South America to protect themselves against hepatitis A and B. Consult your doctor for more information about these vaccinations.

Before You Go -- It can be hard to find a doctor you can trust when you're in an unfamiliar place. Try to take proper precautions the week before you depart to avoid falling ill while you're away from home. Amid the last-minute frenzy that often precedes a vacation, make an extra effort to eat and sleep well.

Pack prescription medications in their original labeled containers in your carry-on luggage. Also, bring along copies of your prescriptions in case you lose your pills or run out. Carry written prescriptions in generic form, in case a local pharmacist is unfamiliar with the brand name. If you wear contact lenses, pack an extra pair or your glasses.

If you worry about getting sick away from home, you may want to consider medical travel insurance (see "Travel Insurance," above). Be sure to carry your identification card in your wallet.

If you suffer from a chronic illness, consult your doctor before your departure. For conditions such as 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.

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 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 necessary vaccines and health hazards by region or country.

General Availability Of Care -- Not surprisingly, most of the best hospitals and healthcare centers are in the big cities, but service varies widely. If you do get sick, it's best to contact your home country's consulate or embassy. They all have health departments with staff who can recommend the best English-speaking doctors and hospitals in the area.

Common Diseases & Ailments

Dietary Distress -- It's unfortunate, but many travelers to South America do suffer from some sort of food or waterborne illness. Symptoms vary widely -- from minor cases of diarrhea to debilitating flulike illnesses. To minimize your chances of getting sick, be sure to always drink bottled or boiled water and avoid ice. In high altitudes, you will need to boil water for several minutes longer before it is safe to drink. If you don't have access to bottled water, you can treat it with iodine or chlorine, with iodine being more effective. You can buy water purification tablets at pharmacies and sporting-goods stores. You should be careful to avoid raw food, especially meats, fruits, and vegetables. If you peel the fruit yourself, you should be fine.

If you do suffer from diarrhea, it's important to keep yourself hydrated. Many pharmacies sell Pedialyte, which is a mild rehydrating solution. Drinking fruit juices or soft drinks (preferably without caffeine) and eating salted crackers are also good remedies.

Tropical Illnesses -- Yellow fever, which is transmitted by mosquitoes, exists in the forests of remote jungle areas of South America, mainly in Brazil. You can easily get vaccinated against the disease. After you receive the vaccine, you will receive a certificate, which is good for 10 years.

In the rural, tropical areas of Ecuador, Venezuela, Brazil, Bolivia, Peru, and Colombia, there is a small risk of contracting malaria. Mosquitoes carrying malaria cannot survive in altitudes over 1,500m (5,000 ft.), so if you're traveling in the Andes, you won't have to worry about this disease. To protect yourself, wear mosquito repellent with DEET, wear long-sleeved shirts and trousers, and use mosquito nets. You can also take antimalaria drugs before you go; consult your doctor about the pros and cons of such medications.

Dengue fever, transmitted by an aggressive daytime mosquito, is also a risk in tropical areas. As with malaria, the best prevention is to avoid mosquito bites; there is no vaccine available to protect you from infection.

Bugs & Bites -- Snakes, scorpions, and spiders rarely bite without provocation. Keep your eyes open and never walk barefoot. If you're in the jungle or rainforest, be sure to shake your clothes and check your shoes before putting them on.

For most travelers, disease-carrying mosquitoes will prove to be the most dangerous creatures you encounter. To protect yourself from bites, always wear mosquito repellent and a long-sleeved shirt and trousers. As an extra precaution, check to see whether your hotel offers mosquito netting (or bring your own). Still water is also a source of disease. If you're drawing water from a spring or freshwater source, always be sure to purify it before you drink it.

The chances of contracting rabies while traveling in South America are slim. Most infected animals live in rural areas. If you are bitten by an infected cat or dog, wash the wound and get yourself to a hospital as quickly as possible.

High Altitude Hazards -- Altitude sickness is the most common ailment affecting people who travel to high-altitude areas such as Quito, Cusco, or La Paz. 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; consult your doctor for a prescription.

The sun can also be very dangerous in high altitudes. Be sure to bring plenty of high-powered sunblock and a wide-brimmed hat. Don't let the cold weather fool you -- even when it's cold, the sun can inflict serious damage on your skin.

Medical Warning -- The U.S. State Department's Office of Medical Services warns people suffering from the following ailments to exercise caution when traveling to high-altitude destinations such as La Paz, Lake Titicaca, Cusco, and Machu Picchu: sickle cell anemia, heart disease (for men 45 or over or women 55 or over who have two of the following risk factors: hypertension, diabetes, cigarette smoking, or elevated cholesterol), lung disease, and anyone with asthma and on the maximum dosage of medication for daily maintenance, or anyone who has been hospitalized for asthma within a year of their intended trip. It's best to talk with your doctor before planning a trip to a high-altitude destination in South America.

Staying Safe

Millions of travelers visit South America without any problems. But as in any foreign destination, you should always keep your wits about you. Before you depart, check for travel advisories from the U.S. State Department (www.travel.state.gov), the Canadian Department of Foreign Affairs (www.voyage.gc.ca), the U.K. Foreign & Commonwealth Office (www.fco.gov.uk/travel), and the Australian Department of Foreign Affairs (www.dfat.gov.au/consular/advice).

Once you're there, keep some common-sense safety advice in mind: Stay alert and be aware of your surroundings; don't walk down dark, deserted streets; and always keep an eye on your personal belongings. Theft at airports and bus stations is not unheard of, so be sure to put a lock on your luggage.

Eco-Tourism

The International Ecotourism Society (TIES) defines eco-tourism as "responsible travel to natural areas that conserves the environment and improves the well-being of local people." You can find eco-friendly travel tips, statistics, and touring companies and associations -- listed by destination under "Travel Choice" -- at the TIES website, www.ecotourism.org. Ecotravel.com is part online magazine and part eco-directory that lets you search for touring companies in several categories (water-based, land-based, spiritually oriented, and so on). Also check out Conservation International (www.conservation.org) -- which, with National Geographic Traveler, annually presents World Legacy Awards (www.wlaward.org) to those travel tour operators, businesses, organizations, and places that have made a significant contribution to sustainable tourism.