Health & Safety

General Availability of Health Care

In most of the Yucatán's resort destinations, healthcare meeting U.S. standards is now available. Mexico's major cities are also known for their quality healthcare, although the facilities available may be sparser, and the equipment may be older than what is available at home. Prescription medicine is broadly available at Mexico pharmacies; however be aware that you may have to have a copy of your prescription or obtain a prescription from a local doctor.

Contact the International Association for Medical Assistance to Travelers (IAMAT; tel. 716/754-4883, or 416/652-0137 in Canada; www.iamat.org) for tips on travel and health concerns in the countries you're visiting and lists of local, English-speaking doctors. The U.S. 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. The website 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 clinics overseas at the International Society of Travel Medicine (www.istm.org).

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.

Common Ailments

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 1,515m/4,969 ft.). Symptoms include shortness of breath, fatigue, headache, insomnia, and even nausea. Mexico City is at 2,121m (6,957 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 alcoholic beverages, and don't overexert yourself during the first few days. If you have heart or lung problems, talk to your doctor before going above 2,424m (7,951 ft.).

Bugs, Bites & Other Wildlife Concerns -- Mosquitoes and gnats are prevalent along the coast and in the Yucatán lowlands. Insect repellent (repelente contra insectos) 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 hospital or a doctor. The one lethal scorpion found in some parts of Mexico is the Centruroides, part of the Buthidea 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 (£14). This is a good idea if you plan to camp in a remote area where medical assistance can be several hours away.

More Serious Diseases -- 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.

What to Do If You Get Sick Away from Home

Any foreign consulate can provide 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. 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 the high price of an emergency room visit.

If you suffer from a chronic illness, consult your doctor before you depart. 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.

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. 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.

Contact the International Association for Medical Assistance to Travelers (tel. 716/754-4883 or 416/652-0137; www.iamat.org) for tips on travel and health concerns in Mexico and lists of local English-speaking doctors. The U.S. 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.

Emergency Evacuation -- In extreme medical emergencies, a service from the United States will fly people to American hospitals. Global Life Flights (tel. 800/831-9307, or 01-800/305-9400 in Mexico; www.globallifeflight.com) is a 24-hour air-ambulance service.

Treating & Avoiding Digestive Trouble -- It's called "travelers' diarrhea" or turista, the Spanish word for "tourist": persistent diarrhea, often accompanied by fever, nausea, and vomiting, that 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.

How to prevent it: 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. Avoid eating food prepared by street vendors. Choose food that is freshly cooked and still hot. In addition, something as simple as clean hands can go a long way toward preventing turista.

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

U.S.: www.cdc.gov/travel

Safety

Crime -- Crime in Mexico -- especially in Mexico City, in selected cities along the U.S. border, and in some states affected by drug violence -- has received attention in the North American press over the past several years. Many feel this unfairly exaggerates the real dangers, but it should be noted that crime rates, including taxi robberies, kidnappings, and highway car-jackings, have risen in recent years. The most severe problems have been concentrated in Mexico City, where even longtime foreign residents will attest to the overall lack of security. Violent crime has also continued at high levels in Tijuana, Ciudad Juarez, Nuevo Laredo, Acapulco, and the state of Sinaloa. The U.S. Department of State recommends caution in traveling to the southern states of Oaxaca, Chiapas, and Guerrero due to sporadic incidents of politically motivated violence there. Check the U.S. Department of State Consular Information Sheet (and any applicable travel advisories) for Mexico before you travel to any notable "hot spots.

Precautions are necessary, but travelers should be realistic. Common sense is essential. You can generally trust people whom you approach for help or directions -- but be wary of anyone who approaches you offering the same. The more insistent the person is, the more cautious you should be. The crime rate is, on the whole, much lower in Mexico than in many parts of the United States, and the nature of crimes in general is less violent.

Travelers should exercise caution in traveling Mexico's highways, avoiding travel at night, and using toll (cuota) roads rather than the less secure libre (free) roads whenever possible. It is also advised that you should not hike alone in backcountry areas, nor walk alone on scarcely frequented beaches, ruins, or trails.

Bribes & Scams -- As is the case around the world, there are the occasional bribes and scams in Mexico, targeted at people believed to be naive -- such as the telltale tourist. For years, Mexico was known as a place where bribes -- called mordidas (bites) -- were expected; however, the country is rapidly changing. Frequently, offering a bribe today, especially to a police officer, is considered an insult, and it can land you in deeper trouble.

If you believe a bribe is being requested, here are a few tips on dealing with the situation. Even if you speak Spanish, don't utter a word of it to Mexican officials. That way you'll appear innocent while understanding every word.

When you are crossing the border, should the person who inspects your car ask for a tip, you can ignore this request -- but understand that the official may suddenly decide that a complete search of your belongings is in order. If faced with a situation where you feel you're being asked for a propina (literally, "tip"; colloquially, "bribe"), how much should you offer? Usually $3 to $5 (£1.65-£2.75) or the equivalent in pesos will do the trick. Many tourists have the impression that everything works better in Mexico if you "tip"; however, in reality, this only perpetuates the mordida attitude. If you are pleased with a service, feel free to tip, but you shouldn't tip simply to attempt to get away with something illegal or inappropriate, whether it is crossing the border without having your car inspected or not getting a ticket that's deserved.

Whatever you do, avoid impoliteness; under no circumstances should you insult a Latin American official. Extreme politeness, even in the face of adversity, rules Mexico. In Mexico, gringos have a reputation for being loud and demanding. By adopting the local custom of excessive courtesy, you'll have greater success in negotiations of any kind. Stand your ground, but do it politely.

As you travel in Mexico, you may encounter several types of scams, which are typical throughout the world. One involves some kind of a distraction or feigned commotion. While your attention is diverted, a pickpocket makes a grab for your wallet. In another common scam, an unaccompanied child pretends to be lost and frightened and takes your hand for safety. Meanwhile the child or an accomplice plunders your pockets. A third involves confusing currency. A shoeshine boy, street musician, guide, or other individual might offer you a service for a price that seems reasonable -- in pesos. When it comes time to pay, he or she tells you the price is in dollars, not pesos. Be very clear on the price and currency when services are involved.

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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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