Prague Healthcare and What to Expect
In an EMERGENCY – EU Citizen
As all of my Prague healthcare experiences go into this webpage it means the not so nice ones as well. We were walking in the forest when my elderly father complained of a stomach pain. This rapidly deteriorated to the point where an ambulance had to be called. You can substitute any type of emergency because it’s what came next that surprised me. My father had a European Health Insurance Card which for the British is now the GHIC (Global Health Insurance Card). It is a credit card sized plastic card with your full name, a couple of numbers that link to your national insurance details in your country of origin and your date of birth etc. The front of the Card is different in each EU country but, the rear of the card is in a standard format and is recognised in the Czech Republic by all the Prague healthcare authorities. Along with a passport which proved his identity, my father was taken to a local hospital for tests to find out that he had a perforated stomach ulcer and then onto a second hospital for an operation less than 6 hours after the ulcer burst. He spent a week in a ward and all of this was covered by the European Health Insurance Card. I didn’t know it existed until this happened and it’s well worth having it if you are an EU Citizen travelling in the EU. You still have to pay cash for prescriptions. EU citizens can apply for one at the post office, just ask for the EHIC application. From 2021 Brits should see the section below for the GHIC. You need to be paying regular NI contributions and the validity of the card is three years so, you’ll have to re-apply occasionally.
Necessary healthcare means healthcare which becomes medically necessary during your stay, and you cannot reasonably wait until you’re back in the UK to get it. This includes things like emergency treatment and visits to A&E, treatment for a long-term or pre-existing medical condition, routine medical care for pre-existing conditions that need monitoring, routine maternity care (as long as you’re not going abroad to give birth), oxygen and kidney dialysis. Note that from January 1st 2021 that if you are from the UK then you can apply for the GHIC (Global Health Insurance Card) which is valid here and covers some services but you may be expected to pay for others. Here are details on Applying for a GHIC from the UK.
How Private Prague Healthcare Works
I used to have BUPA International classic cover so it came as a shock that the biggest hospital in the Czech Republic would not accept it. It was pure chance that two years earlier I had an ear infection that required me to join the Unicare medical practice here in Prague (1000kc per year at the time). The hospital (MOTOL) would not deal directly with BUPA but, so long as Unicare guaranteed payment there would be no problem so that’s how it works. If I go to MOTOL, their foreign department gives me a piece of paper which when treatment is completed I return to them. They claim from Unicare and Unicare claims from BUPA. You can pay for treatment with a credit card but I’m sure that there is a limit. Bear in mind that if you are not an EU citizen, you will almost certainly have to join one of the International clinics if you need a hospital stay.
How Public Healthcare works
First you need to be paying your social money. In England this is what would be covered by National Insurance but in Czech this is a payment taken from your salary at source or paid separately if you are self-employed. You then join a Czech Health Insurance company i.e. I belong to VZP. Once you have a VZP registration you can then find a GP and from that point on it’s the same as you are used to in that the GP will either treat you or refer you.
Following a little drama that we had I thought that parents would like to know what is available in chemists here to buy off the shelf. If you wake up in the middle of the night in your hotel and the child is running a high temperature or has an allergic reaction to something then it’s not really the best time to try and get to a chemist. If the small child or baby starts to be incoherent or shaking then it’s a borderline hospital visit. You’ll be asking to be taken to the MOTOL hospital (biggest in Prague). If it’s still a high temperature then all of the following stuff is available from any Chemist/Lekarna which you can consider having available during your stay. You can also ask if the hotel has any of this as well. Any Prague healthcare advice from me will always tell you to adhere to the stated dose (in Czech, “rok/roky/let” all mean years, “mesice” means months, “pul” means half);
1) Panadol Baby – 3 to 18 months. Taken orally. This is very popular with parents to give to a smaller child running a temperature.
2) Panadol – Same make as above but for older children.
3) Paralen 100 – For babies and very small children. This is the rectal option.
4) Paralen 125 – Tablet. For children capable of swallowing with no problems. The doseage increases depending on the age but, generally children under 2 years get a half tablet.
5) Nurofen (Deti) – “Deti” means “children” in Czech but, it’s given in the same way as Panadol Baby.
If you have a small child or baby running a high temperature then you can alternate Panadol Baby (Paracetomol based) with Nurofen Deti (Ibuprofen based). If you only use one type then you cannot administer a second dose until 6 hours after the first. We know that a dose of Panadol Baby followed after 3 hours by a dose of Nurofen if the temperature starts to return will work fine.
NOTE: if your child reacts badly to high temperatures i.e. 39/40 degrees then there is a prescribed medicine here called Diazepam (rectal for less than 18 months or in case of incoherency. It also comes in tablet form for symptom prevention) which is stronger than the usual childrens drugs and is used to treat the “shock” side of the illness. Again if you know of this problem then you’ll probably be prepared for it anyway but remember that with Prague healthcare for foreigners that ambulances will almost certainly take you to MOTOL.
Prague healthcare isn’t just about pills and powders. If our child suddenly gets a rash or a sting then we generally use something called “fenistil”. Again it’s an orange box. It comes in “squeezy tube” or “oral” forms. The squeezy tube type is more for highly localised allergies or stings etc. The “oral” form is more for the “all over itchy” kind of allergy. This is often used in the Summer months here.
If it’s a troubling cough that is the problem then any chemist will stock “Robitussin Junior” which we’ve found to be quite effective.
If antibiotics are prescribed by a doctor then it’s likely to be something called OSPEN.
What About The Water?
It is pretty much agreed that although the water is drinkable and does not contain too much in the way of bacteria etc (it’s within “most” of the EU limits), I think that as far as Prague healthcare is concerned then for a week or two you’d have no problems. For long term use I’d stick to bottled water for drinking and tap water for boiling. You’ll find several types of bottled water in the Prague shops. Perliva means “with bubbles” and neperliva is “without bubbles”. A third type is “Jemne Perliva” which is with bubbles but not as sharp taste. Personally we use Dobra Voda for most stuff and Mattoni (with bubbles) for drinking. You may see bottles labelled as “Pitna Voda”. This means it is “drinking water” but not mineral water.
The problem here is the cobbles and the no-motion issues like when you sit down to lunch and leave your arm in the sun for an hour. Use a sunscreen, a hat and barrier cream for your nose and lips. Calamine lotion is a good way to soothe mild sunburn and Aloe Vera products are available in a Prague healthcare shop which in Czech is called a “Drogerie” (like Superdrug in the UK). Protect your eyes with good quality sunglasses.
Prickly heat would be unusual in Prague and is an itchy rash caused by excessive perspiration trapped under the skin. It usually strikes people who have just arrived in a hot climate. Keeping cool but bathing often, using a mild talcum powder or even resorting to air-conditioning may help until you acclimatise.
As you probably will not be spending hours sunbathing here this should not be a big issue. Dehydration and salt deficiency can cause heat exhaustion. Take time to acclimatise to high temperatures and make sure you get sufficient liquids. Wear loose clothing and a broad-brimmed hat. Do not do anything too physically demanding. Salt deficiency is characterised by fatigue, lethargy, headaches, giddiness and muscle cramps; salt tablets may help, but adding extra salt to your food is better or again Prague healthcare shops sell salt tablets. Anhydrotic heat exhaustion, caused by an inability to sweat, is quite rare. Unlike the other forms of heat exhaustion, it is likely to strike people who have been in a hot climate for some time, rather than newcomers. In summary, drink little and often. Add salt to meals.
Even in Prague, this serious, sometimes fatal condition can occur if the body’s heat-regulating mechanism breaks down and the body temperature rises to dangerous levels. Long, continuous periods of exposure to high temperatures can leave you vulnerable to heat stroke.
The symptoms are feeling unwell, not sweating very much or at all and a high body temperature (39 to 41 degrees Celsius or 102 to 106 degrees Fahrenheit). Where sweating has ceased the skin becomes flushed and red. Severe, throbbing headaches and lack of coordination will also occur, and the sufferer may be confused or aggressive. Eventually the victim will become delirious or convulse.
Prague healthcare in this case means an ambulance and hospitalisation is essential, but meanwhile get victims out of the sun, remove their clothing, cover them with a wet sheet or towel (or place under arm pits) and then fan continually. Give fluids only if they are conscious.
Eating lightly before and during a trip will reduce the chances of motion sickness. If you are prone to motion sickness try to find a place that minimises disturbance – near the wings on aircraft, close to midships on boats, near the centre on buses. Fresh air usually helps; reading and cigarette smoke don’t. Commercial antimotion-sickness preparations, which can cause drowsiness, have to be taken before the trip commences; when you’re feeling sick it’s too late. Ginger (available in capsule form) and peppermint (including mint-flavoured sweets) are natural preventatives.
The bags are packed and then you hop on a flight of over 18 hours’ duration, to the other side of the earth, with transfers increasing the travel time to what feels like two days. You arrive at your destination not quite at your best, headache, nauseous, tired, dazed, somewhat confused and unable to stay awake yet unable to sleep. You’ve even lost your appetite for all that interesting food. That’s jet lag, the curse of the ‘time’ traveller.
Jet lag is experienced when a person travels by air across more than three time zones (each time zone usually represents a one-hour time difference). It occurs because many of the functions of the human body (such as temperature, pulse rate and emptying of the bladder and bowels) are regulated by internal 24-hour cycles called circadian rhythms.
When we travel long distances rapidly, our bodies take time (usually about three days) to adjust to the ‘new time’ of our destination, and we may experience fatigue, disorientation, insomnia, anxiety, impaired concentration and loss of appetite. There is no local Prague healthcare that can help you, it’s all in the recovery period.
The direction of travel is a major factor. Heading east will disrupt the body more than heading west. This is because when travelling west you are essentially lengthening your day to something between 24 and 27 hours which the body can adapt to. Travelling East however will shorten your day and this can throw your rhythm out of sync. Travel stress is another factor: pre-travel parties, packing, separation from family and loss of security all take their toll. The flight itself creates many stress factors such as dehydration, poor sleep, alcohol intake and long periods of inactivity. Once at the destination there are language, diet and climate factors.
Ideally, you could minimise time-lag problems by sleeping and eating at times closer to the time of your destination before you leave, but in practice this is difficult. Instead you should minimise the pain of travel by taking plenty of rest before the flight and avoiding late nights and last-minute dashes for travellers’ cheques, passport etc. Try to select flight schedules that minimise sleep deprivation; arriving late in the day means you can go to sleep soon after you arrive. For very long flights (especially eastbound), try to organise a stopover and also try to minimise those three-hour transit stops.
During the flight, try to plan meals and sleep around the expected destination times. Drink plenty of water, try to exercise and avoid taking too much alcohol. Make yourself comfortable by wearing loose-fitting clothes and perhaps bringing an eye mask and ear plugs to help you sleep. Sleeping tablets may help regulate patterns, but be sure that they are short-acting – you don’t want to be doped-out at the airport. On arrival, stimulate your body to the new time by eating and sleeping at the relevant local times. Exercise helps, and light walking is ideal. Many travellers report that exposure to sunlight after arrival also aids synchronisation.
Contrary to what most people think, the major cause of this condition is change. Whether to a hotter temperature (generally moving to a colder temperature is less likely to cause problems depending on the size of temperature difference). It has a combined effect of making us drink more and eat less (especially if it is a long flight) along with a much greater exposure to the sun than normal. Or suddenly deciding to try that “extra-spicy” food when you wouldn’t normally touch it at home. Common sense precautions are to stay as close to your normal diet as possible, try to incorporate the types of food that you may have to eat into your normal diet (rice etc), avoid exposure to the hottest part of the day and avoid excessive amounts of alcohol.
The other cause of course is food and general hygiene. When you are in a different place, try to adopt the same standard of cleanliness that you would at home. A good tip is to note the appearance of people using the place where you intend to eat. Be aware that one of the greatest dangers is not the food but, what you use to eat it. Using a normal antisceptic wipe to clean knives and forks etc is a good tip. In China, a pair of chopsticks should need to be broken before being used (to show they have not been used before). Never use individual chopsticks. Street stalls generally have a lower standard of cleanliness by their nature. Observe the seller’s manner for a few minutes before buying food at a stall. Remember most stalls to not have running water so, they don’t wash their hands.
Most diarrhoeal attacks are self-limiting and clear up in a few days. The important thing is to avoid becoming dehydrated. As soon as diarrhoea starts, drink more fluids, such as bottled, boiled or treated water, or weak tea. Fruit juice (diluted with safe water) or soup may also be taken. If diarrhoea continues for more than one day then Prague healthcare means a trip to the chemist (in Czech it’s a Lekarna) where you can buy, prepare and drink an ORS (Oral Rehydration Salts) solution and continue to eat normally.
AMOUNTS OF FLUID OR ORS TO DRINK:
Children less than 2 years: 1/4 – 1/2cup (50 – 100ml) after each loose stool
2 years to 10 years: 1/2 – 1 cup (100 – 200ml) after each loose stool.
Older children and adults: unlimited amount.
SEEK MEDICAL HELP IF:
a) Diarrhoea lasts for more than 3 days and/or there are very frequent watery bowel movements, blood in the stools, repeated vomiting or fever.
b) When there is no medical help available and there is blood in the stools, a course (5 days) of cotrimoxazole may be taken. See note below. Prophylactic use of antibiotics is not recommended. Antidiarrhoeals (e.g. loperamide) are not recommended but may be used, in addition to fluids, by adults only, for symptomatic relief. They should never be used for children. If there are other symptoms, seek medical advice.
The World Health Organisation recommendation for Oral rehydration is “for 1 litre of clean drinking-water (boiled and cooled before mixing if there is any doubt): 3.5g sodium chloride, 2.9g trisodium citrate dihydrate (or 2.5g sodium bicarbonate), 1.5g potassium chloride, 20g glucose (or 40g sucrose)”. Or for those of us without a degree in Dispensing Chemistry;
Mix 6 level teaspoons of sugar plus 1 level teaspoon of salt in one litre of safe water.