Whether travelling the globe with a backpack and a sense of adventure or establishing a settled family life in another country, it’s important to have insurance that will cover the cost of medical treatment.
Nobody plans on getting themselves hospitalised when overseas, but it does happen. Anyone spending time abroad is likely to be undertaking activities and adventures that are more active than their normal daily life as well as exposing their bodies to a whole host of new bugs and bacteria.Everyone has given themselves a dose of sunburn on holiday, but the mild red rash can become a catastrophic heat injury that can leave you in a coma or worse. We’ve all enjoyed a beer or wine when relaxing, but after a few too many we can get into escapades that end in the emergency room.
It’s easy to twist an ankle when climbing over ancient ruins or to have a close encounter with speeding traffic on congested foreign roads. The terrifying tales we tell here aren’t intended to scare anyone off moving overseas, but rather are a little reminder to make sure that insurance and healthcare policies will cover the cost of treatment. If there’s one thing that hurts more than the pain of a broken bone, it’s a hefty bill from the hospital that treated you.
Anyone living overseas for a long time needs to make arrangements for regular health check ups. It’s easy to put off your next dental appointment, until the pain of a cavity lets you know it’s been too long. Regular health checks from a physician increase the chances of catching long-term issues before they can impact your life in a major way. Most healthcare policies around the world will cover both the cost of regular treatment and emergency care should the unforeseen happen.
We’ve collected tales of woe from expats and adventurers, listing the strange ways in which they’ve fallen victim to some of the most common illnesses and injuries that bedevil those overseas.
Climatic injury
Being in a strange country with a different climate, it’s hardly surprising that expats complain of feeling too hot, too cold or too sweaty and sticky as they swelter in the humid air.
Far from just being mildly uncomfortably, extremes of temperature can represent a major health threat to expats, particularly the young and the old.
When the human body gets too hot or too cold, it starts doing things to protect its most important parts, the vital organs. This can cause unpleasant and often painful symptoms that can indicate the body is struggling.
When the body gets too hot, not only is it susceptible to sunburn and dehydration, but when internal body temperatures rise, the twin conditions of heat exhaustion and heatstroke can set in.
Heat exhaustion kicks in when the body is dehydrated and begins struggling to continue normal function. Patients will complain or tiredness, dizziness and feeling sick. Intense thirst and headaches indicate that the condition is moving toward potentially deadly heatstroke.
When the body overheats, the brain starts to struggle, manifesting itself as confusion, disorientation, seizures and unconsciousness. Heat exhaustion can be treated by getting the patient into shade or an air conditioned room and getting them to drink fluids. Anyone passing out should be placed in the recovery position and medical assistance sought.
Manda experienced heatstroke when building a house in Mexico and found just how debilitating it can be. “I spent the next 3 hours tacking black tar paper to the side of the house while the sun beat down, hitting the black paper and intensifying the heat,” she told medicinenet.com. “I decided to sit down and take a 5 minute break. When the time came to get up and start working again I couldn’t move and I could only barely mumble in response, and it took a lot of effort to get that mumble!”
Structural failure
Even being safe and sound in your expat home might not be as safe as you might think. Building regulations overseas aren’t always strictly adhered to, meaning your new home might be hiding some nasty surprises.
Shoddy electrical works, poorly finished plumbing and substandard fixtures can all deliver some nasty surprises, not only damaging your home but possibly causing injury.
Anna Faustino, who blogs on adventureinyou.com, found this out the hard way in a friend’s apartment in Vietnam. “All I wanted to do was take a long shower and chill out. Little did I know that this would be the most eventful shower of my life,” she writes. “As I was finishing up, the glass door of the shower suddenly collapsed on me. I was wet, covered in glass shards, and bleeding profusely as I stood there completely shocked and confused. I was rushed to the emergency room in an ambulance and suffered 5 major lacerations and 22 stitches all over my arms and hands.”
Drunken antics
They say necessity is the mother of all invention; well, alcohol might be the mother of all bad ideas.
Expats overseas often take to alcohol as a way of quickly bonding with friends as well as letting off steam. So it’s hardly surprising that a lot of tales or expat exploits begin with a beer and end with a trip to the hospital.
Obviously, the best way to avoid such injuries yourself is to drink in moderation, with people you trust not to lead you too far astray. Being under the the influence can also cause problems when claiming on insurance or even attract unwanted legal attention.
Although Chris Backe claims he was not drunk, he doesn’t pretend he was totally sober when he broke his arm, cycling home from a bar in Thailand. “It was a road I had cycled down a hundred times before, though all of a sudden I flipped…straight over my handlebars and landed on the road,” he told mappingmegan.com.
“I continued to make my way home completely fine…until I realized my right arm was hanging in a very awkward way. A rush to the hospital revealed [the bones] in my right forearm were broken.”
Misadventure
Sadly, even when sober expats can manage to do silly things that cause them pain and inconvenience, especially youngsters.
Children are always getting themselves into scrapes as they explore the world with more of a sense of wonder than concern for their own wellbeing. Parents are more likely to be taking their kids for treatment than themselves, which is exactly what happened to the nomadic Bender family.
When living in Israel, their son broke his wrist. Erin Bender tells the story at travelwithbender.com, “my son was climbing off a bunk bed when he fell and fractured his wrist. We ended up taking him to the Emergency Room, though no one could speak English to let us know what was happening. It was not a very happy affair.”
“We were able to visit a doctor in Haifa who explained what had happened and how long he would be in a cast.”
Sexually transmitted diseases
May expat destinations are also booming cities with a lively nightlife scene. It’s not uncommon for expats to get amorous with the locals or each other. It’s even more important overseas to practice safe sex as infection rates for sexually transmitted diseases can be high.
Unprotected sex can leave you open to a dose of chlamydia, syphilis or gonorrhoea, as well as hepatitis or HIV. There is a risk of catching these illnesses whatever your sexual orientation, in casual sex, paid sex or in a long-term relationship if you are not both tested and certified as infection-free.
Due to the sensitive nature of these infections, it’s difficult to source statistics on just how many expats catch them. One study found that only half of Australians abroad used a condom for every sexual encounter and estimated that three in every 1,000 expats returned from Indonesia with HIV.
Vehicle accidents
Road safety varies wildly around the world. Speed limits may be strictly followed or freely ignored, traffic may flow in all directions regardless of road markings and the pavements may just be an extension of the highways.
Expats travelling in their own vehicles need to make sure they understand local traffic laws as well as the customs that may disregard these rules.
Sometimes there is nothing to stop unfortunate incidents, and expat news sources are filled with stories of injury or death in cars and on public transport. American Drew Binsky moved to South Korea to teach English, but had a brush with death on a bus ride in India. “About an hour into the ride, in the middle of nowhere, the bus driver slammed on his breaks and the bus flipped over the side of the highway. Glass shattered everywhere and parts of the bus exploded,” he wrote on thehungrypartier.com. “I was lucky to not have been injured badly. I only had pieces of glass stuck in my right foot and it was while it was bloody, I was lucky to have healed quickly. I saw others with major cuts over their body, and they were taken away in an ambulance.”
Travellers’ diarrhoea
It’s unpleasant, uncomfortable and very easy to pick up. Even if you follow all the advice about washing hands and avoiding tap water, it’s possible to pick up a tummy bug from eating poorly prepared food.
New arrivals are more likely to suffer as they have not built up resistance to local bugs, but even the longest serving expat can find themselves wiped out by a bout of diarrhoea.
Unsafe tap water may be used to wash fruit or salad, be turned into ice in cold drinks or used to make ice cream. Food may be prepared with ingredients that aren’t entirely fresh or be infected with viruses that livestock are inoculated against at home.
In most cases diarrhoea is just an inconvenience, confining sufferers to home for a day until they recover. But in hot countries, it can lead to severe dehydration and bring on the effects of heatstroke. Young children and the elderly are especially vulnerable to complications from this illness.
Globetrotting American Mike Danneskjold and his family found out just how unpleasant it can be to have a whole family afflicted by sickness. “This was not the quaint little “I had too much to drink” trip to the porcelain altar. “Projectile” is an understatement,” he wrote on mikedanneskjold.wordpress.com. “It felt as though at least half of my internal organs were being rejected and expelled. My wife said, “My stomach feels a little rough too.” Then one of the other children walks into our room looking pale, eyes watering, holding his tummy. Mommy, I don’t feel so well.” Everyone had it – the whole family.”
Sporting injuries
Sporting injuries can range from twisted ankles to breaks, concussion and damage to internal organs. Stumbling on a hike or suffering the bends on a scuba diving expedition, there are all kinds of ways expats can injure themselves.
Crucially, not all of these activities will be covered by even the most comprehensive sounding insurance policy. Unless you sit down and read the small print, you can’t be sure that your specific sport will be insured.
Some policies may claim to cover scuba diving, but the small print will only insure divers down to a depth of a 10 metres. Hiking might be included in the policy, but not over certain altitudes.
Expats especially may find holes in their policy as they can’t always predict the activities they may undertake long after taking out the policy. Debbie Kleiner-Gaines, Managing Director of Best Health, told the Telegraph; “Often people don’t know what they will do abroad before they travel. They don’t know if they are going to get into snowboarding or sandboarding. And they don’t generally understand exclusions.”
Lukily Ashley Hubbard was covered for her skiing injury. “I only made it about halfway down [the slope] before my legs were going in different directions and I heard that infamous popping noise, followed by excruciating pain,” she told mappingmegan.com. “Surgery was almost immediate followed by months of even more excruciating physical therapy. For the first 6 months, I had no idea how I was ever going to bend my knee completely again.”
Insect and Tick-borne infections
Malaria, Yellow Fever, Lyme Disease. There is a plethora of unpleasant and possibly deadly illnesses carried by biting bugs and other nasty creatures.
There’s something fundamentally, skin crawlingly awful about considering an animal burrowing under your skin and feasting on your flesh, but even worse can be the fevers and illnesses they leave behind.
Malaria is the world’s biggest killer, claiming more than 3 million lives a year. It’s estimated that 30% of expats in at-risk areas will develop the illness within two years.
There’s plenty of advice out there about avoiding mosquito bites, involving pills, sprays, nets and not going certain areas at certain times.
But even after following all the advice, biting creatures can sometime make it through, as Claudia Tavani found in Colombia. “One night I felt an itch and started to scratch my back,” she wrote on myadventuresacrosstheworld.com. “It was then that a friend caught a tick trying to crawl its way into my skin! I was terrified. Ticks in Europe and in the US can be deadly.”
Mental and emotional health
This is probably the most common condition to afflict expats, but also the least talked about. Culture shock and homesickness are often discussed on expat platforms; sadly though, it’s rare to discuss more sustained mental health issues.
In theory expats might be living an exciting, privileged life. But the reality can be an upsetting mix of stress, loneliness and uncertainty, all endured far from the support networks of family and friends.
One study estimated that half of American expats were at high risk of anxiety and depression, two and a half times the rate of non-expat Americans.
Separation from family, feelings of being trapped, isolation from the local culture and elevated levels of work stress can drive expats to seek solutions in drugs, alcohol or sex, further complicating their situation.
There is a lot of reluctance to discuss mental health issues and different countries may not have established treatments or even recognise conditions.
Expats feeling the weight of living overseas shouldn’t be afraid to seek help from therapists who specialise in expat emotional health. Dariusz Skowronski is a Japan-based psychotherapist who helps expats in need. “Providing education and information on mental health is necessary,” he told williamrussel.com. “But most of all, an environment for openly discussing stress-related issues and the risks of developing problems is what we need to enable expats to find help for their concerns.”
Article by Andy Scofield, Expat Focus International Features Writer