Moving is a challenging experience for everyone, but moving to a new country adds extra challenges. Each country has its own culture, language or dialect, and methods of dealing with events of daily living. These are some of the things which make relocation a unique experience.
You have used moved to a developing country and have a child with attention deficit – hyperactive disorder (ADHD) and realize that you are running low on Ritalin. You go to the local pharmacy to obtain additional medicine and are told it is not available in country. Now what do you do? You contact resources back home and find out that this medicine is a tightly controlled drug that cannot just be shipped through regular channels. What seemed like a simple problem is quickly becoming an emergency or a crisis.
When offered an international assignment most employees consider salary as their first priority, then the location of the new assignment, followed by details of the relocation package (housing, household goods, home-sale assistance, etc.). Most employees do not ask and many companies do not provide information about medical care at the new assignment. If there are medical issues in a family, they need to be discussed before a move is made.
Most companies provide salary and relocation package information for employees leaving the U.S. (ex-pats). Some companies provide cross-cultural training for the relocating worker. Very few companies routinely provide information about health risks and medical care in the new work location for these employees. With little or no preparation the relocating family must flounder along trying to adapt in the new medical system. They may be fortunate enough not to need much medical care; however, when a significant problem arises in areas with poor medical care, it will be very stressful for the family and in some cases result in bad medical outcomes. The poor preparation can lead to a failed assignment if the family stress levels rise too high or too frequently. Failed assignments are costly to the employer in lost productivity and actual dollars from the “bottom line,” and the failed assignment hinders if not destroys a career for the worker.
Several companies provide some type of information for ex-pats moving to lesser developed countries, but do not provide any specific medical information or assistance for the ex-pat moving to the more developed countries in Europe, Asia, or Australia. There is an assumption that good medical care exists in the country, but there is no preparation about how to best utilize the system. Medicine is not practiced the same around the world. The time to learn about a medical system is not when a person is ill or is dealing with a sick family member. Good planning always improves the odds of good outcomes.
Moving from the U.S. medical care system into a socialized medical care system can be very difficult. In the U.S. system Americans frequently choose a specialist to care for the immediate medical problem. They can call and schedule an appointment with the specialist at any time. However, in a socialized system all specialist appointments are by physician referral only. The primary doctor, usually a general practitioner must write a letter of referral and the specialist must accept the referral prior to an appointment for the patient. For an impatient American this can seem to be an “unnecessary” delay in medical care. Hospitalizations and procedures are prioritized and non-emergent problems must ‘wait in queue” for the medical procedure.
Type of Information Needed?
Families with chronic medical conditions, special medication needs, or special needs children should be certain that medical care for their condition is available at the new location before departing for the assignment. Families, even those with good health, need to be fully apprised of the health risks in the new area so they can make informed decisions and preparation for the assignment. People relocating to developing countries need to:
1) understand the health risks associated with the new country,
2) understand how these health risks might affect their medical condition, and
3) understand the limitations of the medical facilities in the new location. In addition the company should have a contingency plan to move severely injured or critically ill personnel or family to a quality regional medical facility.
One part of the medical information that a family needs is how to get medical assistance in an emergency. Most Americans would call 911. However, the emergency contact number varies by country around the world. It may be 119, 190, 192, 999, 112, 000, etc. Good information and planning can help avoid a panic situation during a crisis and expedite medical assistance.
Just as due diligence reduces risks in business deals and good planning improves the chance of success for projects, so too good preparation of employees for international relocation improves the chances for a productive and successful assignment.
J. David Clyde is President & CEO of Spinnaker Medical Consultants International, LLC, Atlanta, GA.
E:mail: [email protected]
Spinnaker Medical Consultants International provides services in the following areas: 1) Relocation Medical Assistance for families during international assignments, 2) Training programs for business travelers and expatriate workers involved in international business, 3) Medical Director and Occupational Medicine consultation and advisory services, and 4) Resource assessments and medical crisis plans for international locations.
Our company mission is to provide relevant medical advice, training, and support to companies which will enhance the productivity and health of their employees in diverse work environments and locations.