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Vivian Chiona
Vivian Chiona is the founder and director of Expat Nest (www.expatnest.com), which provides emotional support to expats and their families through online counseling services. A bicultural, multilingual expat with family all over the world, Vivian is familiar with the blessings and challenges of a mobile life. Created in 2013, Expat Nest's e-counseling service was conceived exclusively for expats as a way of offering counseling without borders. As a professional psychologist with a Bachelor's degree in Psychology and a Master's degree in both Child & Adolescent Psychology and Health Psychology, Vivian has successfully consulted with more than 1,000 clients and has delivered training on a variety of topics such as transition, Third Culture Kids (TCKs), coping with change, dealing with stress, bereavement and expat loss, special educational needs, and more. You can join her free newsletter and get more of her tips, here: www.expatnest.comRead more

How to cope with a health condition abroad

Apr 21, 2018

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, expat physicians, and 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

The following challenges are very common to experience when you are ill abroad:

Isolation

Isolation is the most common challenge reported. For example, 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

Poor knowledge of the local healthcare system, its process, coverage, and payment protocols, can sometimes lead to financial stress and / or crisis. 

Private insurance options

Unfamiliarity with private insurance options and coverage.

Lack of trust

Lack of trust in the local medical team / treatment. 

Miscommunication

Misunderstandings with healthcare providers, especially when there is a language barrier or cultural communication differences. 

Physical discomfort / pain

Depending on the illness you have.

Emotional discomfort / pain

This can include guilt, self-blame, doubt, sense of loss and grief, anxiety/depression, hopelessness and helplessness. 

Being overwhelmed

Perhaps you have a long list of tasks to complete, and you do not know where to begin. 

Difficulties parenting

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:

1. Shift your mindset

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.

2. Be proactive

Plan what you can, and prepare and educate yourself about the diagnosis and treatment protocol, your medical coverage, and the local medical system.

3. Be aware

Be aware of your (or your loved one’s) personal coping style and the quality of energy you bring to the table.

4. Prioritise self-care

Sleep, relaxation, movement, essential oils, nutrition and therapy / coaching can help get us to get “unstuck”.

5. Practise mindfulness

This may 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.

6. Work through it

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.

7. Pay attention to the labels you use

For example, do you see yourself as a “survivor” or a “patient” or “victim of...”?

8. Seize the opportunity

Seize the opportunity to practise a new hobby or do something that brings you joy.

9. Embrace humour when possible

Laughter helps us to relax, has health benefits, and reminds us of the bigger picture.

10. Think about what you share with others

Choose carefully what you share, and with whom.

11. Choose your attitude

How do you respond to situations? It’s okay to get help with this!

12. Have faith 

This may mean turning to your religion, or turning towards a life philosophy that holds meaning and hope for you.

13. Expand your support system

Include local people, professionals and online or face-to-face groups.

14. Use social media consciously!

Social media can be a great source of support and information, but it can also be a source of stress when there is oversharing or unhelpful feedback - or when it intensifies our tendency to compare ourselves, or our lives, to others.

15. Practise gratitude

Practice gratitude for what is working and right. Consider starting a gratitude journal to capture these moments of appreciation.

16. Celebrate

Celebrate both your large and small victories!

Professional support

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.

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!

By Vivian Chiona