Although such demonstrations are usually peaceful, travelers are urged to exercise caution when in areas where large groups are gathered. Air travel within Russia is often unreliable, with unpredictable schedules and difficult conditions, including deterioration of the quality of service. Russian based airlines certified to operate internationally meet higher standards than domestic-only air carriers and fly to most domestic destinations. Inclement weather and lack of routine maintenance of roads and vehicles make road conditions throughout Russia highly variable. Drivers and pedestrians should exercise extreme caution to avoid accidents, which are commonplace.
Many accidents involve drunk drivers.
Access to the few quality facilities that exist in major cities usually requires cash payment at Western rates upon admission. The U.S. Embassy and consulates maintain lists of such facilities and English-speaking doctors. Therefore, travelers may wish to check their insurance coverage and consider supplemental coverage for medical evacuation. Elderly travelers and those with existing health problems may be at particular risk. It is helpful to carry a letter, in Russian, from your health care provider, describing the nature of any personal medication that you carry into Russia.