Panama - Introduction

Panama has no military forces. A constitutional amendment passed in 1994 permanently abolished the military. The Panamanian National Police (PNP) is principally responsible for internal law enforcement and public order. Other Panamanian Security Forces include the National Frontier Service (Servicio Nacional de Fronteras or SENAFRONT), the National Aero-Naval Service (Servicio Nacional Aero-Naval or SENAN), and the Institutional Protection Service (SPI--a secret service equivalent).

The Republic of Panama is home to 3.5 million people, a world famous canal and a modern financial sector that contributes to the country’s strong economic performance. At the same time, despite boasting the highest per capita income in Central America, rural poverty in Panama is quite high; in 2003, 54 percent of non-indigenous rural residents were poor, and 22 percent were extremely poor. Barriers to poverty alleviation include limited economic opportunities, a deteriorated natural resource base, an inequitable land tenure system, lack of access to microfinance and structural constraints that impede competition in the agriculture sector.

Malaria is a risk throughout the year in Boca del Toro, Darien and San Blas but is not a risk in Panama City. Outbreaks of the mosquito-borne illness dengue fever and Chikungunya virus also occur from time to time. Water-borne, food-borne and other infectious diseases (including HIV/AIDS, hepatitis, yellow fever, tuberculosis, rabies and brucellosis) are a risk with more serious outbreaks occurring from time to time. Panama is listed by the World Health Organization (WHO) as endemic for yellow fever. Yellow fever is a potentially fatal viral disease transmitted by mosquitoes, which is preventable by vaccination.

The reputed vectors of Chagas' disease are the reduviid bugs Triatoma dimidiata and Rhodnius pallescens. Many reduviid species are sylvatic and their habitats are associated with animal burrows or nests. However, peridomestic species are responsible for most disease transmission to humans. These bugs are typically associated with poor housing areas (i.e., habitations with adobe walls, thatched-roofs, and/or earthen-floors provide innumerable daytime harborage sites). Reduviids may also be associated with woodpiles, stored clothing, and pet or domestic animal shelters.

Algal blooms in coastal waters off Panama can result in contamination of reef fish, primarily barracuda, but also grouper, red snapper, amberjack, sea bass, and kingfish. Consumption of contaminated fish may cause ciguatera fish poisoning. Paralytic shellfish poisoning also was reported from Panama's northern pacific coast up through Guatemala in 2001. The acute health effects of ciguatera fish poisoning include nausea, diarrhea, vomiting, abdominal pain, muscular aches, inversion of hot and cold temperature sensations, and tingling and numbness of the lips and tongue. These symptoms may persist for up to several months. Cooking does not destroy the ciguatera toxin. The acute effects of paralytic shellfish poisoning normally appear within one hour and include tingling, numbness, burning of the lips, rash, and fever. In severe cases, paralytic shellfish poisoning may cause respiratory paralysis and death. Cooking does not destroy the toxin causing paralytic shellfish poisoning.

Panama has some good private hospitals and clinics, however, medical facilities outside the capital are limited. Many doctors and hospitals require cash payment prior to providing services, including emergency care. Panama City is known to have some good hospitals and clinics, but medical facilities outside of the capital are limited. Hospitals in Panama are either private hospitals or government-run public hospitals. Private hospitals typically require payment of the anticipated costs of hospitalization prior to providing services and require payment of any additional costs upon release from the hospital. These costs can be in excess of USD$10,000-$20,000, depending on the nature of the treatment.

In Panama, most hospitals accept credit cards for hospital charges, but not for doctors' fees and do not accept international wire transfers or credit card payments over the phone. Medical emergencies may require evacuation to a third country, most likely the US, where the cost of medical treatment can be extremely high. Medical evacuation costs would be considerable (in the tens of thousands of dollars).

Protests and demonstrations, primarily concerning local social and political issues, occur from time to time and are often centred on the campus of the University of Panama, the National Assembly, the Presidential Palace in Panama City and on main streets and highways. Avoid all demonstrations and protests as they may turn violent.

Use only registered taxis and, wherever possible, call a taxi rather than hail one off the street. Do not share taxis with unknown passengers and always sit in the back seat. Travel on local buses is not recommended as they do not follow permanent routes and, in terms of security and maintenance, are often unsafe.

Driving in Panama is often hazardous and difficult due to heavy traffic, undisciplined driving habits, poorly maintained streets and a shortage of effective signs and traffic signals. Night driving is particularly hazardous on the old Panama City – Colon highway. Riding your bicycle on the streets is not recommended. Road travel is more dangerous during the rainy season (April to December) due to flooding. Rainy season occasionally makes city streets impassible and washes out some roads in the interior of the country. In addition, roads in rural areas are often poorly maintained and lack light at night.

Road conditions, street lighting and vehicle maintenance are generally poor and driving at night is hazardous. Night construction on the Pan-American Highway is frequent, often with little or no signage to alert drivers. Travellers should keep windows closed and their doors locked at all times.

Petty crime, such as pick-pocketing and bag-snatching is common, especially in Panama City and Colon, at airports, bus terminals and on public transport. Violent crime, including armed robbery and muggings, is less common, but does occur throughout Panama. High-crime areas in Panama City include Calidonia, San Miguelito, Rio Bajo, El Chorillo, Ancon, Curundu, Veracruz Beach, Parque Soberania, Tocumen, Panama Viejo, Casco Viejo and shopping areas on Avenida Central. Travellers should avoid walking alone after dark in Panama City. Travellers have been targeted by armed criminals, especially at Madden Dam, a tourist site north east of Panama City in the Chagre National Park.

Access to the “Mosquito Coast” region is almost exclusively by boat and/or aircraft. Sections of this coastline are reportedly used for narco-trafficking and other illicit activities. Boaters should be wary of vessels that may be transporting narcotics, illicit materials, and illegal immigrants. Packages containing narcotics have been found floating in the ocean or lying on remote beaches.

The Pan American Highway ends at Yaviza in the Darién Province of Panama and does not continue through to Colombia. Governments advise exercising a high degree of caution in Panama due to high levels of criminal activity and incidents of civil unrest. They advise not to travel to the Darien Gap, beyond Yaviza, because of the risk of violent criminal activity, including Colombian guerrilla groups and drug traffickers. There have been numerous reports of kidnappings and murders (including of foreigners), armed robberies, injuries from recently-planted landmines, deaths and disappearances in this area. The dangerous zone begins at the end of the Pan American highway (at Yaviza, about 230km southeast of Panama City) and ends at the Colombian border. This area includes the Darien National Park and privately owned nature reserves and tourist resorts.