Scott Fairley could outwalk most other mortals.

Friends and family marveled at the 53-year-old’s stamina and love for hiking and biking. He walked his redbone coonhound up and down the hills of his Pendleton neighborhood and often backpacked into the wilderness with friends.

Despite Fairley’s robust health, he started having horrible abdominal cramps while vacationing with his family in Mexico during the holidays. At first, suspecting food poisoning, the Pendleton City Councilman toughed it out in his hotel room, waiting for the symptoms to pass. When the pain worsened, his wife and son called an ambulance. A doctor at the hospital discovered a rare aneurysm of the hepatic artery (an artery that supplies blood to the liver). Fairley and wife Kimbra Cook attempted all weekend to get authorization for surgery from their insurance company back in the United States.

“We could never get emergency authorization,” Cook said. “By Monday, we still didn’t have approval.”

Finally, Fairley and Cook decided to pay for the surgery themselves. Before the operation, however, the aneurysm burst and Fairley bled out. Had he received immediate surgery, he might have lived. But Cook will never know.

The couple is like many people who travel to foreign countries, optimistically assuming things will go well — until they don’t.

A medical emergency wasn’t on Fairley’s and Cook’s minds. They were only popping down to Mexico with their adult son Lieden for some fun in the sun. They snorkeled, bicycled, paddled sea kayaks and hung out on the beach in swimsuits and flip-flops. The vacation was perfect until Fairley was forced to retreat to his hotel bed.

The couple is not alone in leaving themselves vulnerable to health emergencies. Not by a long shot. According to a AAA report, only about 38 percent of American travelers buy travel insurance. A comparison of travel policies at the squaremouth.com site shows prices ranging from $42 to $845 that cover trip interruption, medical evacuation and medical care in varying amounts. Travel cancellation insurance bumps the cost further.

Buying such insurance is seriously worth considering, said Heather Hill, public health nurse and communicable disease program manager with the Benton Franklin Health District Travel Health Clinic in Kennewick, Washington.

“Most people don’t realize their U.S. policy doesn’t cover them in foreign countries,” Hill said. “Even if they do, it’s not uncommon for foreign hospitals to require payment upfront.”

The nurse said Medicare does not usually cover medical care outside the U.S. or its territories.

She didn’t become a travel nurse by accident. Hill, who loves to travel, was leaving the day after this interview for China, one of many places she and her husband have visited around the world. Hill has an adventurous palate and has consumed everything from Tibetan worm grass and yak steak to scorpions and snake wine. Eating such exotic food is one of the calculated risks she is willing to take, but she isn’t reckless. Depending on her destination, she usually purchases travel policies that include emergency care for illness or accident, evacuation and even cremation.

Hill takes other health precautions, too. Since she has a lung condition, she packs an ample supply of her prescription medications in their original bottles. She will carry 25 vials of antibiotics that she uses in her portable nebulizer.

“Liquid medications are exempt from TSA restrictions,” Hill said. “There’s a little card you can fill out and hand to the TSA agent.”

She packs over-the-counter medications for diarrhea, upset stomach, body aches, fever and constipation. Finding such medications in foreign countries can prove challenging, Hill said.

In her job at the travel clinic, Hill meets with people planning trips and makes recommendations. She advises them on which vaccines they need, depending on the destination. They talk about altitude sickness, malaria and other conditions.

“You need to learn about where you are going and about all the risks,” she said.

Harriet Isom, who lives in Pendleton, is a frequent traveler who learned many lessons of travel survival during Foreign Service stints in Africa, Asia, Indonesia, Laos and other locations. She served as the United States ambassador to Cameroon and Benin.

During a pleasure trip to Beijing, she learned the importance of special medical and evacuation insurance when a fellow traveler had a stroke. The tour guide got the Canadian man to a hospital that treated foreigners, but getting him admitted was a challenge.

“They would not accept him until the wife gave them a credit card that would pay for the services,” Isom said. “He was there for about a year until he was well enough to travel home.”

Isom’s travel insurance agent, Ani Ranian of Dick Ranian Travel Advisors in Lake Oswego told a story with a happier ending. Ranian relayed the account of a client suffering a recent medical emergency while vacationing in South America.

“During the third day of the trip, she went horseback riding and a dog ran out in front of the horses,” Ranian said. “The lady fell from her horse and broke her tailbone.”

The injury prevented the woman from flying home via commercial airlines. Her policy paid for medical care, lodging for her husband and an air ambulance back to the U.S. Experts recommend purchasing travel insurance to cover each trip for such things as emergency medical, evacuation and trip cancellation. 

“If you are 24 or 25 and traveling to Europe with your backpack, maybe not,” she said. “If you are middle age or older, it’s a necessity.”

Dr. Andrew Clark, Pendleton resident and former official veterinarian for the state of Oregon, travels with his health in mind. He often goes to East Africa where he serves as an international veterinary consultant.

“I always have the medical coverage and evacuation insurance, my U.S. insurance card and my cremation card on my person in any traveling I’ve done,” he said.

Clark said he also uses local water with caution.

“Good research has been done on faucets that shows quite a lot of resident bacteria, so for face washing and toothbrushing, I open the hot water tap, run it for five or 10 seconds to flush it out, then fill a water glass,” he said.

The idea he said is that the boiler or hot water heater will kill most of the bacteria and the flushing will reduce the risk even further.

The thought of possible medical risks can be daunting and many of us simply don’t dwell on it. Cook, who was schooled on this topic in the most brutal of ways, urges others to take time to prepare. Accident or illness can come when least expected.

“You don’t get to choose when you are going to be sick,” she said.

She advises people to contact their insurance companies before leaving and keep policy numbers and contact info with them. Locate emergency services facilities at every destination. If disaster strikes, call the American Consulate, which helped her get Fairley’s body home to Oregon.

“They’re there to advocate for you,” Cook said.

The whole experience still feels surreal.

“This took us by surprise,” she said. “I still expect to see Scott coming through the door.”