The expat guide to a healthy start
Moving abroad with your family is a huge change; different culture, different weather, different way of life… and in many places, completely different healthcare provisions.
There are lots of things to consider. Do you need vaccinations to travel to your new home? Anti-malaria tablets? Is Yellow Fever a problem and is the water safe to drink? Are you on prescribed medication and do you know whether this is readily available after you move?
This guide is a valuable starting point for planning a healthy and happy move. But please ensure you do your own research before you relocate, as different origin countries, and different destination countries will have their own rules.
Make sure you have Healthcare Insurance
Your move may mean you sacrifice your entitlement to NHS care (there are a few exceptions, see www.nhs.uk/healthcareabroad). You must plan for this to ensure your family stays safe and healthy. And, of course, if you’re moving from somewhere other than the UK, please check your own requirements.
Some countries have a healthcare provision based on National Insurance contributions, similar to the NHS (such as Austria, Denmark, France and Tunisia). Some offer limited free healthcare but it’s so chronically underfunded that you’ll find it safer to explore private options (examples include South Africa and Egypt).
Then there are those destinations which rely solely on private healthcare insurance, such as the Unites States, where without cover you will simply not be entitled to medical treatment.
Wherever you’re going you must set up some form of global healthcare insurance or expat medical insurance before you go. We cannot stress the importance of this enough; it’s too late once you arrive and have a medical emergency. There are lots of health insurance providers and the good news is they’re all in competition for your business, so shop around to get the best deal. But make sure you understand exactly what you’re covered for and against. Especially with regards to maternity cover – did you know you can’t get covered once you are pregnant? Planning for all eventualities is vital!
Vaccination requirements are not as straightforward as you might think. There are lots of variations to consider such as where you’ll be living, whether rural or urban, your age and general health and even what time of year you’ll be arriving.
That probably sounds crazy so here’s an example to show the variances…
If you are moving to urban India in typical hot weather conditions then you may be advised to get boosters for tetanus, Japanese encephalitis and Hepatitis B. But if you’ll be arriving during the rainy season and living or working in some of the less affluent rural areas, you may also be recommended vaccinations for Hepatitis A, cholera, diphtheria and even rabies. You’ll also need to and make sure you have adequate and suitable anti-malaria medication and emergency malaria treatment for the whole family.
By contrast, if you are moving to Spain, then apart from making sure your tetanus jab is up to date (which you should be doing anyway!) there are no further recommendations for vaccinations and malaria is not a known risk.
Research is essential to understand what you might be up against.
See your GP before you go
Visit your local GP at least 6-8 weeks before your move to allow sufficient time for any recommended precautions. Listen carefully to his or her advice; even if you think you already know the answers. Vaccinations and precautions can change, and healthcare professionals will have up-to-date advice about your specific destination.
Seeing your dentist and/or optician before you leave is a smart move too. You may not have another opportunity until you’re well established in your new home and know how everything works.
Know how to contact the emergency services
Here’s another easy thing to overlook in the myriad of things you have to remember… once you have your insurance in place and feel confident about your entitlements to medical care, you still need to know how to access it.
In the UK it’s as simple as dialling 999 for all emergency services and being talked through the choices. Elsewhere, not only will it be a different number but there may be more than one choice depending on the nature of your predicament. Make a list of emergency numbers, GPs, hospitals and clinics. We recommend printing it onto a card that will fit in your wallet and can be carried everywhere with you. And make sure you know how to get to your nearest hospital with an emergency room, too – the ambulance service in some countries can be somewhat lacking!
As an aside, if you have pets, make sure you know where your nearest vet is, too – something that didn’t occur to me on arrival in Japan, with sad and tragic consequences.
Plan ahead for your medications
If you are on prescribed medications, talk to your pharmacist about your move.
India, Pakistan and Turkey are among the countries that will not allow certain prescribed medications to be imported. Make sure you know if you are allowed to take your medications with you, whether you will need a Personal Medicines License (available from the Home Office), whether storing them will be a problem during transit (do they need to be kept refrigerated?) and if they will be available over the counter or on prescription in your new home.
Don’t just think about prescribed meds either, consider anything and everything that you commonly use – paracetamol, codeine, cough & cold medicines, antihistamines – you need to know whether you can buy them and if not, whether it’s even legal to carry them into the country with you.
Dubai is a great example of why you need to do your research… Many common pain killers, cold and flu remedies and even prescription medications are available over the counter in Dubai and other Emirates, sometimes in higher doses than you can purchase in the UK. However, nothing containing codeine is available there and you will need a license to take any with you. Codeine is not just unavailable, but actually illegal in Dubai and if you are carrying it without a license you may just find yourself arrested and detained!
Don’t forget emergency first aid
Finally, put together a comprehensive first aid kit to carry on the plane with you, ready for your arrival so you aren’t searching for emergency plasters on your first day.
Carry the basics; antiseptic cream, bandages, plasters, burn treatments etc. but also consider whether you might need anti-malarial tablets and emergency malaria medication, antihistamines, insect repellent and bite treatment, medication for existing conditions, re-hydration sachets and anti-sickness/diarrhoea pills. Also, spare inhalers for asthmatics and pain killers for all the family. It can be quite a shock to discover that only suppository medications are available for kids when we are used to tasty, neon-coloured liquid medicines! (But see the note above regarding codeine).
I’m sure you can add many of your own first aid necessities, depending on your family’s personal needs.
It sounds like a lot to consider and it may feel a bit scary to have to think so far ahead but don’t lose sight of the advantages. Travelling to (and living in) a new country is an amazing thing to do. It will broaden your horizons and provide your family with a multitude of incredible and valuable experiences that they might otherwise miss out on.
Don’t be put off by healthcare differences, just be aware, be prepared and be safe.