Many diseases including dengue fever, brucelloosis and chagas disease are water-borne. Food-borne or insect-borne diseases can strike in Panama, and unfortunately there aren't any available vaccinations. The best cure for these types of diseases is prevention.
Use insect repellent at all times, and keep an insect net over your bed when you're sleeping in rural areas.
If you're arriving from Bolivia, Brazil, Colombia, Ecuador, Peru or Venezuela, you'll be required to present a valid Yellow Fever certificate to be allowed entry into Panama. Which presents a problem to pregnant women and children who are less than nine months of age, since Yellow Fever vaccine may not be safe for them.
Tap water in Panama City is generally safe to drink, however in rural areas it's best to boil all drinking water (for at least one minute), avoid ice cubes, and do not eat any raw or under-cooked food.
Don't swim in the Bay of Panama – doing so poses serious health risks, as it's polluted with untreated sewage and industrial waste. Seek medical advice if you have a fever, or are suffering from diarrhoea.
¡Llame una ambulancia! Which translates to "Call an Ambulance" – don't worry, if you do need emergency medical treatment, Panama has some good private hospitals and clinics. However medical facilities outside the capital are limited.
Panamanian doctors tend to be US trained, and the standards of the top hospitals compare favorably to US standards.
It's important to know that many doctors and hospitals require cash payment prior to providing services, including emergency care.
Medical emergencies may require evacuation to a third country, most likely the US, where the cost of medical treatment can be extremely high.
You may survive the drug cartels, street crime, and risks to your health, but you may not survive the dangerous ocean currents, severe tropical storms, earthquakes, floods or landslides that sometimes plague Panama.
Here's another useful Spanish word to commit to memory: ¡Socorro! Which means "Help!".
Many beaches on the Pacific Ocean side of Panama and in the Bocas del Toro Province have dangerous currents. The risks at these beaches are not signposted, nor are the beaches patrolled by lifeguards, so swimming is best avoided.
During the rainy season (April–December) occasional flooding and landslides occur in rural areas, and some city streets become temporarily impassable due to flooding. Listen for local warnings and information, and use your common sense if landslides to occur.
Earthquakes are a possibility in Panama. In the province of Chiriqui, near the border with Costa Rica, there have been a number of earthquakes above 5.5 on the richter scale. While they have not caused widespread destruction in recent years, you should familiarize yourself with your hotels' evacuation plan and again monitor local media.
Due to the risk of natural disasters, you should carry your travel documents at all times (i.e. passport, photo ID, etc.) or secure them in a safe, waterproof location. It's also a good idea to register your travels with your Embassy or Consular Representative on arrival in Panama.
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