Health & safety
If you’re an EU citizen, a European Health Insurance Card (EHIC) form, available from health centres or via www.dh.gov.uk in the UK, covers you for most medical care. Valid for three to five years, the EHIC will not cover you for nonemergencies or emergency repatriation. Citizens from other countries should find out if there is a reciprocal arrangement for free medical care between their country and the country visited. If you need health insurance, consider a policy that covers you for the worst possible scenario, such as an accident requiring an emergency flight home.
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The WHO’s publication International Travel and Health is revised annually and is available online at www.who.int/ith/. Other useful websites include www.mdtravelhealth.com (travel health recommendations for every country; updated daily), www.fitfortravel.scot.nhs.uk (general travel advice for the layperson), www.ageconcern.org.uk (advice on travel for the elderly) and www.mariestopes.org.uk (information on women’s health and contraception).
Prevention is the key to staying healthy while abroad. A little planning before departure, particularly for pre-existing illnesses, will save trouble later. Carry a spare pair of contact lenses and glasses, and take your optical prescription with you. Bring extra medications in their original, clearly labelled, containers. A signed and dated letter from your doctor describing your medical conditions and medications, including generic names, is also a good idea. If carrying syringes or needles, be sure to have a doctor’s letter documenting their medical necessity.
Romania (and Moldova) can get a bad rap, but don’t cancel your trip if you’re worried about losing a wallet or getting a dog bite –it’s not that extreme.
Prominent scams in the country are jacked-up prices for tourists in Bucharest and Chişinău restaurants, taxis that charge extortionate fares (call for a taxi with companies as recommended by your hotel), and a lifted wallet if you’re not careful in public squares or jam-packed buses – like much of the world. Outside the capital, and away from touristy zones like Braşov, you might end up being surprised you were ever concerned.
In Moldova, you should have US$5, US$10 and US$20 bills ready – it’s hard to do much without some ‘fees’ (such as crossing the border: generally US$5). Don’t expect police to offer any change.
In the past guys in bogus uniforms have asked to see passports in Bucharest, and run off with them. Don’t hand over your passport in public.
To call the (Romanian-speaking only) police, dial 955. In Moldova, dial 902.
Hypothermia & frostbite
Proper preparation will reduce the risks of getting hypothermia. Even on a hot day in the mountains, the weather can change rapidly, so carry waterproof garments and warm layers, and inform others of your route.
Hypothermia starts with shivering, loss of judgment and clumsiness. Unless rewarming occurs, the sufferer deteriorates into apathy, confusion and coma. Prevent further heat loss with warm dry clothing, hot sweet drinks and shared bodily warmth, and by seeking shelter.
Frostbite is caused by freezing and subsequent damage to bodily extremities. It is dependent on wind-chill, temperature and length of exposure. Frostbite starts as frostnip (white, numb areas of skin) from which complete recovery is expected with rewarming. As frostbite develops, the skin blisters and blackens. Adequate clothing, staying dry, keeping well hydrated and ensuring adequate calorie intake is the best prevention for frostbite.
Tap water is generally considered safe to drink in Romania and Moldova. Beware drinking water from the polluted Danube River; some travellers have reported upset stomachs after drinking tea or eating soup or fish prepared with the Danube’s waters. In this case, get yourself some Ercefuryl (200mg), an antibiotic available at any pharmacy; it will stop you from doubling over.
Any water found in the mountains should be treated with suspicion – never drink it without purifying (with filters, iodine or chlorine) or boiling it first, unless assured that it’s safe to drink by a guide or local authority. At high altitude water boils at a lower temperature, so germs are less likely to be killed. Boil it for longer in these environments.
In 2005 and 2006, several case of avian influenza were reported near Tulcea and other parts of the country, with poultry cases reported in May 2006. The Romanian government quarantined a number of towns, including Făgăraş in Transylvania, as a safety measure. No human cases were reported.
This is spread by tick bites. It is a serious infection of the brain and vaccination is advised for those in risk areas. Two doses of vaccine will give a year’s protection, three doses up to three years’ protection.
Typhoid & hepatitis A
These diseases are spread through contaminated food (particularly shellfish) and water. Typhoid can cause septicaemia; Hepatitis A causes liver inflammation and jaundice. Neither is usually fatal but recovery can be prolonged. Hepatitis A and typhoid vaccines can be given as a single dose vaccine, Hepatyrix or Viatim.
This is a potential concern considering the number of stray dogs running around Romania. If bitten by a homeless dog, seek medical attention within 72 hours (most main hospitals will have a rabies clinic), but don’t panic – while rabies is transmitted via the animal’s saliva, the rabies virus is present in saliva only during the final stages of the disease in the animal. It is therefore a relatively rarely transmitted disease. Still, do not take any chances and seek medical attention. Any bite, scratch or even lick from an unknown animal should be cleaned immediately and thoroughly. Scrub with soap and running water, and then apply alcohol or iodine solution.
Availability & cost of health care
Medical care is not always readily available outside of major cities, but embassies, consulates and five-star hotels can usually recommend doctors or clinics. They can also recommend where to seek treatment in smaller towns or rural areas. Note that there is an increased risk of Hepatitis B and HIV transmission via poorly sterilised equipment.
If you develop diarrhoea, be sure to drink plenty of fluids, preferably an oral rehydration solution (eg Dioralyte). A few loose stools don’t require treatment, but if you start having more than four or five stools a day, you should start taking an antibiotic (usually a quinolone drug) and an antidiarrhoeal agent (such as loperamide). If diarrhoea is bloody, persists for more than 72 hours or is accompanied by fever, shaking, chills or severe abdominal pain you should seek medical attention.
Emotional stress, exhaustion and travelling through different time zones can all contribute to an upset in the menstrual pattern. If using oral contraceptives, remember some antibiotics, diarrhoea and vomiting can stop the pill from working and lead to the risk of pregnancy – remember to take condoms with you just in case. Time zones, gastrointestinal upsets and antibiotics do not affect injectable contraception. Travelling during pregnancy is usually possible, but always consult your doctor before planning your trip. The most risky times for travel are during the first 12 weeks of pregnancy and after 30 weeks.