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Transylvania - Health and safety
With Dr Felicity Nicholson
If you are living in one of the member states of the European Economic Area (EEA) plus Switzerland you should obtain a European Health Insurance Card (EHIC) before travelling to Romania, in order to allow free or reduced-cost access to healthcare provided by the statutory healthcare system. If you are resident in the UK you can apply for an EHIC on the NHS website, free of charge.
No vaccinations are legally required, but it is wise to be up to date with routine vaccinations such as the diphtheria, tetanus and polio and measles, mumps and rubella vaccines. Hepatitis A should also be considered – a viral infection which is spread by infected food and water. For those who are going to be working in hospitals or in close contact with children, or for those whose activities otherwise put them at increased risk, hepatitis B vaccination may be recommended. Typhoid vaccine may also be considered for longer-stay travellers.
A 2010 report by the Health Protection Agency in the UK categorised Romania as a country of intermediate-level risk for travellers’ diarrhoea, so you should exercise usual good practice around frequent hand-washing, choosing freshly prepared, well-cooked food served hot, and avoiding tap water if in doubt about the quality of the local water (although it is fine to drink in many places), but there is no need to get obsessive.
Rabies has been reported in both domestic and wild animals in Romania. Visitors should be wary of, and try to avoid, contact with stray dogs and sheepdogs guarding flocks in the mountains. But remember rabies can be carried by any warm-blooded mammal and not just dogs! If bitten, scratched or simply licked visitors should thoroughly clean the wound immediately with soap and water, and seek an urgent local medical assessment, even if the wound appears a minor one.
Another risk to be aware of is posed by the humble tick, again a particular concern for trekkers, mountain-bikers and anyone whose Romanian holiday plans are more focused on the countryside than the cities. Ticks are most active between spring and autumn, and typically at altitudes below 1,500m. Infected ticks can carry a viral infection called tick-borne encephalitis (TBE). The foothills of the Carpathians in Transylvania are among the areas presumed to be infected. You may wish to ask about vaccination, particularly if planning to camp or hike in Transylvania. The website Tick Alert has more information about TBE.
Lyme disease is another infection spread to humans by ticks, and in this case there is currently no vaccine available to prevent it. The most distinctive symptom, though not everyone with Lyme disease experiences it, is a circular rash at the site of the bite, usually between three and 30 days after being bitten, often described as similar in appearance to the bull’s-eye on a dartboard. Fever, chills, fatigue, muscle aches and a headache may accompany the rash. Early treatment, usually by means of antibiotics, should prevent the emergence of more serious later symptoms.
Mosquitoes can be irritating, but fortunately not more than that, as Romania does not fall within a malarial area. Take a good supply of insect repellent and cream. Other health risks to be aware of are those connected with the sun and altitude.
Travel clinics and health information
A full list of current travel clinic websites worldwide is available on ISTM. For other journey preparation information, consult NaTHNac (UK) or CDC (US). Information about various medications may be found on NetDoctor. All advice found online should be used in conjunction with expert advice received prior to or during travel.
The vast majority of visits to Romania are trouble-free, and Transylvanian cities and villages alike are welcoming and feel safe. Violent street crime is very rare in Romania. In many villages, where everyone knows everyone else, doors are left open and children run around until late at night. As anywhere though, you should maintain a good level of personal security awareness. Petty theft does occur, with pickpockets operating in crowded places frequented by tourists, including airport terminals and railway stations, and on public transport, especially busy buses. Thefts of valuables from hotel rooms are also a risk, as worldwide, and you should use hotel safes if available. There are occasional reports of scams, sometimes involving thieves impersonating plain-clothes policemen and asking to check documents as a way of trying to syphon away some cash, or involving demands for on-the-spot payments of fines for fictitious offences. The incidence of this type of activity seems to be declining, and you are highly unlikely to encounter anything like this.
The tragic fire at the Club Colectiv nightclub in Bucharest on 31 October 2015, which resulted in the deaths of 64 people, highlighted the risks of some venues circumventing fire safety and other rules. If you do not feel safe in a club or restaurant, you might wish to choose somewhere else.
Road safety is an issue in Romania, and the statistics are not at all encouraging. Road deaths in Romania in 2015, for example, equated to 9.5 per 100,000 people, against 2.8 in the UK over the same period. Aggressive and poor driving seem to go hand in hand in Romania, and the risks are compounded by the sheer variety of vehicles on many Romanian roads, all travelling at different speeds, from horsedrawn carts to BMWs. Constant vigilance is required when driving a hire car. If you are unlucky enough to have an accident, do not leave the site or attempt to move the car. You should call the police and make sure that you obtain a copy of the police report, as you will need it for your insurers.
In an emergency
The common phone number for all emergency services in Romania is 112. It covers the police, ambulance, General Inspectorate for Emergency Situations, gendarmerie (an agency with military status responsible for defending public order) and SMURD, a mobile emergency service for resuscitation and extrication. Call centres are usually able to respond in English. The only additional emergency number you might need, and should have ready if you are planning any climbing or remote trekking in Romania, is that of the mountain rescue service Salvamont: 0725 826 668, or 0Salvamont for phone keypads featuring letters as well as numbers.
Conservative attitudes are still pretty common in Transylvania, and women travelling on their own are likely to encounter some surprise from the locals at the idea, particularly if the women in question should enter such traditionally male preserves as the village bar. But with the right precautions and security awareness it is unlikely to be a dangerous experience, and Transylvanian friendliness and hospitality usually win out. While you will see women of all ages hitchhiking, particularly in rural areas with little or no public transport, it would, however, be particularly risky for a single woman traveller to attempt to do so.
Travelling with children
Transylvania can be a great place to travel with children, given the diversity of its attractions and links to all sorts of themes that fascinate young ones, from vampires to dinosaurs, medieval knights to bears. Entrance tickets for children to most attractions are considerably reduced. Many hotels offer cots for babies and small children; you are more likely to have to pay a charge for these at more expensive hotels, while they are often given free of charge where available at pensions. Highchairs for children are available in many restaurants.
Travellers with a disability
Disabled travellers will find Transylvania a challenge. Its towns, with their winding, cobbled streets, frequently with cars parked astride pavements, are not wheelchair-friendly. Buses in some cities offer wheelchair access, but these are still far from the standard. And a surprisingly large number of hotels and guesthouses lack lifts. Awareness in Romania of the needs of disabled people is patchy too. A Bucharest based charity providing training for guide dogs for the blind found during trials in local stores and supermarkets that many outlets were unwilling to grant an exception to their policies of no dogs in the store to guide dogs.
There are signs of positive changes being made, including the provision of ramps to allow wheelchair access to banks and hotel receptions. But it still seems in all too many towns that, for every accessible restaurant, there are half a dozen more for which the only access is down a steep flight of stairs. One relative exception to the overall somewhat gloomy picture is in the more modern of the spa resorts, where hotels are more likely to offer spacious lifts and rooms fitted out to meet the needs of guests with disabilities. Romanians are, however, very willing to help where they can. Useful sources of general information for travellers with disabilities include the website of Tourism for All UK, the Rolling Rains Report and the UK Government’s site.
Gay and lesbian travellers
The lesbian and gay community in Romania faced persecution during the Communist period. Article 200 of the Penal Code, introduced by Ceauşescu in 1968, criminalised homosexual relationships. The repeal of the last vestiges of Article 200, and thus the final decriminalisation of all same-sex sexual activity, only took effect in 2002. Attitudes towards gays, lesbians, bisexual and transgender people are often unsympathetic, and at the time of writing a campaign was underway promoted by a group of organisations calling themselves the Coalition for Family for a referendum aiming to revise the Constitution in such a way as to prevent any possibility of the introduction of gay marriage in Romania.
The major non-governmental organisation in Romania campaigning for the rights of lesbian, gay, bisexual and trans-gender people is Asociaţia ACCEPT, which organises the annual Bucharest Pride parade in May. The university city of Cluj-Napoca has a reputation as the most gay-friendly city in Transylvania, and has a number of gay and gay-friendly bars and clubs. Elsewhere, conservatism tends to increase with decreasing settlement size. You are less likely to face prejudice when booking into larger hotels than family-owned guesthouses, but of course there are many exceptions. And it would be wise to be cautious about public displays of affection, especially in smaller communities.