Nepal Medical Insurance
Locked between the world’s two most populated countries, India and China, is the geographically rich country of Nepal. Formally known as the Federal Democratic Republic of Nepal, Nepal is a landlocked country controlling 147,181 km² of land with an estimated population of 28,951,852 in 2010. Nepal was a monarchy through most of its history but in 2006 a decade-long civil war and mass political protests lead to the establishment of the federal democratic republic in may 28th of May 2008. Though Nepal’s government is still under reform in 2010, this doesn’t stop it from being a hotspot for tourists. Nepal, having a multitude of languages, cultures and religions makes it a unique and beautiful Himalayan country to experience. The vast mountain ranges have created some of the best trekking locations on earth. But with all of Nepal’s diversity it is still one the poorest countries in the world, with close to one-quarter of its population below the poverty line.
The health care system is run by the Ministry of Health & Family Welfare, and is provided through 180 primary health centres, 711 health posts and 3179 sub health posts. There are both private and public facilities that provide medical care, although a majority of the private facilities are located within the capital of Nepal, Kathmandu. These private centres are used usually by foreign visitors and wealthier Nepalese, which can be very expensive. Public health care facilities throughout Nepal are generally poorly equipped and extremely limited by international standards, especially in the rural areas. Nepal has improved public healthcare facilities, but due to lack of funding there still are many issues with the care provided within rural areas. The majority of funding goes to hospitals and medical facilities within the larger urban areas, such as Kathmandu and Pokhara. With highly centralized planning and finance for health care, many rural areas lack proper medical facilities. Only within Kathmandu is it advised you trust medical facilities for basic medical diagnosis and treatment. With any major illness or injury it is recommended to get evacuated to the nearest adequate medical facility, which in most cases would mean evacuation to Singapore, Bangkok or New Delhi.
Communicable diseases constitute close to 70% of the causes of morbidity and mortality in Nepal. People in Nepal may contract one of several potentially dangerous diseases, such as Hepatitis A, Hepatitis B, HIV/AIDS, Dengue fever, Malaria, Typhoid and bacterial diarrhoea. For the mosquito born diseases of Dengue, Malaria and Japanese Encephalitis, they are mainly seen in the lower areas of Nepal and rarely seen in higher altitudes, although expatriates should be cautious not to get bitten. In 2007, 0.5% of the population of Nepal carried HIV/ AIDS, although this is expected to increase in the future. In order for a travelers or expatriates to avoid being affected by Typhoid and bacterial diarrhea, ensure you purchase food from hotels or trusted restaurants and filter or boil all of your drinking water. If you are not sure what your filter will actually clean from your drinking water than boil it as well, but at higher altitudes water boils at lower temperatures so it is advised to boil water for at least 10 minutes at higher altitudes in Nepal.
Nepal is a country that is susceptible to several different kinds of natural disasters. The most common reoccurring natural disaster is Earthquakes. Due to the country’s location between the Eurasian and Indo-Australian tectonic plates, tremors and earthquakes are common throughout the country. The danger it creates for people living in Nepal is not the tremor itself, but the effects on poorly reinforced buildings. These tremors found throughout the Himalayas also can cause landslides and avalanches which block roads and can cut off travel to parts of the country. The Monsoon season, from June to September, can also be hazardous for expatriates if care is not taken. Heavy Monsoon rains cause flooding and landslides throughout the region, which has been known to cut off some towns for days at a time.
With the large amount of mountainous terrain covering Nepal, travel within the country can be quite challenging. The combination of extreme weather, severe terrain, and a remarkable amount of disorganization causes many cross country travels to not go according to plan. For expatriates this will mean that planning any kind of travel in Nepal will require the scheduling of extra time to allow for any inevitable delays, though on a positive note Nepal does offer a wide variety of methods to travel from hot air balloons to elephants. The most common and reliable way to get around/ move cargo in Nepal is still by walking; people carry and move cargo on foot more than every other form of transportation combined. With such difficult conditions for travel it is important to remember that medical evacuation by helicopter may be the best way to ensure you can obtain medical treatment as soon as possible. Discuss with you international health insurance provider what possibilities exist for medical evacuation in Nepal.
Though safety and security threats are rarely seen in highly traveled tourist areas it is still a cause for concern for expatriates living in the country. Theft, while not on a scale seen in other countries, has been known to happen within hotel rooms and tourist areas. Be sure not to keep money out in your room or to show expensive items in public for it might provoke such acts of theft. Maoists have been known to approach trekkers for a ‘tax’. It is important to budget for such an eventuality. People have been known to be beaten for not paying such tax. Lastly, there is a general threat of terrorism within Nepal. The recent years have seen reoccurring shootings, bomb attacks, and violent clashes throughout Nepal, including Kathmandu and other areas frequently visited by travellers and expatriates.
Nepal has one of the highest average elevations in the world, which also means expatriates have a high possibility of running into acute mountain sickness (AMS). AMS, or altitude sickness, is set on by the lack of oxygen at altitude over 2500 meters. The effect can be mild or severe and can crop up with little to no warning. It occurs because less oxygen reaches the muscles and brain requiring the lungs and heart to work harder and faster. AMS has been fatal at 3000 meters but usually is found fatal above altitudes of 3500 meters. The best way to prevent AMS is to avoid rapid ascents to higher altitudes. When traveling to the higher altitude locations of Nepal via bus or plane, make sure to take it easy for three days after you arrive to allow your body to adjust to the smaller amount of oxygen.