Updated: May 28, 2020
This year brought disturbing reports of visitors mysteriously falling ill, and, in a handful of cases, dying in the Dominican Republic. It sounded bad — maybe even trip-cancelling bad. But assessing the risk of visiting a particular destination is always complicated.
Dominican authorities argued that the number of fatalities this year is not out of the ordinary for the two million Americans who visit each year. The U.S. State Department seems to agree: Its travel advisory for the country is still at Level 2, or “Exercise increased caution,” the same level as France.
It's worth paying attention to such reports, of course, but they can be a distraction from the problems you're far more likely to encounter when you travel.
Tips for avoiding the most common, though still relatively rare, threats to travelers:
1. Drive carefully and wear your seatbelt. The leading cause of death among Americans abroad, according to State Department data, is motor vehicle accidents. Over the past decade, car, bus, motorcycle and train accidents have killed an annual average of 224 American drivers, passengers and pedestrians while abroad.
It can be easy to slack off on good habits on vacation, especially in nations where wearing seatbelts has yet to catch on. But if anything, you should be more cautious, especially in developing countries where road conditions can be bad and brake inspections rare. If you're renting a car, consider spending extra to rent a high-quality one, or hire a local driver instead. And stay off the two-wheeled motor vehicles entirely unless you're an experienced rider.
2. Be careful in the water. Drowning is another surprisingly common cause of death for Americans abroad, killing more than 120 Americans per year. (It also kills thousands in the United States.) So, tempting though the turquoise waters in that hidden cove may be, don't swim in lifeguard-free areas if you're not a strong swimmer. Of course, don't drink and swim. And you know those hilarious photos of “NO SWIMMING” signs with hundreds of people in the water behind them? Don't appear in them.
Keep the threat of terrorism in perspective. Of course you should worry about terrorism ... and be prudent. But by the numbers, terrorism is an extremely minor danger for Americans traveling abroad. Of the 84 Americans killed by terrorist attacks in the last decade, only a fraction occurred in common tourist destinations, including ten in Europe, two in Istanbul and four in Jerusalem. (Thirty-three were in Afghanistan.) So make sure you maintain a proportionate view of the risk.
3. Follow the news. The Dominican Republic example notwithstanding, following the news is a good way to determine whether trouble – man-made or natural – is brewing in another country. Just be sure you're getting your information from 2019 and not from memories of news from decades past. Colombia, Nicaragua and Lebanon are not perfectly safe destinations, but they are far safer than they were when many of us got our first impressions of them. Supplement the news with State Department travel advisories by signing up for alerts through its free Smart Traveler Enrollment Program (STEP). You can always crosscheck that advice with similar services from the British and Australian governments, which have similar services.
4. Download important apps. “Someone call 112!” Would you know to yell that in Australia in case of emergency? If not, be sure you have an app like TravelSmart, free from Allianz Global Assistance. Its easy interface provides local emergency numbers and contact information for U.S. consulates and will locate pharmacies, hospitals and doctors near you, wherever you are. (And it will know where you are.) The free Sitata Travel Safe app will alert you to potential travel-disrupting events wherever you or your loved ones are traveling.
5. Stay fully charged. Neither those apps nor other valuable safety tools like Google Translate and Google Maps will work if your phone isn't charged. So keep a portable charger fully charged and with you at all times: It may help you get out of the woods, literally or figuratively.
6. Consider medical travel insurance. Do you need extra coverage? The answer may be easier if you depend exclusively on Medicare: When traveling abroad you are almost certainly not covered. In the U.S., you'll be covered everywhere, at least for emergencies.
If you have a private plan (including Medigap coverage), things get trickier. Get a representative of your plan on the phone and question them relentlessly. Are you covered for emergencies? What counts as an emergency? Will you have to pay out of pocket and then get reimbursed? What documentation do you need to bring back? What about non-emergencies? You'll also want to read up on the health system in your destination. Is there a public health service and is it good? Will you need to pay in cash in emergency rooms? Once you know, you can make a more educated decision.
7. Consider evacuation insurance. These policies cover the very expensive process of air-lifting you back to the United States in case of a serious medical condition. They also usually cover evacuation if political upheaval or war breaks out near you. It's a very reassuring thing to have, and plans for two-week vacations can cost well under $200.