Accidents that happen at home are pretty straightforward. You know where to turn should an emergency arise.
Accidents that happen when you travel are a different matter. When you're in a foreign country, and especially when you're traveling solo, what to do may not be so clear.
What should you do if you have a travel health emergency?
It will depend on the emergency, how serious it is and where you are. Surprisingly, my moderate problem in France was more difficult to sort out than my serious problem in China. When the problem is acute, you get swept up in a system of care. When it's not serious enough to require an emergency department, the path to care can be less clear.
Below are two personal stories. The first is my experience in France this past October when I sprained my ankle. Further down is the story of the face plant I did in Beijing and my experience with the Chinese health care system.
When I was in France with my foot up, icing my ankle, I thought it would be interesting to learn what injuries or illnesses readers have experienced and how they managed them. We received over 60 responses. Between my two stories are a number of short reports on travel health emergencies from readers. I hope you find them helpful.
Solo Traveler Injured in France
I arrived early in the morning after my flights from Toronto to Munich and then Munich to Lyon. A train into the city was easy. I used, as usual, Rome2Rio for directions. I found my apartment easily as well, using Google maps. And, with only a little confusion over the codes to enter the building and then the apartment, I truly landed. I dropped my bags and headed out to watch the thousands of people running the Lyon marathon a block away. I didn't want to miss it. I love watching locals do what they do.
However, a shower was needed. After a quick stop into the Carrefour Express to pick up a few grocery items, I returned home to shower before really heading out for the day. That's when my unexpected adventure began.
My apartment was in a very old building with a tiny elevator going up the center of a spiral staircase that was open to the elements. Leaving, I took the stairs down and, with light from the sky, I could see every step. However, at the bottom, the light disappeared and I noticed, just at the last moment, that there was one more step to go. In fact, there were two.
That last step I hit with just part of my left foot and down I went. Lying on the floor in the dark, no one around, I assessed the situation. Best to take the elevator back to my apartment before making any decisions.
By the time I got there the swelling had begun. First things first: rest, ice, elevation. I did every RICE step except compression.
French Health Care System Comes to Traveler's Aid
My ankle was not bad enough to require a hospital visit but I felt it needed to be looked at. Fortunately, pharmacies in France are a good starting point for medical care. The next morning I booked an Uber to transport me 5 blocks to the nearest open pharmacy. The pharmacist was fantastic. She gave me a gel, the equivalent of ibuprofen, and, most importantly, an appointment with a sports medicine doctor for that afternoon.
I hobbled back to my apartment to ice, elevate, and wait.
The doctor was very close by, so I walked to the appointment. Access to the building was puzzling but thankfully a resident let me in. I entered the waiting room which had a few chairs and nothing else. I sat. I waited (I was there early). The doctor eventually opened his door and welcomed me in. I'm proud to say that I gave my medical history in French. My French was better than his English, with the exception of medical terms. He assessed my ankle and concluded that nothing was broken. It was a sprain. In addition to the suggestion of RICE and the anti-inflammatory gel I had picked up that morning, he gave me a prescription for a specific splint and arnica homeopathic medicine. The latter was a surprise coming from a western doctor.
I went back to the pharmacy where I picked up both items and went home for more RICE. All receipts have now been submitted for my insurance claim.
It was not the experience that I was expecting in Lyon but it was an adventure nonetheless. I learned about the French medical system. I watched French television, which is a cultural experience, and I had a Rear Window experience watching the people in the street and other buildings. Rear Window without quite so much drama, that is. We take what we can get.
Stories of Travel Health Emergencies
And now for reader stories about medical emergencies in countries around the world.
Anne in Iceland – On the first day on a stopover in Reykjavik, Iceland I missed the curb and went down, breaking the fall with my wrist. I had a displaced fracture. I took a taxi to the hospital. One of the first questions asked in the Emergency Room was if I had insurance (I did have comprehensive travel insurance). My bill was $750, which I was expected to pay upon leaving. The care was ultimately good. They stabilized me and suggested I return home. I did need surgery. I was surprised at how readily they handed out pain pills, yet no vitals were taken. When after a few hours of sitting in the hallway I asked for ice for my arm, they just asked if I wanted more pain meds! My US health insurance covered the emergency visit, minus a $250 deductible, which my travel insurance paid, along with taxis and other incidental expenses related to the fall and injury.
Haydee in Italy– Two years ago I was in Florence, Italy. I fell down the stairs while returning from enjoying the magnificent Duomo. The security staff brought ice for my ankle and a nice German couple helped me to get to a safe place. They called a taxi service to get me to my hotel. I thought my trip had ended and I felt miserable for being alone. Then I called my travel insurance company and they sent a doctor to the hotel who confirmed there was no broken bone but asked me to stay in bed. Unfortunately, I missed a tour to Siena, Pisa, and a wine dinner and they would not reimburse the cost. The good thing is that I was able to walk (slowly and with a stick) to continue my trip in Rome for 12 more days. Now I think that even if not perfect, it was a wonderful experience and so worthwhile. Now I need to start planning for Siena again in the future.
Miranda in Bhutan – I slipped on mud and broke my ankle in Bhutan, high in the mountains and a 90-minute drive from the nearest hospital (thankfully I never had any pain from it). I actually did such a good job that I broke the bone and also dislocated it on the other side of my ankle (my foot was dangling at an angle it just shouldn’t be able to get to). My guide carried me to the car that thankfully wasn’t too far away, and we drove to the hospital. They took x-rays and put on a cast (the hospital staff were lovely), then it took about 16 hours of driving over three days to get back to the town that had the international airport. I actually also got quite sick after a couple of days because of the constant change in altitude, so that wasn’t fun on crutches! Thankfully, the tour company I was with had a family member who knew the CEO of the only Bhutanese airline, so I got the CEO’s seat on the flight to Singapore and insurance was able to handle the rest! I had surgery within a couple of days of getting back to Australia, followed by eight weeks of non-weight bearing and then learning to walk again!
Vicky in Poland – I sprained my ankle in Poland. I had to spend a whole morning at the hospital and then I continued sightseeing, albeit at a much slower pace. I have international health insurance through my work but I had to pay up front. Luckily Poland is cheap. I did find English speakers at the hospital to help me, thankfully.
Cautionary Tales Provide Tips for Travel Health and Safety
Some of the stories of travel health emergencies from our readers had specific lessons from which all of us can learn. Here are a few.
Sea lions do bite. Sherry in the Galapagos – On a trip to the Galapagos I was bitten by a sea lion. There happened to be a doctor with another group on the island I was on and he had a look at it. He said it was wide but not deep and hadn’t affected any major arteries. Back on the boat they cleaned it and gave me an antibiotic. I’d had my tetanus shot before I left home. The next day on a different island I saw a woman with a similar bandage on her knee. When I asked what had happened she said a sea lion had bitten her! What are the odds?
Beyond concern for drinking water. Leslie in Tanzania – Fortunately, I haven't had to seek medical treatment but I had an incident when I traveled solo to Tanzania. I joined a group trip once I was there. On the first day, I apparently drank some water even though I was so careful (I suspect I ate some fresh fruit or veggies that had been washed in it). On day two I got sick and incredibly dehydrated, so much so that I fainted during our visit to a Maasai village. That's a great story I will always have. Luckily there were three nurses on my tour and they sprang into action and took great care of me.
Elevation can cause temporary tooth pain. Scott in China – After flying back into Chengdu, China in 1985 after 12 days in Lhasa I noticed that many teeth in my mouth were hurting. I went to a dentist in Chengdu. He spoke no English and I spoke no Mandarin. We decided that while in Lhasa the small gaps of air in my teeth beneath fillings had depressurized and upon return, they'd pressurized again and expanded, causing the pain. In three days it was over.
The importance of emergency cash. Pat in Costa Rica – On a small group tour in Costa Rica, one woman lost three dental crowns over several days. Our leader found dentists for her each time and she had to pay the dentists cash each time. It made me realize that I need to carry more “emergency cash” with me on international trips.
Insurance recoups cost of trip canceled for medical reasons. Hilary – Good practice is to get cover as soon as you book. I was about to go solo to Sri Lanka but had to cancel three days before for medical reasons. I got my money back and did eventually go six months later. It was an amazing trip.
Don't tempt fate. Alexander in Philippines – I stupidly encouraged Tiger Mosquitoes (Aedes aegypti) to bite me so I could photograph them. I regretted it a week later when I had to travel home on four flights, 38 hours alone back to the UK feeling like death. Also, the mood lighting on the long flights really made my rash show up. I looked so infectious! Also I was quarantined in the hostel in Manila, everybody thought I had measles. It was Chikungunya Virus.
Dealing with a Travel Health Emergency in China
Here's my story, written in 2013, about my need for emergency health care in China.
Suddenly, the pavement was at my face. Or, more accurately, my face became part of the pavement.
All for the sake of another photo of a beautiful door.
When I was a child, my father taught me to appreciate doors by pointing out the best while driving up and down the streets of Westmount in Montreal. On my travels, I continue to enjoy the craftsmanship, design, and cultural nuances of doors. From Italy to Chile to China and points in between, I have taken pictures of doors.
But in the Hutong of Beijing, this obsession resulted in injury and an introduction to the Chinese health care system.
As accidents go, this one was simple. There were not multiple factors at play – only a cement post about 10 inches in diameter and twenty inches high on my right that I hadn't noticed. Once I'd got my photo of the door, I turned to my right to run and catch up with the group and was immediately flipped and thrown onto my face. My left arm took the majority of the impact but the blood flowing out of my nose drew everyone's attention.
Fortunately, on this trip, I was traveling with a group. I was the guest of Overseas Adventure Travel, a company that specializes in small group trips that take one behind the usual activities available in a country. We had just come from the home of a woman in the Beijing Hutong where we'd had a home-cooked meal and learned to make dumplings.
The reaction of the group was swift. A retired school principal and a teacher were on the spot quickly. A physiotherapist was close behind. As someone who has always traveled alone in the past, this was a moment that made me appreciate group travel.
(What would I have done had a travel health emergency occurred while I was traveling totally solo? There were Chinese people around who also tried to help with tissues and wipes. I'm sure I would have been okay.)
The blood would not stop flowing from my nose no matter how many tissues we stuffed up it so, once I had collected myself, we decided to get me up and head back to the bus.
On the bus I lay down on the back seat and the physiotherapist did his magic on my still bleeding nose. With me fully reclined, he held my leg extended and gave the bottom of my foot a good whack. He did the same on the other foot for good measure even though one should have worked. I sat up and we waited thirty seconds as we didn't want to dislodge a clot. Then, pulling the tissue out of my nose very gently, it was confirmed. The massive blood flow had stopped completely.
Blood gets a lot of attention. But once the bleeding had stopped and I passed through a period of shock (my heart rate dipped to the mid 40s), the real injury became clear. It was my arm that had incurred the most damage.
That night we took an overnight train from Beijing to Xian. In the narrow bunks there was no position for my arm that was comfortable. The pain kept me up most of the night. As I massaged it for hours, using my rudimentary knowledge of acupressure (shiatsu), it suddenly occurred to me that I was in China, where acupuncture originated, and acupuncture was exactly what this injury needed.
Once we got to our hotel that morning, I immediately started to work with the hotel concierge and our tour guide to find a clinic where I could be treated.
A Guest of the Chinese Health Care System
While the rest of the group spent the morning settling into the hotel, Alex, our tour guide and I headed to the hospital. We only had two hours before Alex had to be onto the next stage of the trip with the group. I really didn't think we could possibly do everything in that time frame, but we did.
Upon arriving at the hospital, we went to registration. A decision was required; I could register as a foreigner and get a doctor who spoke English or I could register as a local, more or less. We debated the issue. Which doctor would be better? I decided to go the local route as I had Alex as a translator and, we thought, the English-speaking doctor might only be better in language, not medicine.
Once registered, we went to the third floor for the acupuncture department. As you can see from the photo above, the hospital in China was not that different from older ones in North America. Yes, the ceilings were a bit lower, the lights had the glare of fluorescent bulbs, and it needed paint but the halls were wide, the design functional, and the system worked very efficiently.
The acupuncture department was very small. We first met an administrative person who took the paperwork from registration. While he was completing information on the computer a doctor came over to check my arm. My hand was swollen and I had little movement. He didn't want to do anything until he confirmed that it was not broken. I received a requisition for an x-ray. About 20 minutes later I returned with the x-ray that confirmed there wasn't a break.
The Acupuncture Treatment
Unrelated to travel health emergencies, I have had acupuncture treatments at home in Toronto for a variety of ailments, from tennis elbow to an injured knee that prohibited me from raising my foot more than a few inches off the ground. It has always been a very successful form of treatment for me, however, I knew going into the Chinese hospital that the treatment would be more of a challenge than at home. Westerners are not accustomed to acupuncture so therapists in the west go lightly on us. I expected a more intense experience from a Chinese doctor.
As it turned out, the doctor decided to use only five needles. One was placed just above my ankle on the inside of my right leg and another in the same place on my left leg. Then, one was placed on the outside of my right calf just below the knee – this one hurt. The pain was not from the needle but from the chi or electricity or whatever blockage it was breaking up. Finally, two needles were placed on my left arm – one in the soft tissue between my index finger and my thumb and the other about five inches up from the bone bump on the outside of my wrist.
I was left to let the needles do their work for about 15 minutes. Then the doctor returned and turned each of them, intensifying the experience.
And that was it. I got up and went back to the hotel.
The whole experience–transportation to and from the hospital, registration, x-rays, and treatment–took two hours.
Acupuncture does not work immediately. It takes a bit of time but, by the end of the day, I had some mobility in my hand. By the following morning, the swelling was gone. Within four days, I had almost full mobility. There is no way this healing would have happened in this way without the treatment I received.
I'm home now and I have booked an appointment with my acupuncture therapist. The damage I did was serious. The Chinese doctor had wanted me to return for further treatments but, knowing that I had support available at home, I really wanted to get on with the trip.
I was incredibly impressed with this Chinese hospital, the care I was given and the efficiency of the system. I also have to give a big shout-out to our tour guide and my medical translator, Alex. I am told by others on the trip that all OAT trip leaders are of the same caliber but that's hard to believe. Alex truly is a star.
Have you experienced a travel health emergency while on a solo journey? Please share your experiences in the comments section below.
