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Transylvania - Health and safety
With Dr Felicity Nicholson
The standard of public health in Transylvania is good. However, be sure to take out adequate health insurance before setting off. No vaccinations are legally required but it is wise to be up to date with routine vaccinations such as diphtheria, tetanus and polio.
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, hepatitis B vaccination is recommended which is a course of three vaccines taken over a minimum of 21 days for those aged 16 and over and over two months for those under 16. Typhoid vaccine may also be considered for longer stay travellers.
General standards of healthcare in the towns are satisfactory but in the countryside it can be a long journey before you reach a qualified medical worker. Romanian doctors are educated, well trained and highly competent, but they are woefully underpaid and the system is underfunded. Emergency medical treatment is free, but you may have to pay for some medicines.
It is the custom in central Europe to tip the doctors and nurses because it is universally acknowledged that the state salary is ridiculously low. This is done by discreetly handing over an envelope containing lei or euros (between €20 and €100 or the equivalent in lei, depending on the severity of the problem). Foreigners who would like to tip can give it a go but the envelope may not be accepted.
During the communist era of careless factory practices, toxic chemicals penetrated deep into the soil. If in doubt, even in the countryside, don’t risk drinking tap water. Mineral water (apă minerală) is widely available, cheap and tastes good. Don’t risk tap water unless you’re sure it is from a spring source and don’t drink tap water in towns – I suffered a particularly nasty bout of giardiasis on one visit (I’m sure I caught it at the heavily polluted Copşa Mică railway station’s medieval loos), and I’ve felt nervous about tap water ever since. In restaurants, it is common practice for the waiter to bring a bottle of water to your table and open it in front of the guest, which is reassuring if you’re worried about a gippy tummy interrupting your hiking trip.
Stray dogs, deer and foxes roam the countryside and carry a risk of rabies. Rabies is endemic in Romania, but has largely been confined to the rural mountain areas. 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 licked over an open wound visitors should scrub the wound immediately with soap and water, apply an antiseptic and seek medical assistance as soon as possible.
If no pre-exposure rabies vaccine has been taken then treatment with the blood product Rabies Immunoglobulin (RIG) and five doses of vaccine over a month is necessary to prevent the disease. RIG is not always easy to come by but is an imperative part of post-exposure prevention unless you have had the pre-exposure course of vaccine in which case it is not needed. Pre-exposure rabies vaccine (three over a minimum of 21 days) is advised for all travellers but particularly if you are planning longer stays in more rural areas of Romania and is an absolute must if you are working with animals. The air content is relatively good as there is not so much heavy industry in Romania, but almost everybody smokes heavily and the concept of non-smoking areas in restaurants has been slow to catch on.
Travel clinics and health information
A full list of current travel clinic websites worldwide is available on www.istm.org. For other journey preparation information, consult www.travelhealthpro.org.uk (UK) or http://wwwnc.cdc.gov/travel/ (US). Information about various medications may be found on www.netdoctor.co.uk/travel. All advice found online should be used in conjunction with expert advice received prior to or during travel.
According to the Foreign Office, around 75,000 British nationals visit Romania every year and almost all visits are trouble-free. The main types of incident for which British nationals required consular assistance in Romania generally involves petty crime, lost or stolen passports and car theft. Visitors should be alert to the risk of petty theft in large towns, especially in Bucharest, and to pickpockets and bag snatchers in crowded areas, particularly near exchange shops, on buses (especially to the airport), main railway stations and inside airport areas.
There have been reports of policemen stopping foreign cars and demanding payment of fines in hard currency for spurious offences. Bogus policemen may also approach pedestrians and ask to check their documents as a way of stealing cash. If approached in this way, visitors should decline to pay any fine or hand over any documents but offer instead to go with them to the nearest police station or back to the hotel. British visitors have reported thefts of valuables including passports from hotel rooms. Items of value, including passports and credit cards, should be deposited in hotel safes.
Transylvania, especially in the rural areas, is a very safe place. In many villages where everyone knows everyone else, doors are left open and children run around until late at night. This is the place to find charming Old-World courtesy and good manners. People say Buna zuia/Jó napot kivánok (‘Good day’ in Romanian/Hungarian) to every single person in the street and elderly gentlemen tip their hats and greet ladies with respect.
Stray dogs are present throughout Romania and while aggressive in Bucharest, in the countryside they tend to be of a nervous disposition and easily shooed away. The ones to watch out for are sheepdogs when walking in the countryside. These are trained to protect the sheep from wolves – and tourists, as the local joke says – but it’s not funny if one attacks and hikers should always carry a big stick.
Another omnipresent danger is Romanian drivers who view all road journeys as an extreme sport. If I thought that Slovak locals were risky on the road, they are not in the same league as Romanians who have some of the worst road accident statistics in Europe. Tailgating, speeding and overtaking on bends and hills are widespread and the only way the local authorities in Cluj-Napoca could stop drivers from risking their own and everybody else’s lives was to build a low concrete wall along the middle of the road. Speed traps, cameras and heavy speeding fines have been introduced on highways but signs by the side of the road list the gruesome statistics of how many deaths and injuries occurred during the previous month.
For all her efforts following World War I, Queen Marie of Romania was dubbed ‘The only man in Romania’, but – of course – she had used a lot of eyelash fluttering and feminine wiles to get her way. For women travelling on their own in Transylvania the trip can be lonely without somebody to discuss the beauty of the view, but, taking the right precautions, it should not be dangerous. Entering a bar, women will get some strange looks anyway, as these are usually exclusively male domains.
In 1990, Dervla Murphy, then aged 59, cycled and walked around Transylvania a few months after the fall of Ceauşescu. In her evocative travelogue, Transylvania and Beyond she described how she set off walking across the countryside in the middle of the night, with nothing except some money, a few notebooks and minimal Romanian language skills after her rucksack was stolen from the train on the Hungarian–Romanian border near Arad.
In the memorable opening passages, Murphy hurls herself into Transylvanian life and does not appear to encounter too much sexism, apart from many funny sideways glances when she enters a pub on her own and downs a ţuică with the best of them.
Transylvania is still pretty old-fashioned in attitude and macho posturing is widespread, particularly on the road. Men are surprised and bemused by the idea of a woman on holiday without a male guardian. Romanians are not backward about coming forward and love to ask questions. If you can communicate with the village’s head grandma, be prepared for some pretty probing enquiries as to where your husband is, why he lets you travel alone, how you manage to drive a car and use a map without your lord and master, and who is at home feeding the chickens while you are off gallivanting.
You will often see women of all ages, but particularly grannies, hitchhiking. This will occur in regions where local buses are non-existent and while locals will be respected, tourists might be viewed as foolhardy, wealthy Westerners and could be taken advantage of. Hitchhiking should not be attempted by anyone on their own and only by two women with first-class local language skills.
Travellers with a disability
Transylvania is not very wheelchair-friendly. Many towns have winding, cobbled streets, which can make for a bumpy, uncomfortable ride. The Carpathian mountain range surrounds Transylvania on three sides and, while an ideal destination for hikers and skiers, is not designed with wheelchairs in mind and some hotels do not even have a lift to their upper floors. Having said that, larger towns such as Sibiu and Braşov have sensitively restored centres with a pedestrian heart built of smooth concrete, but side/back streets are riddled with pot-holes and bumps to make getting around a tiresome procedure.
Every bank and many hotels are supposed to have an entrance ramp and lifts to their upper floors, but many restaurants are situated in inaccessible cellars or up the side of a mountain. Conversely, almost all the spa hotels are designed for visitors with limited mobility and have a range of facilities and treatments.
In 2007, Bucharest introduced buses and trolleybuses with wheelchair access, although the steep metro escalators still need some skill to negotiate. Boarding trams is only possible if someone strong hauls the wheelchair up the very steep steps and on board. People always come to assist, but it’s hard going. Romanian trains are not equipped for wheelchairs, although you would never be short of willing helpers attempting to lift the chair up the vertiginous steps.
Look at Gordon Rattray’s website (www.able-travel.com) for advice on travel for not only people with physical disabilities, but also for those with sensory problems and the elderly who worry about climbing hundreds of steps, the availability of bathrooms and the possibility on some tours of a sit down and a rest. Other useful sites are www.globalaccessnews.com, www.tourismforall.org.uk and www.rollingrains.com.
If you are homosexual, then Transylvania is not the best destination for a fun, gay holiday. During the Ceauşescu period, many homosexuals were imprisoned and gay life was denied or firmly closeted. Homosexuality was decriminalised only in 2001, but the majority of the population is very religious and still finds the idea of it to be against nature. Gays, lesbians, bisexual and trans-gender people face daily prejudice and are forced to keep their private lives hidden. Gigi Becali, the right-wing, nationalist politician exploits the religious feelings of country folk and once offered a reward of millions to anyone who could ‘root out homosexuality in Romania’. Becali leads the PNG Party and said about the Eurovision Song Contest, ‘It’s just a show for faggots and mafiosi.’
The US appeared to be playing with fire when they appointed openly gay diplomat Michael Guest as US Ambassador to Romania who served from 2001–03. His same-sex partner even accompanied Guest to official functions. One wonders what the Bucharest cocktail party glitterati made of it. Mr Guest was, however, accepted by some members of society: when we were looking around the ancient Densuş Church in the Haţeg region, the severe-looking priest mentioned that Guest was instrumental in the US government’s funding of the church’s renovation. Accept ( is the country’s solitary gay organisation, registered in 1996. Another website with gay travel advice is www.gayromania.ro.