medical facilities in Colombia are generally of good quality, but may be expensive. Medical facilities in many areas of rural Colombia are limited. Most medicines are generally available, but can be costly. Medical care is adequate in major cities but varies greatly in quality elsewhere. Emergency rooms in Colombia, even at top-quality facilities, are frequently overcrowded and ambulance service can be slow. Many private health care providers in Colombia require that patients pay for care before treatment, even in an emergency. Some providers in major cities may accept credit cards, but those that do not may request advance payment in cash. Uninsured travelers without financial resources may be unable to obtain care, or relegated to seeking treatment in public hospitals where care is far below U.S. standards.Travellers to Colombia must be sure to take preventative measures, pack enough mosquito repellent and wear concealing clothing. A yellow fever vaccination is recommended for all travellers. Visitors should not drink tap water, unbottled beverages or drinks with ice. Fruit and vegetables should be peeled, cooked and eaten while piping hot. Avoid undercooked meat or fish. Medical care is adequate in major cities but varies in quality elsewhere. Medical insurance is essential. Travelers with circulatory or respiratory problems should consult a physician before traveling to Bogota or other high-altitude locations.