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For Visitors with Special Physical & Dietary Needs
In the past, travel for those with physical challenges was a challenge in itself. In some ways, it still is. If you plan on traveling in Sicily but your health or physical mobility (or that of somebody you're traveling with) requires special attention, it is worth planning for some of the circumstances that you may encounter during your trip or even during a day of sightseeing. Let's also consider dietary restrictions.

• Public Wheelchair Access
When we discuss access for persons challenged by physical disabilities, we usually refer to those who require wheelchairs or crutches to get around. (There are, of course, persons with other medical needs.) Except for airports and certain public buildings, access for wheelchairs is not widely implemented in Italy. Newly remodeled restaurants and hotels offer such accommodations (ramps, wider doors, etc.) because they're legally required to do so, but these measures have not been introduced everywhere. In most of the larger hotels, access for those visitors with physical challenges can generally be presumed. Restaurants usually offer the advantage of being at ground level. Some buses, and newer trains, have ramps for wheelchair access, but that is the exception rather than the rule.

• Limited Access
Let's consider situations you may encounter where access may be more difficult. In many older buildings, elevators (lifts) certainly exist, but many are too small to accommodate a wheelchair, and you may have to brave a short stairway even to reach the elevator. However, many such buildings have doormen (portieri) willing to assist you. The fact that Italians are generally willing to offer assistance in such circumstances helps to alleviate certain problems to a considerable extent.

• An Island of Mountains
Palermo, Catania and Siracusa are generally flat, but many localities are literally built on mountains. Even the main streets in such places may be hilly (not too different from those in some districts of San Francisco), and some narrow side streets may actually be glorified flights of stairs. Another potential problem is that some narrow, winding medieval streets are virtually inaccessible by car. In certain cities traffic is so chaotic that moving around by car is virtually impossible in the center of town, where you want to see the sights. Some hilltop towns, like Taormina, Monreale and Erice don't present too many difficulties once you've actually arrived (the main streets within these towns are fairly level despite the large number of ramps and steps in smaller streets adjoining them), though their stone streets are usually rougher than paved ones. Consider that the large abbey complex at Monreale has more open - and more level - architecture than the monastery of Saint John of the Hermits (in Palermo), a multilevel complex full of narrow portals and winding steps. A few of the "entry" areas at the ancient sites (Segesta, Siracusa, Agrigento) are reasonably accessible if you must rely on a wheelchair, but many medieval churches are not. (We were made aware of this when we visited Cefalù Cathedral with a lady who didn't require a wheelchair but did have difficulty climbing stairs.) In some cases, churches have side entrances that obviate the need for ascending a main entrance's steps. In general, it's best to be prepared to expect certain challenges during your trip, and to avoid use of a wheelchair whenever possible.

• Special Medical Needs
If you have special medical needs, such as the requirement for special medication or treatment, it's better to make provision for this before you arrive. Filling a prescription in Italy would be a difficult and time-consuming experience best avoided. Another point to consider is that Sicilian summers are very hot and often extremely humid. If this is a health issue, you may wish to consider visiting during months other than June, July, August and September.

• Dietary Restrictions and Medical Conditions
Meeting the needs of a special diet for health reasons (if you're sodium-restricted, or diabetic, for example) usually is not too difficult in Italy. Sicilian cuisine offers enough choice to accommodate most requirements, and (within reason) most restaurants can prepare traditional dishes to suit you. However, there's no substitute for sound nutritional knowledge (rather than vague dietary guidelines) when you have to confront unfamiliar foods made with various (and possibly "hidden") ingredients. Gluten-free pasta and pizza are offered in a few restaurants, but this is highly exceptional. Those with allergies to fava beans and peas (favism) should be careful, and the same applies to those who are allergic to nuts (as many Sicilian pastries and ice creams contain almonds, pistachios, pine nuts or hazelnuts). Where a dish contains shellfish (shrimp) or other seafood, this is usually fairly obvious; note that pasta alla norma contains sword fish, to which some people are allergic.

• Vegetarians and Vegans
You may find restaurant menus challenging. In Sicily, vegetarian - and especially vegan - diets can be difficult to follow because many of the "alternatives" to animal sources of protein (such as soy products) are available only in specialty stores, which in Italy overcharge for almost every item. While organic farming exists, organic ("natural") restaurants are few in number.

• Kosher and Halal
It's amazing how much pork (especially ham) finds its way into Sicilian dishes. More generally, though some Sicilian specialties have medieval Arab roots and influences, don't expect to find much accommodation in this regard. Many Sicilians barely understand the concept of religious dietary proscriptions; on Lenten Fridays you'll see plenty of "Catholic" Sicilians indulging in meat.

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