My right upper deltoid is sore because I've just gone through another round of travel immunizations with my new travel doctor. I wanted a second opinion because I found conflicting advice and didn't feel I received adequate explanations. So I searched for someone who has had experience "in the field" and hit the jackpot.
Even though you assume all doctors ought to have the same book knowledge, real experience does stand out. She was able to list all the recent travel health notices, anticipate my questions, understand my concerns right away and could help me anticipate for the future. Having recently returned from a 3 month mission in Asia was just the bonus. That alone was worth many times the second consult fee. Outside of the rabies vaccines, I am now ready for the developing world!
You'll read a lot of varying opinions on the merits and costs of travel medication and immunization. A lot of people complain about the cost. My tally so far is around $500. And surprisingly our extended health insurance covered about 2/3rd of it. Wasn't expecting that. Last time I went for shots (Yellow Fever and Typhoid), I hadn't even bothered to submit a claim as I assumed it fell in the category of elective procedures. A lot of other people complain about potentially disastrous side effects. Friends of ours feel so strongly against it, they won't immunize their children. It can be a touchy subject, that's for sure.
I think of it this way: Drugs and immunization has helped more people than not. Considering the flight alone cost more than our new washer and dryer, what's $500? How much is my life worth to me? How much risk do I want to take on physically and mentally? How keen am I to want to be looking around for a qualified doctor and clinic solo in a country where I don't speak the language and where I may be hundreds of miles away from anything? Some countries will require proof for entry. Yes, you can choose to not go. That's where D stands and it works for him. No hassle then.
You can apply the above thinking to the topic of travel insurance. We have coverage through our travel credit cards and through D's work which we've paid extra for. And silly me has been travelling without really knowing the absolute direct number to call as I've been complacent with the places I've gone to. Even when I knew I was going to Greenland I felt secure that I would receive good care should something happen. Having gone, I would say -- Know your policy and make sure it covers the activities you plan on undertaking as well as emergency evacuation for the country you are visiting. Plans often have their own definition of what a "risky" activity is (ie. dogsledding, camel riding).
Levels of medical facilities and care in the developing world can be real scary. In the "I would not allow them to put an IV in me" (and hopefully I'd be lucid enough to say that) sense because of incidences of re-using needles even in hospitals and prevalence of HIV etc. For example in Cambodia, the level of care is basic enough that should anything moderately serious happens, you will want/need to be medically evacuated to Bangkok. And seriously, the Only Thing remotely exciting about that would be the potential helicopter ride...and even that isn't always as straightforward as described in your policy. Have a read of this post.
So make sure your policy really will get you out of there if need be. Know where your home country's Embassy is (There isn't one in Cambodia for us Canadians -- We have to go to the Australian Embassy). And talking to agents at an insurance call centre isn't all that fruitful as they aren't always able to tell you much outside of what you are able to read anyways. And being told "You'll be covered..." when they can't get over the concept why you'd go to places where there is no running water, cell phone coverage or a hospital hasn't been all that confidence boosting. Talk to someone in the actual claims department if you can. Or buy extra insurance from a company that does lay it all out and have experience in certain types of travel. Unless I get better answers, that's what I'm going to do.
On a real positive note about travel, my flights in April have been changed by the airline fairly significantly. It wasn't such a great itinerary to begin with (3 hops each way with an 11 hour layover in Seoul on the way home) but I was making the best of it -- 5 hour free transit tour and time at what is supposed to be an incredible airport! The email came barely 2 weeks after I purchased the ticket. I panicked because it made things even more uncomfortable on the way there and back, increasing my average layover to 4 hours and the one return layover in Seoul to 13+ hours.
So I called and got someone right away. He was fantastic. Didn't explain any rules or anything to me when I asked what my options were. Just asked me if I had to connect through Seoul? When I said 'no', he proceeded to find me flights that were so good, I almost giggled out loud.
Not only do I no longer have to make 3 hops each way, I am now able to make it home on the same day I left. It's still going to take about 30 hours but psychologically it feels better, like I've cheated time or something. And the kicker? When D called (because it wasn't available to be purchased online and having seen what I've come up with for that trip, has decided he might want to join me after all...) to see how much it would cost to take the same flight? $4200..... Score!!! And that's for economy....