2018 Soccer/Football Tournament - Russia

Transcription

1 Special Report Special Report: FIFA Tournament 2018 UnitedHealthcare Global Soccer/Football Tournament - will be hosting one of the biggest and most anticipated tournaments across the world from 14 June 15 July With the finals expected to take place in at the Luzhniki Stadium, the tournament will be played in 12 venues across 11 cities in the Western part of. This report provides intelligence on the overall healthcare environment and security concerns in along with hospital referrals in each of the host cities, and logistical information on the various higher-level-of-care medical destinations considered by UnitedHealthcare Global during a medical evacuation. Venues and Cities: Yekaterinburg Arena, Ekaterinburg Stadium, Kaliningrad Stadium, Kaliningrad Volgograd Arena, Volgograd Rostov Arena, Rostov-on-Don Fisht Olympic Stadium, Sochi Luzhniki Stadium, Otkritie Stadium, Nizhny Novgorod Stadium, Nizhny Novgorod Mordovia Arena, Saransk Kazan Arena, Kazan Samara Arena, Samara Health Intelligence Quality of Care Summary Historically, the healthcare system and the overall condition of medical facilities in have been below international standards. The quality of medical services countrywide varies significantly depending on the region. Generally, larger cities such as and are better served compared to rural areas and have medical facilities that provide adequate care, and are accustomed to providing services to globally mobile patients. MEDIAL RISK RATING Overall Medical Risk 4 Disease Risks 3 Quality of Care Risks 3 Remoteness Risks 4 Cultural Challenge Risks 5 UnitedHealthcare Global advises against elective hospitalization in.

2 Special Report: 2018 Soccer/Football Tournament 2 Language Proficiency Only a small percentage of n health care workers speak English; travelers have reported difficulties communicating medical problems to n physicians, nurses, and hospital supporting staff. Given the expected influx of travelers attending the tournament, language courses will be provided at the designated hospitals along with the support of reportedly 15,000 volunteers including interpreters. The level of fluency speaking English is expected to vary drastically. Diseases and Health Risks, particularly in remote areas, carries several health risks for foreign visitors, including diseases spread by ticks and other insects. Alcohol related incidents such as road traffic injuries, and second hand smoke are also health risks for visitors. Food and water also present risks for travelers, as tap water even in the major cities of is not considered safe for consumption. General food and water precautions should be observed when traveling to. Immunizations and Preventative Treatments For recommended and required vaccinations as well as preventative treatment for travel to, visit the US Centers for Disease Control and Prevention. Hospital Care Outside of major cities and travel destinations where quality private outpatient and inpatient medical facilities are available, state-run hospitals are in most instances, the best and only options for the provision of emergency medical care and for stabilization purposes. Private facilities are generally not equipped to deal with the most serious medical conditions (e.g. trauma cases) and will refer patients to public institutions. It is important to note that the physical appearance of the medical infrastructure, level of hygiene, accommodations, and hospitality services at some facilities may be below one s expectations, especially for globally mobile populations. In addition, patients may find the quality and availability of nursing support to be below one s expectations and it is important to remember that the training, and the role and duties carried out by nursing support are different than those in other countries; and patients- especially those hospitalized, may be approached for additional, although unofficial, requests for payments to provide such services. In preparation for the event, 3500 physicians will be mobilized at the medical facilities and the various outpatient medical posts near the stadium venues. Ground ambulances and paramedics will also be on standby near the stadiums. Patients presenting to hospitals for care, especially public facilities, should expect to show their hard-copy passport prior to entry. You may be asked by security officers stationed inside the hospital doors to yield your passport during your time in the facility. UnitedHealthcare Global may recommend medical evacuation for serious medical conditions and emergencies requiring invasive procedures, serious surgical intervention or prolonged hospitalization. Non-Urgent Care Whenever possible, it is recommended to seek non-urgent care at the designated private facilities where available. Alternatively, house-call physician service can be coordinated to the member s hotel. Medical units will also be accessible near the various stadiums for the provision of first aid for minor illnesses and injuries. Medical Intelligence General Health and Medical Assistance from Medications Call 8 ~ (can be dialed collect) Fax assistance@uhcglobal.com Available 24/7 Local Medical Emergency Services Ambulance and Medical emergency services: 03 or 112 Fire: 01 or 112 Police: 02 or 112 Ground Ambulance and Emergency Rescue Services Access to ground ambulance through the public EMS will be available in all the host cities for the tournament. Medical posts with ground ambulances and medical personnel will be set up near each designated sporting venue. Ambulances can be dispatched by dialing 03. Travelers should be advised that dispatchers and ambulance staff will probably only speak n. During the tournament, English speaking volunteers will be available for over-the-phone interpretation. The public ambulance will transfer the patient directly to the most adequate facility to treat or stabilize their particular symptoms. The levels of care: Resuscitation ambulances -- can be dispatched to respond to cardiac arrest cases and other critical situations. Cardiology ambulances -- may be dispatched to respond to potential cardiac emergencies. Basic emergency medical service ambulances -- are the most common type of emergency care offered in. The n pharmaceutical market is not very reliable and travelers and foreign visitors should take special care to ensure that they have an adequate supply of prescription medications before going to. Travelers should be aware that counterfeit drugs as well as questionable medications imported from the Far East and Eastern Europe are prevalent in. s larger cities have reputable pharmacies that should be able to provide most international medications.it is recommended for travelers to carry all medications in their carry-on luggage if possible - if not, include in their carry-on luggage at least enough supply to cover any unscheduled delays in travel and for the first week at their destination. To help with customs inspections, carry all medications in their original labeled containers, carry their original, written prescriptions and, in a separate place, write down the name (including the generic name), strength and prescribed dosage with their doctor's name and contact information.

3 Special Report: 2018 Soccer/Football Tournament 3 Medical Evacuation/ Repatriation From Western, medical evacuations can be coordinated by commercial flight or air ambulance, depending on the patient s medical condition. The typical evacuation destinations are Western Europe; Helsinki, Finland; or Istanbul, Turkey. Following an emergency medical evacuation, and upon stabilization, UnitedHealthcare Global can assist with the medical repatriation back home, to the patient s work-site, or to the point of origin. In the event of an emergency medical evacuation, UnitedHealthcare Global will always advise transfer to the location and facility that is best suited to handle the patient s particular situation. In cases requiring immediate treatment, this evacuation destination may not be in the patient s home country, and instead may be the closest UnitedHealthcare Global Center of Excellence hospital that can appropriately manage the patient s condition. Air Ambulance UnitedHealthcare Global upholds stringent selection criteria when selection air ambulance partners. The air ambulance crew is composed of two aero-medically qualified clinicians, as well as two pilots. The medical equipment & drugs available during the flight, the medical protocols and the medical staff as well as the airplane, the flight crew and the plane maintenance are reviewed periodically and are consistent with the patient care needs. Upon arrival UnitedHealthcare Global will arrange admission to an approved UnitedHealthcare Global Center of Excellence facility and coordinate hotel accommodations for family members and travel companions. Sample Flight Times by Air Ambulance to Istanbul, Turkey from: : 2 hrs 50 mins nonstop using Learjet 45 : 3 hrs nonstop using Learjet 45 Sochi: 1 hr 30 mins nonstop using Learjet 45 Volgograd: 2 hrs 20 mins nonstop using Learjet 45 Samara: 3 hrs 10 mins nonstop using Learjet 45 Saransk: 3 hrs 10 mins nonstop using Learjet 45 Nizhny Novgorod: 3 hrs 16 mins nonstop using Learjet 45 Yekaterinburg: 4 hrs 15 mins with one stop using Learjet 45 Rostov on Don: 1 hr 55 mins nonstop using Learjet 45 Kazan: 3 hrs 15 mins nonstop using Learjet 45 Kaliningrad: 2 hrs 20 mins nonstop using Learjet 45 Sample Flight Times by Air Ambulance to Helsinki, Finland from: : 1 hr 27 mins nonstop using Cessna Citation Sovereign : 40 mins nonstop using Cessna Citation Sovereign Sochi: 2 hr 51 mins nonstop using Cessna Citation Sovereign Volgograd: 2 hrs 26 mins nonstop using Cessna Citation Sovereign Samara: 2 hrs 20 mins nonstop using Cessna Citation Sovereign Saransk: 1 hr 59 mins nonstop using Cessna Citation Sovereign Nizhny Novgorod: 1 hr 44 mins nonstop using Cessna Citation Sovereign Yekaterinburg: 2 hrs 49 mins nonstop using Cessna Citation Sovereign Rostov on Don: 2 hrs 24 mins nonstop using Cessna Citation Sovereign Kazan: 2 hrs 08 mins nonstop using Cessna Citation Sovereign Kaliningrad: 1 hr 07 mins nonstop using Cessna Citation Sovereign Sample Flight Times by Air Ambulance to Frankfurt, Germany from: : 3 hrs 15 mins nonstop using Learjet 60 : 4 hrs 15 nonstop using Learjet 60 Sochi: 3 hrs 45 mins nonstop using Learjet 60 Volgograd: 3 hrs 50 mins nonstop using Learjet 60 Samara: 4 hrs 15 mins nonstop using Learjet 60 Saransk: 3 hrs 50 mins nonstop using Learjet 60 Nizhny Novgorod: 3 hrs 40 mins nonstop using Learjet 60 Ekaterinburg: 4 hrs 55 mins with zero or one stop using Learjet 60 Rostov on Don: 3 hrs 30 mins nonstop using Learjet 60 Kazan: 4 hrs 05 mins nonstop using Learjet 60 Kaliningrad: 1 hr 50 mins nonstop using Learjet 60 Commercial Evacuation or Repatriation UnitedHealthcare Global will evaluate each patient s medical condition, in collaboration with the treating physician, and may determine the evacuation can be performed via commercial flight. A medical repatriation to the member s country of residence or home country will also be considered when medically fit. A medical repatriation by commercial flight may be necessary, especially for patients that require long term care. When medically necessary, a nurse or a physician escort for medical care during commercial travel will be coordinated to accompany the patient. From the various cities, medical transport by commercial flight will be coordinated to the nearest higher level of care destination, while taking into account the availability of convenient flights, flight time, availability of visa, and the most suitable destination for the treatment or reassessment of the patient s specific condition. Commercial flights are readily available from, the county s main commercial flight hub, to Western Europe, Finland, and Turkey. During the tournament, direct flights may be available from the secondary cities to international evacuation destinations. Wheelchair assistance is available for patients with mobility problems. UnitedHealthcare Global can coordinate all flight arrangements and pre-payments, if applicable. UnitedHealthcare Global can also arrange for the traveler to be seen on an outpatient basis at a UnitedHealthcare Global Center of Excellence facility, as well as providing convenient hotel accommodations. Sample Flight Times by commercial airline from to: New York: Washington: Montreal: Frankfurt: 9 hrs 55 minutes direct flight available daily and operated by Aeroflot or 12 hrs 10 mins with 1 connection in Frankfurt available daily, operated by Lufthansa 10 hrs 20 mins direct flight available daily, operated by Aeroflot 11 hrs 5 mins with 1 connection in Frankfurt, operated by Lufthansa 3 hrs 20 mins Aeroflot Daily Sample Flight Times by commercial airline to from: : 1 hr 15 mins daily flights available Aeroflot Sochi: 2 hr 30 mins daily flights available Aeroflot Volgograd: 1 hrs 45 mins daily flights available Aeroflot Samara: 1 hr 45 mins daily flights available Aeroflot Saransk: 1 hr 35 mins daily flights available Aeroflot Nizhny Novgorod: 40 mins daily flights available Aeroflot Yekaterinburg : 2 hrs 25 mins daily flights available Aeroflot Rostov on Don: 1 hr 55 mins daily flights available Aeroflot Kazan: 1 hr 30 mins daily flights available Aeroflot Kaliningrad: 1 hr 50 mins daily flights available Aeroflot

4 Special Report: 2018 Soccer/Football Tournament 4 Designated Medical Facilities MOSCOW The soccer (football) matches in will be held in Luzhniki Stadium and Otkritie Arena (Spartak Stadium). The closest designated medical facilities to the venues, as part of the tournament preparation program for emergencies, are respectively the staterun hospitals City Clinical Hospital 1. NI Pirogov and Botkin Hospital. Private medical facilities in accustomed to the needs of foreign travelers are also listed for non-emergent situations. The state hospitals are easier to access and the better options for emergent situations near the venues. City Clinical Hospital 1. NI Pirogov (Городская клиническая больница 1 им. Н.И. Пирогова) Leninsky Prospect 10 City Postal Code International Phone Local Phone Website Geo-coordinates Facility Description: Public, multi-specialty hospital specializing in emergency medicine, trauma, cardiologic and neurologic cases. Over 1400-bed capacity. Closest to the Luzhniki Stadium, approximately 7 km. Botkin Hospital 2nd Botkinskiy Proezd 5 City International Phone Local Phone Geo-coordinates Facility Description: Tertiary, public care facility with emergency services available 24/7. Specializes in trauma and neurological and cardiovascular cases. Equipped with advanced diagnostic technologies such as CT and MRI scans. Close to the Spartak Stadium, approximately 9 km. Outpatient Care: Open Monday through Friday, 8am to 7:30pm. JSC Medicina (клиника медицина) Second Tverskoy-Yamskoy pereulok, 10 Near Mayakovski Metro Station City International Phone Local Phone Geo-coordinates Facility Description: Private, Joint Commission International (JCI) accredited facility is one of the best in offering comprehensive range diagnostic services including CT scan and MRI, as well as a wide range of in-and-outpatient services including invasive cardiology. English is spoken by some staff but fluency may vary. Centrally located and is approximately 8 km from Luzhniki Stadium and approximately 12 km from Spartak stadium. Outpatient Care: Dedicated outpatient clinic. Open Monday through Friday, 8am to 9pm, Saturday, 9am to 7pm, and Sunday, 9am to 3pm. English is spoken by some staff but fluency may vary. European Medical Center (EMC) 5/1 Spiridonievsky Pereulok Near Mayakovskaya Metro Station City International Phone Local Phone Geo-coordinates Facility Description: Private, multi-specialty facility with emergency services available 24/7. Offers inpatient and outpatient services supported by advanced diagnostic equipment such as CT scan. English-speaking staff is available. EMC has five other clinics in and has experience treating expatriates. The above facility is in Spiridonievsky Pereulok and is located approximately 6 km from Luzhniki Stadium and 14 km from Spartak stadium. Outpatient Care: Open Monday through Friday, 8am to 9pm and on Saturday, 9am to 2pm. House call service and English speaking staff available. SAINT PETERSBURG The soccer (football) matches in will be held at the Krestovsky Stadium. The closest designated medical facility to the venue, as part of the tournament preparation program for emergencies, is State Budgetary Healthcare Institution City Emergency Medical Care Station: Private medical facilities in accustomed to the needs of foreign travelers are also listed for non-emergent situations. The state hospitals are easier to access and the better options for emergent situations near the venues. State Budgetary Healthcare Institution (Санкт-Петербургское государственное бюджетное учреждение здравоохранения) City Emergency Medical Care Station - (Городская служба скорой медицинской помощи) u.l Small Garden 1/25, International Phone Emergency Number Local Phone Geo-coordinates , Facility Description: Public, multi-specialty facility with 24/7 emergency and ambulance services. Designated emergency hospital as part of the tournament preparation program. Located approximately 10.5 km from Krestovsky Stadium. American Medical Clinic (Американская Медицинская Клиника) 78 Moika Embankment International Phone Local Phone Geo-coordinates Facility Description: Private, multi-specialty facility with emergency and ambulance services available 24/7. Equipped with advanced medical technologies. English speaking staff available. Located approximately 9 km from Saint- Petersburg stadium. Outpatient Care: Outpatient services are available on a walk-in basis. 24/7 clinic. MEDSI - St. Petersburg (Former MEDEM) ulitsa Marata International Phone Local Phone Geo-coordinates Facility Description: Private, multi-specialty facility with 24/7 emergency services supported by advanced diagnostic equipment. English speaking staff available. Located approximately 10 km from

5 Special Report: 2018 Soccer/Football Tournament 5 stadium. Outpatient Care: Offers 24-hour doctor availability with house calls service. SAMARA The soccer (football) matches in Samara will be held at the Samara Arena. The closest part of the tournament preparation program for emergencies, is Samara Regional Clinic Hospital V.D. Seredavina. The Samara City N.I. Pirogov Clinical Hospital 1 is an alternate option for emergencies closer to the city center. Samara City N.I. Pirogov Clinical Hospital 1 (Городская больница 1 им. Н. И. Пирогова) 80 Polevaya Street ул. Полевая, 80 Samara Samara International Phone Local Phone Geo-coordinates Facility Description: Public, tertiary care facility with emergency services available 24/7. Large facility with over 1000-bed capacity. Equipped with advanced medical technologies. Specializes in orthopedic and neurosurgical conditions. Located approximately 14 km (30 mins) from Samara stadium. Samara Regional Clinic Hospital V.D. Seredavina (Самарская областная клиническая больница имени В. Д. Середавина) 159 tashkent Street ул.ташкентская, 159, Samara Samara International Phone Local Phone Geo-coordinates Facility Description: Public, tertiary care facility with 24/7 emergency services. Designated emergency hospital as part of the tournament preparation program. Located approximately 2.9 km from the Samara Arena. SOCHI The soccer (football) games in Sochi will be held at the Fisht Olympic Stadium located in city of Adler. The closest designated medical facility to the venue, as part of the tournament preparation program for emergencies, is the Adler State Regional Hospital No. 4. For traveller in Sochi, Medline Clinic is recommended for general outpatient care via house call physician services, and the Sochi City Hospital No. 4 and Trauma Center is an alternate option for emergencies closer to Sochi city center. Sochi City Hospital No. 4 and Trauma Center (Городская больница 4 и травматологический центр) Dagomsysskaya Ulitsa, 42 - ул. Дагомысская, 42 Central District (Tsentralny Rayon) - Центральный район Sochi Krasnodar International Phone Local Phone Geo-coordinates Facility Description: Located in Sochi City is approximately 17 miles from the Coastal Cluster in Adler. Hospital of first choice for any injuries or illnesses occurring in Sochi City or in nearby Adler at the site of Coastal Cluster venues. Transportation to the facility will be by ground ambulance provided by the Olympic Medical Services, by private ambulance or by helicopter if a patient requires transfer from the Mountain Cluster. Adler State Regional Hospital No. 4 ("Adler Clinic") (Адлер ГБУЗ Краевая больница 4) Kirov Street, 50 - ул. Кирова, 50 (Sochi) Adler District - Адлерский район (Сочи) Sochi Krasnodar International Phone Local Phone Geo-coordinates , Facility Description: 345 bed facility. Not to be confused with the Sochi State Clinical Hospital No. 4 & Trauma Center in Sochi City. Located in the town of Adler nearest to the site of the Olympic Coastal Cluster. 24/7 emergency room. Designated facility for cardiac services and interventions and surgery. First choice for medical emergencies in Adler. EKATERINBURG The soccer (football) matches in Ekaterinburg will be held at the Ekaterinburg Arena. The closest designated medical facility to the venue, as part of the tournament preparation program for emergencies, is the Sverdlovsk Regional Clinical Hospital No.1. This facility offers inpatient and outpatient services. Sverdlovsk Regional Clinical Hospital No. 1 (Свердловская областная клиническая больница 1) 185 Volgogradskaya Street Ekaterinburg Sverdlovsk International Phone Local Phone Geo-coordinates Facility Description: Largest hospital in the Ural Mountain Region and is a regional referral center. Offers in- and outpatient services. Equipped with advanced medical technologies such as CT and MRI scans. Located approximately 3 km or 12 minutes from Ekaterinburg Arena. KALININGRAD The soccer (football) matches in Kaliningrad will be held at the Kaliningrad Stadium. The closest designated medical facility to the venue, as part of the tournament preparation program for emergencies, is the Regional Center for Medical Prevention and Rehabilitation. This facility offers inpatient and outpatient services. Regional Center for Medical Prevention and Rehabilitation (Центр медицинской профилактики и реабилитации Калининградской области) ul.litovsky val, 64-A ул.литовский вал, 64-А Kaliningrad Kaliningrad International Phone Local Phone Geo-coordinates Facility Description: Specializes in Sports Medicine and Rehab. No ER. Located approximately 4 km from Kaliningrad Stadium. KAZAN The soccer (football) matches in Kazan will be held at the Kazan Arena. The closest part of the tournament preparation program for emergencies, is the Republic Clinical Hospital #1. Medel is a private outpatient facility that offers general medicine and specialist consultation services. Republic Clinical Hospital #1 (ГУЗ Республиканская клиническая больница) 138, Orenburgskiy trakt Оренбургский тракт, 138 Kazan Tatarstan International Phone Local Phone Geo-coordinates

6 Special Report: 2018 Soccer/Football Tournament 6 Facility Description: Multi-specialty hospital located the South East region of the city. Regarded as one of the best options for comprehensive medical care in Kazan. Hospital has few English speaking Physicians and 24/7 emergency room. Medel (Многопрофильная Клиника МЕДЕЛ) (ГУЗ Республиканская клиническая больница) 17, Adoratskogo str. Kazan International Phone Local Phone Geo-coordinates , Facility Description: Private outpatient clinic located near the Kazan Arena offering general medicine and specialist consultation. Open Monday-Friday, 8am to 8pm, Saturday 9am to 5pm. Located 2.8 km from Kazan Arena. SARANSK The soccer (football) matches in Saransk will be held at the Mordovia Arena. The closest part of the tournament preparation program for emergencies, is the Mordovia Republican Clinical Hospital. Mordovia Republican Clinical Hospital (Мордовская республиканская клиническая больница) Pobedy Str., 14/5, Saransk Mordovia International Phone Local Phone Geo-coordinates Facility Description: Multi-specialty hospital with 24/7 emergency services. Specializes in cardiovascular and trauma cases. Located approximately 8 km from Mordovia Arena. VOLGOGRAD The soccer (football) games in Volgograd will be held at the Volgograd Arena. The closest part of the tournament preparation program for emergencies, is the Mordovia Republican Clinical Hospital. City Clinical Emergency Hospital No 25 (Городская клиническая больница скорой медицинской помощи 25) Zemlyachki Street, 74, Dzerzhinsky district Volgograd Volgograd International Phone Local Phone Geo-coordinate Facility Description: Public, multi-specialty hospital with emergency services available 24/7. Largest emergency hospital in the city of Volgograd with over 800 bed capacity. Specializes in trauma, burn and cardiovascular cases. Located approximately 7 km from Volgograd Arena. NIZHNY NOVGOROD The soccer (football) matches in Nizhny Novgorod will be held at the Nizhny Novgorod Stadium. The closest designated medical facility to the venue, as part of the tournament preparation program for emergencies, is the Regional Clinical Hospital N.A. Semashko. Regional Clinical Hospital N.A. Semashko (Нижегородская областная клиническая больница им.семашко) Ulitsa Rodionova, 190 Nizhny Novgorod International Phone Local Phone Geo-coordinates , Facility Description: This is a public multi-specialty hospital offering 24/7 emergency services. The hospital has both medical and surgical capabilities. Medical specialties available include neurology, traumatology, general surgery and cardiology. This is a designated emergency hospital as part of the tournament preparation program. ROSTOV ON DON The soccer (football) matches in Rostov on Don will be held at the Rostov Arena. The closest part of the tournament preparation program for emergencies, is the Rostov Regional Clinical Hospital. Rostov Regional Clinical Hospital (РОСТОВСКАЯ ОБЛАСТНАЯ КЛИНИЧЕСКАЯ БОЛЬНИЦА) Western residential area, st. Blessed, 170 Rostov-na-Donu International Phone Local Phone Geo-coordinates , Facility Description: Regional referral hospital with acute surgical capabilities. 24/7 emergency services. Designated emergency hospital as part of the tournament preparation program. NIZHNY NOVGOROD The soccer (football) matches in Nizhny Novgorod will be held at the Nizhny Novgorod Stadium. The closest designated medical facility to the venue, as part of the tournament preparation program for emergencies, is the Regional Clinical Hospital N.A. Semashko. Regional Clinical Hospital N.A. Semashko (Нижегородская областная клиническая больница им.семашко) Ulitsa Rodionova, 190 Nizhny Novgorod International Phone Local Phone Geo-coordinates , Facility Description: This is a public multi-specialty hospital offering 24/7 emergency services.

7 Special Report: 2018 Soccer/Football Tournament 7 Security Concerns Crime Crime, particularly in the form of petty theft, is the security concern most likely to affect travelers to. Petty thieves are especially active in crowded areas, such as transportation hubs, tourist attractions and restaurants. There is a high rate of passport theft in particular. It is also common for such criminals to operate in groups of women, teenagers or children posing as beggars. Additionally, there have been reports of criminals posing as police officers and then robbing unsuspecting foreigners. Criminals have also targeted parked vehicles for theft of its contents. While violent crimes -- including muggings and assaults -- take place in n cities on occasion, they are less likely to affect foreigners than residents. Such crimes include armed robbery and physical assault. Reports also indicate that criminals may drug travelers drinks at bars and nightclubs before physically assaulting them or robbing them. In order to reduce the risk of becoming victims of crime, travelers should undertake basic security precautions, including securing valuables and not traveling alone at night. Criminals will also target foreigners due to perceived affluence, and travelers should therefore avoid ostentatious displays of wealth. Financial fraud is also a significant concern throughout. ATM tampering, credit card fraud and currency exchange scams have targeted travelers in the past, and individuals operating to should only exchange currency at official exchange booths (located in airports, banks and hotels), should keep their credit cards within sight during all purchases and should only use ATMs located inside banks. Organized crime groups are present throughout, and these groups have been known to extort foreign businesspeople in the past; however, this is more of a concern for long-term residents rather than short-term travelers. Organized crime groups have also been responsible for acts of violence in large cities -- including and -- but these incidents rarely target travelers. There have been reports in the past of organized criminals conducting kidnappings for financial, political or other reasons; however, such incidents rarely target foreign travelers and do not occur often. Ethnically motivated attacks and other hate crimes pose a security concern for travelers throughout, as well. Such attacks can range from verbal harassment to physical assault, which has resulted in death in the past. Travelers operating to should be aware that the city typically records some of the highest numbers of hate crimes involving violence in. While homosexuality is not illegal in, a loosely interpreted law does prohibit the dissemination of homosexual propaganda among minors. Authorities have been known to use this law as justification for harassing members of the LGBT community. Crime and Individuals traveling to should exercise caution around the Red Square, the Izmailovsky Market and in Metro stations, as petty thieves are particularly active in those locations. Additionally, travelers should avoid the areas outside central at night to the extent possible, as the suburbs areas are less safe than the city center during non-daylight hours. Travelers to should avoid the Admiralty, Frunze, Kirov, Kronstady and City districts to the extent possible, as reports indicate that these districts have a high incidence of crime. Pickpockets are also prevalent on 's main street Nevsky Prospekt. Travelers should avoid traveling at night to the extent possible as the majority of crimes take place between 2200 and 0300 local time. Terrorism Terrorism is an ongoing concern in. While the threat is greatest in the North Caucuses region -- where a low-level Islamic insurgency has been ongoing since the Second Chechen War ( ) -- Islamic militants have carried out attacks in large urban centers, including cities where tournament matches will take place. Previous attacks in large cities -- such as and -- have often targeted transportation hubs. For example, in April 2017 a radicalized Kyrgyz-born n citizen detonated an explosive device on the Metro, killing 16 people and injuring another 64. Unconfirmed reports indicated that the attacker Higher-Crime Places in Higher-Crime Districts in n hooliganism during the upcoming world soccer tournament matches is a concern. On past occasions, n hooligan groups have been involved in clashes with other hooligan groups and with security forces. Reports emerged in 2017 that some n hooligan groups planned to explicitly target England supporters at the tournament, calling the tournament a festival of violence. While passersby may not be explicitly targeted initially, the clashes pose a significant collateral risk to travelers. Nevertheless, the increased security measures that will be in place during the tournament (see Security Measures) along with an ongoing crackdown on soccer hooligans by n authorities reduce the risk of major incidents of hooliganism.

8 Special Report: 2018 Soccer/Football Tournament 8 was acting on behalf of either the Islamic State (IS) or al-qaeda. In the past, terrorists groups have also targeted transportation hubs in and Volgograd, including airports in the capital. While n authorities have stated that reducing the risk of terrorism during the upcoming competition is their major priority, the threat of terrorism in all host cities during the tournament remains elevated, as militants often seek to target high-profile events to attract attention to their cause. Terrorist groups -- including IS -- have already issued explicit threats to target the tournament. n authorities regularly receive anonymous bomb threats targeting various facilities such as airports and shopping centers across the country, including in, and Yekaterinburg. The n government has increased the sentencing penalties for such threats in an effort to deter these actions; however, reports indicate that false threats continue to occur. Local law enforcement personnel typically evacuates the targeted site(s) upon receiving a threat, which could cause delays or disruptions for travelers. Stadiums where tournament matches are taking place are potential targets for these actions. Travelers should follow authorities instructions and take such threats seriously due to the previously mentioned terrorism-related developments. Demonstrations Demonstrations take place on occasion throughout, particularly in larger cities, such as and. Most demonstrations remain peaceful, but the rallies sometimes disrupt traffic and public transportation. n authorities have placed restrictions on demonstrations, subjecting any protests taking place between 25 May-25 July to the approval of local authorities. These local officials will be able to set the time and place of any protests that are permitted to occur, and it is unlikely that they will approve large demonstrations in the geographic vicinity of tournament matches. On the one hand, this will likely limit the number of protests, but it also makes it more likely that any demonstrations that do occur will turn violent, as security forces typically used force to disperse unauthorized gatherings. Travelers should avoid all political demonstrations due to the risk of violence. Corruption Corruption is a major concern throughout. Short-term travelers to the country are most likely to encounter corruption when dealing with police officers or other security personnel, who may attempt to solicit bribes from foreigners for supposed infractions. Authorities may also harass foreign visitors, especially ethnic minorities and those with nontraditional sexual orientations. If stopped, travelers should ask for the officer s name and badge number and should make every reasonable effort to resist paying any bribes; however, if travelers are forced to pay a bribe, they should report all incidents of misconduct to their nearest embassy or consulate. Espionage Crime Internal security services may monitor travelers upon arrival, including in their hotel rooms, and travelers have reporting having their personal belongings in hotels rooms searched in the past. Travelers should be circumspect when transmitting sensitive information via phone, internet or other methods, as the government frequently conducts espionage against citizens and foreigners alike via communications systems. Authorities have the ability to monitor all internet usage, s, phone calls (both land and cellular), text messages and faxes that take place in the country and store this information for up to three years. Travelers should operate under the assumption that they are being monitored and should refrain from political discussions while in to avoid unwanted attention from authorities. Travelers should also ensure that their electronic devices do not contain any sensitive information prior to arriving in. Anti-Western Sentiment Relations between the West and are tense for various reasons, including the crisis in eastern Ukraine, the subsequent U.S. and EU sanctions on, s involvement in Syria and s involvement in U.S. politics. The deterioration in relations has resulted in increased anti-western sentiment. U.S. nationals have primarily felt the effects of the current tensions in their encounters with n federal authorities. Such sentiment may also take the form of vandalism or other symbolic acts against Western businesses. To date, there have been no reported attacks against Western individuals, and there is no indication that the current situation has increased the chances of Westerners suffering physical harm in due to their nationality. Nevertheless, actions targeting Western nationals cannot be entirely ruled out. Security Measures During the tournament, the n government has indicated that it will deploy an increased number of security personnel as well as surveillance cameras to areas where fans are likely to congregate -- including stadiums, hotels, transportation hubs and match viewing venues. Media reports indicate that this will include approximately 14,500 private security company employees, and authorities also intend to deploy drones to monitor the behavior of fans and combat hooliganism. Units equipped for radiation detection will be present at matches to identify explosives designed to disperse radioactive material. Special tourist police forces are also being established. Officers in these forces will speak multiple languages -- such as English, French, Spanish or Chinese -- to help assist visitors; however, there are concerns that the size of these forces will be small due to a lack of bilingual officers, potentially limiting their utility. Authorities will restrict traffic and public events -- including demonstrations and protests -- around the stadiums where matches will take place, and security services are conducting background checks on all volunteers for the games. National Guard units are also deploying to provide security to bodies of water near the venues, and n military aircraft and surfaceto-air missiles will be deployed near stadiums to prevent attacks utilizing hijacked aircraft. Security forces continue to conduct counterterrorism drills in preparation for the tournament, and n security services maintain cooperation with regional and Western European governments despite ongoing international disputes. Authorities will require all tournament attendees to possess both a ticket and a fan ID in order to enter any of the host stadiums for a match. Foreigners with a fan ID will also be permitted to enter without a visa and will be allowed to stay in the country for the duration of the tournament as well as up to 10 days before the start of the tournament and up to 10 days after the end of the tournament. Nearly all foreigners visiting the host cities between 25 May and 25 July are required to register at their place of stay with s Ministry of Interior within 24 hours of arriving at that location.

9 Special Report: 2018 Soccer/Football Tournament 9 Airports All host cities are equipped with at least one airport available for servicing passengers during the tournament, and authorities have stated that an increased number of flights will be available between these cities throughout the tournament. However, eight airports -- Sochi International Airport (URSS/AER), Krasnodar International Airport (URKK/KRR), Anapa International Airport (URKA/AAQ), Koltsovo Airport (USSS/SVX), Kurumoch International Airport (UWWW/KUF), Strigino Airport (UWGG/GOJ), Platov International Airport (URRP/ROV) and Gelendzhik Airport (URKG/GDZ) -- in the vicinity of host cities are currently operated by companies that the U.S. sanctions, and travelers attempting to travel to those airports may have difficulty finding an international carrier operating to those facilities. Travelers may encounter corruption issues (see Security Concerns) when dealing with airport employees. There have been reports in the past of customs and immigration personnel requesting bribes from passengers, as well as incidents of theft by airport security personnel. -- the host city that is expected to receive the largest number of visitors during the tournament -- has three major international airports: Domodedovo International Airport (UUDD/DME), Sheremetyevo International Airport (UUEE/SVO) and Vnukovo International Airport (UUWW/VKO). Domodedovo International Airport is located approximately 40 km (25 mi) south of the city center, and the journey into the city takes approximately hours by car. Sheremetyevo International Airport is located approximately 28 km (17 mi) north of the city, and the journey takes approximately 1 hour by car. Vnukovo International Airport is located 28 km (17 mi) west of the city, and the journey takes approximately 1 hour by car. Trains, city buses, minibuses, taxis and rental cars are available for transportation between each of these airports and. Pulkovo Airport (ULLI/LED) services, where the second largest number of matches will take place, including one semifinal and the third-place match. The airport is located approximately 20 km (12 mi) south of central, and the journey takes approximately minutes by car. Buses, taxis and rental cars are available for transportation from the airport into the city. Transportation Despite the availability of numerous modes of transportation, secure transportation is recommended for all ground travel within due to the threats of petty crime and terrorism associated with public transportation. Most major cities have extensive public transportation systems that often include a metro (subway), buses, minibuses, trams and in some cities, local commuter trains. Visitors to who possess both a match ticket and a fan ID will be able to utilize special inter-city trains for free; however, they must register ahead of time, and only trains set to operate for their match will be free. Host cities will provide free public transportation on match days. Additional public transportation routes will operate throughout these cities during the tournament as well, with many of the routes connecting passengers to stadiums, airports and major public transportation centers within each city. Travelers should exercise caution if utilizing public transportation due to the prevalence of criminal activity and the threat of terrorism (see Security Concerns). While taxis are widely available, travelers should only use official taxis that they have called in advance to reduce the risk of becoming victims of theft, extortion, assault, robbery and kidnapping. Even with official taxis, travelers may still encounter language barriers, and drivers may not always use meters. Travelers should always agree on the fare before accepting a ride, and travelers should be aware that resisting payment after the trip, or attempting to renegotiate the fare, will increase to the probability of an escalation in security threats. Travelers should never share a cab with a stranger, as this poses significant security concerns as well. Travelers should avoid self-driving in due to generally poor road conditions, the dangerous driving habits of locals and to avoid contact with traffic police officers, who are often corrupt. Additionally, traffic will be restricted in and around stadiums on match days (see Security Measures), likely making self-driving more complicated and inconvenient. Contact Us Call and ask to speak to an Intelligence Department representative. intelligence@uhcglobal.com 2018 UnitedHealth Group Incorporated. All service marks contained in this literature are owned by UnitedHealth Group Incorporated and its affiliated companies, many of which are registered and pending service marks in the United States and in various countries worldwide. UnitedHealth Group cannot guarantee clinical outcomes. Products and services may be limited or excluded by applicable law. 6/18 PUB-C-26486