10 Tips For Staying Healthy in the Caribbean

On Caribbean islands (Bermuda and the Bahamas included), travel-related illnesses are relatively minor, generally predictable, and largely preventable, making the islands comfortable places for family vacations. The exception to this is Hispaniola, where the Dominican Republic and Haiti are (see below).

1. Update your children's vaccinations for trips out of the country. (They should be up-to-date even if you do not travel.)

Hepatitis A vaccine was recently added to the list of recommended immunizations for all children and teenagers. In the Caribbean, the incidence of hepatitis A is higher than in the U.S. The disease is spread by sewage-contaminated food and water.

2. Check your family's health insurance policies for reimbursements.

Likely, they will reimburse you for your medical expenses, but only after you submit the bills. You are responsible for costs when they occur. Good medical care can be as expensive as it is back home.

3. Take out travelers' assistance insurance.

Travelers' assistance insurance companies maintain worldwide, 24-hour telephone "hotlines" with staff to direct you to competent, English-speaking physicians and hospitals. The company pays the medical costs. If medically necessary, the company arranges and pays for evacuation to a larger medical center or, in critical cases, back home. Read policies. Such insurance is available from all major credit card companies. Call the customer service number on your card.

4. Review the quality of medical care on your island.

Available facilities range from good on some of the larger islands to non- existent on small remote ones. Information on each island is posted at the U.S. State Department site: travel.state.gov/travel/cis_pa_tw/cis/cis_1022.html. On Barbados, for example, medical care is generally good, but medical transport can take hours to respond and ambulance attendants are prohibited from applying lifesaving techniques during transport. Minor problems requiring a visit to the emergency room can involve a wait of several hours; private clinics and physicians offer speedier service. Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost thousands of dollars.

5. Leave the driving to others, especially at night.

Automobile-related accidents are the leading cause of serious injuries and deaths among travelers. Many roads are narrow, winding, and in poor condition. People commonly walk on roads. Some islands have safe buses and taxis, others do not. Ask responsible local people about public transportation.

6. Beware of hazardous activities.

Popular activities for travelers on various islands include riding motorized bikes, scuba diving, snorkeling and parasailing. Safety considerations can be lax. Victims commonly are travelers with little or no experience in the sport. Hazards include road conditions, driving on the left side of the road, no EMS or medical backup, and no hyperbaric chambers in case of scuba diving accidents, for example.

7. Watch out for the sun.

Forget about tanning and try to prevent burning. Children from northern climates may be especially vulnerable to the tropical sun in wintertime. They have lost their protective tans from the previous summer and will burn very easily. Sudden, intense sun exposure may be a factor in long-term skin damage.

8. Take special precautions for the Dominican Republic (DR) and Haiti.

The DR has malaria, but mostly in areas infrequently visited by travelers, and the incidence of intestinal illnesses is somewhat higher than on other islands. Precautions can prevent most of these illnesses. In Haiti, both malaria and intestinal illnesses are widespread. (See the following TenTips: Food; water; malaria.)

9. Use good judgment to avoid becoming a victim of crime.

Crime exists on all islands, as it does in the U.S. Ask responsible local people about areas to avoid, especially after dark. Go out in groups. Ride only in registered taxicabs. Report criminal behavior. Often crime victims are under the influence of alcohol. While the legal drinking age generally is 18 years, in many places younger individuals have little trouble getting alcohol.

10. Tell your physician your family has been in the Caribbean if you get sick after returning home.

In rare cases, travel-related diseases surface after you have returned home. Your physicians will not immediately consider such illnesses unless they know where you have been. In recent years, there has been an increase in the incidence of dengue fever in the Caribbean region, for example. This is an insect-transmitted disease that causes flu-like symptoms. Most cases require no treatment.