In the past couple of weeks, I have focused on medical care and precautions for the kids. Last month, I had to get medical clearance for myself as a requirement of the grant I received. That involved going to the doctor and getting a physical and checking to make sure my vaccines were up to date. As for the kids, I discussed these things with the baby’s pediatrician over the course of the year at his regular check-ups. However, the toddler’s check-ups are once per year and insurance only covers “sick visits” outside of the annual physical…he hasn’t been sick (thankfully) so I haven’t been able to talk with his pediatrician. The office offers “travel consults” but insurance doesn’t cover them either. So, I have to get resourceful. Here is what I know based on a combination of doctor visits and my previous experience living in the country:
All of us are up to date on routine vaccines. The baby is a year old now, so he’s had all shots at least once. His pediatrician says he would normally get boosters at 15 and 18 months but he can wait until we get back to get them. There is a nice clinic in the D.R. where he could get his boosters, but his pediatrician expressed concern about proper storage and potency of the vaccine. Since they were not urgent, she preferred that we wait.
Typhoid is a food-borne disease that causes fever, diarrhea and vomiting. The typhoid vaccine can be oral (lasts 5 years) or an injection (lasts 1 year) but neither of these is covered by most insurances. I probably won’t get the vaccine, but the toddler will (it is approved for children over 2). Typhoid is treated with an antibiotic. Avoid street food if you’re worried. Likelihood of getting it: low
¡Este sol caribe pica! (This Caribbean sun burns!) I’ll probably bathe the children in sunscreen and start an aloe plant farm. Likelihood of getting it: high
Sounds like bad news. It comes from food contaminated with E. coli. My doctor wrote me a prescription for antibiotics for the duration of my trip. Kids can’t take it so the fix is to hydrate and move to the BRAT diet (bananas, rice, applesauce, toast). Good thing bananas and rice are cheap…Likelihood of getting it: high
DENGUE FEVER & MALARIA
Dengue mosquitos bite during the day and malaria mosquitos bite at night. There are no vaccines for either (there are preventative malaria pills but the kids are too young to take them, and I’m wary of their long-term use). So, the solution is to try not to get bitten – wear insect repellent, sleep with a mosquito net if your room has open windows or no A/C, avoid areas with standing water. Prevalence of dengue and malaria vary by region. For La Romana, likelihood of getting it: dengue: medium, malaria: low
RESOURCES BEFORE WE GO: Concentra (http://www.concentra.com/employers/occupational-health/travel-health/), Passport Health (http://www.passporthealthusa.com/), and your local Health Department. Each of these places offer travel consultations and vaccines based on where you will be going.
RESOURCES WHILE WE'RE AWAY: We will still be able to call Nurse Advice line of our U.S. pediatrician. Also, since we are living in a city where there is high tourism, many of the clinics and hospitals have doctors that speak English. Some may accept U.S. health insurance.
I’m creating a medical binder which will include health records and information for each of us: shot record, list of allergies, contact phone number of doctors/pediatricians in the D.R. and in the US; copies of insurance cards. I will also travel with a first aid kit and over the counter meds.
*Photo credit: http://www.blog.friskbrisrc.com/wp-content/uploads/2013/10/Paid-Sick-Leave.jpg