Handling A Medical Emergency In Latin America

I’m going to write the full story of what happened and how I handled this situation, in case any of you are ever in similar circumstances.

On the second last day of my trip to the amazon, I started to feel funny.  My eye looked like this:

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It didn’t look that bad.  But I felt terrible.  I told my guide and he said it was nothing and not to worry about it (as you can see in the photo it doesn’t look very serious).   So I let it go.

But the headaches continued.  I’ve had various infections before, no big deal.  But never at the same time as a splitting headache, and not in the jungle which is a pretty hostile environment.  I’m pretty used to travelling to unusual places, and nothing had ever happened before.

So I decided that I’d give it a couple more hours and if it wasn’t improved, I’d organize an evacuation back to Leticia (pop 30,000) to see a doctor.

By 2pm I still felt really terrible.  So I asked my guide to organize for us to return.  We packed and waited for the 4pm boat to arrive, along with another few people.  My guide really didn’t want to do this; he didn’t feel it was serious, but I insisted.

Unfortunately the boat came, but didn’t stop.  It was full.  Uh oh!

I told my guide we needed to find a way out.  He felt we should just stay the night and return the next day.  I insisted, and he had to make several cellphone calls back to his manager at his company.  Finally, he asked around and one of the local indigenous indians had a boat they could take us back to the city.  This was a special and unusual event.  I thought it might have cost several hundred dollars since we had a private boat for 2 hours and it was an emergency.  I was prepared to pay it .  However, it cost $4o.

This is a lesson I learned after 10 years in the Dominican Republic – sometimes the value of money, particularly in an emergency situation can be very different between you and the local people.

On the (slow) ride back, the tour company sent us a fast boat to pick us up.  So we got back to the city in about 90 minutes.

We rushed to see a doctor.  I think the guy thought he was Tom Cruise from Top Gun.    He asked me what happened, winked confidently at me and told me he’d get me some antibiotic drops to fix it.  I asked him if he was going to examine my eye.  He finally did for a second and said his first opinion was exactly right and this was not a big deal at all.

The next morning my eye was worse – a LOT worse.  I could barely move my eye.  The tour company took me to an optometrist across the street.  They were very nice and did an examination.  Unfortunately she was just an assistant as the optometrist comes in infrequently – we were in a small border town.  At the end I asked her if she thought it was serious.   She got a dark look on her face and said that it might be.

After this I went to the airport for my previously arranged flight to Bogota, the capital.  I was next going to catch a flight to Medellin to visit some of my colombian friends I hadn’t seen for 15 years.  And I called of them to ask him to make an appointment with a doctor in Medellin for when I arrived.  He did so.

However during the flight to Bogota my eye hurt.  A LOT.  Here’s how it looked

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And, I had a massive headache so I wasn’t thinking very clearly.  I was in a country I wasn’t familiar with.  I had no cellphone.

But I decided I couldn’t take the risk.  So I asked one of the other passengers on the flight if I could borrow his cellphone when we landed.  He agreed, and as soon as we landed I called my friend and asked him to find the top hospital in Bogota.

Then I went and picked up my bags and went straight to a taxi.  I asked the taxi driver to borrow his cellphone and we figured out where the top hospital was and got going.  By doing this I lost my prebooked flight and hotel.  But it meant I would get to a doctor 15 hours earlier and in the top hospital of the capital city.

The hospital’s name was Santa Fe de Bogota.  When we got to the emergency room (my first time ever) I went through triage and was walked through their system.  By the time I was properly examined I was feeling like I might fall over.  I couldn’t carry my bags anymore

At first they didn’t think it was too serious – and then they took a second look and freaked out.  I was admitted into hospital and 5 hours after arriving I was connected to high dosage antibiotics.

They were very shocked when they examined me and told me the infection was so serious, not only would I have lost my eye without treatment but that I would quite possibly die.  They put me on very strong antibiotics 24 hours/day applied through IV – which were extremely intensive and felt like my brain was being napalmed!

It turned out that the infection was on the way to infecting inside my eye, which would have cost my sight in that eye.  And may have been on the way to infecting my brain.  They told me on a scale of 1-10 it was a 1 if treated properly, and a 10 if not treated soon enough (meaning I would die).  They said this was an infection which could have happened anywhere, not just the amazon.

The next morning they sent me in for a cat scan to see if inside my eye had been infected.  It had not.  Did the fact I jumped off the plane early save my eye?  Maybe..

For the next 6 days I was in hospital receiving antibiotics almost 24 hours/day through IV.  My eye oozed yellow stuff.  But over time the infection became less and less until after 6 days I was allowed to leave.

The hospital was excellent.  They had been trained by Johns Hopkins and have been rated as the 4th best hospital in all Latin America.   The doctors made sense and knew what they were talking about.  So my friend gave me an incredible recommendation during a very risky moment.

You can see Fundacion Santa Fe in 4th place on this list:

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Source:  ranking_hospitales_2012_2

In terms of cost, I was confident I would be covered because I had my american express starwood points credit card and I knew they had travel emergency coverage.  The hospital asked me about my insurance and said, “no problem, it will be post-paid”.   So I charged the bills to my amex.  I did not have the ability to make phone calls however I did have internet.  I certainly didn’t have a very clear head.

When I came back to the US I looked into getting the money back.  Of course after I called Amex, it turned out it was not covered at all and they only cover death or dismemberment.  So, dear reader, keep that in mind for your future travel that the so-called health insurance we are offered on our credit cards is generally not real.  If you are going someone dangerous you can pay extra for health insurance and I would suggest doing that, it only costs ~$50.

I’ve submitted the bill to my US insurance company and am waiting to hear if they cover it.

However there is good news – this was 6 days of 24/7 care in the top hospital IN ONE OF THE CHEAPEST COUNTRIES IN LATIN AMERICA.  So the total cost was just under $3000.  This is the full scan of my paperwork from the hospital and accounting here:  santa-fe-bogota

As of today I’m fine.  I can see perfectly out of my eye.

The interesting lesson out of this is that if you pick your hospital carefully in latin america, I think medical tourism CAN be ok.   I felt very comfortable at Santa Fe De Bogota and they took good care of me.

Why did this happen?  I was putting on a lot of mosquito repellent each day to try to ward off dengue and malaria.  Some of it went into my left eye.  There wasn’t really any place to shower during the trip so I think the repellent got infected in my eye.  I avoided the crocodiles, snakes, slipping on the wood, eating the local food and every other calamity, but this got me.  C’est la vie.

  • Hello sir,
    Thank you for your nice posting.The hospital’s name was Santa Fe de Bogota. When we got to the emergency room (my first time ever) I went through triage and was walked through their system.