Unfortunate for those people but a cruise ship is not a hospital. It cannot be responsible for caring for haert attack victims and therefore will transfer them to a nearby hospital.
The extra insurance cost for medical evacuation via air ambulance for someone who is elderly or a previous existing condition is worth it.
I was treated in an ER at a Cozumel hospital for a dislocated shoulder. The ER was clean, doctor and nurses were very competent, and the drugs were GOOD. I had it checked by the ship doctor and he was impressed by the work done at the ER.
Never, though, would I accept a blood transfusion at a Third World country.
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