Avoid hazards of medical treatment abroad

(CNN) -- Orla Buckley was less than a week into her study abroad program in Spain when things went sour.

Days after arriving in Seville in May 2003, Buckley, then 19, was walking home from a class during a Scotland vs. Portugal soccer match being played in the city. When Scotland scored, an exuberant fan outside the stadium picked Buckley up by the legs, jumped in celebration and fell -- on Buckley.

Her kneecap was shattered and doctors operated that night. She spent about 10 days in a non-air conditioned hospital room that she shared with dozens of people, some of them smoking. Upon returning to the United States, doctors told her the care she received was outdated and would add to her recovery time.

Buckley experienced firsthand how American and overseas medical care can differ. And she wasn't even in a country known for lackluster medicine.

"Western Europe and some of the other countries like Australia, New Zealand, Canada, Japan, for example, all provide services that are reasonably comparable to U.S. standards," said Dr. Gary Brunette, a medical epidemiologist with the U.S. Centers for Disease Control and Prevention's Travelers' Health Team. "But outside of that region, standards can drop off rather dramatically."

Still, with laws and medical practices differing from one country to the next, travelers should educate themselves before any trip overseas.

Find the right hospital

Buckley was "a bit unlucky," she said, because an ambulance transported her to the nearest public hospital, which she later heard was "not the nicest one I could've been in."

But most public hospitals abroad -- especially in less developed countries -- are a gamble, according to Dr. David Goldberg, who specializes in travel health and founded MDtravelhealth.com.

"In general, you avoid the large public hospitals," Goldberg said, adding that most countries have smaller private hospitals that often provide better care.

Being in the wrong hospital is tantamount to no treatment at all, he said. "Just imagine that you're back in the 18th century [and] anything the doctor is doing is likely to make things worse rather than better."

Hospital Web sites can provide insight into their quality, Goldberg said. "If you go to the Web site and you see that the hospital has open heart surgery, there's a coronary unit, has an ICU, a modern emergency room ... it's not an absolute guarantee, but it tells you you're going to be getting Western-style medicine if you go there," he said.

Bring travel insurance

Typically, U.S. health insurance policies don't cover medical care abroad. Many medical and travel experts recommend Americans obtain travel health insurance before going overseas, to ensure travelers get quality treatment without breaking the bank.

Also important, they say, is that the travel insurance covers evacuation services.

"Especially in most developing countries, if you develop any serious injuries, you will want to get out of there. And an air ambulance will cost tens of thousands of dollars," Goldberg said.

Travel insurance can run 5 to 10 percent of the cost of the trip, depending on the traveler's age, length of stay and the type of coverage he or she takes, according to Mike Weingart, president and managing director of Carlson Wagonlit Travel/World Travel Agency in Houston, Texas.

Know what the doctor is saying

The language barrier proved a major hurdle in Buckley's understanding of her injury.

As she underwent surgery her first night in the hospital she still didn't know what part of her body had been hurt. She categorized herself as an intermediate Spanish speaker at the time, but that didn't help her much with medical terms.

A country's U.S. Embassy or consulate can provide help in this type of situation, experts say. Embassy Web sites will often provide health information for American travelers, such as lists of English-speaking doctors, recommended hospitals and other medical services.

The embassy is also on the traveler's side if they're already in a second-rate hospital.

"Say, 'I'm in this situation, I'm concerned about what kind of care I'm getting in this particular hospital, my insurance would cover me in a private hospital, is there some way you can assist in getting me transferred?' " Brunette advised.

Be wary of the pharmacy

Travelers should try to avoid taking medication they buy overseas, particularly in developing nations. The CDC recommends those with existing conditions bring enough medication for their entire trip.

Others should bring a travel medicine kit that includes treatment options for minor medical needs, such as pain medication, anti-diarrhea medication, decongestant and antibiotic ointment.

"Not only might they have difficulty getting medications, but in certain parts of the world there's a real problem with counterfeit medications," Brunette said, adding that the fake versions are visually indistinguishable from the authentic ones.

On top of not treating symptoms, counterfeit drugs can be toxic, he said. "You don't know what they put in those medications. These things are being done on some back street."

Use common sense

While some accidents are unavoidable, travelers can often keep themselves healthy by using simple common sense, Brunette said.

Keeping hands clean by washing with soap and water or using alcohol-based gels can decrease the risk of contracting many infectious diseases, Brunette said.

More people need medical attention for injuries than infectious diseases, Brunette said, so travelers should think before taking risks, such as riding in cars without seatbelts or driving a motorcycle around a beach without a helmet.

Buckley, who recently moved to Ireland, said she sees American tourists being careless all the time.

"For me, it was unlucky. I was in the wrong place at the wrong time," Buckley said. "But it can happen anywhere." E-mail to a friend

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