Health Issues Discussion
Travel and study abroad will most certainly affect your health in one way or another, as many factors that influence your daily health have to do with lifestyle and environment, not to mention that good health (or lack thereof) will have a significant impact on the success and enjoyment of your time abroad. Be sure to plan ahead properly by considering the following:
Assess your health and identify your needs
Please remember that study abroad is not a magic cure for concerns and problems that you may be having at home. Emotional, psychological and physical problems will indeed follow you wherever you go, so it is important to consider honestly your health issues and needs before you go abroad. Contrary to popular belief, travel does not minimize these problems; rather, it often can exacerbate them to the point of crisis if you are not careful.
Be clear and honest about your health needs when applying for a study abroad program and when making your housing arrangements. This includes issues such as medical needs, allergies, psychological treatments, dietary requirements (including vegetarianism), and disabilities. Services for people with disabilities vary widely around the world; if you have questions or concerns about these issues, please feel free to discuss them with the Study Abroad office that manages your program. If you have any kind of mental health problems or eating disorders (or if you have had in the past), think carefully about your decision to study abroad, and please discuss these issues with your physician and with your mental health practitioner.
See your health care practitioners
Before you go abroad, it is a good idea to visit your family physician, dentist, gynecologist and any other health care practitioners that you regularly see. Make sure your health records are up-to-date and that you discuss any medical issues you have that may affect your experience abroad. You should take copies of your medical records with you abroad, especially if you have specific medical conditions or if you expect to need medical care abroad. Also, be sure you have an adequate supply of any prescription medications in their original containers with you, if they are not available in your host country. You will need a physician's prescription (in generic form) for medication and medical supplies to pass through customs in your host country.
Some countries require specific immunizations in order to enter the country, and there are also immunizations recommended for travel to specific areas of the world. Plan this well in advance of your departure, as some immunizations require a series of inoculations starting many months before your scheduled travel.
Check with health care providers or your own records to ensure that your immunizations (e.g., tetanus and polio) are up-to-date. Under the International Health Regulations adopted by the World Health Organization, a country may require International Certificates of Vaccination against yellow fever, and a cholera immunization may be required if you are traveling from an infected area. Prophylactic medication for malaria and certain other preventive measures are advisable for travel to some countries. No immunizations are required to return to the United States.
An increasing number of countries have established regulations regarding AIDS testing, particularly for long-term visitors. Check with the embassy or consulate of the country you plan to visit to verify if this is a requirement for entry.
Detailed health information can be obtained from your local Public Health Department, your physician, or by contacting the Centers for Disease Control and Prevention (phone 888-232-3228 or 877-FYI-TRIP or wwwn.cdc.gov/travel). It is very important to discuss these health guidelines and recommendations with your own physician.
Other health questions to ask
- Are there illnesses that are endemic to the region?
- What medications should you take to prevent these illnesses?
- What is the quality of water in your host country, and what precautions, if any, do you need to take with your drinking water and food preparation?
- What precautions are recommended for safe sexual practices?
- What are the customs, beliefs, and laws in your host country regarding sexual behavior and the use of alcohol and drugs?
- What are the laws in your host country regarding bringing in medications, medical supplies, and contraceptives?
- What kind of medical insurance do you need (see Medical Insurance section for more information)?
Some students have found that bringing a small medical reference book along was helpful. Suggested publications include:
The Pocket Doctor, by Stephen Bezruchka, M.D. Published by The Mountaineers, Seattle, Washington, 3rd edition 1999. (128 pages, pocket size, $6.95.) To order: 1-800-553-4453.
Shoreland’s Travel Health Companion: www.shoreland.com/
When you arrive in your host country
Because of cultural differences, travel and other adjustment concerns, you will need to continue to pay attention to your health (both physical and mental) when you arrive and throughout your program. Know how to get medical help should you need it, including routine healthcare, as well as emergencies. Make your medical needs known to anyone in your host country who can be of assistance. Most importantly, give yourself time to adjust to the new culture, and be attentive to your personal well-being—make sure you eat healthy foods and get regular sleep and exercise.
In the United States, we live in a society which offers a wide range of food choice. When traveling abroad, it is sometimes difficult to maintain a particular diet (for example, a vegetarian or medically-restricted diet). Vegetarianism can mean a variety of things to different people. Think carefully about how your food choices might affect your friends who invite you to dinner, your homestay family or fellowstudents with whom you cook in the residence halls. Prepare yourself for societies in which ingredients are rarely listed on packaging.
While there is currently a strong movement in the United States against smoking in public places, the situation in many other countries is quite different. While abroad, you may encounter more second-hand smoke than you are used to, with smokers showing little concern about whether or not it bothers you (for example, in restaurants or on trains).
You must have adequate health insurance coverage abroad. Check your CISI policy to see what it covers. Take your insurance card with you abroad, as well as any claim forms you will need.
Safety and Legal Issues Discussion
Safety is an understandable concern wherever you may be going; however, it is useful to take a comparative perspective: the United States is known around the world as a relatively dangerous country, and our street crime statistics support this view, and the U.S. certainly has more hand guns and more gun-related deaths and injuries than anywhere else. Even college campuses have their share of robbery, property destruction, drunkenness, violence, and sexual assault. It is also important to consider that the U.S. media coverage of the rest of the world focuses (often sensationally) on overseas political upheavals, violent strife and natural disasters. One of the first reactions study abroad students have is how "normal" life seems abroad, in spite of cultural differences. However, although you may be statistically safer abroad than at home, danger can occur anywhere, and you can play a big part in minimizing risks and hazards.
The following are things you can do to help ensure that your study abroad experience is a safe one:
- Read and evaluate all materials provided by your program or university that relate to safety, health, legal, environmental, political, cultural, and religious conditions in your host country.
- Pay attention to the local conditions. Stay informed about local and regional news, read newspapers with good international coverage and analysis of local issues.
- Keep a low profile and try not to identify yourself as an American by dress, behavior or speech.
- Avoid protests or potentially violent situations or places where Americans are known to congregate. In the event of disturbances, do not get involved.
- Be street smart. Remember that adjusting to city life is part of the cultural adjustment process, since most cities where students study abroad are much larger than Wisconsin cities.
- Keep your residence locked and report any suspicious persons hanging around your building.
- Make sure your program faculty leader, fellow travellers or in-country hosts know how to contact you in case of emergency. Remember to leave your itinerary if you are taking a trip on your own. (NOTE: a study abroad participant has to receive a prior approval for any deviation from the program from the faculty leader and/or the UW Colleges Study Abroad Coordinator)
- Be wary of impairing your judgment through the excessive use of alcohol, and do not use illegal drugs.
- Avoid walking alone at night.
- Do not display money, jewelry, cameras or other valuable items.
- Never carry large amounts of cash.
- Familiarize yourself with your neighborhood, locate your nearest police station and hospital, and collect and save any emergency phone numbers.
- Don't allow yourself to be vulnerable. Take the same precautions you would at home regarding giving out your name and address to unknown people.
- Regarding road travel, be aware that driving customs vary a great deal, and in most countries pedestrians are not given the right of way. Find out which roads are safest and whether it is safe to travel on overnight trains and buses. You are advised not to drive while abroad, especially in countries where driving on the left-hand side of the road is the norm.
- Unfortunately women travelers are more likely to encounter sexual harassment, but dangerous or uncomfortable situations can sometimes be avoided by dressing conservatively, not walking alone at night or in questionable neighborhoods, and not agreeing to meet anyone in a secluded place. In addition, be aware that there are many unfortunate stereotypes about American women.
- If, during your stay abroad, there is a serious event involving casualties (whether or not it has put you personally at risk) that is likely to gain international media exposure, we urge you to contact your family by phone, fax or e-mail, to reassure them that you are okay. Remember that what may seem like a relatively minor local event to you could cause alarm back home.
Alcohol Abuse and Misuse
Although there may be no minimum drinking age in some countries, the customs regarding alcohol use may be very different from the ones in the United States and the state of Wisconsin. The following circumstances might temp you to misuse alcohol while abroad: a mistaken impression of how alcohol is used in your new surroundings; cheaper costs in some countries; a lower minimum drinking age; more lenient laws against drunkenness or a desire to experiment or fit in. When visiting a foreign country, common sense and “good judgment” are essential for keeping one self and the group safe. If you choose to use alcohol, use it responsibly. Keep in mind that being under the influence of alcohol also impairs judgment and increases your chances of being the victim of crime, whether robbery or sexual assault.
Clinical studies have proven that excessive alcohol consumption impairs judgment, rendering people incapacitated in any country, foreign or domestic. Unfortunately, American study abroad trips have shown a tendency for students to develop a “party” attitude when U.S. alcohol laws are suddenly removed when traveling to a foreign country. Another alluring tendency of any student is the perception that a study abroad trip is a vacation, contributing to an increased alcohol consumption compared to daily practices back home. Although certain aspects of study abroad are tourist orientated, these trips are academic in nature and encourage students to immerse themselves in the cultural experience, rather than retreating to less constructive activities.
During your pre-departure orientation you will be informed of program requirements and host country laws regarding alcohol consumption, as well as the consequences for abuse. Most countries – with the exception of those with religious prohibitions – tolerate social drinking. Intoxication, public drunkenness and inebriating behavior, however, are not allowed under any circumstances. Alcohol abuse and misuse are not acceptable anywhere in the world and will not be tolerated on UW Colleges sponsored study abroad programs. Violation of local laws and/or UW Colleges regulations or policies related to alcohol misuse and abuse may result in (i) immediate dismissal from the program including required immediate return home your own cost; (ii) academic withdrawal from the college for the semester in progress; and (iii) disciplinary action upon return to campus.
Alcohol Use for Women Abroad
Please be aware that over consuming alcohol can especially put women in unsafe circumstances. Women who are publicly drunk may be looked at differently abroad than in the U.S. In many countries, a woman who is publicly drunk is looked upon as "loose" or "unladylike" or inviting advances from men.
(Adapted from the U.S. Department of State's Travel Warning on Drugs Abroad)
The UW Colleges has a zero-tolerance policy regarding the possession, use, manufacture, production, sale, exchange or distribution of illegal drugs by students participating in UW Colleges sponsored study abroad programs. Violation of this policy may result in (i) immediate dismissal from the program; (ii) academic withdrawal from the University for the semester in progress; and (iii) disciplinary action upon return to campus.
NOTE: Each year 2,500 Americans are arrested overseas. One third of the arrests are on drug-related charges. If you choose to use illegal drugs abroad, there is very little that anyone at the UW Colleges or the US Government can do to help you if you are arrested. You are operating under the laws of the host country and the regulations of the local institution. Neither the U.S. government nor the home institution will be able to secure your release should you be arrested. It is your responsibility to know the drug laws of a foreign country before you go. Some laws may be applied more strictly to foreigners than to local citizens; therefore, don’t assume that just because local people are using drugs, it’s acceptable for you to use drugs.
Here is what the U.S. Consulate CAN and CANNOT do if you were arrested on drug charges:
The U.S. Consular Office CAN:
- visit you in jail after being notified of your arrest
- give you a list of local attorneys (The U.S. Government cannot assume responsibility for the professional ability or integrity of these individuals or recommend a particular attorney)
- notify your family and/or friends and relay requests for money or other aid - but only with your authorization
- intercede with local authorities to make sure that your rights under local laws are fully observed and that you are treated humanely, according to internationally accepted standards
- protest mistreatment or abuse to the appropriate authorities
The U.S. Consular Office CANNOT:
- demand your immediate release or get you out of jail or the country
- represent you at trial or give legal counsel
- pay legal fees and/or fines with U.S. government funds
If you are caught using illegal drugs by a UW Colleges faculty or staff leader, you may be immediately dismissed from the UW Colleges sponsored study abroad program. If you are caught by local authorities it could mean:
- interrogation and delays before trial, including mistreatment and solitary confinement for up to one year under very primitive conditions
- lengthy trials conducted in a foreign language, with delays and postponements
- weeks, months or life in prison (some places include hard labor, heavy fines, and/or lashings), if found guilty
- death penalty in a growing number of countries (e.g., Malaysia, Pakistan, and Turkey)
Although drug laws vary from country to country, it is important to realize before you make the mistake of getting involved with drugs that foreign countries do not react lightly to drug offenders. In some countries, anyone who is caught with even a very small quantity for personal use may be tried and receive the same sentence as the large-scale trafficker.
Safety Precautions for Times of Political / Social Unrest or Conflict
In times of political or social unrest in the host country or region, or when the United States becomes a party to a political conflict anywhere in the world, additional precautions are advisable:
- Keep in touch with the current political situations by listening daily to the television or radio if available. If not, ask friends, host family, and colleagues to share with you any relevant information they learn. In case of an emergency, advisories may be made to the general public through the media. In case of an emergency, remain in contact with the on-site staff.
- Make an effort to contact the closest American Embassy or Consulate.
- When in large cities and other popular tourist destinations, avoid places frequented by North Americans: bars, discos, and fast food restaurants associated with the US, branches of US banks, American churches, US businesses and offices, US consulates or embassies.
- Keep away from areas known to have large concentrations of residents aligned with interests unfriendly to the United States and its allies. Always consult with the on-site officials before undertaking travel to neighboring cities or popular tourist destinations.
- Be as inconspicuous in dress and demeanor as possible. Wear moderate colors and conservative clothing. Avoid American logos on your belongings and clothing. Avoid large loud groups.
- Keep away from political demonstrations, particularly those directed toward the United Sates. If you see a situation developing, resist the temptation to satisfy your curiosity and investigate what is happening. Walk the other way.
- Do not agree to newspaper or other media interviews regarding political conflicts. It is important to remain as inconspicuous as possible. Do not make reference to your program group. In such cases, always say "no comment" and hang up or walk the other way.
Unfortunately, terrorism is a reality today. Although it is highly unlikely that you will be the object of a terrorist act, there are precautions that you can take to minimize your exposure to risk:
- Keep a low profile.
- Do not draw attention to yourself through culturally inappropriate dress or behavior.
- Avoid traveling in groups of Americans and speaking English in public.
- Avoid areas with U.S. interests, such as the U.S. Embassy, McDonalds, Hard Rock Café, American Express, etc.
- Avoid crowds and protest situations.
- Keep abreast of news and stay in contact with your family.
More Information on Safety
State Department Travel Advisories: reports from the U.S. government which monitor political conditions in every country of the world: www.travel.state.gov
When you are abroad you are subject to the laws of the country in which you are living and studying. The laws are likely to be very different from those in the U.S. and in Wisconsin. You should know that the American principle of "innocent until proven guilty" does not apply in all legal systems abroad, so the best advice for you is to know the laws and obey them. Please remember that if you should get yourself into trouble with the law in your host country, there is nothing Middlebury can do for you, and there is little the U.S. Embassy or Consulate can do.
- The only assistance the U.S. Embassy or Consulate can provide for you is to give you a list of local attorneys and physicians, contact your next of kin in case of emergency, contact friends or relatives on your behalf to request funds or guidance, provide assistance during civil unrest or natural disaster, and replace a lost or stolen passport. They cannot get you out of jail.
- The experience of a foreign jail is not something with which you want to become familiar in your host country. In many cases the conditions are deplorable, and bail provisions as we know them in the U.S. are rare in many countries.
- You should avoid all involvement with illegal drugs. In most cases, drug laws are extremely severe (more so than in the U.S.), regardless of whether the drug is in possession for personal use or for sale, and in many cases regardless of the amount. (There have been cases of Americans arrested and jailed for long periods abroad for possessing as little as 1/10 ounce of marijuana.)