Skip to main content
CountryReports

Travel and Tourism

Travel and Tourism in Panama

Travel alerts, currency, climate, transit, health, and safety information for visitors to Panama.

Practical Information

Travel alert status, currency, climate, and transit details.

Travel Alert Status
Level 2: Exercise Increased Caution
Time Difference
UTC-5 (same time as Washington, DC, during Standard Time)
Currency
balboa (PAB); US dollar (USD)
Climate
tropical maritime; hot, humid, cloudy; prolonged rainy season (May to January), short dry season (January to May)
Language(s) Spoken
Spanish is the official language although many Panamanians in business and the professions speak English.
Ethnic Groups
mestizo (mixed Amerindian and white) 70%, Amerindian and mixed (West Indian) 14%, white 10%, Amerindian 6%
National Holiday
Independence Day (Separation Day), 3 November (1903)
Geographic Coordinates
9 00 N, 80 00 W
Location
Central America, bordering both the Caribbean Sea and the North Pacific Ocean, between Colombia and Costa Rica
Airports
103

Destinations

Regions and cities, top sights, national parks, UNESCO sites, and festivals for visitors.

Panama City — Where Two Oceans Meet

Panama City is unlike any other capital in Central America. While many visitors arrive expecting a colonial city frozen in time, what they find instead is a gleaming, hyper-modern skyline of glass skyscrapers that rises dramatically from a Pacific waterfront, a city that has experienced one of the most rapid economic transformations in the Western Hemisphere over the past two decades. The skyline of Panama City, particularly as seen from the Amador Causeway at sunset, is genuinely extraordinary — a dense cluster of towers that rivals Miami or Singapore in its visual impact, all the more dramatic for being surrounded on nearly every side by water or jungle.

Yet Panama City is not merely a city of towers and shopping malls. It contains layers of history that reward the curious traveler who ventures beyond the obvious. The most significant of these layers is Casco Viejo, the Old Quarter, which UNESCO declared a World Heritage Site for its remarkable collection of colonial architecture, crumbling grandeur, and ongoing transformation. Casco Viejo — also known as the Historic District or Casco Antiguo — occupies a small peninsula on the Pacific waterfront southwest of the modern banking district, and walking its narrow streets is an experience that bounces constantly between past and present. Here you find baroque church facades slowly being restored alongside boutique hotels that have moved into former abandoned mansions; trendy rooftop bars overlooking the Pacific next to crumbling buildings whose upper floors are occupied by families who have lived there for generations; art galleries and craft shops where a few years ago there were only weeds growing from the cracked sidewalks.

The district's history begins in 1673, when the new city of Panama was founded here after the original Panama City — now called Panama Viejo — was sacked and burned by the Welsh privateer Henry Morgan in 1671. Morgan's raid on the original city was one of the most audacious and destructive pirate attacks in Caribbean history: he led an overland force across the isthmus from the Caribbean coast, defeated the Spanish defenders, and looted and burned the city that had been for a century and a half the gateway through which all the silver of the Inca Empire passed on its way to Spain. The new city was built on the more defensible peninsula that is now Casco Viejo, with sea walls on three sides and fortifications at the only land approach.

In Casco Viejo today, the Plaza de la Independencia is the civic heart of the district, surrounded by the Metropolitan Cathedral, the Palacio Municipal, and former hotels that have been converted into museums and cultural spaces. The Catedral Metropolitana, with its distinctive towers decorated with mother-of-pearl mosaics, dominates one side of the plaza and is one of the most visually striking church facades in the country. The Palacio de las Garzas, the Presidential Palace, named for the herons that used to inhabit its inner courtyard, faces the sea and can be visited at certain times. Its ornate rooms reflect the ambitions of Panama's early republican elite.

The Iglesia de San José, tucked into a quieter street in Casco Viejo, contains what is arguably the most famous object in all of Panama: the Golden Altar, a massive baroque altarpiece sheathed in gold leaf that was, according to tradition, saved from Henry Morgan's raid by a quick-thinking friar who painted it black to disguise its value. The story may be apocryphal, but the altar itself — all twisted columns, gilded saints, and exuberant ornamentation — is real and spectacular. It is one of the finest examples of colonial religious art to survive in the Americas.

For a different perspective on Panama City's extraordinary diversity, the Frank Gehry-designed Biomuseo — formally known as the Biodiversity Museum of Panama — occupies a striking building on the Amador Causeway whose multicolored angular roof can be seen from considerable distances. Inaugurated in 2014, the Biomuseo tells the story of how the formation of the Isthmus of Panama, which connected North and South America approximately three million years ago, triggered one of the greatest evolutionary events in the history of life on earth. The closure of the seaway between the Atlantic and Pacific drove the divergence of marine species on either side; the land bridge allowed the Great American Biotic Interchange, in which animals evolved separately on the two continents suddenly had access to each other's territories. This geographic event is why North America has pumas and South America has jaguars, why there are llamas and tapirs but no elephants, and why Panama today is one of the most biodiverse places on earth. The museum's galleries are designed to be experiential rather than merely informational, and the building itself is worth visiting for its Gehry architecture alone.

The Amador Causeway, originally built using rock excavated from the Culebra Cut during canal construction, extends into the Pacific from the former Canal Zone and connects three small islands — Naos, Perico, and Flamenco — to the mainland. It is now a recreational promenade where Panama City residents cycle, jog, and gather on weekends, with the canal channel on one side and the open Pacific on the other. The views of the city skyline from the causeway, particularly at golden hour when the towers glow in the setting sun while container ships glide silently toward the canal entrance in the background, are among the most memorable in all of Panama.

Ancon Hill, rising above the edge of the former Canal Zone just west of Casco Viejo, provides the best elevated view of both the city and the canal entrance. The hill, which was the headquarters of the US Canal Zone administration, is covered in forest and accessible by a trail from its base. From the summit, you can see the Pacific Ocean, the canal's Pacific entrance, the full sweep of Panama City's skyline, and, on clear days, a remarkable visual compression of the entire country's geography: skyscrapers in the foreground, jungle-covered hills behind them, and the glittering water of the Pacific Bay below.

No account of Panama City's geography would be complete without mentioning the extraordinary fact that one of the world's great birdwatching destinations lies within the city's boundaries. The Metropolitan Natural Park, which borders the western edge of the banking district, provides urban birders with access to 280 species of birds within easy taxi or Metro reach of the city center. Toucans, antbirds, flycatchers, raptors, and dozens of other species can be seen from the park's trails, and it is entirely possible to see a troupe of white-faced capuchin monkeys from a Panama City hotel balcony. The city itself, built on a bay that provides feeding habitat for hundreds of species of shorebirds and wading birds, is a more remarkable wildlife destination than almost any city of its size anywhere in the world.

Gamboa, a former Canal Zone town about 30 kilometers north of Panama City along the canal banks, serves as a gateway to the extraordinary birdwatching of Pipeline Road and the Soberanía National Park. The park protects the watershed above Gatun Lake and contains some of the most intact lowland tropical forest in Central America. Dozens of specialist lodges and tours operate from Gamboa, offering birdwatching, canopy tours, night walks, and boat trips on the canal itself.

The Pearl Islands

About 70 kilometers off Panama City in the Gulf of Panama, the Pearl Islands archipelago comprises an extraordinary collection of islands, islets, and reefs that have been famous for their natural riches since the earliest days of European exploration. Vasco Núñez de Balboa, the Spanish conquistador who in 1513 became the first European to see the Pacific Ocean, collected pearls from the archipelago on behalf of King Ferdinand of Spain, establishing a tradition of pearl harvesting that would last for centuries and leave the islands with their permanent name.

The archipelago today is best known internationally as the filming location for the American reality television series Survivor, which used the spectacular beaches and crystal waters of the Pearl Islands for its seventh season in 2003. This exposure introduced the islands to a global audience who had previously been largely unaware of their existence, and tourism has grown considerably since, though the islands remain far less developed and commercialized than Caribbean island destinations of comparable scenic quality.

Contadora, the most visited and most developed island in the archipelago, offers comfortable hotels, restaurants, and day-trip infrastructure within a 20-minute flight or 90-minute speedboat ride from Panama City. The island is small enough to walk across in an hour, but its beaches — particularly the aptly-named Playa de las Suecas (Beach of the Swedish Women) and the sheltered Playa Cacique — are among the finest in Panama, with white sand, clear water, and the sense of isolation that comes from being genuinely far from any urban center. Contadora has a history that goes beyond tourism: during the Cold War, the island was a meeting place for regional diplomacy, and the Contadora Group — Panama, Colombia, Mexico, and Venezuela — negotiated here over Central American peace agreements in the early 1980s.

Isla del Rey is the largest island in the archipelago and remains largely undeveloped, with small fishing communities and inland forest that harbors wildlife rarely disturbed by visitors. The island's extensive beaches, rivers, and mangrove systems offer extraordinary opportunities for exploration by visitors who arrange private boat access, and the surrounding waters are renowned for sport fishing: wahoo, dorado, yellowfin tuna, and Pacific sailfish are among the target species in waters that are considered among the finest sport fishing in the Pacific.

The marine environment of the Pearl Islands is exceptional across the entire archipelago. The upwelling of cold, nutrient-rich water from the deep Pacific creates conditions that support extraordinary concentrations of marine life. Humpback whales are reliably present from July to October, when they migrate from their Antarctic feeding grounds to calve and mate in the warm waters of the Gulf of Panama. The spectacle of humpback whales breaching, tail-slapping, and singing in the waters around the Pearl Islands, with the distant Panama City skyline visible in the background, is one of the most extraordinary wildlife experiences available anywhere in the Americas. Pacific manta rays, which gather in feeding aggregations around the archipelago, provide snorkelers and divers with close encounters with animals that can reach wingspans of five meters or more. Whale sharks — the world's largest fish — are also sighted in the archipelago's waters, and dive operators offer trips that provide the once-in-a-lifetime experience of swimming alongside these gentle filter-feeding giants.

All UNESCO World Heritage Sites in Panama

Panama is home to five UNESCO World Heritage Sites, a remarkable collection for a country of its size and one that reflects the extraordinary diversity of natural and cultural heritage compressed into this narrow isthmus.

Darién National Park (1981)

Darién National Park, inscribed in 1981, was one of the first UNESCO World Heritage Sites in Central America and remains one of the most significant natural heritage designations in the Western Hemisphere. The park covers approximately 575,000 hectares in the southeastern corner of Panama, encompassing ecosystems that range from coastal mangroves and coral reefs to lowland tropical forest, highland cloud forest, and the high-altitude summit areas of the Serranía del Darién and Serranía de Pirre mountain ranges. The park contains the full range of habitats present in the Neotropical biogeographic region and serves as a critical corridor for the movement of wildlife between North and South America.

The biodiversity of the Darién National Park is staggering. The park protects over 500 species of birds, including the harpy eagle, Panama's national bird, whose enormous size — females can weigh up to nine kilograms with a wingspan of over two meters — makes it the largest eagle in the Americas by weight and wingspan. The park also protects populations of jaguar, puma, ocelot, margay, jaguarundi, tapir, giant anteater, white-lipped peccary, collared peccary, deer, howler monkey, spider monkey, capuchin monkey, and dozens of other mammal species. The Darién is one of the few places in Central America where populations of these large mammals remain viable rather than merely residual, and its conservation is therefore critical not just for Panama but for the long-term survival of these species throughout the region.

La Amistad International Park (1983)

La Amistad International Park, jointly designated by Panama and Costa Rica and inscribed on the UNESCO World Heritage List in 1983, is the largest protected area in Central America and one of the most important conservation initiatives in the region's history. The park covers approximately 401,000 hectares on the Panamanian side (in the Chiriquí and Bocas del Toro provinces) and approximately 200,000 hectares on the Costa Rican side, with the two national protected areas forming a contiguous trans-boundary reserve that protects the entire upper watershed of both countries' major rivers.

The name La Amistad — "Friendship" in Spanish — reflects the spirit of international cooperation that the park embodies, and it has served as a model for trans-boundary conservation initiatives around the world. The park protects an extraordinary range of altitude zones, from lowland Caribbean forest below 100 meters to páramo grasslands above 3,000 meters at the highest points of the Talamanca mountain range. This altitudinal diversity creates a corresponding diversity of habitats and species: the park is home to resplendent quetzals, three-wattled bellbirds, tapirs, jaguars, pumas, ocelots, giant anteaters, and hundreds of endemic plant species found nowhere else on earth. Several indigenous groups, including Ngöbe-Buglé and Bribri communities, maintain traditional territories within or adjacent to the park and have been involved in its management and protection.

Coiba National Park and Its Special Zone of Marine Protection (2005)

Coiba National Park, inscribed as a UNESCO World Heritage Site in 2005, protects Coiba Island — the largest island in Central America — and the surrounding Pacific waters, including the second-largest coral reef in the eastern Pacific Ocean. Located about 60 kilometers offshore in the Gulf of Chiriquí, off the western coast of the Azuero Peninsula, the park covers approximately 270,000 hectares of land and sea. The isolation of Coiba Island — which was used as a penal colony for most of the twentieth century, restricting human access and development — has allowed its forests and marine environments to remain in an exceptional state of preservation.

The marine environment of Coiba is extraordinary. The park sits at the confluence of cold, nutrient-rich upwelling currents from the south and warm Pacific water from the north, creating conditions that support remarkable concentrations of large marine life. Whale sharks, humpback whales, orcas, scalloped hammerhead sharks, enormous schools of fish, sea turtles, dolphins, manta rays, and hundreds of species of reef fish inhabit the park's waters, and the diving and snorkeling are considered among the finest in the eastern Pacific. The island itself supports a population of Coiba white-fronted capuchins, a subspecies of the white-faced capuchin monkey found nowhere else on earth. The island's forest also harbors populations of scarlet macaws, which are common here but have been extirpated from most of their former range in Pacific-facing Panama. Access to Coiba requires advance permission from the Panama National Environmental Authority (ANAM) and is typically arranged through authorized dive operators based in Pedasí, Las Lajas, or Santa Catalina.

Outdoor Adventures and Nature

Panama's extraordinary natural endowment, combined with a growing adventure tourism industry, makes it one of the most rewarding destinations in the Americas for travelers who want to be physically active in spectacular natural settings. The range of activities available — from technical mountaineering to gentle nature walks, from expert-only surfing to beginner-level kayaking, from deep-sea fishing to cave exploration — is remarkable for a country of Panama's size.

The summit climb of Volcán Barú, Panama's highest peak at 3,475 meters, is the most demanding and most rewarding of the country's major hiking challenges. The standard route ascends from a trailhead above the town of Boquete on a steep, unpaved jeep track that gains approximately 2,400 meters of elevation over about 14 kilometers. Most climbers begin around midnight — headlamps are essential — in order to arrive at the summit at dawn, before clouds gather and block what is, on clear days, the only place in the world where you can simultaneously see both the Atlantic and Pacific oceans. The summit area, at 3,475 meters, can be bitterly cold and windy, and appropriate clothing is essential. A guide is not strictly necessary for this route, but is highly recommended for first-time visitors who may not be familiar with the trail's junctions and the rapidly changing mountain weather.

The Lost Waterfalls trail outside Boquete provides a more accessible hiking experience that is still physically engaging and rewarding. The trail passes three waterfalls of increasing height and force, threading through cloud forest that is excellent for birdwatching, particularly in the early morning hours. The largest waterfall, the third on the trail, drops approximately 40 meters through a narrow basalt gorge and is genuinely spectacular. The trail is well-maintained and appropriately signed, and the combination of forest scenery, waterfall drama, and birdwatching opportunity makes it one of the best half-day nature walks in Central America.

El Valle de Antón, a small town built inside the caldera of an ancient extinct volcano about two hours west of Panama City, offers an extraordinary concentration of natural attractions in a compact area. The Valley — as it is universally known — sits at around 600 meters elevation and enjoys a significantly cooler climate than the capital, making it a popular weekend escape for Panama City residents. The El Chorro Macho waterfall, accessible by a trail from the edge of town, plunges nearly 35 meters in a single drop surrounded by orchids and bromeliads. Hot springs at La India Dormida and on the outskirts of the valley provide thermal bathing in natural pools. The El Nispero Zoo and botanical garden houses a collection of Panama's wildlife, including the critically endangered golden frog (Atelopus zeteki), a small yellow frog with distinctive black spots that has become a symbol of Panama's biodiversity and its conservation challenges. The El Valle Amphibian Conservation Center, associated with El Nispero, is working to breed the golden frog in captivity in an attempt to prevent its extinction.

White-water rafting on the Chiriquí River and its tributaries provides some of the best technical white water in Central America, with runnable sections for all skill levels. The upper Chiriquí gorge offers expert-only class V rapids in a spectacular canyon setting, while the lower sections provide excellent class II and III water appropriate for families and beginners. The rivers of Bocas del Toro province, flowing from the La Amistad mountains to the Caribbean coast, also offer good rafting and kayaking opportunities with the added attraction of wildlife-rich jungle surroundings.

Surfing in Panama has grown dramatically as an activity and a driver of tourism over the past decade. Bocas del Toro's reef breaks attract surfers from throughout Central America, with the best waves typically occurring between December and March. Santa Catalina, a small Pacific coast village near Coiba National Park, is considered by many experts to be the best surf spot in Panama, with powerful point and beach breaks that handle a range of swell sizes. Playa Venao on the Azuero Peninsula has developed into a surf community with good infrastructure and reliable waves. For beginners, numerous surf schools in Bocas and on the Pacific coast offer lessons in calm water before progressing to smaller waves.

Festivals and Events

Panama's calendar is rich with celebrations that reflect the country's diverse cultural heritage, from pre-Lenten carnivals that rival anything in Latin America to indigenous festivals, independence commemorations, and international jazz gatherings of considerable prestige.

Carnival is Panama's most spectacular popular celebration, occurring in the four days before Ash Wednesday — usually in February. While Panama City hosts a large Carnival, the most famous celebrations take place in the interior provinces, particularly in Las Tablas in the Los Santos province and in Penonomé in the Coclé province. Las Tablas Carnival has a legendary reputation as the finest in Panama and among the best in Central America: the town is divided into two rival neighborhoods — Calle Arriba (High Street) and Calle Abajo (Low Street) — each of which parades queens, floats, costumes, and comparsas (dance troupes) in fierce and entirely good-natured competition. The culecos — parades during which water is sprayed on the crowds from fire trucks and water tankers — are particularly beloved in the intense February heat. The combination of music, dancing, traditional dress, and communal exuberance makes Las Tablas Carnival one of the most genuinely joyful public events in the Americas.

The Panama Jazz Festival, held annually in January in Panama City, has grown over the years since its founding in 2003 into one of the most internationally recognized jazz events in Latin America. Founded by Panamanian jazz pianist Danilo Pérez, the festival brings world-class musicians to free outdoor concerts in the city's parks, attracting both serious jazz aficionados and casual listeners. The festival's combination of accessible programming, world-class talent, and the setting of the Panama City waterfront has made it a highlight of the January events calendar throughout the region.

The Boquete Coffee and Flower Festival (Feria de las Flores y del Café) occurs in January each year in the Chiriquí highlands and celebrates the two things that have made Boquete famous internationally: its extraordinary coffee and its year-round flower cultivation. The festival includes coffee tastings and competitions, floral exhibitions of remarkable horticultural diversity, cultural performances, traditional food vendors, and the opportunity to visit nearby farms during a period when they are prepared for visitors. The event has grown considerably in recent years and now attracts visitors from throughout Central America and beyond.

The Bocas del Toro Festival of the Sea (Festival del Mar) takes place in October and celebrates the maritime heritage and Afro-Caribbean culture of the archipelago with boat races, traditional music, dance performances, and seafood events that showcase the region's culinary traditions. The festival is also an important moment for environmental awareness about the marine ecosystems that sustain the archipelago's communities.

Portobelo's Diablos y Congos festival, which takes place during Carnival season and continues until Easter, is one of the most culturally significant African-derived traditions in Panama. The Congos tradition — which has been performed continuously in the Afro-Panamanian communities of the Caribbean coast for over three centuries — reenacts the history of the cimarrones (escaped slaves) who established free communities in the Panamanian jungle and resisted capture. The "Devil" of the Diablos y Congos is not a Christian devil but a symbol of Spanish colonial oppression, and the ritual drama plays out in elaborate improvised dialogue, dances, and theatrical confrontations between the Congos and the Devils, using a special form of invented language accessible only to community insiders.

November is Panama's month of independence celebrations, with a cascade of patriotic observances: First Call of Independence (November 10, commemorating the 1821 declaration of independence from Spain in Villa de Los Santos), Independence Day (November 3, commemorating independence from Colombia in 1903), and Flag Day (November 4). The November celebrations are particularly intense in Panama City, where parades, military ceremonies, and cultural events fill the streets.

Day Trips and Excursions from Panama City

Panama City's position as the logistical hub of the country makes it an ideal base for day trips and short excursions that reveal the astonishing diversity available within a short radius of the capital. Within two hours of the city's center, travelers can experience the Panama Canal up close, walk through primary tropical forest, visit an indigenous community, explore colonial ruins, take a boat across a man-made lake that is one of the engineering wonders of the region, and return to the city in time for dinner at a rooftop restaurant overlooking the Pacific.

The town of Gamboa, about 30 kilometers north of Panama City along the canal banks, is a former Canal Zone residential community that has been partly repurposed as a center for nature tourism. The Gamboa Rainforest Resort operates a variety of nature experiences including an aerial tram through the forest canopy, a botanical garden, a serpentarium, and one of the most comprehensive wildlife rescue and rehabilitation facilities in the country. The resort sits at the confluence of the Chagres River and the Panama Canal, and from its elevated position you can watch both canal traffic and the wildlife of the forest simultaneously. The Chagres River itself, which was dammed to create Gatun Lake, can be explored by boat from Gamboa, passing through gallery forest that supports abundant birdlife and offering the possibility of visiting Emberá communities on the river's upper reaches.

The Miraflores Locks, as described elsewhere in this guide, can be combined with the Panama Canal Museum in Casco Viejo for a comprehensive full-day exploration of Panama's most famous landmark. The Panama Canal Railway — a restored train that runs between Panama City and Colón along the route of the original 1855 Panama Railroad — provides a memorable perspective on the canal zone landscape and passes along the shores of Gatun Lake before arriving at the Caribbean coast. The train journey takes approximately one hour in each direction and runs Monday through Friday, carrying both business commuters and tourists. The views from the train, which runs along the canal's edge for portions of the route, are excellent for birding and wildlife observation.

The ruins of Panama Viejo, the original Spanish colonial city sacked by Henry Morgan in 1671, are accessible by taxi from anywhere in Panama City in about 20 minutes. The archaeological zone is compact enough to explore thoroughly in two to three hours, and the adjacent museum provides essential context for what you see in the ruins. Combining Panama Viejo with a walk through Casco Viejo on the same day is perhaps the single best introduction to Panama City's layered history: you begin at the ruins of the city that defined Panama's colonial importance and end in the elegantly decaying and actively reviving streets of the colonial quarter that replaced it.

Transport Between Regions

Getting between Panama's main regions is relatively straightforward, with a combination of air, bus, and boat connections that cover the country efficiently. The David-Panama City route, covering the length of the Inter-American Highway through the central provinces, is served by comfortable long-distance buses that run both day and overnight services and take approximately six to seven hours. The highway passes through the provinces of Coclé, Veraguas, and Chiriquí, offering views of the central mountain range and passing through the distinctive landscape of the Azuero Peninsula turnoff. Bus travelers can break the journey in Santiago, Chitré, or other provincial towns to explore the heartland of traditional Panamanian culture.

The journey to Bocas del Toro by land involves crossing the continental divide on the Chiriquí Highland road — a spectacular mountain journey in itself — before descending to the Caribbean coast and crossing by ferry to the archipelago from the port of Almirante. The entire journey from Panama City by land and boat takes approximately ten to twelve hours and requires an overnight stay in David or Boquete to break the trip comfortably. Most visitors to Bocas del Toro opt for the 40-minute domestic flight from Panama City, but the overland journey offers an extraordinarily diverse cross-section of Panamanian landscapes.

The road to El Valle de Antón branches off the Inter-American Highway about 100 kilometers west of Panama City and climbs through sugarcane and cattle country before ascending into the extinct volcanic caldera where the town sits. The journey from Panama City takes about two hours by car or by direct bus from the Albrook bus terminal, and is comfortable enough for day trippers while offering sufficient attractions for a multi-night stay.

Health and Safety

Medical facilities, vaccinations, disease risk, and sanitation conditions.

Medical Facilities and Care

Medical Facilities and Health Information
Panama City has some very 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. Many foreign doctors and hospitals require payment in cash prior to providing service. Medical evacuation to the U.S. may cost well in excess of $50,000. In Panama, most hospitals accept credit cards for hospital charges, but not for doctors' fees. Except for antibiotics and narcotics, most medications are available without a prescription. The 911 call center also provides ambulance service. However, an ambulance may not always be available and, given difficulties with traffic jams and poor road conditions, there may be a significant delay in response. There are also private ambulance services available on a subscription basis. Panama is actively promoting medical tourism, and many companies are now offering vacation packages bundled with medical consultations for assisted reproduction technology treatments, dental procedures, and a wide range of plastic surgery. While there are advantages, like affordable costs, quality health care, and a chance to recuperate while vacationing, there are also risks. Individuals considering plastic surgery should always make sure that emergency medical facilities are available in or near the facility where the surgery will be performed. Some “boutique” plastic surgery operations offer luxurious facilities but are not hospitals and are therefore unable to deal with unforeseen emergencies. Dengue and Malaria: Prevention of mosquito bites is the best way to avoid these illnesses. Use of topical repellants and wearing long sleeves and pants are recommended in areas affected. Dengue fever outbreaks have been occurring annually in Panama in both urban and rural areas, this is a mosquito borne virus that can cause fever, severe headache and body aches, it can also cause severe disease with bleeding and even death. Dengue carrying mosquitoes are different than those carrying malaria and bite during the day and frequently live in homes and hotel rooms. Malaria, also mosquito borne, occurs in rural areas of Panama. Malaria in Panama is almost exclusively P. vivax (P. falciparum transmission is minimal and limited to areas east of the Canal Zone). Transmission occurs throughout the year. Malaria Chemoprophylaxis is recommended for all travelers: throughout the provinces and comarcas of Darién, Kuna Yala (including the San Blas Islands), Kuna de Madugandi, Kuna de Wargandi, and –Emberá. Protective measures: Evening and nighttime insect precautions are essential in areas with any level of malaria transmission. Atovaquone/proguanil (Malarone or generic), doxycycline, and mefloquine are protective east of the Canal Zone. For the exceptional case of a vulnerable traveler with underlying medical conditions and/or the potential for an especially adverse outcome from malaria, chloroquine and other antimalarials (atovaquone/proguanil, doxycycline, and mefloquine) are protective west of the Canal Zone. Drug choice should be discussed with your medical provider before travel. Traveler's Diarrhea: Moderate risk exists even in deluxe accommodations; high risk exists elsewhere. Food and beverage precautions are essential to reduce the likelihood of illness. Diarrhea risk can be minimized by avoiding fresh fruit and vegetables that cannot be peeled or are not cooked and served hot. Tap water is not safe to drink in many areas of Panama, and visitors should use bottled water. Traveling with antibiotics such as ciprofloxacin or levofloxacin and the antimotility agent loperamide in case of diarrhea should be considered. You can find detailed information on vaccinations and other health precautions on the Centers for Disease Control (CDC) website. For information about outbreaks of infectious diseases abroad, consult the World Health Organization (WHO) website, which contains additional health information for travelers, including detailed country-specific health information. Tuberculosis is significantly more common in Panama than in the US. Although no particular precautions are recommended those with extended stays (more than 3 months) or extensive contact with disadvantaged populations should discuss with their medical provider TB testing before and after their travel to Panama.
Accessibility
While in Panama, individuals with disabilities may find accessibility and accommodation very different from what you find in the United States. Panamanian law only mandates access to new or remodeled public buildings for persons with disabilities, which is being enforced for new construction. While some public buses and buildings do accommodate wheelchairs, many do not. Handicapped parking is often available at many larger parking lots.

Disease Risk

Degree of Risk
intermediate
Food and Waterborne Diseases
bacterial diarrhea
Vectorborne Diseases
dengue fever