Medical Facilities
Medical care is below western standards, with shortages of basic medical supplies and equipment and inferior standards of care and hygiene. The few qualified facilities in Moscow that approach acceptable standards have limited spaces and do not accept all cases (i.e., they may reject cases of infectious illnesses or trauma ). Access to these facilities usually requires cash payment at western rates upon admission.
The U.S. embassy and consulates maintain lists of such facilities and English-speaking doctors. Many resident Americans travel to the west for their medical needs. Such travel can be very expensive if undertaken under emergency conditions. Travelers should check their insurance coverage and purchase supplemental coverage for medical evacuation. A medical evacuation from Russian can cost between 50,000 to 100,000 U.S. dollars, depending on the complexity of the situation. Elderly travelers and those with existing health problems may be at particular risk. Elective surgery and non-essential blood transfusions are not recommended, due to uncertainties surrounding the local blood supply. Most hospitals and clinics in major urban areas have adopted the use of disposable syringes as standard practice; however, travelers to remote regions should bring a supply of sterile, disposable syringes for eventualities. Travelers should refrain from visiting tattoo parlors or piercing services due to the risk of infection.
Rates of HIV infection have risen markedly in recent years. While most prevalent among intravenous drug users, prostitutes, and their clients, the HIV/AIDS rate in the general population is increasing. Reported cases of syphilis are much higher than in the U.S., and some sources suggest that gonorrhea and Chlamydia are also more prevalent than in Western Europe or the U.S. Travelers should be aware of the related health and legal risks and take all appropriate measures.
Information on appropriate health precautions can be obtained from local health departments or private doctors. General guidance can also be found in the U.S. Public Health Service book, “Health Information For International Travel,” available from the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402. Tourists in frail health are strongly advised not to visit Russia because of the harsh conditions and lack of adequate medical facilities.
Medical Insurance
The Department of State strongly urges Americans to consult with their medical insurance company prior to traveling abroad to confirm whether their policy applies overseas and if it will cover emergency expenses such as a medical evacuation. U.S. medical insurance plans seldom cover health costs incurred outside the United States unless supplemental coverage is purchased. Further, U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States. However, many travel agents and private companies offer insurance plans that will cover health care expenses incurred overseas including emergency services such as medical evacuations.
When making a decision regarding health insurance, Americans should consider that many foreign doctors and hospitals require payment in cash prior to providing service and that a medical evacuation to the U.S. may cost well in excess of $50,000. Because conditions in many hospitals do not meet American standards, medical evacuation is frequently necessary for illnesses or injuries that could be treated locally in other countries. Medical evacuation companies can require a substantial down payment before they commit themselves to arranging a flight out of Russia. In addition, medical evacuation from remote areas can be especially long and difficult. Evacuation from the interior of the country, such as Siberia, can take days to organize and set into motion. Also note that the U.S. Government cannot pay for a medical evacuation. Uninsured travelers who require medical care overseas often face extreme difficulties. When consulting with your insurer prior to your trip, ascertain whether payment will be made to the overseas healthcare provider or if you will be reimbursed later for expenses you incur. Some insurance policies also include coverage for psychiatric treatment and for disposition of remains in the event of death.
Useful information on medical emergencies abroad, including overseas insurance programs, is provided in the Department of State’s Bureau of Consular Affairs brochure, “ Medical Information for Americans Traveling Abroad ,” available via the Bureau of Consular Affairs home page.
OTHER HEALTH INFORMATION: Outbreaks of diphtheria have been reported throughout the country, even in large cities such as Moscow and St. Petersburg. The U.S. Centers for Disease Control and Prevention recommend up-to-date diphtheria immunizations before traveling to Russia and neighboring countries. Typhoid can be a concern for those who plan to travel extensively in the region. Cases of cholera have also been reported throughout the area. Tap water in St. Petersburg is considered unsafe to drink due to giardia. Drinking bottled water can reduce the risk of exposure to cholera. Tuberculosis and HIV have been an increasing source of concern for Russian healthcare providers. Information on vaccinations and other health precautions may be obtained from the Centers for Disease Control and Prevention’s international traveler’s hotline at (877) FYI-TRIP (1-877-394-8747); fax: 1-888-CDC-FAXX (1-888-232-3299), or via their Internet site at http://www.cdc.gov .
