MEDICAL REALITIES OF DIPLOMATIC AND
INTERNATIONAL CAREERS
Health considerations for you & your family relocating abroadDr Franck SCOLA
Health and Expatriation
- Specificity
- Awareness raising
- Cross-culturality
- Multidisciplinary approach
• Sociological evolution
• New profiles
• New needs
• New demands
Comtemporary Trends in Expatriation
Seeking Medical Care In A Cross-cultural Context
Facing the unknown:
- Local risks
- Variations in health systems
- Accessibility to medical care
Seeking Medical Care In A Cross-cultural Context
Consequences from problems accessing medical care:
- Non-treatment
- Neglecting preventive health measures
- Inappropriate medical care
Aggravating factors of medical risks :
- Unpreparedness of key players
- Lack of training for care-givers
- Risks connected with social networking
- Lack of information for patients
Seeking Medical Care In A Cross-cultural Context
Being ill far from Home
Discovering the host country’s health
system
Patient and caregiver from different
cultures
Language barrier
Cross-cultural Issues In Medical Care
Anticipating measures of: Information Prevention Medical assistance in case of
emergency Evaluating specific health risks for
each family member
Goals for HR Departments
For the:• Expatriate employee• Accompagnying spouse• Children
What kind of medical follow up ?
Evaluating medical needs ofeach family member
Change of status+
Change of environment
Risks(disease, accident, pregnancy, disability…)
Difficulty in accessing medical care+
Inappropriate trends in health behavior+
Risks connected with social networks
Medical And Social Specificity In Expatriate Life
Vulnerability
Aggravating factors
Physical Health
Aggravating factors depending on: Patient’s reaction: reluctance, procrastination, panic
Information: availibility and validity
Cultural and linguistic factors
Healthcare facility: cross cultural competences
The Children
Status of follower
Influence of mother’s condition
Pediatric follow-up
Early bilingualism
0
1
2
3
4
5
6
7
0-2 3-4 4-6 6-9 10-12 13-24 25-36 46-48 49+
Mastery
AdaptationDisillusion
Culture Shock
Honeymoon
Months passed in the foreign culture
Mor
al/ C
onfo
rt p
sych
olog
iqu
e M
oral
e/ P
sych
olo
gic
al
com
fort
La théorie de la courbe en U d’après Black et Mendenhall (1991)
27
Cycles Of Adaptation
6. Acceptation of host culture7. Anxiety of repatriation8. Reverse culture shock 9. Reintegration
Adaptation Stages
Emotionsand Energy
1. Initial anxiety2. Honeymoon period3. Initial culture shock4. Disillusion5. Adaptation process
Country of origin
LOW
Country of origin
Host country
HIGH
Reverse culture shock Reintegration
Honeymoon period
Honeymoon period
Strangeness of others’ behaviourBehaviour does not get expected resultsUnreadiness for environmental pressures
Gradual adaptation and integration to the host culture
1
xa2
3
4
5
67
8
9
28
Cycles Of Adaptation
6. Acceptation of host culture7. Anxiety of repatriation8. Reverse culture shock 9. Reintegration
Adaptation Stages
Emotionsand Energy
1. Initial anxiety2. Honeymoon period3. Initial culture shock4. Disillusion5. Adaptation process
Country of origin
LOW
Country of origin
Host country
HIGH
Reverse Culture scock Reintegration
1
2
3
4
5
67
8
9
PreparationPreparation
Intercultural training and coaching
Intercultural training and coaching
Language lessons
Language lessons
Expatriate Support programme (ESP) Domestic ESPExpatriate Support programme (ESP) Domestic ESP
repatriation services repatriation services
Services in destination
country
Services in destination
country
Before departure: selection & preparation (training on the country, culture, personal & family variables);
On arrival: continued support in the field (language training, coaching, programme of expat aid, destination services);
Repatriation: reintegration (return training, integration to the department & the work team, support).
Support for Expatriat Workers
Three critical times for intervention
Transferring a
problem colleague
Career burnout
Excessive technical qualifications
Family problems Culture shock
WHY!?
Source: Gomez-Mejia et al., p. 508, (2000)
Expatriation Sometimes Fails
Ineffective training
Behaviour In Seeking Medical Care
• Conservatives
• Defensives
• Converted
• Opportunistics
• Transnationals
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