Health Consideration Contents

Predeparture Checkups

One of the first steps is to make sure that you schedule health-related check-ups before you go. About two months before you depart, you should have:

a general physical exam
a dental check-up
an eye exam (if you anticipate your prescription may need to be updated)
a gynecological visit (for females) before leaving
Travel clinic for any extra immunizations
Therapist/Counselor as needed, see the Psychological and Emotional Wellness for more information. Visit the DU Health and Counseling Center.

If you currently wear a MedicAlert emblem, you should contact MedicAlert to ask for the international number for outside of the U.S. MedicAlert is recognized internationally. For more information, contact the MedicAlert Foundation International online.

Routine Care While Abroad

Not all healthcare systems are alike and can vary greatly around the world; therefore, it is important that you make sure that you can get the medical and psychological support that you need. You may find that you are given a higher quality of treatment abroad, or you may be frustrated by lower quality. If you need to see a health care provider on a regular basis while overseas, you should inform your host program or university ahead of time to identify whether there is a health care provider or clinic with appropriate services available near your program location. Or, call ISOSto find a doctor/hospital. Bring a copy of your complete medical and prescription histories with you. A general description of your host country’s health system can be found on the Department of State's website.

If you are switching health insurance plans to one that is better suited for study abroad; remember to consider your own particular health needs and make sure you feel comfortable with the level of coverage that you choose.

Prescription medications vary from country to country in name, potency, and purity, and may not be sent through international mail. In fact, some drugs that are legal in the U.S. may not be legal in other countries. Contact International SOS to find out the regulations on prescription medications for the country where you will be living and to see if the medication is available in-country.

Most likely, you and your health care provider and International SOS will help you to decide the safest and most convenient way for you to have enough of your medication while you’re abroad. If you decide to take a complete supply with you, remember the following to avoid complications:

Take your medication in your carry-on luggage so that it cannot be lost or delayed with checked luggage. If you must check medication, make sure that you keep a minimum of a ten-day (or more) supply with you.
Keep all medications in their original containers.
Be ready to present a prescription from your health care provider if asked at customs. Make sure that the prescription states the generic name of the drug because brand names can differ overseas.
Although taking all of your medication with you is safe and convenient, it is not always possible for three reasons:

1. There may be a limit on the amount of medication that can be brought into the host country. Controlled drugs are typically - but not limited to - medications that may have street value like pain killers, relaxants, and so on. To find out whether or not there is such a limit, contact International SOS or the embassy/consular office of the host country.
2. The medication may need to be refrigerated or may be too large to bring an entire four-month supply.
3. Some health insurance agencies may be unwilling to give you a four-month supply of your medication at one time (if this is the case, show them your acceptance letter to the program and give them our contact information if they want the details of the program).

Psychological & Emotional Wellness

Due to the heightened emotions and the additional stresses of culture shock, psychological, and emotional issues can become more pronounced or even manifest for the first time during a study abroad experience.

Many study abroad program providers can arrange counseling services for you on-site in English. If this is an option for you, we advise you to take advantage of these services. If you find that the services are not a good fit for you, you can always stop going. As with medical care, it is best to have the services set up and available before you need them.

We recommend that students complete the Student Success Plan worksheet and speak with a counselor about their study abroad plans prior to departure and upon return in order to get the most out of their experience. You can discuss with the counselor your motives for going, your goals, and how you will deal with unusually high and low feelings while abroad. All DU students have access to counseling services through DU’s Health and Counseling Center (HCC) here on campus, and we strongly recommend you reach out to them before you go abroad to think through coping strategies and ideas to help support you while you are abroad. The cost of visits is determined by your coverage with the Health and Counseling Fee and/or the DU Student Health Insurance Plan. You can review service costs on the HCC website or you can contact the HCC directly to inquire about counseling fees.

When you are feeling upset, there are proactive ways to deal with these emotions.

Some Positive Coping Mechanisms

Reading or studying things you enjoy
Meeting regularly with a counselor or a spiritual/religious group at your program site
Communicating with your family and friends at home
Spending time with your friends abroad
Physical exercise
Learning to laugh at yourself
Talking about issues with your on-site program contact
Expressing yourself creatively through journaling, drawing, or painting
Giving yourself structure by getting involved on campus or in the community

Destructive Coping Behaviors (Avoid)

Some destructive coping behaviors you should avoid include:

Binge drinking and/or other substance abuse
Oversleeping or sleeping too little
Spending excessive amounts of time in your room/apartment
Changing eating habits
Avoiding your friends, classmates, and/or program contact
Engaging in risky sexual behaviors
Destroying your dorm room or host university property
Illegal activity

If you notice yourself or your classmates demonstrating any of these behaviors, reach out to a staff member for support.

For more information on how to talk to a friend that you are worried about, visit the HCC's website.

Symptoms of Serious Psychological Stress

Serious psychological stress symptoms may include:

Repeated risky behavior or personality changes
Habitually sleeping more or less than usual
Missing class and neglecting coursework
Unusual and prolonged isolation
Lack of personal hygiene
Giving away prized possessions
Excessive fatigue
Prolonged depression
Changes in eating habits
Anxiety that interferes with normal functioning
Violent or self-destructive behavior
Alcohol or substance abuse
Ignoring medical recommendations
Essays or notes that focus on death, suicide, or despair
Expressions of concern from mutual friends
Threatening to hurt or kill oneself
Looking for ways to kill oneself, such as seeking access to pills, weapons, or other means

If you are currently seeing a mental health professional for treatment or are thinking about seeing one, you should find out about similar services available at your study abroad program site. Continuing treatment while abroad can be helpful as preexisting emotional difficulties are often intensified - not resolved - by living in a foreign country.

Before You Go Abroad

Research services at your university abroad. Links to your program’s Health & Wellbeing websites are included in the “Resources” section of your program’s brochure in DU Passport. However, we advise you to spend time researching additional details such as available on-campus support groups, counseling hours, and the locations of campus health facilities.

We also recommend you proactively work with your existing support systems (including DU's Health and Counseling Center) to plan for coping strategies and questions to ask of your program to ensure you know what resources are available to you.

Self-disclose any mental health needs in your university application. Your university abroad may be able to provide you with beneficial resources and staff contacts before your program begins.

Getting Help While Abroad

Note that you are eligible for Emotional Support coverage through International SOS’ Workplace Options. Counseling sessions can be organized through International SOS, and you can speak to a Western-trained counselor up to five 45-minute sessions per incident by phone, Skype or the like, and possibly in-person depending on the situation. To utilize this option, call International SOS at +1 215.942.8478, provide the DU membership ID (11BSGC000067), and ask for WPO support.

If you are studying in a non-English speaking country and are uncomfortable using the host language to discuss these types of concerns, you should ask if an English-speaking counselor is available. International SOS can be a service to help you find a counselor.

For more information, make an appointment with a counselor, or for referrals within the Denver community, see the HCC's Counseling Resources page or call 303.871.2205. Contact your program provider or OIE advisor to find out more about arranging on-site counseling (see below for My SSP resources as well).

Emotional Support Flyer

My SSP

The University of Denver has also partnered with Lifeworks, a leader in remote based counseling, to provide to students the Student Support Program (My SSP). Through My SSP, you have free and confidential access to remote mental health and wellbeing support 24 hours a day, 7 days a week, from anywhere. Download the free “My SSP” app from the App Store or Google Play Store and complete your profile to connect with a counselor who is experienced in helping students with the challenges they face when adjusting to a new culture. Looking for real-time support? Connect with a My SSP counselor via talk or text straight from the app, no appointment necessary. Need more than a single session or want to schedule something in the future? Call My SSP from the app and request to schedule an ongoing telephone or video appointment. If you are not able to access the My SSP app, you can also reach out for text support through the My SSP website or call 001.416.380.6578. Click here for step-by-step instructions to download the app and set up an account.

Food & Water Safety

Food Allergies, Sensitivities, & Preferences: Adjusting to the Local Diet Abroad

To learn what kind of local diet to expect in your host country, the best resources are the students who have recently returned from your study abroad program. Returnee names and email addresses are available in your DU Passport account. You may also ask your study abroad advisor.

Sticking to a vegetarian, vegan, kosher, gluten-free, dairy-free, and/or nut free diet while abroad can be challenging in some countries. This is something that you can discuss with your study abroad advisor before selecting a program or once you are nominated to go abroad. If you will be living with a host family and you have specific dietary needs or preferences, remember to let your study abroad provider know as soon as possible. If you have a severe food allergy, consider the local diet before making a decision on your program.

No matter where you are traveling, you will probably find the food to be very different from home. The diet may be more or less healthy than in the U.S. Either way, this will be an area in which you will need to be adaptable and flexible. It can be challenging to impose American eating habits upon your host country.

A great resource for students is an e-book published by a DU study abroad alumni, Morgan Smith:

“Studying Abroad with Food Allergies.” You can find the book here: https://www.amazon.com/dp/B078LBLF2K

Food and Water Considerations

It’s common for people who are traveling and eating new foods to become sick—especially if food or beverages are prepared in less than sanitary conditions. So common, in fact, it has been dubbed Travelers’ Diarrhea (TD). TD is rarely life threatening, but you want to avoid it if you can. Consider taking a prescription for TD from your health care provider with you on your trip. You can also use the following tips to avoid food-borne illnesses, especially in areas where poor hygiene and sanitation standards exist:

Foods

Avoid eating any raw food, including:
- Salads and uncooked vegetables (they may be washed in impure water)
- Fruit (unless you wash and peel it)
- Raw or under-cooked meats and seafood
Avoid unpasteurized milk and milk products
Eat only properly cooked food that’s still hot (best if cooked in front of you)
Avoid cooked food that has been left in the open for several hours
Avoid foods that haven't been properly refrigerated
Be cautious of food sold by street vendors abroad. Although street vendors may offer a cheaper and more authentic version of a local favorite, locals have an immunity that visitors lack. Therefore, food that’s safe for locals might not be safe for you.

Beverages

Canned or bottled beverages, as well as tea and coffee made with boiled water are safe options
Choose bottled water over tap water
Drink directly from the original containers rather than pouring into glasses first

Be wary of ice cubes as they will most likely made from local tap water

If you have diarrhea that persists for more than 3-5 days, contains blood or mucus, or is combined with a fever, then you should seek professional medical advice immediately.