I was recently asked my opinion on what are the three most dangerous countries. Based on our experience, Sudan, Samolia, and Nigeria fall into this category. None of these countries are tourist attractions as they are all poor areas with very little to visit, but we see a lot of missionary groups and outreach organizations traveling to these areas to help the impoverished peole who are in need of many services. What makes these countries so dangerous begins with the infrastructure of the areas and is further complicated by the political culture, the crime, the unsafe healthcare delivery system, the lack of availability of medicine, and the logistics in general. It is easier to become sick or injured in these countries and it is harder to get appropriate treatment. From our personal experiences, we have outlined below all of the things that can go wrong in these countries. First, there are more ways to get sick or injured due to the crime and general condition of the area. They also have some of the highest HIV and AIDs infected populations and do not have the capabilities to educate, prevent, or control the spread of any disease or virus that is present in the area. If someone does get sick, there are no resources to treat that person. Due to crime, all organizations literally shut down at 6pm, go home and lock up for safety reasons. If a doctor is in a hospital, that hospital can even be locked up. The embassy itself is shut down at 6pm. If an ill or injured person is lucky enough to get to an area where care can be delivered to them, there is a huge lack of available medication and equipment. As an example, we had to evacuate one member after being bitten by a bat because there was no rabies vaccination available. We also had to make a medical call to move an injured patient before we could get needed spinal x-rays to assist in determining the potential for paralysis because the appropriate medical equipment was not available to diagnose the injury. Another area of concern is the criminal activity. Even a hospital may not be above credit card fraud. A patient would want to be sure to pay in cash for services received if payment is being mandated prior to treatment. If the patient has insurance, they should coordinate immediately with the insurance company so the insurance company can coordinate payment discussion with providers. Once an ill or injured person is ready and available to be moved, then the infrastructure and political environment comes into play to further complicate a patient's issues. If a medical escort is needed, a visa has to be obtained for that escort which in these inefficient areas can take 4 days even in urgent situations. Even if a medical escort is not needed, air ambulance pilots are usually not from the country, so they need appropriate visas which can also take 4 days to process. If a patient's visa has expired due to the length of stay being elongated due to their medical conditions, they are not able to exit the country without renewing their visa, which again adds time to the process. The entrance and exit politics and inefficiencies are further complicated by poor airports conditions. Many airports don't have lights so air ambulances can only enter or exit during the day. In addition, the closest quality facilities are South Africa or Saudi Arabia, which are eight hour flight times. We're here to assist. In addition, our Wellabroad website also has member specific access that provides country profiles with lists of quality doctors and hospitals in an area or those we have worked with in the past as well as all of the medical information about a country where our insureds are traveling.
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