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Staying healthy in Asia - you don’t know what you got till it’s gone.

“…got a lady doctor, cures the pain for free - she says be a patient patient, stretch right out on this couch - help yourself to some pills, cure your ills…” Graham Parker

I’m in far Western China. Big bustling city of Chengdu, famous as the only known habitat for those cuddly cute Pandas. On my way to the border town of Golmud, one of the few places foreigners are allowed entry overland into Tibet. It’s said – if the Chinese’ll let you in - you may be able to hitch a ride with a long-haul trucker for the 3 day trip to Lhasa. May get in. May get a ride. May make it. Yes indeed, quite the well-thought-out plan I got…

China’s wonderful training if like me, you think you’re destined someday to go to hell. Walk into a hotel, guy instantly says “aw foo!” What the fuck? “Aw foo?” Turns out means all full. Place’s empty, but this far from Beijing, there’s still Communism. Why rent out a room - only gotta clean it again…

Public execution tomorrow. Caught 3 poachers with a Panda skin. Big, big, no-no. Standing room only in the 100,000 seat Coliseum. As some Greek once said, “fear, not clemency, restrains the wicked.”

“How they doin’ it?” I wheeze - got a serious case of flu. “Hanging? Firing squad?” Blow my nose loudly. “Cut off their heads? Gonna let us gwailohs watch…?”

“That’s disgusting!

“Huh?” I look up surprised, “what’s disgusting? Blowin’ my nose? Sorry, I’m dyin’ here.”

“Not your nose! You, you are disgusting - wanting to see people murdered!”

I focus filmy eyes on her - young pimply face, soft thru the middle, budget backpacker. “You really don’t wanna see an execution? Really? No shit? Man, that’s high on my ‘125-things-to-do-before-I-die’ list.”

“That’s barbaric,” she snorts in a whiney British accent. “What if it was your brother?”

“Yeah yeah - and if the Queen had balls she’d be King. Listen, you don’t wanna go, don’t go. I could give a fuck less.” I need both hands to steady myself as I wobble up from the table. “You know, you should watch your mouth – someone’s gonna wash it out with soap. Now, excuse me, I gotta puke.”

It sucks being sick anywhere – most especially in a foreign country.

So, thoughts on lowering risks and easing pains

First, vaccinations - gotten, registered, and boosted. Did you know that Polio vaccine needs a timely boost? You can still get Polio in parts of India. Ever hear of Japanese Encephalitis? No? That’s ok, there’s a vaccine - also for Rabies, Typhoid, Yellow Fever, Hepatitis…pretty lengthy list.

Which you need? Depends - where you going; for how long; what’ll you be doing; what’ve you had; allergic to anything; taking medication now? 3 months up-country Thailand, helping farmers in a remote province, is a lot different than a week in Singapore. Recommendations and requirements vary considerably. A Best Bet for this stuff is IAMAT (International Association for Medical Assistance to Travelers). Excellent info on immunizations; locally available Western-trained English-speaking doctors; malaria prevention and treatment. Funded by donations, membership is well worth it.

Where do you get ‘em? Costs? Again, it depends. You can get shots for free, for reduced prices at clinics, or at so-called “travel specialist” Doctors. Be aware that any Doctor can claim to be a travel expert. Wise to double-check their advice. They can be helpful with exotic vaccines, often having ‘em in stock.

You gotta remember to remember. Not as stupid as it sounds. Many – hepatitis for example – are spaced over a period of months. Others require periodic boosts. Since shots are standard world-wide, you can start in your home country and complete on your travels – international airports are often good for this. The Yellow Card is a formal document that lists and certifies what you’ve had. With shots overseas, make certain entries are legible. Trying to decipher what the hell was done in Penang, Malayasia 3 years ago is an idiot’s game.

Have checkups – especially if it’s been a while. Do a routine physical, plus eyes and teeth. Deal with medical devices or prosthetics – maintenance, batteries. Stuff that’s real easy at home’s often impossible in Asia. Try getting your progressive, tri-focal, coated-lens reading glasses replaced while visiting an ashram in Goa, India.

I know, I know, you don’t wanna. You hate the doctor. The dentist always hurts. They tell you what a bad boy you’ve been. And new glasses? Shit, all you gotta do is hold the page a little further away… But go, get it over with. The tests and any work will take time, so the sooner the better. Consider – while it’s best to get diagnosed at home, dental, medical and surgical procedures are often breathtakingly cheaper in Asia - with acceptably high standards as well.

Bring copies of all health-related documents, including prescriptions. Medication is routinely cheaper in Asia, with no note from your Mother required. One can walk into a pharmacy on Bangkok’s Sukhumvit Rd and buy Valium, Xanax, antibiotics…but nothing hard-core. For a cheap high - and by-the-way an effective runs-stopper-upper - try the Kaolin and Morphine mixture available in Singapore. If you buy stuff, copies may help with Customs; “Uh, Sir, about these 200 Viagra you got here…?”

Prepare a medical kit, which always goes in your carry-on luggage. Link below lists items to include. Add anything personal you might need, such as medical devices, batteries, repair equipment…some folks bring their own sterile syringes.

Health Insurance check - coverage in Asia for how long; for how much; for what condition? There’s often a limit if you remain out of your home country for a certain period. Do you pay first and get reimbursed – if so, what documentation is required; need prior approval; air ambulance covered? Just for fun, call an International Airline and gently inquire what it’d cost by plane on a stretcher from - oh, let’s say Manila - to Chicago. There’re also “stand alone” travel policies, for specific time frames - very pricey, but only if you don’t need it…

Ah, insurance. When you trek in Nepal, you can be rescued by helicopter - sorta handy if you get a kidney stone 12 days hike from civilization. They’ll only come if you’ve put up a hefty deposit. Life or death don’t matter - gotta have money up. It’s informative, sitting lakeside in Pokhara - gateway to the famous Anapurna Circuit - watching assorted casualties being brought down strapped to mules or the stray Yak.

I felt like an assorted casualty myself. Staggering up 3 unending flights of stairs, I open the door and barely make it to the bed. My companion is brimming with cheer. I wanna smash her face in.

“Shit, you look horrible. You sick?” she chirps.

I run through several responses in my head, but they all start with of course I am you fucking moron. Bad choice. Bad bad choice.

“I’m fucked”

“Alright, lemme take your temperature. Roll over.”

It’s a struggle to roll over and get my pants down. I’m sicker than I realize.

“It’s 103. I’m goin’ down to find a doctor. You want anything?”

“Gotta puke. Then just kill me.” Christ, I’m really sick. Fever, chills, can’t focus, can’t hear good. She helps me to the toilet. Dry retching. Back to bed.

“I’ll be right back.”

After a while, the door opens and in she comes with what looks like Ming the Merciless dressed as a Mormon Missionary. Yellowing white shirt buttoned up to the neck, hair sticking out all over, carrying some kinda plastic shopping bag…oh goodie, she found a doctor.

“How are ya’? Uh, listen, this’s the hotel doctor. He don’t seem to speak much English, so we’re gonna have to do this best we can.”

Terrific, just fucking terrific. How’m I gonna explain my symptoms? I’m ready to point this out, when the guy plops down next to me on the bed. Just sits right down comfy as all hell, grabs my wrist, and speaks comfortingly in Chinese. Takes my pulse for a good 10 minutes. I feel like I’ve wandered into an old Twilight Zone episode. Too stunned to speak. Useless anyway.

Eventually he stops, smiles at me gently, stands up, and starts pulling shit out of his shopping bag. Small pile of what looks like wood shavings; foul-smelling vomit green salve; big-ass almost golf-ball-size yellow pills…now the real fun begins.

He starts talking to me, holding up each item while pointing to his watch. Oh! A medications schedule. Swell, but don’t tell me, Ming, tell her. I got no chance of understanding.

They both sit down next to me on the bed. We’re having a party – maybe a threesome? The numbers on his watch face are too small, so she jumps up to get our alarm clock. He’s holding stuff up, pointing at me, pointing at the clock, doing cute little pantomime routines…it’s like watching a retarded version of the Muppets.

Eventually it gets sorted out – sort of. The wood shavings seem to be tea. Drink on schedule. The salve is for my chest. Pills are 4 times a day.

“He wants you to come to his clinic tomorrow, ok?”

“How the fuck you know that?”

“Listen, you wanna go or not?”

“If I can walk, sure. But hey, what about the execution? Ain’t that tomorrow? Shit.”

She stares at me with dangerous eyes, “again with the execution? Which’s more important? Getting healthy so we can go to Tibet? Or watching people get murdered? Asshole.”

“Ok, ok,” I relent, formulating a brilliant plan for tomorrow.

But that’s another story….


IAMAT - International Association for Medical Assitance to Travelers

USA's Department of State - Consular Affairs

CDC - USA's Center for Disease Control

WHO - World Health Organization


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