Our Medical Crisis Abroad
One of the frequent questions we get as a full-time travel family is how to deal with medical issues abroad. What do we do for insurance? How do we handle emergencies? What do we pack for medical needs? (For a list of my medical kit, see the blog post here!) How do we handle the routine stuff?
I’ve been putting off writing a blog about this for a while because, frankly, I felt unqualified. Up until the last few weeks, we hadn’t dealt with any medical issues on our world travels.
I now feel a lot more qualified to write about this 😁
We’ve had two medical emergencies in foreign countries, Vietnam and China, and successfully navigated them. We also had some exposure to non-emergency medicine in Bangkok.
First, our experience.
Leslie’s Eye Emergency
I woke up the morning we were flying to Hanoi, Vietnam looking like I’d been in a Muay Thai fight the night before and taken it all in my right eye. It was incredibly painful to open, totally bloodshot and swollen shut. I panicked. Could I even fly like this? Would I be able to get medical care in Vietnam? We were scheduled to board a 2-night cruise the next day.
After some panic, one of our team members in our business told me her dad is an opthomologist and I could probably video call with him. I did so and was told to stick with some prescription antibiotic eye drops (Vigamox) I had packed for pink eye and see if I improved.
The next morning I was much worse. It was more swollen, way more painful (think dagger sticking into my skull through my eye socket), and I was starting to feel really light-headed overall. I woke Chris and we headed to the international hospital in Ha Long as recommended by our hotel desk.
I didn’t know much about international hospitals before our travels, but I’ll tell you now they are your new friend! I think, after some pondering, that they actually exist not just for tourists, but for the local people that are willing to pay money for better/faster/more responsive medical care. You typically have to pay to even be seen and pay as you go, but the service is really good.
Thankfully, there was an opthomologist on staff and I got right in and under the microscope. The pain was so intense I could not even open my eye to look at the light until she numbed my eye. After some inspection, she stated coming at my eye with tweezers and I panicked! There was in interpreter and after much discussion, confusion, debate, she finally said I probably had an infection, potentially very serious and maybe requiring surgery, and needed to head to Hanoi, about 2 hours drive or more.
I was given, in Vietnamese, the address and doctor I should go see. I did not understand at the time I was being sent to a government hospital under socialized medicine. That was a bit of a shocker when I arrived.
I quickly returned to our hotel, we pushed off our cruise and I packed as if I may have to fly out of the country immediately. Chris and I agreed if surgery was required, I would fly alone to either the US, Japan or Singapore (we’ve since learned from both a foreign and US doctor that Japan is the best choice in Asia so as to minimize travel time). All while packing I was trying to update my kids that I may be leaving for many days, give Chris some instructions on the kids and trying not to fall over from pain and utter fear.
We hired a car to zoom me to the hospital in Hanoi, which he did. I was unloaded on the side of a busy street and the driver quickly pointed in a direction and left. I stumbled around, half-blind, for a while until I could find a nurse that could speak English. I showed her my paper, she hoped on the phone and let me know the doctor I came to see had left 15 minutes before for the day. What?! I literally broke into tears. I was SO scared, so alone and I’m so much pain.
Seeing my distress, she asked why I was there. I showed her my eye (hidden under sunglasses) and she quickly took me to a ticket window. It was like a movie theater ticket window. I paid the equivalent of $25 USD to “get a ticket number” and was lead to a room with lots of people waiting to be seen.
The nurse put me at the front of the line and took me into the nurses room, much to the frustration of those currently waiting to be seen. After doing a vision test (I was quite literally legally blind in my right eye due to the swelling) I was then shuffled up to a doctors room that was obviously finishing up her day. She agreed to see me, looked at me under the microscope again, and basically agreed with the first doc. I probably had a serious infection that would need to be biopsied the next day. It was a Friday, but thankfully this eye hospital is open Saturdays too. She then called someone and chatted in Vietnamese.
She told me the Head of the Corneal Department had agreed to see me the next day. He would determine and take the sample of my eye. I was given a room number, a time and a prescription for an eye lubricant drop and eye ointment (think anti biotic Vaseline in your eye) to use overnight. I shuffled downstairs, got my two prescriptions for about $10 and was on my own! I had to them find a hotel for the night.
After stumbling around for a bit (it is really difficult to walk on uneven sidewalk with just one eye in the dusk), I found a basic hotel around the corner street. I checked into a room, with cash, and locked myself into my room. The pain was so intense and I was so totally overwhelmed.
I didn’t leave that night. I called Chris to update him and went to sleep.
The next morning I showed up at the appointed time to the office number given. I could tell other people were also waiting for the same doctor. When he finally arrived, all the other people shot into his office at once! I tried to be polite and wait my turn, but soon more people came and just went in. I finally did also.
He thankfully knew who I was and saw me right away. He number my eye, showed me a picture of my eye, and showed me the culprit of all my problems- Grace’s fingernail had gone straight into my eye and cut my cornea. It was so deep there was actually a flap of tissue that was moving around each time I moved my eyelid. He told me this was causing most of the inflammation and pain.
He blessedly also said I only had inflammation and no biopsy was needed. Hallelujah!
He asked if I would like him to remove the flap of tissue. I agreed and he came at my eye with the tweezers again. He stripped off a little sliver of eye tissue, which he showed to me.
It looked like a small fingernail. Thanks Grace!
I was given a stronger lubricant drop and more antibiotic drop prescription, given his number and again sent on my way. It was difficult to comprehend. After spending another $10 for prescriptions, I was free to go. No more costs. I realize now these sweet doctors agreed to just see me out of the kindness of their heart. Vietnam is a communist country and many people, I’m sure, have to wait months to be seen at all. I offered to pay and both declined. Wow. Talk about blessings and answers to prayers.
Thankfully, after some significant pain that day, my swelling started to decrease the next morning. I learned all about fungi and amoebas in eyeballs, which I don’t care to know more about ever again. I kept vigilant on my drops and ointment to avoid further infection and lived with sunglasses on for days.
Two weeks later now and I’m good as new on that eye.
Harrison’s Emergency in Beijing
This experience is quite fresh for me still and really difficult to even describe. It’s one thing to have your own crisis, but to experience it for your child is another level. My heart aches for those who are bravely facing medical issues with their children, day after day. This quick experience wiped us out emotionally and left us in shock and sadness.
We arrived in Beijing and had a couple great days of sightseeing. Poor Harrison, as we arrived on the Great Wall, said he had pooped his pants. He had a bit of diarrhea and was so, so weak. That night, at 3:30 am, he woke up vomiting and was quite scared. We brought him to our bed and watched him vomit another two times in five minutes. He tried to drink water and quickly threw it back up. After a couple more vomits, we started to get really worried. He was terrified and just kept saying “help me” and acting like he couldn’t breathe. He was clutching his throat and chest and we were panicked.
We quickly dressed, wrapped him in a robe, and ran downstairs. We let Lucy know we were leaving and one of us would be back about the time she would wake up. The front desk told us there was a hospital within a five minute walk (again, such a blessing!) and gave us rough directions in broken English.
We ran out into the cold air at 4 am and watched as Harrison became unresponsive. He wouldn’t talk to us, looks at us, or respond in any way. We quite literally thought we might be losing our precious 4-year-old son right there on the street of Beijing.
We could not, for the life of us, find the hospital. People were staring at us as we fumbled around and taxis kept stopping, but no one spoke any English. I finally looked up the characters in Chinese for hospital and a nice taxi driver stopped . He kept pointing behind us, like we had missed it, but we had no idea where it was. He finally put us into the back of his car, drove very fast around the same block we had walked, and shoved us into an ER.
We found out the Chinese prize their children highly, especially their sons. Everyone was panicked with us and our sweet boy. In the ER, Harrison finally started coming back to us, although still vomiting bile now. We fumbled to talk to the nurse and she called over a nice man to translate for us. He told us to go over to the international wing and showed us where to go. We walked by dozen and dozens of patients, some 15-20 per rooms and many sleeping on the floor of the ER. It was pretty terrifying.
We arrived to the international wing and blessedly found an English speaking nurse. She had us pay about $150 USD to be seen by the night doctor.
We did an exam, a blood test (pay again), an ultrasound of his stomach (pay again) and were then put into a room with three other people in it. It was about 5 am at this point and we were all exhausted. The other patients were either coughing up major phlegm or vomiting every few minutes, so even Harrison couldn’t catch any sleep. At 6 am it was lights up and rise and shine!
They came back in an requested we do a glucose test (more blood draws and pay again) to which Harrison screamed so much and had to be physically retrained for that he couldn’t control his bowels and had to be cleaned up after. So sad.
As it approached 7:30 am, when our other kids would need one of us to return, I asked if I could buy diapers for Harrison. He was so sick it was a better idea than underwear at the time. Plus, his one pair had to be thrown away! I was lead to a somewhat pharmacy only to find they had newborn size and nothing else.
We found out that there are no extras or frills. We had to buy all of our own food, bring our own supplies and everything in this emergency room.
As I had to leave to be with the other kids, I stepped into talk to the doctor and let her know. She then told me his his enzymes were quite elevated and she was very concerned. This happens, I learned, when there had been surgery or a heart attack. Our hearts sank. I panicked inside. I cried as I left. He would need to be hospitalized at least one night and we would need to check out his heart.
As I walked back to the hotel, I was emotionally lost. I was so sad, so exhausted and so scared. Chris and I texted back and forth and I had to break it to the other kids that things were not looking OK. Poor Grant just started to cry. Lucy took charge and said she would take this kids into her room (we have to have two hotels rooms) and let me get some sleep. It was obvious I was an exhausted mess.
After about an hour of sleep, Chris called.
It was good news! The daytime doc had come on, they had been moved to a very nice, private hospital room and there was a positive update. The new doctor said the enzymes were not as alarming to him as the night time doctor and it wasn’t all that uncommon in children, especially with a bad virus. Since we were schedule to leave Beijing that day on a bullet train, we booked another night at our hotel and the doctor agreed to get an ultrasound of his heart right away.
A couple hours later we received great news- they saw nothing wrong with his heart! What a relief for everyone. They then focused on his fairly serious dehydration through IV and other methods.
After taking some supplies to Chris for the night, I returned to the hotel lobby and paid for our extra night. We changed our train tickets to the next day in hopes we could go and join our group if staff members we flew out to join us (they had already moved onto the next city).
I walked to the elevator, but instead of getting on, I literally just collapsed in a corner and cried. I cried a lot.
The adrenaline had worn off and the fear and panic of it all caught up with me. We went from almost losing one of our precious babies to having everything basically be alright in just a few hours. He was diagnosed with norovirus, which is basically a bad tummy bug and highly contagious.
After relaxing with the other kids and letting the baby nap, I took the kids to pick out a gift for Harrison. We visited him in the hospital and he was tired, but happy. He was the little star of the floor and they had given him the nice corner suite. It had a bedroom with bathroom and then a waiting area/kitchen with another bathroom. He loved the constant cartoons and soda to hide re-hydration salts in.
The next morning, Chris was able to check out quite early and was back with Harrison at 7:30 am. We laid down together and just held each other. It was so terrifying, so overwhelming. Then we had to pack and leave for the train!
Overall, we ended up spending about $800 USD. This is a good chunk of money, but much less than I expected for the overnight stay and battery of tests. In the USA, I think a similar experience would have been at least $10,000.
Bottom line: there isn’t a great option for health insurance abroad that we’ve found.
There is travel insurance, which we have. We have a policy with World Nomads. We like them because you can do flexible countries and cover up to a year. Once that year is up, you can start a new policy the next day. Any pre-existing issue won’t be covered, but I will submit our bills from Beijing to hopefully be reimbursed.
We also have a Christian Healthshare (Liberty HealthShare) plan based in the US that we use for a sort of catastrophe plan. It isn’t health insurance, but acts and feels like it. You submit your bills and try to get them reimbursed. We’ve had it now for over a year and I have yet to successfully get any money back. We used it along side our regular health insurance, which we kept until November last year, and that apparently meant they would pay for anything as a “second insurance”.
Our costs: $3000 for a year of coverage with World Nomads and $450 per month for our family with the healthshare plan.
Our old costs: $450 per month for the healthshare plan. $1500 per month for a high deductible ($15K) plan, so we basically paid $18K in premiums and the first $15K in medical bills every year. Being self-employed has some major downsides health insurance wise!
Overall, we are still way ahead financially with our current plans. We were lucky in both cases for it to not be more serious, of course. A major issue would be very difficult and I’m not totally sure how we return to the US and deal with insurance again, if and when that happens.
We’ve also leaned we may need health insurance to offset the tax penalty for be “uninsured”. We are working with our CPA on this still.
I’ve been told by a follower you can buy insurance fairly cheaply in other countries even if you aren’t a resident. This is true for many European countries and also some middle eastern. We will likely do this, especially in Europe, in order to try to get a visa.
Traveling and Health
It’s sad to say, but I would have to admit that I don’t think it would be possible to travel full-time with any chronic health issues. Finding prescriptions is actually not that hard in other countries. My mom forgot some of her prescriptions when she came to Bali and was actually able to buy some of them just over the counter. Each pharmacy has a different stock and availability. It’s strange! It was much cheaper, but it’s so wildly variable.
Trying to think of constantly trying to find prescription meds is not something I would tackle all over.
How Do We Deal with Other, More Routine Medical Issues?
Dental and Orthodontist
It sounds too easy, but we just find care when and where we need it! Lucy needed a fix when we arrived to Hong Kong (I think her wife broke), so we looked online and found a Canadian-trained doctor and got an appointment that same morning. He did an adjustment at the same time and it cost is about $400. Hong Kong is VERY expensive, so this is a little high.
In Bangkok, we decided to get everyone (except the baby) a cleaning. We all got in the next day, were seen extremely fast and got cleanings for six for about $150. Chris and I also got precessional whitening done (which we hated and don’t recommend in general!) for about another $100. These services in the US would be MUCH more money. We were thrilled with the service and quality.
Child Well-Check Visits
I had a couple of these done in Honolulu before we went international, along with flu shots for everyone. Because we are technically uninsured, this was very affordable at about $50.
We had some vaccinations at a private doctor in Honolulu also, which was VERY expensive. Vaccinations are crazy spendy and probably would be much cheaper overseas. This cost was about $3000.
I need to do well-child visits and more vaccinations for all of my kiddos and plan to have this done in Japan. I will just find a doctor. We will also get orthodontia removed for both Lucy and Grant while in Japan. We will look for an English speaking doctor that maybe has a pay-up-front discount.
Our Experience Overall
I’d say overall I’d have no issues getting medical care overseas. In most places, it is a “pay-to-play” game, so if you can pay for it, you’ll get great care. There may be a bit of language barrier issues and you won’t have all the conveniences you are used to, but there are trained and qualified professions also around the world.
We’ve been very blessed and had super kind professionals help us. Try to find an international hospital if you need to be seen.
Of course, I’m the event of a major issue, we would move to a first-world country or go back to the USA. Since we don’t have a home, we are a little lost when faced with that possibility. I don’t really know what we would do with a new chronic medical problem and just pray for guidance if that comes our way.
If you are scared to travel because of medical reasons, I’d say it’s a valid concern. However, if you are in overall good health, don’t be too scared. Even before this trip we’ve had issues on vacations and it’s always been OK. People get sick and hurt worldwide and there are medical professionals to help.
Do you have more questions I can answer? Let me know!