Armed gangs operate in outlying residential areas, although police anti-crime efforts have somewhat reduced this problem. Armed highway robbery in rural areas is common, especially in the dry season from December until May. When a crime does occur, the victim may have to pay to send a vehicle to pick up police officers due to the shortage of police vehicles. The loss or theft abroad of a U.S. passport should be reported immediately to local police and the nearest U.S. embassy or consulate. U.S. citizens may refer to the Department of State's pamphlet, A Safe Trip Abroad , for ways to promote a more trouble-free journey.
Medical facilities are limited, and the quality of acute care is unreliable.
Sanitation levels are low. Many medicines are not available. Travelers are advised to bring their own properly-labeled supplies. U.S. medical insurance is not always valid outside the United States. U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States.