Pakistan Health Care and Vaccinations
* A yellow fever vaccination certificate is required if travelling from an infected area, although only if you are entering Pakistan within six days of leaving the infected country.
Outside of the major cities healthcare is very basic. You should take out comprehensive travel and medical insurance before travelling, including cover for medical repatriation costs. Seek medical advice before travelling to Pakistan and make certain that all appropriate vaccinations are up to date. Malaria exists in Pakistan, in coastal and low-lying areas. Dengue fever is a threat throughout. In a serious medical emergency the best option is to be evacuated. In an emergency your first point of call should be your embassy and insurance company. To call an ambulance, dial the Edhi Trust Ambulance Service on 115. The Edhi Foundation (www.edhifoundation.com) has eight hospitals in Karachi alone and a fleet of over 400 ambulances. It is funded almost entirely by private donations, 90% of which come from within the country.
Islamabad has several passable medical facilities. Shifa International (Sector H-8/4,Islamabad; tel: (51) 460 3666) - is regarded as the best in the city. In Lahore Mayo Hospital (Hospital Road, Lahore; tel: (42) 921 1100. In Karachi, the Aga Khan University Hospital is a good choice (Stadium Road, tel: (21) 493 0051) and takes credit cards.
Food and Drink
All water should be regarded as being potentially contaminated. Water used for drinking, brushing teeth or making ice should have first been boiled or otherwise sterilised. When buying bottled water check that the seal is intact and that it hasn't been tampered with. Never drink tap water and try to avoid fruit juices unless from a carton as they may have had contaminated water added to them. Milk is unpasteurised and should be boiled. Powdered or tinned milk is available and is advised. Avoid dairy products that are likely to have been made from un-boiled milk. Only eat well-cooked meat and fish, avoid shellfish and be wary of buffets. Vegetables should be cooked and fruit peeled. Try to choose busy restaurants where the food will have a high turnover.
Vaccinations against Japanese B encephalitis, tuberculosis and hepatitis A (a food and water borne virus) and B are sometimes recommended. Long-term travellers might want to consider having an immunisation against rabies.
In the mountains altitude sickness is a real peril and anything above 3,000m (9,843ft) is considered a risk. The key to avoiding this is to ascend slowly and sleep lower than the height reached that day. Avoid alcohol and keep hydrated. Paracetamol can help with headaches associated with altitude sickness. Earth tremors are frequent and mountainous areas frequently experience floods and landslides.
It is a good idea to pack a personal medical kit. Key items to include are DEET-based insect repellent, oral rehydration salts, decongestant, anti-inflammatory tablets, sunscreen and iodine to sterilise water (not good for pregnant women or those with thyroid issues).