Healthcare In Remote Areas: What You Need To Know

As an expat living abroad, there’s a chance you may end up living in a remote or isolated region. Even in our rapidly urbanising world, 43% of people still live in rural areas.

The appeal of living in the countryside is obvious. You’ll enjoy living in plenty of space, perhaps in a larger house with your own garden or plot of land, with ample opportunities for adventure on your doorstep.

However, pastoral living also has its downsides, and one of these is that you may find it harder to access high-quality healthcare. With less access to medical facilities, including emergency support, it’s important to understand your options when moving to a new country, and to have a plan for accessing healthcare if and when you need it.

What challenges do rural hospitals face?

Hospitals in rural and remote areas face a number of challenges that their urban counterparts do not. It’s important to be aware of these challenges, as they may affect your ability to access healthcare when you move abroad. Some of the challenges faced by rural hospitals include:

Smaller hospitals

Research from around the world shows that, while the numbers of hospitals are relatively similar in both urban and rural areas around the world, rural hospitals tend to be just one-third the size of those in cities.

Poorer resources

Urban hospitals tend to be much better equipped than rural hospitals. In India, for instance, 69% of the country’s hospital beds are found in urban hospitals, while in Brazil essential medical technology such as MRI machines are much more highly concentrated in cities, leaving some rural areas without any machines of their own.

Fewer staff

Another challenge faced by rural hospitals is attracting highly-qualified staff. Top healthcare professionals tend to flock to cities, where higher patient volumes and closer proximity to medical schools can help to enhance their careers. This can leave hospitals in rural areas under-stocked or even devoid of certain specialists. In the UK, for instance, rural hospitals have a hard time attracting GPs.

Longer travel times

Patients in rural areas also find it much harder to get to their nearest hospitals. In the USA, rural dwellers live an average of 10.5 miles from their nearest hospitals, while city dwellers usually live within just 4.4 miles. This means urban citizens also have a greater range of options when it comes to choosing a hospital. It also adds additional costs to those living in rural areas, who must pay more for transport to their nearest facilities.

Generally older populations

Another challenge faced by rural hospitals is that they tend to serve a much older population. For instance, in Spain, 11% of people in rural areas are aged 80 and above, compared to just 5% in urban areas. Since older people are more likely to present at hospital, rural hospitals may actually end up experiencing a higher workload.

Poor digital infrastructure

Finally, rural hospitals may face challenges when it comes to aligning themselves with technological standards. They may lack telecommunications infrastructure, or find it hard to employ technology experts, which make it difficult for them to offer the latest digital services. You may therefore find that modern conveniences such as video consultations are less common in rural areas.

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The furthest places on Earth from medical facilities

According to research published in Nature, a few regions on Earth are known for being the furthest away from any suitable medical facilities. These particular areas may involve patients travelling over 24 hours to reach their nearest high-quality medical facilities.

Australian Outback

While Australia’s coastal regions are well-stocked with hospitals, those living inland – and particularly the Gibson desert region in the west of the country – may find it incredibly difficult to access hospitals. Southwestern Tasmania is another region that is not well-stocked with hospitals.

Saudi Arabia

While the Saudi Arabian capital of Riyadh has over 100 hospitals, the rest of the country – particularly the region to the south of the Arabian Peninsula – has limited availability of healthcare services. Those living in the desert regions of Jordan, southern Iraq and northern Yemen may encounter similar difficulties.

Northern Canada and Alaska

The sparsely populated northern regions of Canada contain very few hospitals. Indeed, of the 1,017 hospitals in Canada, only 28 are in Nunavut and 21 are in Northwest Territories. Yukon has just 8 hospitals for the whole region. It’s a similar story in Alaska, where hospitals tend to be found only in the major towns and cities.

Saharan Region

Those who fall sick in the Sahara Desert are in for a long journey to their nearest hospital. The entire region travelling through Western Sahara and Mauritania, via Mali, Algeria, Niger, Libya, Chad, Sudan and Egypt is a black spot for medical facilities.

Amazon Region

The sparsely populated interior of South America is once again a black spot for hospitals. Those living or visiting the Amazon rainforest region, encompassing northwestern Brazil along with parts of Peru, Colombia and Venezuela, may find themselves in need of a plane ride to their nearest hospital.

Himalayan Region

While India and China have over 100,000 hospitals between them, the Himalayan region that separates them is notoriously poorly stocked. This is particularly true in the Chinese region of Tibet, which has just 7 hospitals in 474,000 square miles.

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New Guinea

The island of New Guinea, which includes the Indonesian province of Papua and the country of Papua New Guinea, has some of the lowest numbers of hospitals in the world. Papua New Guinea faces a particular health crisis, whereby despite 80% of its 10 million population living in isolated areas, rural hospitals are closing rapidly, leaving large regions without good access to healthcare.

Sunda Islands

The Greater and Lesser Sunda Islands, which includes regions such as Java, Borneo and Bali, are spread between the countries of Indonesia and Malaysia and also includes the country of Brunei. Many of the Sunda Islands are well stocked with hospitals (with 14 hospitals to itself, Bali is a popular destination for medical tourism) while others may have no hospital at all. The central provinces of Borneo also do not have a hospital.

Patagonia

The wild region of Patagonia, which straddles Argentina and Chile, is notoriously sparsely populated. As such, hospitals can be very hard to come by, particularly in the southernmost regions.

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What to expect from living in a rural area

If you intend to move to an isolated region in a foreign country, you will need to be prepared to face certain complications when it comes to accessing healthcare. These include:

Long journeys to hospitals

Living in a rural region, there’s a strong probability that your nearest hospital will be a considerable journey away from your home. As such, you may not be able to depend on ambulatory care in an emergency, as ambulances may need to travel a considerable distance to reach you. This can have a significant impact in emergency situations, or if you intend to give birth.

If you intend to live alone, you will need to prepare an emergency response protocol for times when you will not be able to transport yourself to hospital. This may include purchasing a panic alarm, which will allow you to summon the emergency services with just the press of a button. You may also wish to consult with your closest neighbours, in case you need to call on them for emergency support or transport to a hospital.

Being prepared to treat yourself

If you will face a long wait for the emergency services, you or your partner should be prepared to administer first aid while you wait. You may wish to attend a first aid course to ensure you know the necessary skills, such as CPR, getting someone into the recovery position, preventing choking, and bandaging a wound.

You should also keep your home well-stocked with medication and first aid equipment. You may want to ask your GP for additional stock of medication, to ensure you’ll never run out. If you have allergies, you should always keep a supply of EPIPENs around the house. If you have diabetes, make sure you keep a good supply of insulin. And if you suffer from asthma, you should always have a spare inhaler close at hand.

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Less access to specialist services

Rural hospitals tend to be less well equipped, both with highly-trained staff and top-of-the-line medical equipment. You may find that your nearest rural hospital lacks certain types of medical specialists, or equipment like CT and MRI scanners.

In these cases, you will need to be prepared to travel further afield for specialist treatment. Depending how far it is to your next-nearest hospital, this may incur significant expenses.

Higher medical expenses

While the cost of treatment tends to be cheaper in rural hospitals, you may find the cost of secondary expenses to be far higher. If you need to take an ambulance over a long distance, or be transported by air, this can add a significant extra cost to your hospital bill. And, if your nearest hospital is too far to travel there and back from in a single day, you may need to pay extra to book a hotel room for the night.

These costs will become apparent if you need to attend a hospital for routine treatments, such as chemotherapy.

More emergency planning

Living in a remote area, you will need to have a strategy in place for if and when you encounter an emergency. This may involve getting in touch with services such as your local air ambulance (if you will need to be airlifted to hospital), mountain rescue and sea transport services (for instance, if you live on an island, or may require emergency sea or river transport).

Before setting off on your new life in a remote region, it’s important to know who you can contact in your region. This is especially true if you will need to register with these services, and you may also be required to make supplementary insurance payments to these services providers.

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The importance of medical evacuation (medevac) insurance

If you intend to live in a rural or remote area, you may wish to consider taking out international health insurance that includes medical evacuation insurance.

Medical evacuation insurance may be helpful if:

You will be living on an island, in a jungle or in a desert area without high-tech medical facilities
You will be living a long way away from your nearest major city
You will be living in an area that does not have its own advanced medical facilities

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Medical evacuation insurance gives you the peace of mind to know that you will always be able to reach a high-quality hospital, wherever you are. This includes transport by land, sea and air, and even transport into other countries, or to your home country.

Medical evacuation insurance with William Russell

At William Russell, all of our international health insurance policies include medical evacuation insurance as standard.

As a William Russell member, we’ll ensure you’re always able to reach your nearest high-quality medical facility or hospital. Depending on your coverage zone, this policy can extend from your own front door to any remote region anywhere in the world – so you can travel freely with total peace of mind.

With William Russell, your medical evacuation insurance covers the cost of your return transport to a hospital via land, sea or air, plus the cost of a friend or family member you wish to travel with you, and accommodation for your travel companion. We will even transport you across national borders, or back to your home country when necessary.

You also have the option to upgrade to our Medevac Plus policy, which offers extended accommodation for your companion, a lower threshold for evacuation, advanced repatriation costs, plus a medical escort to travel with you if you do not travel with a companion.

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Go anywhere with total peace of mind

At William Russell, we have over 30 years’ experience helping expats just like you settle into their new lives overseas.

We offer flexible policies to suit your needs, offering you access to a network of over 40,000 private medical facilities, hospitals and clinics across the globe, and all of our policies include medical evacuation insurance as standard.

Find out more about our international health insurance policies and get a quote online in under two minutes today.

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