Firstly I am not a doctor, so do not take this as gospel, but it is my personal experience after on the ground here for four years. You should still consult your doctor if you are unsure, that being said here is my take on medical information for traveling to Cambodia.
MALARIA INFORMATION AND TREATMENT
Malaria cases are reported in the whole of Cambodia, especially at the border regions in the north of the country where there are dense forest or wet lakes, however you should realize that major tourist areas such as Phnom Penh, Angkor Wat, Tonle Sap and Siem Reap have very low transmission rates because they spray for mosquito’s regularly.
So much so in fact that you can be sat in your apartment and it will look like a foggy world of death outside due to the constant anti mosquito fogging. Also the anti malaria pills are not good for you from the little I have come to understand…so if you are going only to the main population centre’s then my take would be not to worry about it. Use insect repellent measures to narrow the chances down even more. I think you have to be pretty bloody unlucky to get it.
Those traveling to malaria prone areas may need to take prescription medicine before, during as well as after the trip, depending on their traveling plan and whether most of the time is spent indoors or outdoors. Again jungle or off the beaten path travel I may suggest it, but I think you are just as well advised to simply wrap up to protect yourself. However any doctor will always tell you that you must and should take the Anti Malarial medication – this will be your call.
Taking Malaria Drugs in Cambodia
Some of the recommended drugs include mefloquine, malarone and doxycyline. Mefloquine should however not be used in areas near the Thai border because the presence of mefloquine-resistant malaria within the region renders the drug ineffective.
No antimalarial pills are 100 per cent effective and most of them have adverse side effects. That is why they should be taken in moderation, and instead concentrate on avoiding mosquito bites through dressing appropriately and considering other insect repellent measures such us sleeping under a mosquito net.
Symptoms of malaria include fever and chills, nausea as well as joint pain and you must seek medical attention as soon as you experience any of them to rule out the possibility of an infection.
EMERGENCY TREATMENT/ INSURANCE PAYMENT OPTIONS IN CAMBODIA
Although the medical sector in Cambodia keeps growing each day, emergency treatment services are still not up to international standards. Ambulance services are normally not guaranteed and public emergency hotlines may sometimes go unanswered. However in case of an emergency, you may visit any international clinic or hospital for treatment.
Most of the hospitals do not accept insurance and you may be forced to pay in cash or by credit card at the time of your treatment – for that reason make sure have some spare cash in your back pocket to get you on a plane to your own countries free healthcare system if needed or to Thailand or Singapore at all times. It is always a good idea to apply for a decent credit card with as high a limit as you can get, even though you should not need to use it.
Since there is lack of modern and reliable medical care equipment in the country, you may be flown out of Cambodia if you need serious medical attention. If you thus need your insurance company to pay for your medical bills, you may consider seeking treatment in Singapore, Vietnam or Thailand instead. If you are in the capital we have provided a full list of Phnom Penh medical treatment centers available to you.
Here the services are cheaper and the hospital may work with your insurance company to clear the bills. But you again will need the money in your pocket to get you out on the next flight if required.
Medical facilities vary here, and there are some good ones that will accept insurance, but just for now I would suggest if anything did happen that you went to Thailand or Singapore, because if for any reason your condition did worsen then those facilities are much better equipped than Cambodia, I don’t think anyone can argue with that statement at the moment.
Cambodia has a growing healthcare system and there is more investment coming in every day with new facilities being opened – however these tend to be, like most developing markets, the most profitable sectors first such as beauty and cosmetic surgery, they are not going to be able to patch a smashed liver.
Just be sensible, you don’t need to go whacking down malaria pills, or getting shots up to your eyeballs, do what you think you need, have a back up plan and most importantly don’t worry about it so much. Obsessive worrying fucks up your holiday before you have even left home. Who wants to go on holiday scared shitless, that is not a good way to start off.
COMMON MEDICAL ISSUES IN CAMBODIA
Travelers’ diarrhea:This is the most common travel related ailment and is caused by contaminated food and water. All travelers are thus advised to carry antibiotic and antidiarrheal drugs which should be taken as soon as diarrhea occurs. If the condition is accompanied by fever, cramps, vomiting and blood in the stool then medical attention must be sought soonest possible. If the symptoms are not severe, quinolone antibiotics such as ciprofloxacin or levofloxacin are recommended. Quinolone is the most popular but should not be taken by children and pregnant women. However most cases of the disease are usually mild and do not require any medication. (http://www.mdtravelhealth.com/destinations/asia/cambodia.php)
Dengue fever: This is present in densely populated areas, especially during the rainy season. It affects the provinces of kampong Cham, Kampong Thom, Kandal and Siem Riep.
If not treated early enough the disease may result in death in a few rare cases. Dengue fever carries flu-like symptoms and is transmitted by the aedes mosquito. No vaccine is available and thus insect protection measures are advised. (http://www.wpro.who.int/emerging_diseases/DengueSituationUpdates/en/) – realistically you need to be pretty unlucky to die from it. In four years I have met three people that got it, and all of them were long term expats, and all of them had been out in the sticks. One of them fell asleep pissed on the beach next to the jungle on Koh Rong, so honestly what could they expect. If you get this you are unlucky, and if you get it and go to the doctor they are pretty effective at treating it here. It can be very serious in young children and the elderly, so at the first sight of flu or cold like symptoms get off to the doctor and insist on a blood test.
Cholera: cholera outbreaks do happen in Cambodia and symptoms include severe diarrhea and vomiting that if not treated may lead to dehydration and death. Most travelers are normally at a low risk of infection and vaccines are recommended for those traveling to remote areas where the epidemic is present and medical care is limited. Again you should probably have has this shot, but I think that is everywhere you go in the world and not just Cambodia. The last outbreak was in 2010, just to put this in perspective.
Schistosomiasis: Also known as bilharzia. Symptoms of the disease include fever, tiredness, headaches and muscle pain. You may also experience bloody diarrhea on rare occasions. The disease is caused by contaminated water and travelers may contact it through engaging in water activities such as bathing, skiing or boating.
In order to avoid these and many other illnesses, food and water precautions must be put into place. These precautions include:
Only eating well cooked food. I would not recommending avoiding buying food from street vendors, in my experience this is some of the best food available, just make sure the place looks clean. If its busy you know it should be OK, the locals will not frequent market stalls that give them the rampant shits.
Avoid eating raw or undercooked meat and eggs as well as unpasteurized milk products if you know you have a tummy that gets easily upset, and also wash fruits and vegetables before eating/ peeling them. Only take bottled water or if it is tap water ensure it is either boiled or disinfected. Wash your hands often to avoid contacting viruses and bacteria that may cause diseases.
When people get sick at our hostels this is normally because they have purchased a bottle of water that is untreated. Even then its normally the case of the screaming ab dabs (shits) for a few days and nothing serious, always check your water is legit and is purified and not already open when you buy bottles from the street.
RECOMMENDED MEDICAL CENTERS WITHIN CAMBODIA
While most doctors in Cambodia are trained within the country, some are of international standard and can communicate in perfect English. Some of the best medical centres within the country are listed here and these include:
The American medical center: Located in Phnom Penh, the center offers general medical care as well as surgery, emergency and evacuation services. The contact number is 855 23 991 863
Tropical & Travelers medical clinic: The clinic is dedicated to offer excellent medical services to tourists and travelers. It is however closed over the weekends and on public holidays. The phone number is 015 912 100
International SOS Medical and dental center – Also located in Phnom Penh. Contact number is 855 12 816 911
Royal Rattanak Hospital: Offering great facilities including an operating room and an intensive care unit, the hospital is one of the best and the telephone contact is 023 999 042
If you are staying with us at The Mad Monkey and you get ill please ask to speak to one of the directors straight away, we will ensure you get good treatment and are looked after.
EVACUATION PLANS AND AIR AMBULANCES CAMBODIA
Although basic medical care is not that expensive in Cambodia, other emergency procedures done in the country including medical evacuation are always very expensive and if you are not insured you may end up paying over 20000 US dollars just to be transferred by an air ambulance from the country to Singapore, Thailand or Vietnam, and you will need to pay this upfront. This is why most travelers choose travel insurance than expat health insurance which in most cases is not accepted in the country and does not cover for any evacuation plans in case of a serious medical problem.
TRAVEL INSURANCE IN CAMBODIA
Now my honest take on insurance is to get a good one, I am sorry I can not recommend the normal backpacker insurance that I know most people get. World Nomads Insurance, I know they are great at marketing but I have known three people with claim issues since i have been here so it would be wrong of me to recommend them.
I honestly suggest you get a decent insurer that has a good personal recommendation from your friends or go through your family insurance broker who at least can pull some strings should your claim get knocked back. One thing for sure is you 100% do need insurance. Mine is with William Russel and so is my families..No issues as of yet.
I hope that helps answer any questions you may have had. And remember do not let fear get the better of you, Cambodia is an excellent country and you would be very unlucky to have any serious health issues whilst you are here. A simple bit of thinking it through in terms of insurance and emergency money being available before you leave home should be all you need.
Mad Monkey Hostels operates in the following Cambodian locations: Phnom Penh, Siem Reap, Kampot, Koh Rong Samloem