I have Epilepsy. I do not consider myself an Epiletic. It is a disability that I deal with in life but it does not define me as a person. However, when I am traveling, there are considerations that I do have to make due to the disability. A lack of proper support can turn deadly.
The issues of stigma, medical care and access to specialists are just some of the challenges that are faced when traveling internationally. For example, the District Hospital in Cuyo, Palawan was completely unprepared to deal with a seizure. (Ambulance would equate to a 12 hour ferry trip to a “real” hospital.)
This is sad that we are still even having this discussion as over 125,000 new cases happen every year in the United States alone. In fact, it is believed that 1 in 26 residents in America battle Epilepsy. The numbers are largely not known in many other countries but they could easily be much worse.
It does not mean that it should limit travel even if countries like the Philippines officially prohibit people who have Epilepsy from entering the country. There is just steps that need to taken before hand in case of an emergency in most cases.
Epilepsy and Stigma
Probably the biggest challenge is how people view the disorder around the world. If you believe that Americans lack proper education about it, people in some other countries have even less real understanding about it. As I mentioned, the Philippines is one of the countries that just says “Don’t come.”
In many cases, especially in countries that celebrated tribal religions, they connect Epilepsy with witchcraft. They actually think that someone is having a seizure because of a spell put on them by a witch doctor. This makes even disclosing it very complex in our countries.
In some of the more Christianized nations, especially in the South Pacific; it is hard because they believe that Epilepsy is a demonic spirit. They misunderstand a verse in the Bible and use it apply demonology to a medical condition. Because of this, there is a stigma that a person with it must have done some horrible sin.
I have found that in many countries, no matter what they believe about it biblically or tribally, than there is a general lack of education. If you was ask a local Samoan in a village about the disorder, chances are he wouldn’t even know what you was talking about. The same is for sure in the Philippines without question.
I have had some pretty dangerous situations happen while traveling because people I was with just didn’t have a clue what to do. I am talking about situations that would have never happened in the United States. Sadly, I found that even emergencies personnel (Police) were not even trained to help.
With that said, when traveling in some countries, you will be on your own if something happens. The tribal and religious stereotypes concerning the disorder are very serious and they could put you in harm’s way.
What about medical support?
If you need to go to a hospital (which is recommended by most doctors), your options in some places is very limited. El Nido is known for amazing beaches but not its one district hospital with one doctor and two nurses. The same could be said about Kaduvu in Fiji. Typically speaking, paradise puts you a long ways from a decent hospital.
It could get worse. Assume you have a seizure while in Yasawas. You would be several hours by ferry to Nadi to the closest decent hospital (by Fijian standards) and in some cases, 3-4 hours by plane to proper medical care in Hawaii or New Zealand.
I also have found it hard to get some meds in other countries that are common in the United States. One of them had to send to me from Missouri. This is not a problem until you are out of it or you need something that just is not present in the country you are in. This just makes life that much harder while on the road.
I am not saying that you should not go to developing countries like Fiji or Samoa. I am just saying you need to have a plan in place if something does happen. It might be researching what resources are in the country and having a plan ready if you do need to leave early for a more developed country.
Just remember the old motto from the local Boy Scouts troop: Be Prepared!
and about Neurologists?
The worse case is you need to see a Neurologist for most. Well, you might be in a wild goose chase in Samoa. I was. The good news is a thirty minute flight and you are on US Soil in America Samoa. The bad news is the hospital there only has the Neurologist on island a few times a year. (However, the doctors in American Samoa are much better trained.)
I can not really speak about what is available in Fiji as I did not need to see one. However, it is safe to assume that any that is in the country would only be found in Suva. For most, this is the last place you want to be when having a Fiji holiday.
The only other country that I have had to seek out one was the Philippines. What I found was most of them were not trained well and in some cases, they were completely clueless. There is about three of them in Makati that are worth a dime. The rest are not even worth seeing. The good news is Hong Kong or Singapore is much better and less than an hour away.
This is one of those things you don’t really want to need but you need to consider when traveling in a country with limited medical facilities. Nothing can end an amazing vacation in paradise faster than a seizure and you are hours from treatment by a doctor that knows much about Epilepsy.