The Maldives is not a dangerous destination, with few poisonous animals and – by regional standards – excellent health care and hygiene awareness. Staying healthy here is mainly about being sensible and careful.
This is a very serious condition – usually, though not always, associated with diver error. The most common symptoms are unusual fatigue or weakness; skin itch; pain in the arms, legs (joints or mid-limb) or torso; dizziness and vertigo; local numbness, tingling or paralysis; and shortness of breath. Signs may also include a blotchy skin rash, a tendency to favour an arm or a leg, staggering, coughing spasms, collapse or unconsciousness. These symptoms and signs can occur individually, or a number of them can appear at one time.
The most common causes of decompression sickness (or ‘the bends’ as it is commonly known) are diving too deep, staying at depth for too long or ascending too quickly. This results in nitrogen coming out of solution in the blood and forming bubbles, most commonly in the bones and particularly in the joints or in weak spots such as healed fracture sites.
Avoid flying after diving, as it causes nitrogen to come out of the blood even faster than it would at sea level. Low-altitude flights, like a seaplane transfer to the airport, can be just as dangerous because the aircraft are not pressurised.
The only treatment for decompression sickness is to put the patient into a recompression chamber. That puts a person back under pressure similar to that of the depth at which they were diving so nitrogen bubbles can be reabsorbed. The time required in the chamber is usually three to eight hours. There are decompression chambers at both Baros and Kuramathi resorts.
All divers must purchase compulsory Maldivian diving insurance before their first dive in the Maldives. This will automatically be done at the dive school where you do your first dive, and is not expensive. This remains valid for 30 days, no matter where in the country you dive.
In addition to normal travel insurance, it’s a very good idea to take out specific diving cover, which will pay for evacuation to a recompression facility and the cost of hyperbaric treatment in a chamber. Evacuation is normally by chartered speedboat or seaplane, both of which are very expensive. Divers Alert Network is a nonprofit diving-safety organisation. It can be contacted through most dive shops and clubs, and it offers a DAN TravelAssist policy that provides evacuation and recompression coverage.
Officially, a doctor should check you over before you do a course, and fill out a form full of diving health questions. In practice, most dive schools will let you dive or do a course if you’re under 50 years old and complete a medical questionnaire yourself, but the check-up is still a good idea. This is especially so if you have any problem at all with your breathing, ears or sinuses. If you are an asthmatic, have any other chronic breathing difficulties or any inner-ear problems, you shouldn’t do any scuba diving. Be aware that most dive centres will not let you dive if you are taking any regular medicine for other ailments.
The following laws apply to recreational diving in the Maldives, and divemasters should enforce them:
Most of the potential danger (you have to be extremely unlucky or very foolhardy to actually get hurt) lies under the sea.
These colourful creatures are poisonous, and putting your hand into one can give you a painful sting. If stung, consult a doctor as quickly as possible; the usual procedure is to soak the sting in vinegar.
Coral is sharp stuff and brushing up against it is likely to cause a cut or abrasion. Most corals contain poisons and you’re likely to get some in any wound, along with tiny grains of broken coral. The result is that a small cut can take a long time to heal. Wash any coral cuts very thoroughly with fresh water and then treat them liberally with antiseptic. Brushing against fire coral or the feathery hydroid can give you a painful sting and a persistent itchy rash.
Dehydration and salt deficiency can cause heat exhaustion. Take the time to acclimatise to high temperatures, drink sufficient liquids and don’t do anything too physically demanding.
Salt deficiency is characterised by fatigue, lethargy, headaches, giddiness and muscle cramps; salt tablets may help, but adding extra salt to your food is better.
This serious condition can occur if the body’s heat-regulating mechanism breaks down and the body temperature rises to dangerous levels. Long, continuous periods of exposure to high temperatures and insufficient fluids can leave you vulnerable to heatstroke.
The symptoms are feeling unwell, not sweating very much (or at all) and a high body temperature (39°C to 41°C, or 102°F to 106°F). Where sweating has ceased, the skin becomes flushed and red. Severe, throbbing headaches and lack of coordination will also occur, and the sufferer may be confused or aggressive. Hospitalisation is essential, but in the interim get victims out of the sun, remove their clothing, cover them with a wet sheet or towel and then fan continuously. Give them fluids if they are conscious.
Sea urchins generally grow on reefs, and most resorts remove them if they’re a danger to casual waders in the shallows, though the waters are generally so clear that it’s easy to spot them. Watch out though, as the spines are long and sharp, break off easily and once embedded in your flesh are very difficult to remove.
These rays lie on sandy sea beds, and if you step on one, its barbed tail can whip up into your leg and cause a nasty, poisoned wound. Sand can drift over stingrays, so they can become all but invisible while basking on the bottom. Fortunately, stingrays will usually glide away as you approach. If you’re wading in the sandy shallows, try to shuffle along and make some noise. If stung, bathing the affected area in hot water is the best treatment; medical attention should be sought to ensure the wound is properly cleaned.
These fish lie on reefs and the sea bed, and are well camouflaged. When stepped on, their sharp dorsal spines pop up and inject a venom that causes intense pain and sometimes death. Stonefish are usually found in shallow, muddy water, but also on rock and coral sea beds.
Bathing the wound in very hot water reduces the pain and effects of the venom. An antivenene is available, and medical attention should be sought, as the after-effects can be long lasting.
A change of water, food or climate can all cause a mild bout of diarrhoea, but a few rushed toilet trips with no other symptoms is not indicative of a serious problem. Dehydration is the main danger with any diarrhoea. Fluid replacement and rehydration salts remain the mainstay in managing this condition.
Tap water in the Maldives is all treated rain water and it’s not advisable to drink it, not least as it has generally got an unpleasant taste. Nearly all resorts supply drinking water to their guests for free – some cheaper resorts make you pay for it, though. Either way, it’s a far better option.
Most resorts have a resident doctor, or share one with another nearby resort. However, if you are seriously unwell it will be necessary to go to Male, or to the nearest atoll capital with a hospital if you’re in a far-flung resort. The Maldivian health service relies heavily on doctors, nurses and dentists from overseas, and facilities outside the capital are very limited. The country’s main hospital is the Indira Gandhi Memorial Hospital in Male. Male also has the ADK Private Hospital, which offers high-quality care at high prices, but as it’s important to travel with medical insurance to the Maldives, the cost shouldn’t be too much of a worry. The capital island of each atoll has a government hospital or at least a health centre – these are being improved, but for any serious problem you’ll have to go to Male.
Mosquitoes vary from non-existent to very troublesome depending on which island you're on and what time of year it is. In general, mosquitoes aren't a huge problem because there are few areas of open fresh water where they can breed. However, they can be a problem at certain times of the year (usually after heavy rainfall), so if they do tend to annoy you, use repellent or burn mosquito coils, available from resort shops at vast expense (bring your own just in case). Dengue fever, a viral disease transmitted by mosquitoes, occurs in Maldivian villages but is not a significant risk on resort islands or in the capital.
The Maldives is an exceptionally safe destination for children, with almost no medical dangers from the environment. The biggest worry, as with all travellers, will be the strength of the sun. Ensure than kids are well covered with waterproof sunscreen (it’s best to bring this with you as the mark up in the resorts can be huge) and that they take it easy during the first few days.
Make sure that you have adequate health insurance and that it covers you for expensive evacuations by seaplane or speedboat, and for any diving or water-sports risks.
The only vaccination officially required by the Maldives is one for yellow fever if you’re coming from an area where yellow fever is endemic. Malaria prophylaxis is not necessary.
Be aware that in resorts all medical care will be available only through the resort doctor or, when the resort doesn’t have a doctor in residence, from a nurse or a member of staff with access to basic medical supplies. Bringing a few basic supplies such as plasters for small cuts is a good idea, as is mosquito repellent for the evenings on most islands. Mosquito nets are often provided by resorts where there is a consistent mosquito problem, but bringing your own is a good idea if they're not included and you normally suffer from bites.