Buy insurance before you leave home
This is the one non-negotiable. Get a policy that explicitly covers medical evacuation, not just clinic bills; helicopter retrieval from a remote plateau is the expensive scenario, and it’s the one your card’s free insurance usually excludes. Check that it covers what you’re doing — skiing, trekking above a certain altitude, scooters — because a policy that quietly omits “hazardous activities” can leave you exposed on a bike in the countryside. I buy a standalone annual policy and photograph the certificate and the emergency number; you won’t want to hunt PDFs while queasy at altitude. Fold it into the same pre-trip checklist as your apps so it’s done in one sitting, before excitement about the trip pushes it off the list.
Where to get care in the cities
Major cities have international-standard clinics geared to expats and travelers, and they’re far better than a random hospital ER for a foreigner with limited Chinese. In Beijing, Shanghai, Guangzhou, Chengdu, and Shenzhen, look for an “international medical center” or a named expat clinic — staff speak English, they take foreign insurance directly, and they won’t blink at a sprained ankle or a bout of food poisoning. For anything serious, go there first rather than a crowded public hospital where the language gap adds stress to an already bad day. Keep one clinic’s address and phone saved per city you visit; I keep a notes folder titled “doctors” with the three I might need. Know too that public hospitals in big cities are world-class if it’s an emergency — the ERs are efficient, just bring patience and a translation app.
Pharmacy basics you can buy over the counter
Chinese pharmacies (药店) are everywhere and well stocked. Common OTC items: anti-diarrhea tablets, oral rehydration salts, basic painkillers (ibuprofen or paracetamol), motion-sickness patches, throat lozenges, and a small tube of antibiotic cream for scrapes. Bring your own if you have a specific brand, but don’t panic if you run out — a pharmacist will usually understand “肚子疼” (stomach hurts) or “头疼” (headache) and point you right. One caveat: some Western brand names differ, and a few cold medicines here contain ingredients restricted back home, so read the packet or show it to a clinic if unsure. For regular prescriptions, carry a copy of yours in case you need a refill, and keep medicines in their original boxes at customs.
Food and simple stomach sense
The single most common issue is simply a gut adjusting to new bacteria and more oil than it’s used to. Ease in — don’t eat eight street snacks the first night, however good they smell. Bottled water is cheap and everywhere; I skip tap water for drinking and brush with it cautiously. Cooked food from busy stalls is generally safer than sad-looking buffets, because the turnover is high and the wok is hot. Peel it, boil it, or forget it is the old line, and it still mostly holds. A day of plain congee fixes most mild stomach turns faster than any pill.
Routine vaccinations worth a thought
Nothing exotic is required for most of China, but make sure your routine shots — tetanus, hepatitis A, typhoid — are current before you go, since you’ll eat from places a careful home kitchen wouldn’t approve of. Hepatitis A in particular is worth it if you’ll be eating street food for two weeks. Talk to a travel clinic at least a month out; some vaccines need a series. This is the boring part of the pre-trip checklist, but a sore arm at home beats a fever in a town with no English-speaking doctor.
Altitude: the one real risk
This is where “ordinary” stops. The Qinghai–Gansu loop and anywhere on the Tibetan plateau sits well above 3,000 meters, and altitude sickness doesn’t care how fit you are — I’ve seen marathon runners fold at 4,000 meters. The rules that actually work: ascend gradually, build in a night at a middle altitude before going higher, drink more water than feels necessary, and skip the first-day exertion. At Mount Gongga and similar peaks, base camps start high — plan acclimatization days, not just summit pushes. Know the warning signs: a pounding headache that worsens with rest, breathlessness at rest, loss of coordination, confusion. Those mean descend, not rest, and descent is the only reliable cure.
A doctor’s blunt advice
A physician in Lhasa once told me the tourists who get into trouble are the ones who fly straight to 3,600 meters and immediately go for a run or a hike. Don’t be that person. Prescription altitude meds exist (acetazolamide, and in some cases dexamethasone for real emergencies) and are worth discussing with your GP before a plateau trip; buy them at home where you can ask questions and learn the dose. A pulse oximeter in your bag costs little and tells you more than guesswork when someone feels off.
Eat for the altitude
Up high, carbs and warmth help, and the local food is built for it. Tibetan cuisine — butter tea, noodle soups, momos, tsampa — is exactly the heavy, hot fuel a cold plateau demands, and it’s a nice change from the Han Chinese staples you’ll have eaten for weeks. Eat often, drink constantly, and go easy on the alcohol, which hides altitude effects and dehydrates you faster.
None of this is scary. China is an easy place to stay healthy if you respect the altitude, sort insurance at home, and know which clinic to walk into. The bugs pass; the views don’t.