Healthcare for Cruisers

It’s one of those questions that comes up again and again—‘are we covered by health insurance, if so which insurance, what does it cost, and what does it cover?’

First off a caveat—we’re Canadian so our worst case scenario is even if we have been out of the country long enough that we’ve lost our healthcare coverage (this varies from province—but the cut-off is typically 183 days per year with some provinces allowing you to be out longer as long as you have an intent to return) our coverage will resume after a waiting period (typically three mos—but there are provinces with no wait period).

cruisers need to take preventative measures when it comes to staying healthy--rescues are hard to come by

That said, this is what we’ve done:

US West Coast—We were insured beyond our basic Canadian insurance. Our Canadian insurance reimburses costs up to what it pays in Canada—which comes no where close to the US cost of healthcare, so we decided ages ago never to be in the US without some sort of additional coverage—we always have visitors insurance for the US no matter how brief the visit might be. On the trip down the coast we didn’t need to use it.

Mexico—We maintained our Canadian coverage but had no supplemental coverage for Mexico. We had one bad experience in Mexico—we needed to update vaccines and in Santa Rosalia the Doctor offered to get us them—charged $80 in advance, then failed to get the vaxes or to reimburse us. But this was an exception.

Mexico is one of the countries that is considered great for routine healthcare (others we've heard raves about include French Polynesia (we got free vaxes in Nuku Hiva), and Malaysia). And both La Paz and La Cruz are popular for check-ups. Typically treatment was excellent and modern—my skin cancer checks (I went for two, Ev had one) were accurate and affordable ($125 for a full screen and biopsy). Treatment for pneumonia was straightforward--two doctor visits ($30, $50), x-rays ($25), inhalers ($50).

During our 18 months we also visited local dentists every six mos—basic cleanings were around $30, fillings another $30 and Evan needed a root canal which ended up in the $600 range. Keep in mind Mexican dentists rarely use x-rays and rely on physical signs of decay. So our rule of thumb is to visit the same dentist at the same time as another family. If too many cavities are found we know we’ve hit on someone who’s too enthusiastic with the drill and we all move on.

Between preventative care, prescriptions, two eye doctor visits and glasses and contacts for Ev (we got Maia's glasses in Canada), skin-cancer check-ups and a root canal, treatment for pneumonia our expenses were about $1200 for the 16 months we were in Mexico. We could have squeezed in check-ups on a visit home the first year, but we were confident enough in the Mexican system that for preventative care and day-to-day follow-up care we were happy.

Crossing the South Pacific we carried Dan evacuation insurance. This insurance can evacuate us to a place we can be treated—but it doesn’t cover treatment costs once you’re there—so having a plan about where to go is vital. We did get some prescription drugs—anti-malarials in Vanuatu ($20), cream for a skin infection in French Poly $30.

In Australia we have bought basic insurance (ranges from $150/per month per family up). Dental is out of pocket—Ev and I went to the school and had checkups for $60 each, Maia went to a local dentist and her check-up and cleaning was $200 and a filling was $210. I’ve had a ‘well-woman’ check-up $110 and a skin check for $185. Evan saw a Dr. for sore knees which came to $75 plus $133 for x-rays (should get some of these expenditures back).

So all this said—there really is no one medical insurance answer. It varies according to how long you are away from your home country and where you spend your time while away. Our basic plan is to keep up to date on all preventative healthcare—we vaccinate for whatever the locals are vaxing against (assuming we may be even more susceptible), we take our anti-malarials or whatever preventative drugs are needed, we get check-ups, we don’t let things linger (too long…)and we buy insurance when we're in more expensive countries.


Staying on top of things is vital to staying healthy though.

Coral’s Quinceañera

I cried when Coral entered the church. 

 The memories came flooding back: of meeting Dee and Stew after a storm blew us into Westport, WA and sailing down the coast with them; of being the first to meet Coral in the minutes after she was born; of cruising Mexico with them; and then taking a trip together to Mexico City to visit Ramon and his family, our newfound Mexican friends, and celebrate Coral’s 1^st birthday.

 That night—when Coral was in her fancy party dress, and her birthday fiesta had gone far too late for the wee girl, Dee proposed we do it all again, in fourteen years—for Coral’s Quinceañera.

Ivan & Dee, Coral, Stew & Wendy

 Not all friendship pacts make it through the challenges of time and geography—and our little group changed shape over the years. But Coral went ahead and grew-up anyway, and last night was her fiesta.

Ramone, Coral & Pat

 A Quinceañera is a celebration of the end of childhood and the beginning of young womanhood. It’s a beautiful ritual that lets a girl’s parents tell her how much they love who she’s growing into. Perhaps it’s a bit like a debutant ball, or a coming out—but the rituals: the first make-up, and first high-heels, and the tossing away of a childhood doll are solemn ones. And for Coral—who is Mexican by birth and who spent her first four years here--it’s a link to a culture that she's just beginning to learn about.

Maia and Carolyne imagine their own parties

 Mass was lengthier than the, “sprinkle of water and a few nice words about growing up” that Stew said he had hoped for. But it ended without the overhead pigeon pooping on Coral, or any of us bursting into spontaneous flames…

 We headed to dinner afterward and continued to catch up—and admire Coral. I cried when she got her high heels, and again when she danced her first dance with Stew. I cried when Maia caught Coral’s (now headless after a bad bounce) doll and marveled again about how quickly it had all passed. Just yesterday, it seems, I was scooping Coral out of Dee’s arms at beach landings, and standing at the top of pyramids with her—showing her the world.

 

 And now it’s hers.

Road Trip to Comala

 Although as we’ve lived in Mexico for more than a year now, most of our experiences have been coastal. And while we love the coast—there is a different feeling to the country when you get up into the mountains. The sultry air gives way to a softer, less pungent breeze, the locals are less travelled and more curious about visitors. And the nostalgic things: the colonial churches, the haciendas, and the musical traditions are still current things--thanks to the slower pace.

I love Mexico. I deeply, deeply love it here. And leaving, before knowing it more fully, is occasionally heart breaking. So as our goodbye kiss from Mexico we decided to splurge on a minivan, scoop up the Hotspur family, and head inland to one of Mexico’s Magic Cities—Comala.

 There is nothing flash about this little colonial city. It’s much like so many of the ones that dot Mexico’s interior. It’s a simple place where the focus is on family, friendship, faith and fiestas. It’s all painted white and in the afternoons mariachi bands stroll the square. We sat eating our tapas and listening to the old songs, drinking beer and talking about nothing in particular.

 The sun was warm, but not too hot. Venders stopped by, chatting and showing their wares. Nothing dramatic occurred. But it was perfect: Simple and small, uncomplicated and colourful.

Inland to the Ruins of El Chanal

 

 I’m a sucker for ruins. I can spend hours sitting in the rubble of forgotten civilizations imagining the past. What I love most is to wander slowly and silently, taking in different vantages. Sometimes when I close my eyes I swear I feel the echoes of the long ago people.

My biggest regret, when we changed our plans and decided not to go to the Galapagos, was we’d miss southern Mexico and Central America and not see the big ruins with Maia. So when we learned of the ruins outside of Comila (about 3 hours from Barra) I wanted to head inland. And when I shared our idea with Meri from Hotspur she told me she’d be all over that plan and her family would love to join us.

Colima actually has two sets of ruins: El Chanal and La Compana, and both are found on the northern outskirts of Colima. El Chanal is located in the residential area at the end of Venustiano Carranza street just north of the Tercer Anillo Periferico (3rd ring highway) and it’s really poorly signed so be prepared to ask for directions.

 The ruins themselves are modest and infrequently visited. A fact that meant we were the only ones there. But being the only people wandering through an ancient city is a magical experience. And as we climbed the pyramids and pondered the ball court my imagination flowed freely. I tried to see the site bustling with people and then tried to imagine the excitement of the first archaeologist who stumbled across the remains.

Very little is known about El Chanal, including who occupied it. Archeologists have figured out that the site was occupied from roughly1100 AD to 1400 AD, and it was mysteriously abandoned about 200 years before the Spanish arrived—probably because of warfare.

Maia and Carolyne being sacrificed

Today though the site is still and silent—a testament to a mysterious time when people thought dogs accompanied the soul through the dark of the underworld to a sunny afterlife and blood sacrifices kept the earth in balance...

A Monkey in the Moment

It seems like the getting-to-know-Barra phase has evolved into settling in. We have a standing order with the French Baker (I even got a rose on Valentine’s thanks to our regular patronage), a favourite beach, we know where to get great tacos, and where to find our groceries, and we’ve even figured out how to crash the local posh resort for a swim in the pool. In other words; it’s time to move on…

 I realized this yesterday at the beach. The kids were having a blast, body surfing and digging holes (what is it with kids and dogs that they have such a driving need to dig?). I was as relaxed as I get—sitting under my umbrella, pondering Captain Cook, occasionally laughing at the kid's crazy antics. Ann from Hanacrew was thumbing through my Lonely Planet Mexico guide, planning their next adventure (Morelia) while I was daydreaming about ours (Moorea).

 It’s becoming harder and harder to stay in this moment. Our thoughts are straying across the Pacific well ahead of our boat. And while the books I read and websites I visit are all about the South Pacific, we’re still here, in Barra. The thing is it becomes even more difficult to stay present once a place gets familiar. No matter how cool a spot it is, and how much it has to offer, it’s easy to get distracted and restless and dream only about getting gone.

 From the beach last night we headed to a fundraiser dinner the Sands Hotel. It’s the local cruiser’s hangout with a pool, cheap happy hour drinks, and, it turns out, an unusual mascot.

“Mum!! Dad!! The monkey stole my potato!!” Maia yelled as she raced up to us. I’m not sure how you react to stuff like this, but I just shrugged and told her she’d have to tell her unlikely story to the dinner’s organizers and ask for a new one. Evan, being the more imaginative parent, went to see who exactly had stolen her food and came face to face with a spider monkey.

 Somehow we’ve spent almost three weeks here and never noticed the monkey, despite the fact we walk past him every day. And somehow, this very simple realization reeled my thoughts back in from across the Pacific and planted them firmly back in Barra.

We’re not leaving Mexico for more than a month. And if I keep dreaming about being gone, I might miss the monkey. Literally.

Adventures in Messy Mexico

an evening performance

It’s easy to reach a point, when you don’t blog every day, where you end up with a backlog of pictures and stories. The impulse then is to do a long detailed ‘how I spent my summer vacation’ post that recounts surf landings and foredeck plays, dinners with friends and bus trips to other towns, drunk English barkeeps and meals served in sizzling molcajetes.

a molcajete

 But I’m terrible at making that sort of recitation interesting (although if you make it to Barra, head to Veleros and order a molcajete of mixed seafood—if you’re lucky it will be amazing…). And the other option—writing six separate stories, would probably keep me from having time to hang out on the beach and watch Maia play in the surf…

dinner aboard

 So I’ll just move on.

we saw the staircase and had to see where it led 

 Somehow my parent’s three-week holiday with us has sped by. I guess if there was a theme it was explore. Most days we met midday and went somewhere. Sometimes we went on foot, sometimes by bus, but typically we set out with only the mildest notion of where we were going.

an unexpected beach on the other side of the stairs

 The other day our plan was to walk across Isla Navidad to the outer beach. We had the same directions, and set off around the same time as our friends from Hanacrew, but somehow we ended up at different beaches. And one evening Evan and I went to a bar (thanks to babysitting grandparents)--we’d had it described several ways, by several different people, but none of what we were told resembled the cute boy band with its lead singer who struggled through English songs, his hand gestures and facial expressions coming a little out of sync with the words; or the mixed crowd of hard drinking expats, local tourism employees, and middle-aged holiday makers dancing urgently to ‘Pretty Women’...

“Not everyone can appreciate the unpredictable messiness of Mexico,” Estevan, the innkeeper at my parent’s hotel, told us after one outing that went unexpectedly but turned out happily. He and his wife run Hotel Delfin, a little inn that’s been in his family for 27 years, and we often turned to him for suggestions of what to do, or explanations of life in Mexico.

exploring the canals of Barra

He said that some people find it frustrating when they order the same dish, in the same restaurant, on different days and get two completely different meals--or when none of the things in the guide book are open, or even in the location indicated.

And I can see how this can be problematic. But if you have no (or limited) expectations and simply set off for a town you know nothing about, you can end up being thrilled with the banana plantations and mango orchards on the outskirts that you didn't know were there, or amazed by the skim boarders on a new stretch of beach rather than the being disappointed by not eating at the restaurant you just couldn’t find.

 And as our final weeks in Mexico are running out, I find myself embracing the oddities and unpredictability  of life here even more more. Before today I never knew that Valentines is a huge event, seemingly celebrated with roses, huge stuffed animals and sullen clowns who wander the streets foisting off balloon sculptures on  unsuspecting lovers. And I'm amazed by how much I love this new knowledge...

Stupid Steps

This will be one of those mostly photo-free blog posts. Not because I don’t want to share my stupidity, but because my stupidity lead to something that would make for ugly pictures…

One of the first things we tell visitors who are coming to Mexico is to bring comfortable shoes, suitable for rough terrain. Even if they insist they’ll never leave the city, we explain that Mexican sidewalks aren’t for sissies and frivolous shoes really have no place here.

 Then, once they get here, we point out all the dangers: crumbling pavement, stairs with big drop offs, loose cobble stones, collapsible sewer covers, leg eating gratings, washed out streets—that sort of thing. Once you get over the initial shock that people actually brave these hazards rather handily, and often in towering heels, you sort of forget about them.

 Which is how I found myself mid-intersection with my leg wedged up to my knee between the street and a metal grating.

Initially, my biggest concern was that I get myself removed from the street’s grasp quickly enough that I didn’t miss my bus. Then I realized I was sort of blocking the bus and it was dark, and there was a lot of traffic around. So my next concern was I extract myself before I was killed.

Once I was free I had other worries. My leg had a few large dents and less skin than I’d like, and it was also swelling and my toes had gone numb. I hobbled home with Evan and Maia watching me nervously but ended up looking better with a bit of first aid and a good amount of ice.

Now I just need something to treat my ego…

Bucerias Festival--Celebrating Life by Defying Death

 If Mexico had personal injury lawyers this country would be a lot less fun. Although I must say it’s become a much safer country over the past 15-years. Yes, there is that drug war stuff—but I’m talking about the fact your chance of being blinded by a random firework or injured on an unsafe children’s ride has been reduced considerably.

not sure how these shoes make sense anywhere let alone in a town of cobbled streets, but all the girls were wearing them...

But this is still a user beware kind of country. If something looks unsafe, appears poorly maintained, or seems like a bad idea—it probably is. It really is that simple. Beyond that, it’s a heck of a lot of fun to live without fences and warning signs and use your common sense when it comes to adventure.

Which brings us to last night:

 Festivals are the ultimate user-beware adventure: there are inebriated vaqueros with bb guns (whose pellets can ricochet back into the crowd even after they hit the target that makes the gorilla pee on their buddies…); there’s children’s rides that were either retired or condemned at some point in MY childhood; there are twelve-piece brass bands in every corner competing against the cacophony (and the performances on the main stage); and there are the fireworks.

 If Mexico didn’t already have a patron saint, I would have nominated the guy who invented fireworks. Their role in daily life really is really something to behold. Last night we realized we’ve probably seen more fireworks in our year here, than Maia had previously seen in her life to date.

the castillo before it's lit

 But last night’s lighting of the Castillo was something she’d never seen before. A Castillo (Castle) is a three story tower filled with fireworks. The fireworks go off in stages and as each stage fires, images appear and then spin--shooting sparks into the crowd. The show took about 20-minutes and culminated with Jesus’ crown flying off his head and into the sky where it exploded into overhead fireworks.

 And that was the point where we collected our very tired girl and caught a cab home. The revelry continued into the night—and no doubt the town will be very quiet today. But living with this kind of break-neck joy feels pretty right to us…

Isla Isabela

yes, mum, their feet really are blue

 I’m a terrible one for developing expectations of a place. I can’t say I ever end up really disappointed—but it’s just I have a really vivid imagination, so very few things live up to my own mental hype.

landing our dingy in the fish camp

 Isla Isabela looked like it might be one of these places. The guide books call the National Wildlife Preserve Mexico’s version of the Galapagos. And everyone we’ve spoken to has really loved it. We, however, have sailed by twice--both times unable to stop—either because of the weather or the hour (it’s not an anchorage to enter at night or in bad weather.) But this time we timed our arrival perfectly, we were early enough to hike the island and then have dinner before continuing south.

look for the little white-headed chick under the mama

 Isabela looks like a barren rock on approach. A barren rock that’s lousy with birds… In this respect it doesn’t seem much different than most of the islands we’ve visited this year. But once we were ashore we saw it was unique. I have never seen (or smelled) so many Frigate birds. They filled the trees, filled the sky and walked around on the ground beside us.

Trails crisscross the island and we headed through the jungle to the old volcanic crater (the source of the fresh water that supports the huge population) then around the crater lake and out to the bluffs.

Along the way we were treated to the sight of baby frigates peering out from their nests at us as well as the male frigates in full courting mode.

 Out at the bluffs we encountered the blue footed boobies. We understood there were some chicks around—but only saw the nesting birds and the courting males. Perhaps the fact the frigates were dive bombing the nesting birds was keeping the chicks in hiding.

We got a bit lost on our return hike and came across one of the many teams of researchers that have visited the island since Jacque Cousteau first made it famous—as we spoke briefly to them (and were set back on the trail) I wished we had longer to ask questions and really learn about this wondrous island.

A frigate going after a booby

 There is a wildness to Isabela that reminds us of all that is good in the world. And as we made our way back to the boat Maia spoke for all of us, “I’m so grateful we came here.”