Healthcare on the road – an interview with Dr. Ruben Martinez

Traveling to countries on the other side of the world can be challenging in a lot of ways. Different language, culture and habits are just a few things we have to deal with, when we are abroad. For the most things we can’t prepare ourself, what also makes the beauty of traveling, but there are some things we should do a good research and get well prepared before leaving for a new adventure. 

To stay safe and healthy it is needed to be informed about health issues and conditions in the country of your destination and take the necessary preventions before start traveling.

Dr, Ruben Martinez, a Spanish doctor from an international clinic in Ho Chi Minh in Vietnam has been taking care of travellers and foreign residents for the last 10 years.

He knows exactly what are the typical problems travellers have to deal with overall in southeast asian countries, how they can prepare and what they should do before starting their journey. 

After meeting him in Ho Chi Minh because I had health problems by myself while my stay in Vietnam, he was willing to answer some important question for all the travellers who plan to go to an foreign country to be prepared in the best possible way.

General travel information:

Dr, Martinez, before traveling for a longer time, what should every traveller do?

Plan your trip, Check potential threats to your health (environmental, political, hygienic, allergies). Ex: Weather (typhoons, storms, volcanos, raining or winter seasons, heat waves), wars, political unrest (Hong Kong recently), food (typhoid fever, Hep A), animal related (avian flu, Coronavirus, mosquito born diseases, (ex: malaria, dengue, Japanese Encephalitis), rabies)). And of course, get a VISA for the country if needed with some extra days in case your return is delayed by an unforeseen hospital admission. 

What vaccines should I have regardless of where I’m going? 

Tetanus, thyphoid fever, check if Hep A and B are updated. Yellow fever in some countries. Rabies if potential exposure, Japanese Encephalitis if long term in Asia. 

What should I do if I don’t know if I am vaccinated against these issues? 

Check antibodies with a blood test or get the vaccine again.

Does it make sense to vaccinate against rabies? 

Absolutely

Does Malaria prophylaxis make sense? 

In some countries yes. Other option is to be very proactive with chemical and physical repellents (permethrin, mosquito nets).

Doxycycline in a cheap option. Proguanil-atovaquone (malarone) is more comfortable but expensive.

What should I put in my first aid bag when I travel outside of Europe?

Broad spectrum antibiotic (azitromycin, ciprofloxacin), antiallergic pills (antihistaminics, steroids), pain killers, antiseptic solution, band aids, bandage and tapes, American tape (if trekking), steroid and moisturizer creams, anti spasmodic pills, electrolytes. 

Travel information for Asia & India

What special vaccines should I have for my trip to Asia? 

Asia is big, some countries don’t require any vaccine. (North of Asia, flu vaccine may be enough). For tropical areas, I already mention: Typhoid, tetanus, Hep B, Hep A (if not updated), rabies, Japanese encephalitis.

Why do a lot of people suffer from food intolerance and are affected with diarrhea?

Food intolerance may be a result from allergies, inflammatory bowel disease or infection. All can cause diarrhea. In travellers food ingestion of bacteria (cholera, E Coli, Campylobacter, others), toxins (from Staphylococus, scombrotoxin, ciguatera), parasites (Ameba, Giardia) all can cause diarrhea, that in many cases self-resolve in 2-3 days but in others need medical care. In long term travellers, worm infestations also possible. 

What should I do to prevent getting this sort of bacteria? 

Boiled water, avoid raw or poor cooked food, don’t eat food long time stored out of fridge, avoid ice cubes.

What should I do if I think I am suffering from Dengue or Malaria? 

If high fever and retroorbital headache or severe abdominal pain with no symptoms of runny nose or sore throat, go to see a doctor. Dengue has no treatment but support measures may be necessaries. Dengue in Asia seems to be less aggressive than in South America.

Malaria can be treated with oral or IV antimalarials. The severity of the situation will be conditioned by the Plasmodium species (several species, with Falciparum the more dangerous traditionally, but now other species in Indonesia can be equally aggressive) 

What is the typical issue tourists have traveling to Asia? 

Diarrhoea and traumatisms, followed by insect bites, robberies, syncope, chest infections, kidney infections…

Any other suggestions? 

Yes. Before travelling, invest in a good travel insurance that can pay a good international hospital to take care of you and in case of need an airplane ticket to take you home.

Good Luck

Ruben Martinez
Internal Medicine Specialist
Family Medical Practice, Ho Chi Minh City

To find further information about the travel requirements for any country in the world, check the foreign office from the UK for information in English or from Germany for information in German. For specific information about visas etc. you can consult the website of the foreign office of your country.

Foreign office UK: https://www.gov.uk/foreign-travel-advice/

Foreign office Germany: https://www.auswaertiges-amt.de/de/

Allianz Care provids a worldwide service to find medical assistance for travellers all over the world. https://apps.allianzworldwidecare.com/poi/hospital-doctor-and-health-practitioner-finder