Spain should not pose any major health hazards. The rich cuisine -- garlic, olive oil, and wine -- may give some travelers mild diarrhea, so take along some antidiarrhea medicine, moderate your eating habits, and even though the water is generally safe, drink mineral water only. Fish and shellfish from the polluted Mediterranean should only be eaten cooked, though in Madrid most seafood comes from the cleaner Atlantic-washed Northern provinces, and you might risk the odd raw percebe (goose barnacle) if you can afford it.
The water is safe to drink through Spain; however, do not drink the water in mountain streams, regardless of how clear and pure it looks.
General Availability of Health Care -- No shots of any sort are required before traveling to Spain. Once there, medicines for common ailments, from colds to diarrhea, can be obtained over the counter at local chemists or farmacias. Generic equivalents of common prescription drugs are also usually available in Spain. (However, it does no harm to bring over-the-counter medicines with you to be on the safe side.)
Contact the International Association for Medical Assistance to Travelers (IAMAT; tel. 716/754-4883 in the U.S., 416/652-0137 in Canada; www.iamat.org) for specific tips on travel and health concerns in Spain 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. 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).
Change of Diet -- No need to go on a tempting cholesterol binge if you really don't want to. Vegetarians can follow their usual diet pattern in Madrid, as there is an increasing number of vegetarian eating spots available as well as a multitude of herbolarios, or health-food shops.
Sun Exposure -- Madrid has a dry, sunny climate (over 300 cloudless days a year), and it's best to take protective measures against sunburn and heatstroke. This is particularly valid in May and June, when the days are long and the sun's rays are deceptively intense. The temperatures then are not as oppressive as those of July and August when you feel more inclination to stay in the shade or seek solace in an air-conditioned locale. Limit your exposure to the sun, especially during the first few days of your trip if you're traveling to the south, 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.
Visitors with eyesight problems should also take care to avoid the sun's strong glare, using prescription sunglasses.
What To Do If You Get Sick Away From Home -- Spanish medical facilities are among the best in the world. If a medical emergency arises, your hotel staff can usually put you in touch with a reliable doctor. If not, contact your embassy or consulate; each one maintains a list of English-speaking doctors. Medical and hospital services aren't free, so be sure that you have appropriate insurance coverage before you travel.
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.
Terrorism -- Since the Al Qaeda bomb attacks on three suburban trains in and around Atocha station on March 11, 2004, which resulted in the deaths of 200 people, both political and public attention in Spain has been strongly focused on the global nature of terrorism now threatening Western society.
A direct or indirect consequence of the massacre was that after a massive protest demonstration of two million people in the streets of the city, voters unexpectedly returned the Socialist party to power in the March 14 general elections. The policy of the new president, Rodríguez Zapatero, had always been to oppose the war in Iraq, and one of his first acts was to authorize the full withdrawal of Spanish troops from that country just over 3 months later.
Life in Madrid continued more or less unchanged after this event, though the memory of it remains indelible. To date, there is nothing to suggest that Islamic terrorism constitutes a more serious threat in Madrid than in any other major world city. U.S. tourists traveling to Spain should exercise caution and refer to the guidance offered in the Worldwide Caution Public Announcements issued in the wake of the September 11, 2001, terrorist attacks, also bearing in mind the abovementioned March 11, 2004, tragedy.
After 4 decades of deadly bomb attacks on police and public (even including tourists), the ETA, the Basque separatist movement, announced a "permanent" ceasefire in 2006, which was quickly broken. The group killed a French policeman during an attempted car robbery near Paris in late 2009 and since then is apparently racked by internal dissensions, and members are now hunted as criminals in two countries. Of late they have become notably silent. Whether this heralds the beginning of the end for them as a purported "political force" still remains to be seen.
"Conventional" Crime -- While most of Spain has a moderate rate of "conventional" crime, and most tourists have trouble-free visits to Spain, the principal tourist areas have been experiencing an increase in violent crime. Madrid has reported growing incidents of muggings and violent attacks, and older tourists and Asian-Americans seem to be particularly at risk. Criminals frequent tourist areas and major attractions such as museums, monuments, restaurants, hotels, beach resorts, trains, train stations, airports, subways, and ATMs.
Reported incidents have occurred in key tourist areas, including the zones around the Prado Museum and Atocha train station, and parts of old Madrid such as Puerta del Sol, El Rastro flea market, and Plaza Mayor. Travelers should exercise caution, carry limited cash and credit cards, and leave extra cash, credit cards, passports, and personal documents in a safe location. Crimes have occurred at all times of day and night, though visitors and residents alike are more vulnerable in the early hours of the morning.
Thieves often work in teams or pairs. In most cases, one person distracts a victim while the accomplice performs the robbery. For example, a stranger might wave a map in your face and ask for directions or "inadvertently" spill something on you. While your attention is diverted, an accomplice makes off with the valuables. Attacks can also be initiated from behind, with the victim being grabbed around the neck and choked by one assailant while others rifle through the belongings. A group of assailants may surround the victim, maybe in a crowded popular tourist area or on public transportation, and only after the group has departed does the person discover he or she has been robbed. Some attacks have been so violent that victims have needed to seek medical attention afterward.
Theft from parked cars is also common. Small items such as luggage, cameras, or briefcases are often stolen from them. Travelers are advised not to leave valuables in cars when they park them and to keep doors locked, windows rolled up, and valuables out of sight when driving. "Good Samaritan" scams are unfortunately common. A passing car will attempt to divert the driver's attention by indicating there is a mechanical problem. If the driver stops to check the vehicle, accomplices steal from the car while the driver is looking elsewhere. Drivers should be cautious about accepting help from anyone other than a uniformed Spanish police officer or Civil Guard.
Dealing with Discrimination
As Madrid's population slowly becomes more international, overt racial prejudice -- never a dominant issue here anyway -- appears to be diminishing, though as John Vorwald points out below ("A Note on Discrimination") there will always be a hard core of people -- such as the fascist fringe supporters of certain Spanish football clubs -- whose attitude is affected simply by the color of a person's skin.
In the aftermath of the March 11 rail bombings of 2004, there was a hardening of attitudes toward Arabic nationalities by certain members of the community, though there is less evidence of that now. Feelings toward the increasing numbers of Latin American immigrants were similarly soured by the appearance (in relatively small numbers) of young L.A.-style South American criminal bands such as the "Latin Kings" and "Dominicans Don't Play" in the outer areas of the city. After a flurry of arrests and subsequent releases in 2009, things have calmed down and attempts by social groups to integrate these delinquent minorities more effectively into the community have proved reasonably successful.
A Note on Discrimination -- A fierce sense of national pride might lead many Spaniards to bristle at the suggestion that racism is a problem in their country, but events during the past decade and a new report by Amnesty International have brought to the fore concerns over racism and racial profiling in Spain. In January 2002, Rodney Mack, an African American and the principal trumpet player with the Barcelona Symphony Orchestra, was attacked and beaten in Madrid by four police officers who later said they mistook the musician for a car thief. The thief had been described as a black man of roughly Mr. Mack's height, and a police official later admitted that Mack was singled out because of "the color of his skin and his height." In April 2002, Amnesty International cited the Mack case in an exhaustive report accusing Spain of "frequent and widespread" mistreatment of foreigners and ethnic minorities. The report investigated more than 320 cases of abuse from 1995 to 2002, including deaths and rapes while in police custody, as well as beatings, verbal abuse, and the use of racial profiling by police. The report claims that an increase in racist attacks in Spain has coincided with a dramatic growth in the country's immigrant population over the last 20 years. Spanish officials, however, rejected the report, and Congressman Ignacio Gil-Lázaro of Spain's ruling Popular Party said, "The police and Civil Guard confront immigration in a deeply humanitarian way."
While Amnesty's report may rightfully dispel the notion that Spain is exempt from the problems of racism, it does not suggest that the country is Europe's only offender. In recent years, Amnesty has pointed up race-based abuses in numerous European nations, including Austria, Greece, and Italy, as well as the United States. Travelers of color may have a perfectly enjoyable trip in Spain, but visitors to the area should travel with the knowledge that racism and xenophobia may well be as serious a problem in Spain as anywhere in Europe or the United States. If you encounter discrimination or mistreatment while traveling in Spain, please report it to your embassy immediately.
-- John Vorwald