Many medicines requiring a doctor's prescription at home don't require one in Belize; drugstores often sell prescription antibiotics, sleeping aids, and painkillers. However, pharmacies generally have a very small inventory, and only the most commonly prescribed drugs are available. In Belize private physicians often own an associated pharmacy, so they sell you the medicine they prescribe. A few pharmacies are open 24 hours and deliver directly to hotel rooms. Most hotel proprietors will direct you to such services.
Sand flies (also sometimes referred to as no-see-ums, or as sand fleas, which are a different insect) are common on many beaches, cayes, and in swampy areas. They can infect you with leishmaniasis, a disease that can cause the skin to develop sores that can leave scars. In rare cases, the visceral form of leishmaniasis, if untreated, can be fatal.
Use repellent containing at least a 30% concentration of DEET to help deter sand flies. Some say lathering on Avon's Skin So Soft or any oily lotion such as baby oil helps, too, as it drowns the little bugs.
The botfly or beefworm is one of the most unpleasant of Central American pests. Botfly eggs are deposited under your skin with the help of a mosquito, where one can grow into larva, a large living worm. To rid yourself of your unwanted pal, cover the larva's airhole in your skin with Vaseline, and after it suffocates you can remove it with a sterile knife. Or see your doctor. The good news is that unless you spend a lot of time in the bush in Belize, you are unlikely to encounter botflies.
Virtually all honeybees in Belize and Guatemala are Africanized. The sting of these killer bees is no worse than that of regular bees, but the hives are much more aggressive. Farm animals and pets frequently are killed by Africanized bees, and in 2013 a young Mennonite boy in northern Belize died after being stung hundreds of times in his backyard. If attacked by Africanized bees, try to get into a building, vehicle, or under water; protect your mouth, nose, and other orifices.
Scorpions are common in Belize and around Tikal. Their stings are painful, but not fatal. There are many venomous snakes in Belize and lowland Guatemala, including the notorious fer-de-lance and small but deadly coral snakes. Most visitors never even see a snake, but if bitten can go to medical centers for antivenom.
Crocodiles (called alligators by many Belizeans) are present in many lagoons and rivers, but very rarely are they known to attack humans.
Divers and snorkelers may experience "itchy itchy" or pica pica, a skin rash, in spring and early summer, when the tiny larvae of thimble jellyfish may get on the skin. Putting Vaseline or other greasy lotion on the skin before entering the water may help prevent the itch, and applying Benadryl, vinegar, or even Windex to the affected area may help stop the itch.
If you're a light sleeper, you might want to pack earplugs. Monkeys howling through the night and birds chirping at the crack of dawn are only charming on the first night of your nature excursion.
Food and Drink
Belize has a high standard of health and hygiene, so the major health risk is sunburn, not digestive distress. You can drink the water in Belize City, the Cayo, Placencia, on Ambergris Caye, and in most other areas you're likely to visit, though you may prefer the taste of bottled water. In remote villages, however, water may come from shallow wells or cisterns and may not be safe to drink.
On trips to Tikal or other areas in Guatemala, assume that the water isn't safe to drink. Bottled water—agua mineral or agua pura in Spanish—is available even at the smallest tiendas (stores) and is cheaper than in the U.S. or Canada. Eating contaminated fruit or vegetables or drinking contaminated water (even ice) could result in a case of Montezuma's revenge, or traveler's diarrhea. Also skip uncooked food and unpasteurized milk and milk products.
HIV/AIDS is an increasing concern in Central America. This is especially true in Belize, where the incidence on a per capita basis is the highest in the region.
According to the U.S. Centers for Disease Control and Prevention, there's a limited risk of malaria, hepatitis A and B, dengue fever, typhoid fever, and rabies in Central America. In most urban or easily accessible areas you need not worry. However, if you plan to spend a lot of time in the jungles, rain forests, or other remote regions, or if you want to stay for more than six weeks, check the CDC website.
In areas where malaria and dengue are prevalent, sleep under mosquito nets. If you're a real worrier, pack your own—it's the only way to be sure there are no tears. Although most hotels in Belize have screened or glassed windows, your room probably won't be completely mosquito-proof. Wear clothing that covers your arms and legs, apply repellent containing at least 30% DEET, and spray for flying insects in living and sleeping areas.
There's no vaccine for dengue, but you can take antimalarial pills; chloroquine (the commonly recommended antimalarial for Belize and Guatemala) is sold as Aralen in Central America. It must be started a week before entering an area with malaria risk. Malarone is prescribed as an alternative, and it can be started only two days before arrival in a risk area. Don't overstress about this: in Belize there are fewer than 1,000 reported cases of malaria a year, mostly in the far south, actually fewer cases than are reported in the United States. In Guatemala, El Petén is a risk area.
You should be up-to-date on shots for tetanus and hepatitis A and B. Children traveling to Central America should have current inoculations against measles, mumps, rubella, hepatitis, and polio.
United States Centers for Disease Control & Prevention (800/232–4636. www.cdc.gov.)
World Health Organization (www.who.int.)
Medical Insurance and Assistance
Consider buying trip insurance with medical-only coverage. Neither Medicare nor some private insurers cover medical expenses anywhere outside of the United States. Medical-only policies typically reimburse you for medical care (excluding that related to preexisting conditions) and hospitalization abroad, and provide for evacuation. You still have to pay the bills and await reimbursement from the insurer, though.
Another option is to sign up with a medical-evacuation assistance company. A membership in one of these companies gets you doctor referrals, emergency evacuation or repatriation, 24-hour hotlines for medical consultation, and other assistance. A few credit cards, such as American Express Platinum, include medical evacuation among their perks. International SOS Assistance Emergency and AirMed International provide evacuation services and medical referrals. MedjetAssist offers medical evacuation.
Medical Assistance Companies
AirMed International (205/443–4840 or 800/356–2161. www.airmed.com.)
MedjetAssist (800/527–7478. www.medjetassist.com.)
International Medical Group (800/628–4664 or 317/655–4500. www.imglobal.com.)
International SOS (www.internationalsos.com.)
Wallach & Company (800/237–6615 or 540/687–3172. www.wallach.com.)