Thailand is a fairly safe country, and simple health and safety precautions keep the vast majority of travelers out of trouble. For instance, ignore hustlers, keep away from troubled border areas, take care of valuables, and avoid staying or eating in unsanitary conditions. The infrastructure of emergency services for both health and crime is efficient throughout Bangkok and provincial capitals. As a rule of thumb, the more remote the area, the higher the health risk and the less support available in the event of any mishap. The main hospitals in Bangkok, Chiang Mai, the main resorts, and other large cities have modern equipment and welltrained doctors, many of whom speak some English.
In an Emergency
There are no national emergency telephone lines except for ambulances, and operators do not speak English. For English speaking help, call the Tourist Assistance Center, which will contact the appropriate service for you. Lines are open from 8am to midnight, after which you will have to rely on English speaking hotel staff. During office hours, TAT may also be able to help. The Metropolitan Mobile Police cover general emergencies in Bangkok. All Bangkok’s hospitals have 24-hour accident and emergency departments.
Despite its size, Bangkok is relatively safe. Crime and violence do exist, but most travelers are untouched by it. Discretion and sobriety are the best means of avoiding problems. Be alert at tourist sights and bus and train stations, where hustlers and pickpockets occasionally operate: scam artists outside the Grand Palace (see pp84–5) direct tourists to pricier, less impressive sights. Do not flash large amounts of cash or leave your luggage unattended. If you are leaving valuables in a hotel safe, make sure to get a receipt, and do not let credit cards out of your sight when paying for shopping. The drugging, then robbing, of tourists on long-distance trains and buses has occurred, so politely decline food or drink from strangers. Thailand is an excellent place to buy gems (see p438), but do not be tempted into buying large quantities to sell back at home unless you are familiar with the market and its pitfalls. Extra care is necessary in more remote areas of the country where locals are less accustomed to tourists and you are more likely to stand out. Care should also be taken in poorer parts of cities, particularly at night, or if traveling alone.
Thai law prohibits the sale or purchase of opium, heroin, or marijuana. Charges for posses sion, smuggling, or dealing drugs can lead to a 2–15-year jail sentence or, in extreme cases, the death sentence. Border areas in the north attract drug runners. Be wary of strangers in these areas, and do not leave baggage unattended, or offer to check in a stranger’s suitcase at airports.
Border areas are sometimes precarious places. Changing political conditions, tribal skir mishes, and the haziness of border lines have made a few areas of Thailand dangerous.
There are sporadic clashes on the Myanmar (Burmese) and Cambodian borders, so it is best to avoid traveling alone on remote roads in those areas. In the three Deep South provinces of Narathiwat, Pattani, and Yala, the militant Malay Muslim group, PULO (Pattani United Liberation Organization) represents a real danger, and has made travel in this region extremely difficult. Again, common sense should prevail and it is wise to stay away from the most remote border areas.
Female travelers are unlikely to be harassed in Thailand. Bangkok itself is not dangerous for women; hotels are safe, and taxis are readily available. If traveling alone it is a good idea to keep in touch with some one in Bangkok and let them know where you are going and for how long. Note that Thais perceive lone travelers as people to be pitied, and may offer to accompany you without any ulterior motive.
There are tourist police stations in the main tourist cities. Tourist police officers all speak some English and are attached to TAT offices. Set up to deal with touristrelated crime, they help with anything from credit card scams to ludicrous bar surcharges. They are also helpful in emergencies and can act as an Englishspeaking liaison. Foreign residents also volunteer with the tourist police. The Bangkok branch of the tourist police is located in front of the southwest entrance to Lumphini Park. The Tourist Assistance Center is also helpful in emergencies, and is experienced in dealing with complaints such as fraudulent business charges.
Some insurance policies cover legal costs, for example, after an accident. If involved in an crash when driving a rental car, it may be wise to go to the nearest telephone and call the tourist police or the Tourist Assis tance Center, then return to the scene of the accident. In Thailand there are no legal bodies specifically representing foreigners. In an emergency, contact your embassy . At night there is an answering service, giving the number of the duty officer. If you are not insured for legal proceedings, then you should contact your nearest consulate for advice
Medical insurance is advisable when traveling in Thailand. Some policies pay bills direct, while others refund you later. Hospitals in Bangkok, both public and private, are modern, clean, and efficient, although waiting times are longer at public ones. Some doctors are Western-trained and speak good English. Outside the capital the best facilities are in large towns: Khon Kaen in the northeast, Chiang Mai in the north, or Phuket in the south. Emergency care is available from military hospitals. For dental or eye care, it is best to seek treatment in Bangkok. The Thai Red Cross on Rama IV Road does not offer medical treatment, but is able to deal with vaccinations and snake bites.
There is no shortage of well stocked pharmacies in Bangkok – there will be several on every main street and shopping mall, and supermarkets will have drugstore kiosks. They are all supplied with up-to-date medications and can dispense antibiotics over the counter without a prescription. Most pharmacies are open from 8am to 9pm. In the central areas of Bangkok, around Silom and Sukhumvit Roads, a few stay open until 10pm or 11pm. Pharmacy signs are the same all over the country. In small towns pharmacies are less prolific and have fewer supplies. For instance, disposable diapers and tampons can be hard to find in remote area
All hotels and many guesthouses have Western-style flush toilets. In some restaurants and at many major sights, you will encounter the Asian squat toilet. Nearby will be a bucket of water, used to sluice out the toilet after use. Paper is disposed of in a bin
There are no legal immunization requirements unless you are traveling from a country known to be infected with yellow fever. It is recommended that everyone be immunized against polio, tetanus, typhoid, and hepatitis A. In addition, for those travelers going to remote or rural areas, or who are staying more than two to three weeks, BCG (tuberculosis), hepatitis B, rabies, diphtheria, and Japanese encephalitis vaccinations are advised. For the most up-todate advice, contact your doctor, who will also be able to advise on the current guidelines for malaria prevention, as the drug recommendations change fairly often. Some vaccines need to be given separately or in stages. Some malaria tablets, meanwhile, are started a week before traveling and continued for several weeks after returning. Therefore, it is advisable to contact your doctor at least eight weeks before departure.
Coping with the Heat
Acclimatization to the sometimes oppressive humidity and heat of Thailand can often take longer than expected. In the first few days it is not advisable to exert yourself. Make sure you drink plenty of bottled water, take plenty of rest in the shade, and avoid being out and about in the midday sun. Once you are acclimatized, dehydration and salt deficiency can still be a problem – always keep up a high intake of bottled water. Minor fungal infections can occur due to the heat, especially if tight clothing or shoes are worn. Perspiration trapped beneath the skin can cause the itchy rash called prickly heat. The local remedy and prophylactic for this is a talcum powder that contains a tingling cooling agent. Clothing should be loose and light – 100 percent cotton is best. The sun, especially at midday and on the islands, is very powerful; sunscreen and a wide-brimmed hat are indispensable
Kit Although most first-aid items can be obtained from any pharmacy in main towns, when traveling to rural areas or quiet islands it is advisable to carry a basic first-aid kit. This should include the following: any personal medication; aspirin or paracetamol for fevers and minor aches and pains; an antiseptic for minor cuts and bites; a digestive preparation to soothe upset stomachs; insect repellent; bandages; scissors, tweezers, and a thermometer. Tiger Balm, available at any pharmacy, is Asia’s miracle cureall, relieving headaches, muscle pains, and insect bites.
Minor Stomach Upsets
If you should contract diarrhea, eat plain foods for a few days and drink plenty of fluids. Do not drink the tap water – bottled water is readily available throughout the country. Ice should be fine in main hotels and restaurants, but avoid crushed iced drinks from street vendors. Eating in hotels and restaurants is generally safe. It is when you venture into the street vendors’ moveable feasts that the danger of “Bangkok belly” can arise. Choose food stalls that are popular with locals, and watch how the dishes are prepared. It can take time for visitors’ stomachs to adjust to new foods. If your constitution is delicate, stick to unpeeled fruits and well-cooked foods, and make sure you eat dishes while they are still hot.
Drugs such as Lomotil and Imodium can bring relief to diarrhea, but rehydrating solutions are usually the best remedy. For immediate relief, a single 500 mg dose of the prescription called Ciprofloxacin is effective and safe.
Cuts and Bites
Always take precautions in rural areas: wear boots and long trousers when walking through grassland or forested areas to protect against snake bites and leeches (in the rainy season). Few snake bites are dangerous. If you are bitten, apply an elastic bandage firmly to the bite, keep the limb immobile, and seek immediate medical help. Jellyfish stings are painful – vinegar will soothe the wound. Coral cuts are slow to heal as coral contains a mild poison. Cuts should be treated with an antiseptic to prevent infection. Bandages keep wounds wet so should be used only sparingly.
Seven of Thailand’s 410 mosquito species carry malaria. Symptoms of the disease include headache, fever, and violent chills. If you experience such symptoms, seek medical advice immediately. Pollution in the main towns and resorts keeps them largely free of malarial mosquitoes. The areas of greatest risk are the Myanmar (Burmese) and Cambodian border regions and some rural areas north of Chiang Mai. However, malarial zones are continually changing. For up-to date information and advice on the most suitable prophylactic drug, visit your doctor or contact a specialist travel clinic. Mosquitoes have become resistant to certain malaria tablets. Prevention is by far the best defense against the disease. Malarial mosquitoes are active from sundown till sunrise, during which time you should spray on plenty of repellent, wear longsleeved clothing in light colors (dark attracts mosquitoes), and use mosquito nets and coils. Dengue fever, another mosquito borne disease, is a risk during the daytime. However, few mosquitoes are infected with the virus, and the symptoms, though intense and unpleasant, are rarely fatal. These include fever, headache, severe joint and muscle pains, and a rash. Cases of Dengue fever have increased, so avoid stagnant bodies of water. No preventive treatment or vaccination is available. In Northern Thailand and some rural areas there is a risk of con tracting Japanese encephalitis, spread by night-biting ticks and mosquitoes. The symptoms are headache, fever, chills, and vomiting. Vaccination is advisable for travel to rural areas (particularly during the rainy season) or trekking. Should any of the above symptoms occur seek immediate medical help
People- and Animal Borne Diseases
Acquired immune deficiency syndrome (AIDS) is passed through bodily fluids. Blood transfusion methods in Thailand are not always reliable – it is safest to seek treatment in the main hospitals. The same goes for inoculations – make sure needles are new or bring your own supply. Be wary of all procedures involving needles, including ear piercing, dentistry, and tattooing.
The high turnover of clients in Thailand’s pervasive sex industry means that unprotected sex carries a serious risk (see p120). Not only AIDS, but other sexually transmitted diseases are commonplace.
Hepatitis B is also transmitted through bodily fluids. Symptoms include fever, nausea, fatigue, and jaundice, and it can lead to severe liver damage. A prophylactic vaccine is available.
Rabies is carried in the saliva of infected animals and can be passed on by a bite or lick to a wound or scratch. Any bite from a dog, cat, or monkey should be cleaned immediately and checked by a doctor. Treatment involves a long series of inoculations. Tetanus is a potentially lethal disease transmitted through infected cuts and animal bites. The first symptoms are difficulty in swallowing (tetanus is also known as lockjaw) and muscle stiffness in the neck area, which can lead to convulsions. As with rabies, all wounds should be speedily cleaned and examined by a doctor. Effective vaccinations are available. Bilharzia is contracted from tiny worms that infect some types of freshwater snail. They burrow into the skin and cause a general feeling of sickness and abdominal pain. Avoid swimming in untested rivers and lakes
Food- and Water-Borne Diseases
Dysentery, a severe form of food or water poisoning, is rare in Thailand, but not unknown. Bacillary dysentery – characterized by stomach pains, vomiting, and fever – is highly contagious but rarely lasts longer than a week. Amebic dysentery has similar symptoms but takes longer to develop. It can recur and cause chronic health problems. Medical help should be sought without delay if you think you have either type. Hepatitis A is passed on in conditions of poor sanitation (contaminated water or food) and can be prevented with a vaccine. Symptoms include fatigue, aching, fever, chills, and jaundice. Little can be done to treat it beyond rest. Typhoid is transmitted through contaminated water or food, and fluid replacement is the most important treatment. Symptoms are similar to those of flu but quickly accelerate to fever, weight loss, and severe dehydration. Medical attention is essential as complications such as pneumonia can easily occur. Although a vaccination is avail able, it is not always reliable.