Health insurance for any trip to St Petersburg is necessary (and often a pre-condition of getting your visa). Note that, officially at least, most Russian embassies issuing visas require you to purchase travel insurance from a list of companies given on the embassy website. This doesn’t appear to be strictly implemented, however: by all means try sending them a copy of a non-approved policy if you already have one.
Health care in the city is very good if you’re going private. Using public hospitals is not something you should consider, so even if your local Russian embassy doesn’t require valid health insurance, you should definitely purchase it.
St Petersburg does not pose any particular threats to your health, although you should be aware of the risks associated with drinking the tap water; you're strongly advised to only drink bottled water, or at least to boil local water thoroughly. Also be aware that the city was built on a swamp, which means the mosquitoes are nasty in the summer months. Be sure to bring plenty of insect repellent. You may also want to bring some painkillers with you – those post-vodka mornings can be hard work without them.
These private clinics have facilities of an international standard and are pricey, but generally accept major international insurance policies, including direct billing.
Look for the sign АПТЕКА (apteka) or the usual green cross to find a pharmacy. 36.6 Pharmacy (www.366.ru) is a chain of 24-hour pharmacies with many branches around the city, including the following:
Reports about the harmful effects of drinking tap water in St Petersburg have been widely publicised and greatly exaggerated. The city’s water supplier, Vodokanal, insists that the water is safe to drink, as many local residents do. Nonetheless, the pipes are antiquated, so the water may contain some metal pollutants. Furthermore, traces of Giardia lamblia have been found on a very small scale. This is a nasty parasite that causes unpleasant stomach cramps, nausea, bloated stomach, diarrhoea and frequent gas. There is no preventative drug, and it is worth taking precautions against contracting it.
To be absolutely safe, only drink water that has been boiled for 10 minutes or filtered through an antimicrobial water filter (PUR brand makes a good portable one). It’s probably safe to accept tea or coffee at someone’s house, and all restaurants and hotels will have filtration systems. Bathing, showering and brushing your teeth cause no problems at all.
If you develop diarrhoea, be sure to drink plenty of fluids, preferably including an oral rehydration solution. Imodium is to be taken only in an emergency; otherwise it’s best to let the diarrhoea run its course and eliminate the parasite from the body. Metronidazole (brand name Flagyl) or Tinidazole (known as Fasigyn) are the recommended treatments for Giardia lamblia.