Accidental Medical Tourism or When Will This Stop Hurting?
Four days before we flew out to Vietnam, when the backpacks were already laid out on the floor in preparation for packing and to warn the cats of the upcoming vacation, I woke up with a sore throat. I spent the previous evening hanging out with my toddler niece who diligently rubbed her saliva into my face with an old toothbrush (“We are playing SPA, aunt Julia!”) and an infant nephew who coughed directly into my mouth with a speed, frequency, and precision of a well-trained sharp shooter. I spent the morning denying the obvious, telling myself that it was just allergies or a tonsil flare up, my throat is not actually sore, it will definitely pass by the time we land in Vietnam, oh god why is this happening to me, until I finally reached the stage of acceptance that I am sick and I will have to deal with this as an adult. As the first order of business I called my sister and blamed her germy children on my terrible predicament. My sister politely blew her nose into the phone.
“Yeah, I am sick too. And I have to remain in the house with the germy children instead of relaxing on a nice vacation halfway around the world.” Her sarcastic tirade was somewhat interrupted by what sounded like my nephew repeatedly coughing into her mouth. I decided to treat this as an apology and move on with my life.
Over the next four days, my cold progressed from sore throat to runny nose to incessant coughing and back to sore throat again. By the time we were ready to take off for Vietnam, I loudly announced to Victor that my body was almost done fighting off toddler germs. If this was a sitcom, this is where the narrator’s voice would chime in with “Of course, she was wrong.”
First few hard days in Ho Chi Minh City, besides dealing with the heat, the traffic, and the depressing realities of Vietnam war history, I was trying to figure out what’s going on with my throat. It seemed to be getting worse and worse every day. Hot tea and cough drops would ease my discomfort only temporarily and soon stopped working all together. I started taking ibuprofen and while it worked at first, by the third day it barely made a difference. On the last day of Ho Chi Minh City, I opened my mouth to reply to one of Victor’s questions and my throat seized with pain. I gulped air and closed my mouth. Obviously, something had to be done.
In the airport, while waiting on the plane to Hue, I threw my increasingly desperate questions into the depths of Google: What does a tourist do in Vietnam in case of a medical emergency? Are there English-speaking doctors? Do I need international medical insurance? How reliable is medical care in socialist Vietnam? I’ve heard nothing but horror stories from my parents about medical care in former Soviet Union with unequipped hospitals, bare walls in the pharmacy, and uncaring nurses. In all of my years of traveling, I’ve never had to see a doctor in another country and was slowly realizing just how lucky I have been. At most, I’ve visited foreign pharmacies and communicated through the miracle of hand gestures and miming of my symptoms to receive whatever I was looking for. This time, I had no idea what was going on with my throat and what I needed to make it stop. I needed to see a medical professional.
Surprisingly enough, I found Hue Central Hospital just mere blocks from our Airbnb in Hue and a very cheerful review in English which stated something along the lines of, “Was in a motorbike accident, they patched me up in three hours, two thumbs up. Go to the International wing for English-speaking assistance.” It also looked like the hospital was open 24 hours a day.
Next morning, we woke up at 6am and headed directly to the hospital, hoping that this visit wouldn’t eat up most of our sightseeing hours in Hue and well, the entirety of our travel budget.
After circling the hospital, we found the International entrance and went into an empty lobby.
“This is much better than an average Belarussian hospital,” Victor immediately commented. The lobby was large, clean, and airy, very much on par with smaller Western counterparts. There was no line at the reception, and I was quickly assisted in very good English. After being asked basic questions about my name, address, and symptoms, I was told to pay $35 for the consultation with an ENT doctor. I paid at a different window, received a paper receipt and a referral to see a specialist on the 2nd floor, Room 203. On the 2nd floor, we sat down on the row of empty chairs outside the closed door and were immediately approached by a nurse. She reviewed my referral paperwork and walked me into the cabinet. The medical cabinet, unlike the lobby, definitely looked like something out of an Eastern European Soviet times hospital, albeit well stocked and more modern looking. Unlike Western hospitals where there are multiple cabinets and one doctor makes rounds between rooms with patients already waiting inside, the Soviet-style hospitals have one doctor’s room and patients lining up on the outside. Inside, there were two tables, one for the nurse and one for the doctor, as well as an area by the window with a patient chair and medical devices.
First thing I noticed were the sterilization station and the fact that all instruments were sterling silver. Last time I visited a doctor in US, I hazily recalled most instruments being plastic and individually pre-wrapped. The doctor was in his mid-thirties, spoke excellent English, and took time to make me comfortable, chat with me, and thoroughly examine my throat, nose, and ears. In the end, he concluded that I had acute tonsillitis and prescribed antibiotics, anti-inflammatory, antihistamine, and pain reducing drugs for the next five days. The nurse immediately typed up the prescription and they carefully went through each drug to describe usage and side effects. While I was discussing the medicine with the nurse, next patient, a well-dressed Vietnamese man walked into the office and was being examined by the doctor. Clearly, medical patient privacy laws are not quite a thing yet in Vietnam. I was told that the pharmacy is conveniently located on the first floor of the hospital and bid my goodbyes to the nurse and the doctor as his entire hand was inside another patient’s throat. I stopped myself from physically waving at him, in case he reflectively waved back.
Downstairs, it took the pharmacy technicians ten minutes to put together my order and the total came up to around $9. Altogether, I was out of $44 and around 50 minutes of time, and I did not have to schedule an appointment or fill out extensive paperwork. My throat stopped hurting about an hour after the first round of pills and didn’t bother me again.
Later, when we chatted about local medical care with our Vietnamese motorbike guides, they were quick to point out that an average Vietnamese citizen visits the main hospital, rather than the International wing, where the prices are much cheaper, the lines much longer, and the doctor’s attention not quite as “attentive”. If I could do it all over again, I would have walked into the main hospital lobby to see exactly how different it was from my prim and proper concierge experience, but honestly it would have been hard to gather much information from first impressions. I imagine that medical care for an average Vietnamese citizen, while attainable and not bank-breaking, is not even close to standards of Western medicine.
Even though I have heard of medical tourism from friends who have traveled to other countries for medical or dental procedures at a fraction of what it would cost in the U.S., I have been very uncertain if I would ever feel comfortable with developing country’s medical care. For someone who is willing to eat basically any street food, gulp down even the strangest drinks from unidentifiable ingredients, and sleep inside stranger’s homes in rural India, apparently, I can still be fairly close-minded.
Hopefully, my future travels will be slightly less unburdened with knowledge that socialized medicine, at least for minor issues such as mine, can provide great care when far away from home. Also, I am planning on implementing “For a week before vacation NO CHILDREN allowed within 20 feet” rule and that should pretty much take care of any possible medical misfortunes… unless there is a motorbike accident.
Coming up NEXT: “Part I: Asia, Motorbikes, and Us”.