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Laura Hilton serves as head of International Provider Network Development. Laura oversees all HTH international medical assistance operations and leads development of HTH’s international provider community and online databases from her office in London. Laura joined HTH in 2000 in the role of international provider recruitment and relations. She has extensive experience in emergency assistance operations and has developed medical evacuation plans for over 500 corporations. Fluent in five languages, she has traveled throughout Europe, Asia, the Middle East, Latin America and the former Soviet Union to evaluate international medical facilities and design healthcare solutions for travelers and business expatriates. Laura is a graduate of Yale University with a B.A.

Travel Bulletin: UK Public-sector Set to Strike on Wednesday

Monday, November 28th, 2011 by

A nationwide public-sector strike scheduled for Wednesday, November 30th threatens to impact daily operations in the UK – most notably that of air travel and medical services.                

Air Travel

Many airlines are allowing rebooking and reducing flight schedules to ease the flow of people into UK airports Wednesday in an effort to reduce the number of incoming passengers.  Officials at Heathrow anticipate that they will need to potentially hold passengers on planes to manage the immigrations lines in the terminals.  Passengers from outside the EU may experience longer delays than those with EU passports, but all arriving passengers will be affected given that the border control is expected to be operating at 50% of normal staffing.   Outbound passengers may also be affected – if incoming passengers are not allowed to disembark, the aircraft and gates will not be available for departing flights, causing cancellations and possible gridlock.

Medical Care

Unions representing over 400,000 nurses, paramedics, physiotherapists and support staff are expected to participate in the strike. Because the National Health Service (NHS) is not allowed to bring in outside help to cover staff on strike, thousands of operations and appointments are being canceled for Wednesday. Many hospitals will be operating emergency services only.

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Is London Burning?

Tuesday, August 9th, 2011 by

It’s almost dinner time in London and like most of my neighbours, I am wondering what tonight will bring.  So far, my location in Islington has been spared any major damage, as have most locations HTH members frequent in Central London.  Nevertheless, over the past few nights, even those of us lucky to be far from the turmoil have heard more police and ambulance sirens than usual as they rush to their colleagues in the more peripheral parts of Greater London where most of the violence has taken place.  On Monday night, no fewer than eight fully loaded police minibuses erupted from the UCLH area on Tottenham Court Road just after 8 pm to head east towards the melee.

The Prime Minister and Mayor of London both returned to the UK from vacation last night to be personally briefed by their crisis management teams, but no one is sure what will happen tonight.  London hospitals have increased their security guard cover from 8 pm – 8 am.  There was apparently a bit of a skirmish at Kings College Hospital in Denmark Hill last night, but services have not been interrupted in any way. 

In Central London today, the riots were certainly a subject of conversation, but in their typical fashion, Londoners were keeping calm and carrying on.  When I popped out at lunchtime for a manicure appointment, I found the door of the salon locked – the reception staff had secured it in case of any trouble – they used this opportunity to personally welcome clients at the threshold.  Although I appreciated the additional care they were taking to ensure the security of their staff and customers, I shared a good laugh with them about the added precaution.

While walking through Kings Cross Station today, there was an announcement on the loudspeaker, imploring the owner of a suitcase left unattended to please return to it immediately before the authorities would be forced to evacuate the building and close London’s busiest train station.  A bobby in a bulletproof vest was monitoring the ticket turnstiles for the Underground, but train and tube passengers carried on without any sign of unease.   Tonight, central London is strangely quiet.  Stores on Oxford Street, a major shopping and tourist thoroughfare, have closed early.  Traffic is light and sidewalks are empty, apart from a few bemused tourists, hoping that this temporary lull in activity might mean a shorter wait for a table at the Hard Rock Café.

The bottom line is that  London isn’t burning much if at all right now; central London is rather pleasantly empty as long as you don’t want to shop; everything still works here; the hospitals are OK; and unless you really work hard to find trouble, it won’t come and find you.

Photo by belkus.

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Travel Bulletin Egypt: Emergency Medical Care Available

Monday, January 31st, 2011 by

HTH sources in Egypt indicate that private hospitals in Cairo and Alexandria remain open and comparatively well-supplied at the moment.  Many of them are focusing on emergency cases and inpatient care, so routine scheduled outpatient care may not currently be available.

Public hospitals are likely to be operating beyond normal capacity during times of crisis, as the ongoing demonstrations have left over 100 dead and scores of others injured and requiring medical attention.

Response services for emergency situations is poor, especially in Cairo and Alexandria, as well as other major cities where ambulances are subject to significant traffic congestion. The current situation has resulted in reduced traffic on the roads, but response times will, however, be affected by the increase in demand, especially during periods of intense rioting.

Most private physicians in Cairo and Alexandria have closed their practices today, although many are still seeing emergency patients with limited hours at private hospitals.

Starting today, the U.S. Department of State is assisting U.S. citizens in coordinating “transportation to safehaven locations in Europe” on a reimbursement basis. According to the U.S. Government, “priority will be given to persons with medical emergencies or severe medical conditions.”  Interested U.S. Citizens should contact the U.S. Department of State by calling +1.202.501.4444 and be prepared with their name, age, place of birth, U.S. passport number and any special medical needs.

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Vegans Abroad: Bring Your Ingenuity Along

Thursday, September 30th, 2010 by

In many parts of the world, declaring yourself to be a vegetarian, much less a vegan, is often met with anything from well-meaning curiosity to complete disbelief.  In many developing countries where starch is a staple and meat is traditionally somewhat of a luxury, the idea that someone would just prefer not to eat meat, either for ethical or dietary reasons, usually comes as a bit of a shock.  Your hosts may jump to the conclusion that you are sick (either physically or in the head) or that you are turning your nose up at their local cuisine, so it is important to handle the matter delicately. 

If you are a strict vegan, it can be a challenge to find animal-free sources of protein while abroad.  Of course, you may find a lot of options in Asian countries where soy is a familiar ingredient.  Coffee with soy milk, called “soya milk” in the UK, is widely available through the Starbucks chain.  You may end up spending a lot of time in the hotel bar – not for the drinks, but for the bowls of nuts!

In Latin America, although rice and beans are traditional staples, the beans may be prepared with meat products – it’s not unusual to find a pig’s ear floating in the traditional Brazilian feijoada (bean stew). But it is also common to find beans prepared with just water and salt.   I have admittedly found myself eating a lot of lettuce and French fries in some locations, so I tend to bring along my share of packaged protein bars to tide me over.  There are also websites like vegdining.com and happycow.net which have listings of restaurants with vegetarian or vegan options. My advice is to confirm the information carefully. Unfortunately, given that omnivores vastly outnumber vegetarians and vegans, these specialty restaurants do not always stay in business.

I recently found a vegan blogger who is traveling to Istanbul and providing vegan travel tips on the way; she also has some tips on using vegan foods to remedy some of the more common travel maladies. Let us know if you have some tips on how to manage a vegan diet in the four corners of the world.  Also, check out our earlier post on resources for vegetarians which included a link to the International Vegetarian Union.

Photo by victoriafee.

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Posted in Destinations, Food and Diet, Travel Tips | Comments »

Volcanic Ash Spillover: Travelers Encounter Medical Issues

Monday, April 19th, 2010 by

Dateline: Vienna
Situation: Stranded by Airport Closures
Medical Report: You can breathe the air but check out these developing issues.

There’s no ash in the air here in Austria, but besides all the general travel headaches you are seeing on the news, I’ve uncovered some disconcerting trends in working with our members traveling around the world:

  • Travelers are running out of the prescription medicines: Type 1 diabetes patient in Singapore needs insulin; traveler in London needs high blood pressure medicine; a couple in Milan needs to replenish medicines for cholesterol levels, thyroid condition and birth control; a liver transplant patient in London needs medication to control organ rejection.  All these cases are being sorted out by HTH Worldwide staff via visits to doctors to get new prescriptions.
  • Doctor displacement causing problems: April is prime time for medical conferences around the world as well as high vacation season for physicians in tourist destinations where they are busy in the height of summer.  A lot of doctors we know were away last week and cannot get back to their practices.  We have heard from a doctor from the UK who is stranded in Budapest as well as a doctor from Rome who is stuck in Spain.  Some London hospitals are doing a department by department survey to see how many specialists are Missing In Action, so they can restructure staffing. It’s not an overwhelming problem by any means, but a lot of senior physicians were away when volcano erupted.

We will keep tracking developments while Ejafjallajokull continues to spew.

Photo info: http://www.flickr.com/photos/gsfc/ / CC BY 2.0

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Venturing to Vancouver? These Medical Services Take the Gold

Thursday, February 11th, 2010 by

The XXI Olympic Games will commence tomorrow in Vancouver, Canada.  If you are one of the 2.3 million people expected to descend on British Columbia you should familiarize yourself with the recommended hospitals and emergency information.  You could be perfectly healthy when you arrive, but the elements and the large volume of people in crowded areas will expose you to potential injury or illness.  The Centers for Disease Control has put together a webpage full of suggestions for keeping healthy at the games, but in the event these tips fail to help you, here is some additional information:

In the event of an emergency anywhere in British Columbia, call 911. 

If you don’t need immediate assistance, but you are looking for medical advice, HealthLink BC offers 24/7 non-emergency access to a nurse hotline by calling 811.

Looking for a pharmacy?  Chain stores include Shoppers Drug Mart, London Drugs and Pharmasave.  Pharmacies are also available in supermarkets and discount stores, such as Zellers.

The majority of the Olympic events will be held in Vancouver, but some events will be held in Whistler and Richmond.  Familiarize yourself with the options closest to where you will be staying and the events which you will be attending. 

VANCOUVER
St. Paul’s Hospital in Vancouver was selected by the Vancouver Organizing Committee for the 2010 Olympic and Paralympic Winter Games (VANOC) as the primary hospital for Olympic visitors.  Vancouver General Hospital will play a similar role for Olympic and Paralympic athletes and coaches.    

St. Paul’s Hospital
1081 Burrard St
Vancouver
+1.604.682.2344

Vancouver General Hospital
855 West 12th Ave
Vancouver
+1.604.875.411

Vancouver Coastal Health operates hospitals and urgent care centers in the greater Vancouver area.

There are also other facilities available in Vancouver, including the University of British Columbia Hospital, which also operates an Urgent Care Centre in the Koerner Pavillion.  A private outpatient facility called False Creek Surgical Centre is also offering urgent care services during the games.

UBC Hospital – Koerner Pavillion
2211 Wesbrook Mall
Vancouver
+1.604.822.7121

False Creek Surgical Centre
6th Floor – 555 West 8th Ave
Vancouver
+1.604.739.9695

RICHMOND
Richmond, the site of the speed skating events, is served by Richmond Hospital.  There is also a private urgent care center called MCI Medical, located next to Zellers at the Landsdowne Mall in Richmond.

Richmond Hospital
7000 Westminster Highway
Richmond
+1.604.278.9711

MCI Medical
8311 Lansdowne Road
Richmond
+1.604.276.9550

WHISTLER
Although there is no hospital in Whistler, the site of the alpine events is served by Northlands Medical Clinic:

Northlands Medical Clinic
101-4359 Main Street
Whistler
+1.604.932.8362

If you’re visiting the Olympics, but not staying in Vancouver, Whistler or Richmond, visit mPassport.com for information on the facilities available where you are.  Healthy Travel Blog readers, sign up for a free thirty day trial of the mPassport mobile website here, just select coupon code and enter the code “Vancouver.”

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Notes from an HTH Physician in Port-au-Prince

Friday, January 15th, 2010 by

Dr. Scott Nelson, a U.S. Board Certified Orthopedic Surgeon and HTH provider, has been practicing in Santo Domingo, Dominican Republic for several years.  In conjunction with CURE International, he is leading a team of Dominican orthopedic surgeons to provide  medical services to victims of the earthquake.  Dr. Nelson and his colleagues arrived in Port-au-Prince January 14th. 

January 20, 2010

FYI: the aftershock was a big one, but all is still ok with our CURE team!

January 19, 2010

Our team has done 75 surgeries so far at the Hôpital de la Communauté Haitienne. The entire CURE International group, from the headquarters all the way to the team on the ground in Port-au-Prince is organized and working well.

CURE has also facilitated an 18 person team from Texas to work at the Centre Hospitalier du Sacre-Coeur in Port-au-Prince. Due to the concern of aftershocks toppling certain sections of the hospital, additional ORs had to be created. This team divided an open room ER into 3 ORs; literally set up an OR in the hallway and also set up an OR using a radiology room. Overall, this team performed over 300 operations, including 40 amputations and more than 100 cast/splintings in just 48 hours.

Tomorrow and Thursday, CURE will be sending more than 25 medical, anesthesia, nursing and administrative professionals and a substantial amount of donated orthopedic equipment and supplies to further care for the Haitian people.

There are now hundreds of medical volunteers in Port au Prince – many independent, from a wide range of countries, organizations and backgrounds. There are now many medical supplies in at least 3 hospital sites in Port-au-Prince, where most of these volunteers are. There is no centralized coordination mechanism for administering medical care at this point in time – everyone is working together, working hard and doing everything they can.

January 18, 2010

The electric company of the Dominican Republic has donated a generator and a container, which the CURE hospital in Santo Domingo is filling with supplies and clean clothes for Dr. Nelson and the team.

In the last 48 hours, we were able to take the Hôpital de la Communauté Haitienne from an indescribable battlefield state, with almost no doctors and nurses and supplies, 2 ORs not doing surgery, and utter chaos…to over 100 foreign docs and nurses, 7 ORs, an ICU, stocked supply room and life-saving surgery 24 hours around the clock!

January 15, 2010

“The first hospital we visited was not equipped to do orthopedic surgery even under normal conditions. We then went to Hôpital de la Communauté Haitienne, a 75 bed community hospital in Freres near Delma. There are many orthopedic cases filling the parking lot and patio, as everyone is too scared to be inside a building.  We are mobilizing now.”

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International Docs Anticipate H1N1 Vaccine Shortage

Wednesday, October 7th, 2009 by

h1n1results

Here on the Healthy Travel Blog, we’ve been talking about H1N1 readiness and flu prevention when traveling overseas.  And for good reason.  The “swine flu” is the first pandemic in 41 years and all Americans should be educated about H1N1 both domestically and when traveling out of the country.

A recent poll administered by HTH Worldwide indicates that more than one-third of international physicians are anticipating a shortage of the H1N1 vaccine this fall in their country.  This is certainly not the best news for those who regularly travel abroad, or are overseas for the semester.  These health care providers also dispelled the idea that production of the H1N1 vaccine would interfere with regular production of the seasonal flu vaccine.  Fortunately, about two-thirds of the doctors polled say they expect an adequate supply of seasonal flu vaccine in their country this year.  Unfortunately, physicians from developing countries are more pessimistic, expecting shortages of both vaccines.

Despite concerns over potential shortages, physicians are preparing themselves to care for more patients this fall.  Nearly half of respondents in adult primary care and pediatrics reported increased preparations to treat larger numbers of patients with seasonal flu and H1N1.  These doctors are increasing office hours and staff personnel and accepting patients without appointments.

Who responded to this poll?  English-speaking, international HTH physicians from more than 50 countries like the United Arab Emirates, Thailand, Belize, France, Argentina, Egypt, China, Croatia, India, Pakistan, Spain, Japan, Peru, Brazil, Tunisia and Vietnam, to name a few.

This survey shows that international doctors are taking both seasonal influenza and H1N1 very seriously.  Only time will tell if there is enough of both vaccines, but the medical community is preparing to help more patients than ever.  The majority of respondents are advising patients in their areas who believe they are infected with H1N1 to schedule an appointment with a private physician or visit a public health facility designated specifically to treat those with H1N1. 

If you are an HTH member traveling overseas and think you may have influenza or H1N1, contact HTH to schedule you an appointment with a local, pre-qualified doctor who speaks English.  And you won’t have to worry about paying for your treatment out of pocket.

This is the first glimpse we’ve offered of what international physicians are thinking in terms of preparing for both common influenza and H1N1 treatment this fall.  We will continue to track this issue in an effort to best prepare and educate our customers and readers.

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On the Front Lines in Mexico

Tuesday, April 28th, 2009 by

mexico428092After 24 surreal hours on the ground in Mexico, I’m on my way back out of the country. I had arrived in Monterrey yesterday for a conference of Mexican Hospitals, but the conference has been canceled due to the swine flu outbreak.

 

Here are my observations from my quick stay:

 

The mood and behavior of people has changed dramatically from yesterday; when I first arrived, only a few people were wearing masks. Today, well over half the people are wearing masks. If they don’t have masks on, they’re using bandanas and t-shirts over their mouth and nose. I’d estimate that 80 percent of the people in the Monterrey airport were wearing masks. On the street, not as many people are wearing masks. A lot of people aren’t wearing the masks properly, but they seem comforted by the fact that they have them or their bandanas perched on their head or around their neck.

 

The city seems like a set for a disaster movie with everyone wearing masks and avoiding crowds.  It certainly seemed to me that the onslaught of information from reporters all over the globe has put the local citizens on edge.

 

I know there have been some reports that the Mexican government has been a little slow to act in this emergency, but at least one local seemed pleased with the response. My driver from the airport said that the Mexican government has been very open in its communication, and he didn’t think that past administrations would have been as forthright.

 

One of the funniest observations goes into group psychology – during the normally uncomfortable period of lining up and boarding a plane, everyone was even a little more unsettled than usual brought on by the close proximity of strangers all wearing masks.  Of course, once on the plane, despite the quarters being even more confined, everyone seemed to let out a deep breath of relief.  In this case, most of us were probably just happy to be leaving Mexico behind.

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China: New Healthcare Frontier, or Just Following In Our Footsteps?

Wednesday, April 15th, 2009 by

As we read recently in the Wall Street Journal Health Blog, the U.S. is not the only country grappling with healthcare reform.

CB050932China is dealing with healthcare challenges that come with the reality of having a billion citizens. It will be fascinating to watch as China continues to move beyond the history of peasant farmers playing the role of Barefoot Doctor to try to provide healthcare to the hundreds of millions of Chinese living in its ginormous rural territory. 

International health insurers are jockeying for position in China focusing on the upper echelon of the market – wealthy urban Chinese.  Our sources indicate that the Chinese are hoping to leverage deals with international insurance giants to facilitate healthcare delivery to the rural population. 

China’s cities offer better healthcare operations; there are hospitals operated by the Ministry of Health as well as a growing number of private facilities, many of which are operated as joint ventures between Western and Asian companies.  The best of these facilities offer care at an international standard, with a substantial price tag to match.  Although the history of these joint ventures only goes back about 15 years, there are numerous indications that they are susceptible to the twin evils that plague the U.S. healthcare system (which we discussed recently) – overutilization and overcharging. These trends also extend to the Ministry of Health hospitals, where physicians are encouraged to prescribe high-tech diagnostics and the new prescription drugs through a bonus system. 

It looks like the U.S. is not the only country struggling to find the right mix of incentives to provide the best care at the best price.

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