Our monthly newsletter contains health and financial news, expat articles, social media recommendations and more.
Raising Third Culture Kids
'TCKs' are people raised in a culture different to that of their parents, and the country named on their passport.
My guest, American Rachel Jones, is a mum of three TCKS. She left the USA with her husband and their young twins to work in northern Somaliland, and later Djibouti, where she still lives.
So what’s it like raising your kids in a country that’s so different to your own? How does the experience influence their development, and shape them as adults? And what challenges are you likely to encounter along the way? Rachel’s going to share her insights, which she hopes will help other parents create a thriving family culture while living internationally.
Carlie: Hey there. It’s Carlie with another episode of the Expat Focus podcast.
Today on the show, we’re talking about raising children abroad, specifically, as third-culture kids. TCKs are people raised in a culture different to that of their parents and the country named on their passport. My guest, American Rachel Jones, is the mum of the three TCKs. She left the USA with her husband, also American, and their young twins, to work in northern Somaliland and, later, Djibouti, where she still lives.
So, what’s it like raising your kids in a country that’s so different to your own? How does the experience influence their development and shape them as adults? And what challenges are you likely to encounter along the way? Rachel’s going to share her insights, which she hopes will help other parents create a thriving family culture while living internationally.
Rachel, you’re a mum of three living in the Horn of Africa. Can we start with you telling me a bit about what led you there 16 years ago now?
Rachel: I did not think that I would spend 16 years in the Horn of Africa, so it’s been a little bit of an unexpected adventure for myself. But I’m from Minneapolis, Minnesota originally. My husband and I got married just before I graduated from college, and he was starting a graduate program in engineering at the University of Minnesota. We were very poor students, and so we moved into kind of a low-income housing area, which at that time was filled with a lot of refugees from Somalia and from parts of Ethiopia. And he was studying engineering, but he really wanted to be a teacher. I had studied linguistics for my undergrad, and so I was really interested in foreign languages, and as we spent time there, getting to know our neighbors and … our whole idea of Somalia at that point was civil war, famine, chaos, violence, these kinds of things, the typical ideas that we get out of the Horn of Africa region.
Our neighbors started talking about this northern section of Somalia called Somaliland, that was peaceful, and had been peaceful for a long time, that was really developing. It was kind of a break-off republic area from the south. They were not engaged in the civil war. They had had some fighting in the late ’80s, but for about 15 years, at that point, had been peaceful. And that area had this university that was the only functioning university in the entire country, north and south of Somalia.
And so, through friends there … and they understood that we were interested in experiencing the world outside of Minneapolis – both of us were from Minnesota, our whole life, born and raised there. And we had this vision to go see other parts of the world, and to be involved, and see what we could do in places that needed and wanted what we could offer, which was teaching.
When we were invited by this university to come and teach, and when we kind of heard the community is really supportive, it’s peaceful, it’s a chance to be part of really developing the leaders of this country. Because they wanted English teachers … and my husband then was taken on to teach sciences, which was what he had studied at university. It just felt like a great opportunity. Kind of wild, kind of out of our … definitely out of our realm of experience, having come from Minneapolis. But yeah, because of those personal connections and the invitation, we thought, “Let’s try it. Let’s see what happens.”
We are personally people of faith, we’re Christians by upbringing, and so, we had this real desire to serve, just to be useful, that I think came out of our faith background. So, yeah, 2003 we moved. We had two-year-old twins at the time. And we moved to Northern Somaliland to teach at this university.
Carlie: You had two-year-old twins, as you just said. When you did move, did you have any reservations about taking your very young children so Somaliland?
Rachel: Yeah. [laughs] I don’t think I really recognized it at the time, but I think it would be naïve to say I didn’t. Because it was such a difference, a cultural difference, there was still these ideas of Somalia being a dangerous place. So, I was a little bit nervous, but we just felt like this is something that we want to try. And we didn’t actually intend … I don’t know if we clarified it very specifically, but we didn’t intend or expect, I guess, to stay much longer than two or three years in that place. Because we knew once the kids got older, we would want different educational opportunities for them.
So, it felt like the time when the kids are little was an easier time to move into a place like that, than when they were older. Because they wouldn’t experience things like culture shock the same way that an older kid would. So, even though they were young and a lot of work at that time, it felt like the easiest time for transitioning, for them.
Carlie: Absolutely. And they haven’t formed those friendships and connections that are harder to pull them away from when they’re approaching teenage years, for example.
Rachel: Exactly. Yeah.
Carlie: So, you said you only intended to be there a few years. What was it that made you stay on and still be there now?
Rachel: Well, we were only actually in Somaliland at the university for less than one year. Because, unfortunately, there ended up being some violence in the region. So, we moved there in January/February of 2003, and then, in October of that year, three expatriates were murdered. It was a British couple that were teaching at a different private school in a different village, and then, one woman was working at a tuberculosis center in the village where we lived. And those things, they kind of came out of nowhere. People weren’t expecting that.
And when that happened, because it was such a shock, pretty much all of the foreign organizations, NGOs, teachers, doctors, they left. And there weren’t that many, to begin with, at that time. So, our organization said, “You have to get out of here. We don’t think it’s safe right now.” We could have chosen to stay, but it would have been under kind of a lockdown situation, where my husband would go to work, and come home, and I wouldn’t be able to visit neighbors or go to the market, and that wasn’t the kind of life that we wanted.
So, we left. We actually had to flee. We had 30 minutes to pack a bag and literally rush to the airport. And we ended up going … we were flown to Nairobi, Kenya, and then, we were just kind of in shock, trying to figure out what just happened to this life that we had prepared for and what we want to do next. We didn’t feel ready to move back to the United States. We felt like if we left at that point, if we left Africa, then maybe we would ever make it back. Because it just took so much momentum to get here in the first place.
We were also seeing some post-trauma counsellors at that time, so we had a little bit of time in Nairobi to put our heads back on straight, I guess, and emotionally just find some stability. And then, again, through relationships, through some Somali connections of teachers that my husband had worked with, again, we were invited to come to Djibouti, which is right across the border from Somaliland, and majority Somali population. So, again, these friends, they said, “Hey, why don’t you come to Djibouti, where we’re actually also looking for English teachers?”
So, January of 2004, we actually moved to Djibouti, and now this is where we’ve been ever since then.
Carlie: Now, you’ve produced a book entitled Finding Home, and it’s, as I understand, a collection of essays exploring the realities of children raised internationally. You had your twins with you in Djibouti, and then, you had another child there, which you wrote about for the New York Times, which I found fascinating. What reference point did you have for raising your children as third-culture kids, as they call them? When you first moved abroad, where did you look to for guidance on how to bring up your children in a foreign culture, I guess?
Rachel: There wasn’t, at that time, as much resources available as there are now, especially with blogs and the internet. So, I didn’t have, actually, a very strong reference point for it. There was a book, which is still, I think, the book that every parent of a TCK should read, multiple times. It’s actually just called Third-Culture Kids, by David Pollock and Ruth Van Reken. And even my parents have read it a couple of times, and other friends have read it as they tried to understand our kids. So, I had that book, which covers everything from transitioning to loss to education opportunities, things like that. And then, I talked to some friends that had grown up abroad, that were my same age now, living in the US, just to get their ideas.
But I didn’t have a lot of resources at that time. And so, once we got abroad and I started to see some things, and recognize that my kids’ upbringing was going to be so different than mine was, I started reaching out to other people. And that was through blogging, in particular, through writing. And I found some other TCKs – now ATCKs, or adult TCKs, who really have become mentors for me. And a lot of those people have essays in that book, Finding Home, and I’ve been able to ask them questions and seek help as I raise my own kids. That’s been really helpful.
Carlie: Rachel, tell me about some of the realities for your children, growing up in the Horn of Africa, and some of the challenges that you had to navigate.
Rachel: All three of my kids have explicitly said that they’re really thankful for this upbringing, that they wouldn’t change having lived here. So, they enjoyed it. But there have been some pretty significant challenges. The biggest ones, I think, have been education, and then, the steady stream of people coming and going – mostly going, it seems like. So, there’s a lot of welcoming of new people and then saying goodbye, as we become the long-term stayers.
A lot of people come for one year or two years, and the kids would make these friendships and then they would leave. Even their Djiboutian friends, a lot of them have left as they’ve gotten older, for educational opportunities abroad. So, that’s been hard, as our kids have had to grieve a lot of loss of relationship.
And then, educationally, we’ve pretty much tried everything we could think of, or have at least dabbled in a variety of things. So, that can be really hard for parents to navigate. We started here, once we came to Djibouti, we put the kids in the French schools. [10:52] Djibouti’s a former French colony, and so, from age three until … through sixth grade, all of our kids were just completely educated in the French system. Which was hard in the first year or two, but they were young, so they learned pretty quickly. And now they’re fluent. They have these beautiful accents and … well, they don’t have accents, and they laugh at mine. That’s been a huge gift, in the long term. It took a lot of work to get them very competent in their schools.
And then, we had to do English at home, so I felt like I was home-schooling, a little bit. Not super-intensively, but just to make sure they could read and do a little bit of American history and things like that, in English.
And then, one year we spent in the US, when my husband was giving his PhD, finishing up some studies there. So, we did American public school there for one year. We found a French immersion school.
And now, as they’ve gotten older, and again, as most of their … even Djiboutian community, their peers have gone to Europe or to Canada for education. It became really difficult for them, in terms of peers and social life and opportunities outside of the classroom, like sports and music and drama, and things that we wanted to expose them to. So, after a lot of deep conversation as a family, of saying, “We could go back to the US, we could home-school, we could do all these different opportunities,” the kids said, “We want to stay in Africa, but we don’t feel like the education system in Djibouti is what we need right now.”
So, we ended up choosing boarding school for the three of them. They started when they were 13 at a boarding school in Kenya. And that has actually been really good for them, they’ve loved it. It’s been hard for me, as the mom. And my husband too, as dad. But for the kids, they’ve really, really thrived there.
Carlie: I was going to say it must be so difficult for you to be living in another country with them, and having to send them away to another place. But as you said, it’s for the educational opportunities.
Rachel: Yeah, and I just feel like as a parent, my responsibility is to do what’s best for them, not what feels best for me. And even though there’s been a lot of grief for me about that as a mom, as I’ve watched them really grow and thrive, and they love it … and they come back every three months, so it’s not away for nine months. So, they come home every three months, and I actually go there in between, so every six weeks we’re [audio clips] each other. And what we’ve found is that when we are together, because we all recognize that it’s really precious, that we just have such sweet family time together, and that’s been really valuable. It [looks] a lot different than I imagined my parenting would. But I’ve just really continued to decide that what is best for my kids is what I need to do, no matter how much it hurts me.
Carlie: You’ve mentioned that you and your husband and your children moved back to the USA at one point, for a year, so he could finish his PhD, I believe it was. How else did you make sure you established a connection with your passport country for your children? You mentioned teaching them a bit of American history at home, for example. How else did you give them a connection to the USA when they were growing up abroad?
Rachel: We have gone back almost every summer for at least a month, sometimes up to six weeks or more. Because we’re both from Minnesota and our parents are still there, my kids’ cousins and aunts and uncles are pretty much still around, we go back to the same location every time. So, I do feel like they have a connection that’s pretty good in the US. And we have some friends who have kids the same age, and they’ve recognized that when our kids come back, they need some American friends. So, they’ve really made it an intentional effort to keep our family connected with their family. So, that’s been really helpful. So our kids have both family connections and friend connections in the US.
And then, yeah, we try to celebrate the holidays, for example, of both countries – the national holidays or some of the religious holidays, like the Muslim Eid that’s here, or the Christmas and Easter, which aren’t political or national holidays, but a lot of the culture around those holidays is very connected to our countries where we’re from, if that makes sense. So, we’ve done things like that, and we cheer … for example, for the Olympics, we cheer for the Americans, we cheer for the Djiboutians, and there’s sometimes Somali athletes. We just try to incorporate all of the countries that we’ve been a part of into our celebrations and things like that.
Carlie: I’ve been away from Australia for about six years now, and I’m finding more and more that it’s really hard for me to have reference points. When people ask me about the current political landscape or best things to do in a city, or things to see … and I’m finding, well, I haven’t been there for a while yet, so actually, my point of reference is from six years ago, and now it’s possibly not so relevant. Do you and your children have those moments when it comes to questions about what’s happening in the USA and maintaining a connection?
Rachel: Yeah, that’s a really good point. Yeah, I would say that especially now, as politics seems to really be so consuming for Americans, and as we’re out of that, and have spent so long in different systems, yeah, we’ve lost the reference points. So, one thing we’ve encouraged our kids to do, and even have done ourselves, is when we go back, to consider ourselves kind of like tourists, or to explore, whether it’s the political culture conversations or the cities that we’re in, as if we were new. So, asking questions, and not thinking that we know it all. And that attitude has really been helpful, because yeah, you’re totally right, there’s that loss of point of reference.
Carlie: And have you found any amusing moments with your children from having that upbringing in the Horn of Africa? Plus, a strong reference to the USA but not a strict upbringing there, and so, having some, I suppose, knowledge or cultural gaps?
Rachel: Yeah, there’s been some really funny things. And here, the power goes off, off and on, and then generators will kick on, in all the neighborhoods, and so you get this low rumble. We were in Minnesota once, and the neighbor started mowing their lawn, so they turned on the lawnmower. And my kids said, “Oh, the power must be out.” And I said, “Why would you say that?” And they were like, “Well, because the generators all turned on.” [laughs]
And I said, “That’s a lawnmower.” And they said, “What’s a lawnmower?” [laughter] I said, “That’s to cut the grass.” And they didn’t understand even why you’d have to cut the grass. You know, things like that.
Or, it’s super-hot in Djibouti, it’s one of the hottest countries in the world. So, we always have air conditioners on. And Minnesota is really cold in the winter, and there’s heaters. But they had no idea where the heater was, and so they would say things like, “Let’s turn the air-conditioner on ‘hot’,” and try to get it warmer in here. Things like that. So, yeah, those things have been really fun to … we try not to tease them too bad, but they tease us for our terrible French, and so we can tease them for cultural faux pas. [laughs]
Carlie: [laughs] All evens out.
Carlie: You had one child born in Djibouti. Did you approach raising her any differently to the other two or have you noticed any stronger links?
Rachel: I haven’t really noticed much difference … sometimes we’ll kind of tease each other, like she will say, “I’m Djiboutian, I’m not really American,” or things like that. Or she sometimes will say that she’s African-American by her birth … but yeah, I haven’t noticed them be too much different, I think partly because the twins were so young when we came. She did … the youngest, [Renee], she’s 13 now, and she actually learned some more Somali than they did. And I think that was because she was just hearing it from the people we had in our house from the time she was born. Now she’s pretty much forgotten it anyway. But that was one thing I noticed different. I think she feels a lot of pride, in that she was born here – in a good way. She loves that her passport says that she was born here. So, they kind of tease each other. But it’s about the same amount of connection.
Carlie: You said that your children went to French schools, so they were learning French, and you were learning but possibly didn’t have such a great grasp. How did you make sure that you had adequate communication with them in French, and that you were able to balance that hierarchy when it comes to it, an authority figure and a parent, and keeping control, I suppose, if you don’t have the proficiency in a language that your children do?
Rachel: Well, we definitely spoke English at home. So, in the house, that communication between us was never a problem. What became or could have become a problem was when they would have friends come over. So, they would all speak French together, and then I wouldn’t be able to intervene if they were having an argument or needed some direction as they were playing. So, what I did at first …
When we first lived here, we were in a duplex, and our house was on top, and then downstairs was a Djiboutian family who we just loved and had a great relationship. And they had two kids that would come up to our house, and our kids would go down all the time. So, every day, they were hanging out with these kids. Just grew up together. And when it would come to be time for dinner, or time for bed, and I’d have to send the two kids home, I didn’t know how to get rid of them [laughs] without grabbing them and pushing them out, until I learned enough French. So, I actually picked up from the Teletubbies cartoon that our kids would watch. At the end of the cartoon, they would always say, “It’s time to say goodbye! It’s time to say goodbye!” But they would say it in French. And so, I would just say that. “[20:49]!”
[laughter] And then the kids would understand, and then they would go out. So, I wouldn’t say I was much of an authoritative figure with their play dates and things, at least not for the first year or two. I do speak Somali as well, so if their friends that were over spoke Somali, I could communicate to them in that language. But my kids didn’t speak Somali, and so, they didn’t like that. But yeah, I just would take phrases from wherever I could, and then make it work, and then eventually had enough French to engage.
Carlie: Fake it till you make it.
Carlie: You said your children are studying in Kenya at the moment, is that correct?
Rachel: Our youngest is, yeah. The older two, the twins are now at university in the United States.
Carlie: And how hard was that transition for the older two, leaving Africa to go and study in the USA?
Rachel: It was hard. Hard for me, at least. [laughs] Because now America feels like a foreign country to us. So, we have all these things that we’re feeling nervous about culturally, and … you know, the news coming out of America feels scary, sometimes, when we’re on this side of it.
And for them, it was also … they felt ready, they definitely felt ready, to go on to the next adventure. But it’s been a real learning process, because there’s things that they just didn’t know, and we didn’t know that they didn’t know. But here we’ve never had a house address, because they just don’t do postal services or addresses in the same way, and so they didn’t know how to address envelopes when they were filling out applications for different things in the United States. And I would never have thought to teach them that, or that they wouldn’t even know it – until I saw them try to do it and they couldn’t quite figure it out.
So, there’s things like that, like figuring out how to get an American driver’s license. Figuring out how to get medication. Here, in Djibouti, you pretty much can just walk into a pharmacy and tell them, “This is what I need,” and buy it. But in the US, you have to go to a doctor, get the prescription … there’s much more processes involved that they weren’t familiar with. So, that’s been just a logistical learning curve that they’ve been on. Navigating cultural changes and trying to figure out if they feel American or if they feel like they’re African. So, that’s also been hard.
Our son actually joined the African student group on campus, which he just loves. And our daughter is already planning to study abroad next semester – actually, in Australia. So, they’re definitely already thinking globally, rather than the US.
Carlie: That’s great. And clearly, they’ve got a great grounding for being curious about the world and wanting to see more.
Rachel: Um-hmm. Definitely.
Carlie: I’m guessing it might be really hard for people to empathize with them and those little everyday struggles they might have, particularly if they come across as American and don’t seem foreign on the surface.
Rachel: Yeah, my daughter’s roommate has actually been really good for her, because she thinks it’s just hilarious that my daughter doesn’t know how to do some of these things and is so excited to introduce her to the grocery store, and to … my daughter’s at a school in northern Minnesota, so the snow this year was taller than her, on the sidewalks. And she had never really been sledding or skiing, or ice-skating. So, her roommate just loved showing her all these sort of international things, to my daughter’s perspective, and kind of treated her like a foreign exchange student – which was really a gift. Because otherwise, yeah, it can be hard to tell someone, “I don’t know how to do this thing that everyone else knows how to do.”
Carlie: And it must bring up some frustrating moments for them.
Rachel: Definitely, yeah. They can feel a bit lost sometimes. There’s another term, besides TCK, one called ‘hidden immigrant’, which is a person who looks like they belong – their passport would say they belong, their clothing style, their accent, they look like they belong, but their inside, how they see the world and what they know to do or not do, is different. So, a hidden immigrant, which has been also a useful term for me to understand.
Carlie: Yeah, absolutely. I think it describes TCKs very well in a lot of cases. What qualities in your children do you link to their upbringing as third-culture kids, and how do you think it’s shaped both them and yourself?
Rachel: One I mentioned to you already is curiosity. They’re definitely … just curious about the world, because they know they don’t know everything where they are, whether they’re here in Djibouti or in the US. There’s things they don’t know, and so they ask a lot of questions. I feel like they’re very good conversationalists, and interested in other people, and they have interesting things to share as well, from their own experience. They’re very open to other cultures, to other races, religions, people from economic classes, because they’ve had to navigate that. Sometimes, here, in the morning, we’ll be visiting women that I was doing microloan projects with, so very low-income women, and then, in the afternoon, they would be at someone’s house from the Embassy, the US Embassy, very upper class. So, they’ve had to learn how to navigate those kinds of things.
They have friends … some of their closest friends or their favorite teachers are Muslim, and so they have a lot of respect for people of different religions, because they recognize that everyone is human and they all have value and personality and character. Their understanding of race is different. The twins were eight when Obama was elected president in the US, and they were at the US Ambassador’s house at that time, for … I think it was the inaugural address that he was giving. And it was really emotional for all the people. Some people were crying … and my kids were really surprised that it was so emotional. So, we had to explain some of the American history, of race, and why this was such an important and big deal. But they said, “Well, aren’t all presidents black?” Because all the presidents they had ever lived under were African men who they respected and … so they just had no concept of how this was such a big deal.
We had to really teach them … I want them to understand the American history, and why it matters, because that’s where they potentially would live in the future, and it’s important. But yeah, they definitely have a different perspective on things like that.
Carlie: It’s almost like this ideal perspective that has bypassed the prejudices and things that can ingrain in people when they only grow up knowing one culture.
Rachel: Yeah, like at the church we go to here, we have been, most of the time, the only Western family there. So, in American churches, when we go back to Minnesota, and if we’re at a church there, pretty much everyone in our sections of town, all the leadership, the pastors and the people singing, they’re all white. And here, they’re all black, they’re all African. So, for our kids, it’s been so good for them just to know what is true, which is that anyone from Burundi or from Kenya or from the United States can be an authority or a leader. It’s just been so good for them. I’m so thankful that they’ve had that opportunity to normalize what is really true and beautiful.
Carlie: Rachel, when you embarked on raising your children abroad, you weren’t going to another Western country which might be considered typical. And now especially, with global mobility, there’s such a great rise in the number of foreigners living in other countries and raising children in other countries. What would you say your biggest recommendations to other parents or soon-to-be-parents of third-culture kids and how they can approach raising them in … I wouldn’t say ‘the right way’, but in an optimal way for … to giving them a well-rounded view of the world and of themselves.
Rachel: That’s a good question. I think it’s really important to have open communication with your kids, because every kid is going to respond differently to transition, to cross-cultural situations. So, as parents, we need to pay attention to each of our individual kids, and then asking them questions about what they’re experiencing, how they’re responding to it, giving them vocabulary to use. My kids see a lot of poverty, really, a lot of dire situations. I can’t just let them see that and not give them words for how to respond to it, how to express it, how to say “This isn’t okay.” So yeah, having open communication about how [kids] are doing.
And then, I think making sure that you have maybe a mentor or two, someone else who has either raised kids abroad or was raised abroad, so they can speak into your experiences and give you advice. Some of these books are super helpful. And so many people online that I’ve reached out to have been really responsive. So, I know … in my book, the women and a few men who have essays in there love to engage with people who have questions.
And then, letting kids grieve and letting them celebrate – I think that’s super important. A lot of times, the negative side of TCKs can be emphasized, because there’s so much loss, of these goodbyes, and of culture and things. But there’s also a lot to celebrate that’s really beautiful about their upbringing, and so, to call out that goodness also, I think, is really valuable.
And then, the last thing would just be that our kids, yes, they’re TCKs, but they’re not only TCKs. I don’t want to lock my kids into this label. And I think more and more, some younger kids are cringing under that label. So, just to recognize that. You hear some things about TCKs, they might not tick every box, and they’re so much more than that. So, just to recognize that our kids are all unique, and to appreciate them for that.
Carlie: I read a piece on your blog entitled ’15 Things I Want to Tell My Third-Culture Kids’, and I think you illustrate in that very well the complexity of an international upbringing. If you could do anything again, would you do anything differently?
Rachel: Yeah. I had my twins, in particular, when I was so young, I feel like just as a person I’ve grown a lot. [laughs] I was 22 when they were born. So, as a parent, I’ve learned a lot over the years. But specifically, about raising them … something I thought of that I wish I had known to do was to be more of an advocate for them at school, especially when they were at the French school here.
Part of my hesitation was I just didn’t feel confident in my French, and I was learning it, and eventually got competent enough, but I didn’t know how to navigate the French educational system. I didn’t even know what questions to ask. I had some friends who were helping me, translating documents and things. But I wish I had been more assertive in making appointments with teachers, just to get to know what’s going on, and gotten more involved at the school. So, yeah, that was one thing that I … I would also encourage parents to do, like just be … acknowledge that you don’t know. And then, put yourself into your kids’ lives, and get involved and advocate for them.
Carlie: That’s it for today. If you have any questions for Rachel or want to share your own experience of raising third-culture kids, head over to expatfocus.com, follow the links to our forums and Facebook groups. Remember to check out our other episodes covering all aspects of expat life. If you like what we do, please leave us a review on our website, Apple Podcasts, or however you like to listen to the show. And I’ll catch you next time.
End of Transcript
Expat Health Insurance Partners
Cigna has worked in international health insurance for more than 30 years. Today, Cigna has over 71 million customer relationships around the world. Looking after them is an international workforce of 31,000 people, plus a network of over 1 million hospitals, physicians, clinics and health and wellness specialists worldwide, meaning you have easy access to treatment.