How do you gauge access to modern medical care?

[lulubelle]

This is more of a general travel question.

How does one go about gauging the proximity of modern medical care to diving locations around the world as well as the rough timelines for getting to those facilities based on air ambulance services which operate there? It is a bit hard to figure out. I just had to cancel a dive trip to Indonesia. Part of the issue was a recent hospitalization which was in no way related to diving. Although I was cleared to dive, it was felt that I needed to be in "reasonable" proximity to a good modern hospital in the event that the problem occurred again. The opinion was that Singapore or similar would be the nearest suitable location, and that due to the location of the liveaboard, the availability of medical evacuation services, and the fact that they would be evacuating a diver if something happened, that it was too risky due to the time it might take to see me safely there. So I went to Key Largo instead. All was uneventful.

I looked up Joint Commission International as a start..but so few locations are listed near some of the best diving locations.

Any thoughts?I'd like to get my head around this to plan for the path forward. I of course am fascinated with places in the middle of nowhere. Like the Galapagos.

 

[Codiak]

A few places to start...
1) DAN... well you are diving ;-)
2) Your health insurance company... they have a vested interest in proper care
3) Your place of employment... you'd be surprised what international corps know or are willing to do for emps if simply asked

 

[drbill]

I question my access to good health care living here in the States on Catalina Island.

 

[lulubelle]

I question my access to good health care living here in the States on Catalina Island.

I hear you Bill! I am a bit frustrated. I am healthy enough to dive, but am not really sure how wide of a net I can throw with my dive trip plans. The issue with Indonesia was that there was a liveaboard. There are air ambulance services and such which can pick up on air strips on the nearby islands and get me to the mainland, but in connecting the pieces of an emergency evacuation, should one be necessary, it was not unreasonable to think that getting me to Singapore could take up to 24 hours. Which was too long. So I'm trying to figure out what places I can go where I could reasonably be expected to get to good modern care in under 12 hours. It doesn't help that it would be the medical evacuation of a diver, creating a need to use low flying planes.

FRUSTRATING.

I am seeing someone at Duke in November for a discussion of parameters.

 

[lulubelle]

A few places to start...
1) DAN... well you are diving ;-)
2) Your health insurance company... they have a vested interest in proper care
3) Your place of employment... you'd be surprised what international corps know or are willing to do for emps if simply asked

The problem is that while all of these can give you some information (although DAN is mostly concerned with the locations of chambers, which I don't anticipate needing any more than the next diver does), none of them can tie it all together and give you an estimated evacuation time given all of the resources which must be employed to get you from remote location A to modern hospital Z. But all of these can certainly give me some information to work with.

 

[Hank49]

The problem is that while all of these can give you some information (although DAN is mostly concerned with the locations of chambers, which I don't anticipate needing any more than the next diver does), none of them can tie it all together and give you an estimated evacuation time given all of the resources which must be employed to get you from remote location A to modern hospital Z. But all of these can certainly give me some information to work with.

Can that be done anywhere? You could get in a car wreck 5 miles from your home but be seriously injured to where the fastest ambulance...wasn't fast enough.
Just go for it. Be careful, but not overly worried.
I've lived outside the US for 24 years now and most all my medical care has been in developing countries. My exposure to US medical facilities in the last 10 years were when my mother was dying of lung cancer. I wasn't impressed at all. 4 different doctors and treatment centers and it seemed that they didn't even communicate with each other.

 

[lulubelle]

Can that be done anywhere? You could get in a car wreck 5 miles from your home but be seriously injured to where the fastest ambulance...wasn't fast enough.
Just go for it. Be careful, but not overly worried.
I've lived outside the US for 24 years now and most all my medical care has been in developing countries. My exposure to US medical facilities in the last 10 years were when my mother was dying of lung cancer. I wasn't impressed at all. 4 different doctors and treatment centers and it seemed that they didn't even communicate with each other.

Oh, I would have to agree with you in concept. I was part of the US Healthcare system for a long time. It is the very best, and very worst, of medicine. So sorry about your Mom. But, the reality is, there is a certain level of acuity that only fairly modern hospitals are equipped to handle. In places where they don't exist, certain situations are pretty much death sentences.

To do what you suggest is my nature, and my instinct. But without getting into the gory details, I have had a twice recurring issue which no one quite understands yet where getting to a pretty modern hospital very fast saved my life. The difference between getting to a modern hospital in 12 hours versus 24 hours could be the difference between getting there dead or alive. So an Indonesian liveaboard...maybe not...diving closer to a modern city...maybe so. Of course the conundrum is that the best of the best diving tends to be in more remote locations. Knowing how these locations evacuate ill divers and the speed in which they can get someone to a modern hospital is what I am trying to sort out.

I'm basically trying to establish boundaries that work while my docs continue to try to sort this out. For now, I will probably try to contact dive professionals working in areas which I wish to travel to see what evacuation services exist.

 

[Hank49]

Sorry to hear about your condition. That can be limiting to, as you said, the best diving.

 

[diversteve]

There's some limited country specific medical information on the State Dept. website. For places I've looked (small Caribbean countries mostly) they sometimes list the nearest hospital and/or places you won't find adequate care in the country specific medical information links.

Country Specific Information