In Britain, around 30 percent of the population has a long-term health condition that can be controlled with medication. These can range from asthma to epilepsy and can range from two pills a day to multiple daily injections and diet control. Traveling in such conditions can be challenging, but this should not stop you. I have type 1 diabetes, which requires me to take insulin regularly, manage my food intake, and monitor and respond to my blood sugar levels. Despite this, I managed to spend six months traveling through Australia, New Zealand and South East Asia.
During the trip I learned a lot about how to deal with my condition, even outside the safety net of home. However, I made some mistakes along the way. Early in the trip, I left an essential piece of my medical equipment (my Personal Diabetes Manager) behind for a day until I noticed. (Luckily I was able to retrace my steps.)
Experiencing this taught me to be more aware of where my medications were kept and to check everything twice before packing up and leaving one place. Losing medications is a big risk when traveling with a health problem, so it’s worth investing in air tags or something similar so you can always keep track of where your crucial supplies are.
Unless advised to do so by your doctor, anyone with a health condition should be allowed to travel, not just for a short trip, but for extended periods of time. Just follow these simple steps.
Know how many medications you are taking
Naturally, you will then know what your daily medication use is. Calculate how much you need for the duration of your trip and double it.
Mindy Levitt, a specialist diabetes nurse, advises people to take “more medicine than you think you need – at least two to three times more.” This applies to all conditions, not just diabetes. Make sure you request your medications in advance so that you have time for approval from your doctor, your medication supplier, the delivery person and the pharmacy.
Plan how to carry or collect your medications
Once you’ve imagined how much medication you’ll be taking with you, you can arrange another bag to take with you on the trip, if necessary, or plan to have it delivered to your destination, as some companies deliver internationally (more on couriers below). I took an extra weekend bag that I always brought as carry-on luggage. Although it was a light burden to carry for six months, it lessened as time went on. If I had to travel that long again, I would use a courier.
Although DPD UK does not ship medicines, DHL Express and UPS can assist with the transportation of medical supplies, although destination countries may have different laws, customs regulations and fees to comply with. DHL Express says: “The medication must have a prescription and be accompanied by an invoice stating what each individual medication is, how much there is and how you take it. This invoice can be downloaded as a template online, or via the DHL Express website or in selected stores where DHL Express provides services.” Their vans are not temperature controlled, so if some medications need to be kept cool, like my insulin, you will have to bring them with you, while your non-temperature controlled medications can be shipped for you.
Brian Duggan, pharmacist and general manager of Polar Speed (a UPS company that is part of their healthcare business) says: “The patient must receive the appropriate country-specific drug import authorization and provide UPS with the relevant documentation.” To arrange this, you should “contact the embassy of the destination country for specific information about shipping medications for personal use. The patient can designate an authorized recipient to collect the medicines from a pharmacy on his/her behalf. UPS may act as the nominated authorized recipient. Once collected by UPS, on behalf of the patient, the medications can be shipped to the desired country in temperature-controlled packaging.”
Brenda Walcott, clinical advisor at Diabetes UK, suggests that before you travel, “find out where you can get insulin at your destination in case of an emergency. Before traveling, check with your insulin manufacturer to see if your insulin is supplied in the country you are traveling to.” Ultimately, she adds, “the safest approach is to have your own supplies in certain countries.” This also applies to other medications, not just insulin. As a British citizen traveling to another country, Walcott recommends that you check the health information for the country you are visiting by following the links on the government’s online Foreign Travel Advice page.
Check with your airline whether you can take your medications on board. I would like to know where my medications are and my insulin needs to stay cool, which I can only guarantee if it is in the cabin with me. The temperature in the hold is often very cold and this can damage medication.
Some airlines require medications to be in their original labeled packaging so they can be clearly identified. If this is the case and you want to save space, you can cut the labels into pieces and store them in a separate folder so that you can still provide the packaging if requested.
Request a doctor’s letter in advance
Dr. Anthony Patiniott, clinical director at Enigma Healthcare, says: “It is essential that you take clear documentation of your medical problems and prescribed medications and keep them with you in the cabin when you fly to avoid loss.” These may need to be shown at airport security and can come in handy if you ever need medical attention or medication replacement. Importantly, he also recommends that you “list allergies and emergency contact information about you, in case you are ever unable to communicate.”
Walcott also suggests that if you have medical devices, “you print a Medical Device Awareness Card from the Civil Aviation Authority website to go with your letter. This contains screening advice for you [the passenger] and the security officer who carries out the checks.”
If, like me, you need to carry needles, you must declare them at the screening point. You should also consider how you will dispose of them after use. My experience is that you can go to a pharmacy or doctor’s office almost anywhere and they will safely dispose of them for you. Otherwise, you may have to keep them with you and throw them away in a sharps bin at home.
If you plan to go skydiving, scuba diving or something similar, you will probably need a confirmation letter with approval from your doctor stating that you are suitable to participate. If you cannot submit this to the company conducting the activity, you may not be allowed to participate. Take photos of these letters for backup.
Anticipate changes in the environment
Levitt points out that “temperature, time zone, and routine changes can affect your energy levels.” If you become tired and dehydrated in a hot country, you are more likely to have problems with your health condition. Frio packs (cooling bags designed to keep temperature-sensitive medications at a safe temperature between 18-26°C for at least 45 hours) are very useful when your medications need to stay cool and you are going to a warm place, without adequate air conditioning or guaranteed refrigerators – they only need water to activate.
Plan for the worst and expect to get sick
If you prepare for the worst, you can deal with the worst. Dr. Patiniott recommends researching your travel destinations to be aware of eligibility, access to emergency health care and pharmacies if needed. He also says that if you are abroad, it is wise to learn phrases related to your condition and medication to help you communicate your needs.
You have to accept that your body may find it harder to deal with illness as efficiently as other people without conditions. It’s important to let people know if you have a health problem, especially if you have diabetes. If your speech is slurred or you have trouble walking, people may assume you are drunk and may not realize you need help.
Get coverage for pre-existing conditions
My insurance covered a hospital stay and the medications I needed. I only had to pay a €70 deductible: a small fee compared to the total bill. I had several other appointments while I was away and my claims were all approved when I got home. I used Travel Insurance 4 Medical. You don’t need to use a travel medical insurance specialist, but you should make sure your policy includes medical cover.
Book a package tour
This is not always possible, but if it is possible, it means that the provider has a duty of care to ensure that you receive help if you have a medical problem during your trip and that you always have a useful point of contact.
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