Overseas hospitals

Bupa International's medical director, Dr Sneh Khemka, looks at the issues involved with attending a hospital when abroad

1. What are the main things to do should you find yourself having to go to a hospital in a foreign country?

If you’re being admitted as an emergency or taken by ambulance, you often won’t have much choice in where you go. However, if you can exercise choice, it’s important to select the best hospital for you – does it have the right services (eg a CT scanner), is it clean, can the staff speak your language etc?

Once there, you should let your insurer know you have been admitted as soon as possible so you can ensure you are covered for all treatments that you receive. If you can let them know before you attend, they may even be able to point you to the best facility in town.

Don’t be afraid to ask questions that may seem difficult – it is important that you know what is happening to you, and instead of being offended, medical staff have a duty of care to ensure you are kept up to speed with what’s going on.

2. What information is likely to be requested on admittance?

You will be asked for your demographic details (age, sex, next of kin etc) and your medical history. It is a good idea to carry with you a list of previous operations and treatments you may have had, along with a list of medications and allergies.

You will also be asked about how you are going to pay for treatment. Without insurance, it can be frighteningly expensive, so you’re best to be covered and you can give them the contact details for your company who should then be able to settle your bills.

3. Do hospitals have the same standards of care everywhere?

Absolutely not. Depending on which country you are in, and whether you are in a big city or the rural countryside, hospitals can differ greatly. Many developed countries will have a government regulation committee that will inspect all hospitals to make sure there is a minimum standard of care. However, in other areas it is completely unregulated.

As a general rule of thumb, cleanliness is a good indicator of the level of safety in a hospital. Word of mouth is also a good way of gauging a hospital’s reputation. However, if you are insured with someone like Bupa International, you will more reliably be able to find out which are the good and bad places, as we have experience and check hospitals around the world for quality.

4. Are there any countries where extra care should be taken when visiting hospitals?

Generally speaking, hospitals in developing countries have less regulation and lower standards than those in developed nations. Sub-saharan Africa is notorious for its underfunded and understaffed institutions and parts of South America have poor legacies for the state of healthcare. However, South East Asia and the Indian subcontinent have some of the best hospitals in the world. It’s all a matter of choosing the right place.

5. Do you recommend taking an emergency medical kit when you travel to countries with undeveloped medical systems? What should be included?

An emergency medical kit always comes in handy, but what you can do with one is limited. Kits should ideally contain basic painkillers, antiseptic, anti-diarrhoea and rehydration preparations, bandages and plasters. Customs and prescription laws restrict the amount you can carry around with you.

For any worrying conditions, it is always best to seek expert medical advice – things can be picked up before they develop into major problems and sometimes you need a doctor to give you medications you cannot otherwise access.

If you take any medications, eg insulin, it is essential to keep an adequate supply, and to keep stores in two separate bags in case one is lost. Also, if you are anaphylactic, don’t forget to take adrenaline with you (and give your travelling companion instructions on how to use it).

6. Is it always best to medivac patients home?

No. Bupa International runs a full medivac servicec called WMA (Worldwide Medical Assistance). WMA get calls from all over the world, and because we know the local services and hospitals, we can often find you excellent treatment without having to fly you back home, meaning you can carry on your trip after treatment. We may need to send you to a nearby country, but if you need urgent attention, having you in an aeroplane for an extended period is not the best idea.

7. What do travel insurers like Bupa consider before arranging a medical evacuation?

We look at all the medical details of the customer, what medical services they are likely to need, and the level of cover that they have purchased. We also take into account the personal preferences of the customer, and often will pay for a family member to travel with them should there be the need.

Then we look at where will be the best place to send them so they can get the best and quickest access to the treatment they need.

8. Do hospitals ever overcharge or do unnecessary medical procedures on foreign visitors?

There is an emerging problem amongst certain hospitals that, if incentivised in the wrong way, they are more likely to intervene with a procedure or test which may not be entirely necessary. This is the case with not only foreign visitors, but local patients as well.

We encourage our customers to let us know in advance of any planned treatment so we can talk through the options with both the patient and the doctor, and ensure that they are acting in a medically sound manner, and not just doing things for the sake of a few extra bucks.

9. Are private hospitals generally as good as public hospitals?

Yes, and in many places often better. Private hospitals tend to have better funding and can therefore afford better equipment and facilities.

However, public hospitals may offer a range of services that private ones cannot, including intensive care units, emergency cardiac interventions and a wider range of staff for paramedical services such as physiotherapy and radiology.

10. Could you give any tips to our members to help them keep travelling safely?

It’s really a matter of common sense. The biggest single problem that the traveller will face is dehydration (from diarrheoa and vomiting). Access to a plentiful supply of rehydration salts and clean drinking water is paramount.

And making sure you’re adequately insured so that not only will your bills be paid, but you’ll have a ‘friend’ that can help you through particularly troublesome times.