Nov 9, 2005 - TO YOUR HEALTH!
by Al & Beth Liggett

It's no wonder that "To Your Health" is a well-used toast when friends gather. Having good health is an important criteria for whatever success you wish your future to hold. This certainly is true for the cruising lifestyle as well.

Al and I have been very fortunate to have had good health for all our cruising years – now almost 30 years in SUNFLOWER! We are careful to maintain this status. We don't smoke, we eat a variety of foods - with heavy emphasis on the fresh fruits and vegetables of our area, and we have very moderate drinking habits. In addition, living on board and sailing provides healthy activity. We don't have a car, so we walk a lot, and always seem to be lifting and carrying things around. In addition, this lifestyle provides us with a clean air environment for the most part.

Nevertheless, living in Southeast Asia does present some health concerns. Any of your news today, whether newspaper, radio, or TV, gives you great coverage of the Avian Flu problems in this part of the world. In light of that, I must say that we were in Hong Kong for five months during the 1997 Bird Flu crisis, and were not very concerned (we don't have any pet chickens!). Then there was the SARS epidemic two years ago right in our own backyard: Singapore, Malaysia, and Thailand. Locally, the health care workers, hospitals and clinics, airports and ferry terminals seemed alert and competent dealing with the contagiousness of this disease.

Less reported, but very prevalent, are the more common problems of malaria and dengue fever, both mosquito-borne diseases. We do not take any prophylactic medicines for malaria here; and there aren't any for dengue fever. The reported cases of dengue fever in Malaysia are up 40% over the same period last year. We are careful to screen ports and hatches if the bugs seem bad. When ashore at night I wear long pants and sleeves; we often carry repellent in the backpack, for our feet especially. Anyway, it is not our usual habit to be ashore at night.

Generally, the lack of sanitation common to this part of the world is apt to be more of a problem to us. Food- and waterborne maladies resulting in stomach problems can ruin your day – a bunch of days, for that matter. Yet we eat out a lot. There are cafes and food stands all over the place. The food is good and quite inexpensive. You just need some common sense about where and what to eat. It is usual for the cafes to put their foods of the day in stainless steel pans out on a steam table for self service. This is helpful, as trying to order the same things from a menu without local language skills is not easy. Especially in Thailand! Just be careful, as some of that food may have been sitting around on the table for several hours. I can't deal with chilies very well; my rule of thumb is that if the food is red, I don't eat it. But boy, did I get fooled by a plate of what looked like cooked spinach once!

We try to eat in busy places that have a good turnover of their foods. We like places that look orderly and where the servers seem decently dressed. We generally don't eat foods like oysters and clams, as who knows the source, and they can harbor hepatitis germs. On the street, anything cooked in front of you is probably OK. Be a shame to pass up those fried bananas, wouldn't it!

Bottled water is available everywhere. Buy that, or fill your own bottles on the boat and drag them along. Coffee and tea are OK because the water is boiled. Actually we don't worry about water and ice too much – Malaysia has very good quality water right from their taps, Singapore the same. In Thailand everybody drinks bottled water. You will see the 20-liter jugs in every home, business, restaurant, food stall. Ice is produced and purchased from the same people who bottle the water. But when we land travel away from these countries, we are extra careful. And we carry Lomotil (or similar) for diarrhea and a course of Flagyl in case the belly bug turns out to be giardia.

So what about the times when you do get sick or have an accident? We have been in this area long enough to have established a network of doctors and dentists and medical services to treat whatever complaints arise. We got names of doctors and hospitals from the other cruisers we met when we first arrived, and have edited them to suit our needs along the way. In turn we pass this info on to others new to the area. Thus, about half the cruising community goes to see the same dermatologist in Penang! Local knowledge can also tell you things like: the new hospital in Langkawi is clean and well equipped, but has no doctors. (?) Or, try not to get sick on a Friday because everything is closed for prayers.

Good communication with your doctor is essential. All the doctors we have seen and dealt with have an excellent command of English. Most of them have taken part or all of their medical training abroad: Australia, the UK, Canada or the US. The only thing we don't like is that the doctors tend to want to give you all sorts of pills and potions. Many of them are not necessary, or duplicate the medicines we already have on board. And they are very lax about telling you what the name of the medicine is and what the mg dose is. Perhaps this works best with their local patients, but you need to make them give you the name, dosage and expiration date if possible. Speaking of medicines, another advantage of this part of the world – you can walk into any pharmacy and buy your medicines right over the counter. Only the most controlled substances need doctor's prescriptions.

Because it has a larger population base, we tend to take all of our medical needs to the doctors and hospitals in Penang. The quality of care has been excellent. The prices are most reasonable. A regular doctor visit is $8-10, my yearly mammogram costs about $32. Al has had 2 cataract operations with excellent results at a fraction of what the cost would have been in the US. Both of us had comprehensive blood and other bio tests completed and the total billing was $53. And this is walk in off the street, no waiting around for 3 weeks to get an appointment. Visiting the doctor at the hospital tends to be the same, walk in, but get there early and take a number. Take a good book as well!

Dentists, on the other hand, do take appointments. We have a dentist in Penang, but now prefer to come to Phuket to get our teeth looked at because we can get an appointment much more quickly. And our dentist is excellent. I recently fell on my face and chipped a front tooth badly. He has just repaired it to original equipment status – looks and feels just perfect - for about $20!

About 5 years ago we thought it was probably time for us to invest in health insurance. We had both just climbed the steps to the Senior Citizens lounge, and we had friends of similar vintage who were dealing with serious health matters. It was international insurance, good anywhere in the world except the US and Canada, but had a traveling allowance to cover that if we were there and got sick or had an accident. But it was just too expensive. Our birthdays this year would have sent us into another bracket of premium costs - it would have cost us $9200. So this year we cancelled that insurance. Meanwhile, we are both healthy, and we are located in an area where health treatments don't break the bank. We can do a lot of doctoring for that amount of money here.

Now, if I can just find that "medicinal" bottle of wine, I'll say, "Cheers – To Your Health!!"

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