
Managing a Health Condition Abroad… 16 Strategies to Support You
It can be extremely stressful when we or someone we love becomes ill abroad. As well as the (very normal) physical and mental turmoil of illness, we often find ourselves dealing with additional challenges that are unique to international life.
At the Families in Global Transition (FIGT) conference in March 2018, I got together with professional healthcare and vitality coach Carolyn Parse Rizzo for a “Kitchen Table Conversation” on exactly this topic.
Those taking part in the discussion ranged from parents of children with serious medical conditions, to partners of seriously ill adults, to expat physicians, to former or current patients. It became clear that all sectors of the international community share the challenges of living overseas with a medical condition. Missionaries, international corporations, researchers, government departments, romantic expats, relocation experts, and many others also took part in the discussion.
Below are some of the common challenges that emerged from this fascinating discussion with expert expats and expat experts alike! We also offer some sound, supportive strategies to help you overcome these difficulties.
Common challenges when illness strikes abroad
- Isolation (the most common challenge reported) – includes being alone in a hospital room or recuperating at home, and being isolated in a remote area of the world
- Lack of support – away from our usual support system, we may miss emotional support as well practical support (e.g. like someone to collect kids from school or bring meals to the house)
- Poor knowledge of the local healthcare system – its process, coverage, and payment protocols, sometimes leading to financial stress and/or crisis
- Unfamiliarity with private insurance options and coverage
- Lack of trust in the local medical team/treatment
- Miscommunication or misunderstandings with healthcare providers, especially when there is a language barrier or cultural communication differences
- Physical discomfort/pain
- Emotional discomfort/pain – guilt, self-blame, doubt, sense of loss and grief, anxiety/depression, hopelessness and helplessness
- Overwhelm – a long list of tasks to complete, and not knowing where to begin
- Parenting may become more difficult, especially if one parent must split time between medical visits and home routines; children may also need extra emotional support at a time when the parents’ emotional reserves are low
16 strategies to explore and cultivate
The following pointers have helped countless expats to keep paddling through rough waters…
- Shift your mindset from being a “victim” of your circumstances to the leader of your own (or your loved one’s) healthcare. Think of yourself as the “Multidisciplinary Team Leader” or the “Cross-Cultural Care Coordinator” when it comes to your family’s healthcare.
- Be proactive: plan what you can, prepare, and educate yourself about the diagnosis and treatment protocol, your medical coverage, and the local medical system.
- Be aware of your (or your loved one’s) personal coping style and the quality of energy you bring to the table.
- Prioritise self-care: sleep, relaxation, movement, essential oils, nutrition and therapy/coaching can help get us to get “unstuck”.
- Practise mindfulness – this can mean learning to be in the present moment; carving out time for a regular practice of stillness, meditation or prayer; connecting breath to movement; and noticing small pleasures and joys.
- Work through feelings of guilt and blame for what happened to you or your loved one. You may prefer to do this with an experienced counsellor.
- Pay attention to the labels you use – for example, do you see yourself as a “survivor” or a “patient” or “victim of…”?
- Seize the opportunity to practise a new hobby or do something that brings you joy.
- Embrace humour when possible. Laughter helps us to relax, has health benefits, and reminds us of a bigger picture.
- Choose carefully what you share, and with whom.
- Choose your attitude and how you respond to situations – it’s okay to get help with this!
- Have faith. This may mean turning to your religion, or turning towards a life philosophy that holds meaning and hope for you.
- Expand your support system to include local people, professionals and online or face-to-face groups.
- Use social media consciously! It can be a great source of support and information, but it can also be a source of stresswhen there is oversharing or unhelpful feedback – or when it intensifies our tendency to compare ourselves, or our lives, with others.
- Practise gratitude for what is working and right. Consider starting a gratitude journal to capture these moments of appreciation.
- Celebrate large and small victories!
You may want to consider seeking professional support. By working with an experienced psychologist or coach, you can learn new approaches and skills, as well as specific techniques to help you cope with difficult emotions. You will also have a safe place to express your thoughts and feelings, find solutions, and feel happier.
If you are experiencing some of the challenges above, please know that we understand. Our thoughts are with you and we are sending you great love and strength.
What would you add to this list? What insights do you have for those facing illness abroad? Let’s share our tips and support each other!
FEEL FREE TO USE THIS ARTICLE IN YOUR BLOG OR NEWSLETTER. We ask only that you attribute Expat Nest and include the following: Expat Nest (www.expatnest.com) is a professional online counselling service for expats.
Going for medical treatment abroad is stressful. From standing in a que to see a Dr (vs making an appointment) to the types of treatment recommended, esp in another language and medical culture. In many cultures Drs are not expected to listen, only examine and dispense advice. Living in a post-Soviet country, medical care is different than what I’m used to in the west. From the relatively free prescribing of antibiotics, intravenous treatments, and other kinds of pills which western medicine would not necessarily prescribe there are often contradictions on the right course of treatment, especially for children. Here a Dr will recommend rest when in my country they would want you moving right away (referring to American health care, cost is always a factor). Even simple treatment, like ice or heat, over here ice is never a recommended treatment for anything. As a result of these cultural contradictions, it’s easy to not trust anything the foreign Dr is advising. That said I have followed their treatment recommendations, without the intravenous and antibiotics, and things have in fact worked out fine. For surgery or more complex treatment, however, I would seek treatment in Europe, Singapore, Thailand or Korea where cost is a fraction of the USA. But a word to the wise, if you’re an expat in a developing country, get international health insurance, including medevac.
Jim,
Thanks so much for sharing your insight and experience. You made such an important point that patient/provider trust can erode when the prescribed treatments are contrary to what we’ve grown up believing about what is considered “healthy” or helpful in aiding the healing process. It’s often difficult to discern, especially when in a more vulnerable state due to illness or injury, whether the contradictions are due to cultural differences or a lack of funding or medical advancement. Your final comment is has come up over and over again in my discussions with people who have ended up needing medevac services. So important to understand your coverage and augment it if you travel often or don’t have access to comprehensive medical care, locally.
Aside from the lower cost of healthcare between the US and where you are now, we’d be curious to hear about what other pleasant surprises you’ve come across in your healthcare experiences abroad.
Hi Vivian,
This is a big issue that could face so many people when they move countries, and I would add the language as well. Usually we know some sort of terms in each one’s language that you find yourself ignorant about the same diseases in even English. Going to a doctor trying to describe it rather than telling him/her the term straight away is a big dilemma.
Thx for sharing solutions that are useful to all:)
Abdelrahman
Hi Abdelrahman,
Thanks for your comment and indeed medical terminology in a non-native language can be a big challenge which leads to a lot of frustration and anxiety.
Glad you found this article valuable!
Best wishes
Vivian
thx I needed to know this
Love this post!
For me personally, the biggest challenge is catastrophic thinking. When I moved to Malaysia I found a weird insect bite on the second day. At home I would have thought 2 seconds about it and then moved on with my day, but being in this unknown environment made me instantly assume a tropical spider had laid eggs underneath my skin! ..I felt quite ridiculous when the doctor told me it was just an ant bite.
Many of the strategies you name here will be helpful for me to stop this catastrophic thinking!
Hi Linda
The vulnerability we feel during a relocation often means that we react with heightened emotions much quicker than usual. Tending towards “catastrophic thinking”, as you so aptly describe it, is totally understandable. Thank you for sharing your story (which made me chuckle too). What I most like about these health pointers is that they are empowering – each seeks to support us so that we can feel as strong and confident as possible when facing the very fundamental challenges that a health issue can bring.
Best wishes
Vivian