pollution

5.3 Health and Safety

I wake up every day and think, “I’m breathing! It’s a good day.” – Eve Ensler

Schools In Unhealthy Places

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You could be taking years off your life if you work at a school in a heavily polluted city. “I was sick most days with respiratory problems from the lead used in the fuel of the millions of cars that jammed the roads…lethal air and strange and toxic smells emitted from factories…the worry of food being tampered with, vegetables grown in toxic soil.”

In August 2020 the AQI in Delhi was 597. By comparison a sunny spring day in Oregon AQI is 23; statewide fires that same autumn poisoned the air for weeks. Just try to imagine breathing that every day. Should you work in unhealthy conditions?

As always, do your research. Here are some resources:

  •     Geosure – app that rounds up safety data and warnings.

  •     US Department of State travel advisories.

  •   Center for Disease Control (CDC)– alerts by level.

  •    World Nomads – insurance company that does a good job rounding up alerts and providing good general advice.

     Evaluate the Dangers

I was happy in the midst of dangers
and inconveniences.
- Daniel Boone

“One child developed an odd muscular twitch that wouldn’t go away.” This HuffPost reminiscence from a diplomatic spouse is illuminating, unnerving, and inspiring, all at once. Of course, this decision matters most if you have children. Consider these hazards:

1.     Insects carrying disease (roaches, mosquitos, vermin), tropical diseases like malaria and dengue fever, tropical rashes, and asthma - are there vaccines for these diseases and how clean are school facilities i.e. mold?

2.     Air and water pollution – check the air quality index AQI. Do school facilities have good air purifiers and how frequently is outdoor recess impossible?

In some countries, coal-fired plants, vehicle exhaust, chemical and industrial factories, and burning trash spew toxins without any restraint. Not every country forbids leaded fuel.

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In others like India, Thailand, and Burma, the agricultural burning season darkens and clogs the skies every year. This top 10 most polluted cities roundup is shocking. China shows some improvement but India is worsening.

3. Adulterated food and water - if you can’t flush the toilet paper, you can’t drink the water, so how will you access clean water? In Russia 5-gallon Nestle water jugs were delivered and set up weekly. Will this be possible for you?

Precautions

Precaution is better than cure. - Johann Wolfgang von Goethe

Once you have a handle on exactly how dangerous a location might be, you can make an informed decision. Don’t automatically cross a school off your list, but be proactive. Plenty of teachers work happily and profitably in polluted cities. However,

  •  Be up to date on all necessary vaccinations, especially if certain diseases are endemic. Follow State Department guidelines.

  •  Bring prescription medications with you, enough to last. Occasionally, local equivalents are just fine, but verify ahead of time.

  • Use a water dispenser or safe bottled water and consider installing air purifiers. Some schools may have effective air cleaner systems.

  • Discuss your concerns with the school.

  • Research, read blogs, and talk to staff.

The decide whether to go, but first evaluate the risks. I know all this sounds like you should never leave home, but risk can be managed (mostly.) Of course, think twice if you’re bringing young children with you.

Health Issues

Insurance

Pre-existing health conditions could be a show-stopper. Schools won’t not want to hire someone who will explode their insurance costs. Thoroughly examine the school’s insurance policy and read every word.

Read the fine print and think about worst-case scenarios.

Read the fine print and think about worst-case scenarios.

You never know when disaster may strike. Verify exclusions, pre-existing conditions, dates of cover, and medical facilities the school uses. Consider buying a backup personal policy from World Nomads, which can be expensive but may be necessary. Or just don’t go to a school without good coverage.

Disability Access

There is no ADA overseas (the A stands for American) and countries vary wildly in disability accessibility. If you use a wheelchair, for instance, you might have a problem at the school or in school housing, never mind out in public. There are no guarantees, so discuss this with the school in advance.

Emergency Services

Even if the school’s insurance coverage is excellent, you might also consider evacuation insurance. God forbid you need specialized treatment outside the country or have a bad accident while traveling.

Keep the Embassy emergency number on speed dial.

Keep the Embassy emergency number on speed dial.

And do you know what number to dial in a health emergency? It’s not 911, that’s for sure. Find out before you need to know and keep the phone number handy.

The overseas world features at least two unique medical issues. One is what is currently (Feb. 2020) happening in Wuhan China; you could end up quarantined or locked out of the country. The variables shift daily. Editing this today (April 2021) it all seems prophetic, doesn’t it?

You might also learn the term medical tourism and take advantage of the savings. The cost differentials are stunning. A $40,000 hip replacement would cost $17,000 in Thailand, for instance.

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In Chiang Mai I suddenly developed vision difficulty and had to bail out of school “week without walls.” The doctor correctly diagnosed and treated the problem, the procedure cost virtually nothing, and her English was great (naturally) as she’d trained in Boston. If I ever need knee replacement, I know where I’m going.

Mental Health           

Aristotle said it best – mind and body. To maintain your sanity and happiness, let’s just repeat the standard advice:                   

o   Exercise – although depending on the level of air pollution, you might consider working out in the gym if the school air is filtered to minimize the toxins.

o   Eat healthy, drink moderately, sleep well, repeat.          

o   Avoid risky behaviors.

o   Nurture your support network.

Safety Overseas

An ounce of prevention is worth a stitch in time.
Benjamin Franklin

Actual vs. Perceived Risks

There has been a ton of research on this issue. Suffice it to say that humans are fundamentally irrational in this matter. Humans tend to over-react to spectacular risks and underreact to common dangers.

“People worry more about earthquakes than they do about slipping on the bathroom floor, even though the latter kills far more people than the former,” for instance.

Note: it might provide some perspective to compare threats perceived by travelers to the USA. This summarizes what Aussies think of traveling to the US: guns, terrorism, civil unrest, natural disasters. They also exaggerate the dangers SEE Actual vs. Perceived Risk.

 Political Hot Spots and High-Crime Countries

Besides health hazards, you might also be putting yourself and your family in a dangerous situation by moving to a country experiencing instability or one especially prone to crime. A country can undergo a coup or riots and become unsafe in a flash.

The voice of experience from an ISR thread.

The voice of experience from an ISR thread.

Best to create your own evacuation plan. I always had USD cash ($2000) + local cash, 2 liters water, passport, basic survival gear, and 2 changes of clothing in a backpack for grab and go. If it was a country where dressing local made me invisible, I also had 1 set of “native” clothing. In an emergency minutes count, as borders close quickly. You can bet locals will need to help their families–NOT you. Embassy staff plans fall apart when embassies are overrun. Best bet is often to head to nearest border crossing and bribe to get out. This is the voice of experience talking by the way.

Some places are inherently or currently unsafe, either due to crime or political uproar. What should you do? Should you take a job at that school? How can you practice due diligence? Here are some basic steps:

  •    Follow the news.

  •   Check State Department alerts. This example is Guatemala.

  •  Remember that your Embassy is not responsible for you, although they can assist.

  •  Be blunt and just ask the school what their safety plan is. The director may try to make light of dangers, but you’ve done the research.

  • Then make an informed decision. Why do some expats stay? Here is one answer from Amanda Isberg on the front lines of Venezuela. Here are some other horror stories, which may give you pause.

However, notice a few mitigating factors in both these posts : 

1)     Not all these countries/cities are universally dangerous

Decide for yourself if it’s worth the risk.

Decide for yourself if it’s worth the risk.

2)     Proper care and behavior can definitely mitigate the risk.

3)      Some people have a higher tolerance for crime than others.

4)     Sometimes the benefits outweigh the risks.

5)     Just remind yourself that the US can also be very dangerous.

Common Sense Precautions

These red plates stand out. and mark you instantly as a foreigner. Never mind that it’s an expensive Western car!

These red plates stand out. and mark you instantly as a foreigner. Never mind that it’s an expensive Western car!

You might as well be wearing Day-Glo since the locals can peg you as a foreigner at 100 meters. And if that weren’t enough of a tell, teacher cars in Russia, for instance, were registered as diplomatic vehicles and featured red license plates.

Expats are perceived as wealthy and therefore a high value crime target, mostly petty crime. Get over it and take sensible precautions.

Try to blend in as much as you can, do not flash anything that looks expensive, lock valuables out of sight, be nice to the guards at school housing. The usual precautions apply of course i.e. drunk alone at night in a dodgy neighborhood is asking for trouble, isn’t it?  

Schools that keep your passport, most typically in the Middle East, are generally a red flag. Without a passport and/or exit visa, you are at the mercy of the school. Think twice about going to such a school.

 Terrorism

Of course a terrorist can mow down dozens of people on a sidewalk or classroom. Oh, wait a minute. That was in Parkland, FL, Newtown, MA or manh places in the US _______fill in the blank. The risks are completely random and impossible to truly defend against.

Cynically, we’ve actually felt safer traveling in a place that has had a recent terrorist event. That mean plenty of guards, barely any Westerners, and wonderful service. In Cappadocia, Turkey after an incident, we had the entire site to ourselves, with only a Ukrainian tourist family for company and lots of guards with guns.

Women and People of Color

Sexism is everywhere, bro. I don’t know if it’s ever not somewhere. - Billie Eilish
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Sigh. There is simply no getting around it. Attitudes have changed but not enough. It’s still a man’s world with the dangers and everyday annoyances that weigh most heavily on women and minorities.

Particularly in the Developing World, open displays of racism occur with godawful frequency. From veiled women in the Middle East to catcalls in Italy, women are viewed as weaker and therefore more vulnerable to attack.

Behavior that would not be worth a second thought at home, as in dress or public behaviors, can be provocative in some countries. As always, do your homework.

 Police and Corruption

I’m not against the police; I’m just afraid of them. - Alfred Hitchcock

In many countries, not all, bribery and police corruption may be the norm. The best advice? Do what your Embassy suggests. Trying to bribe an official is not a good idea. Suggestions if you are stopped by the police:

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§  Always carry your official ID card, which is generally required at all times, but do not carry your passport unless you absolutely must.

§  Keep your phone charged and have the Embassy or Consulate emergency number handy. Your school should provide instructions for what to do in this situation.

§  Don’t do anything stupid or be rude and aggressive. Be firm and sit tight. 

Traffic Is the Greatest Danger

They say the universe is expanding. That should help with the traffic. - Steve Wright, comedian

In terms of statistics, transportation is far more likely to get you killed or injured than any other hazard. In my years overseas I was never robbed or assaulted; however, I was involved in two car accidents in Thailand, #2 on this list of accidents per capita.

This is probably about average. If you do decide to buy a car and drive, practice extreme defensive driving and abide by local norms. That means if everybody drives on the sidewalk, you should too.

Much of the problem arises from cheap, barely roadworthy cars dumped on the local market, inexperienced drivers, lax or non-existent licensing, lack of infrastructure like shoulders and zebra crossings, jam-packed buses, and swarms of motorcycles. All this is in addition to the usual speeding, drunk driving, and general carelessness. Good luck.

Perspective On Safety

The desire for safety stands against every great and noble enterprise. - Tacitus

I’ll just leave you with two thoughts and two book recommendations.

  1. There is no such thing as perfect safety. Just prepare as best you can, then live your life joyfully.

  2. The world is actually much safer and more civilized than it has ever been in human history. Try to maintain perspective and relax.

Steven Pinker’s 2011 The Better Angels of Our Nature: Why Violence Has Declined presents authoritative data proving that things are as peaceful today (homicide/violence against women/war) as they have ever been in history.

Otto Bettmann’s The Good Old Days - They Were Terrible! highlights the painful realities of American life in the 1800s, like adulterated food/child labor in sweatshops/rampant opium addiction…

So take care of yourself, do the research before you decide to sign that contract, take sensible precautions, and enjoy the adventure.