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We maintain a state of equilibrium when we are in our home environment. Our bodies get used to the local strains of microorganisms, the climate, altitude, weather, etc. We build up immunities to viruses, bacteria and other disease causing entities. But international relocation can upset this balance and put us at risk for health problems.

Preparing in advance for what types of health risks you may encounter can greatly reduce adverse consequences. I recommend that you visit a travel health clinic, preferably one that handles the entire family, small children included, well in advance of your move for the following:

  • A through health assessment to determine if you or your family members have any pre-existing health concerns that may be upset by international relocation to your country of assignment (COA)
  • To discuss how conditions in your COA may adversely affect any chronic health problems you or your family may have
  • To discuss environmental health risks such as malaria, dengue fever, Japanese encephalitis, hepatitis, and other food, water and
  • vector-borne diseases that may exist in your COA as well as their prevention
  • Vaccinations as available for the above mentioned

Before departure it is advisable to have:

  • an international vaccination card or booklet
  • a complete dental exam
  • a spare set of spectacles if you wear them, as well as your lens prescription
  • extra prescription medications
  • a first aid kit
  • a good supply of your favorite drug store items

Please visit our "Resources" site for useful websites on health information in your country of assignment.


Security and health go hand in hand. It is advisable to be prepared before you leave. Learn as much about your country of assignment (COA) as possible before you start packing. I suggest you visit: for country information, travel alerts, common criminal activity in your COA, as well as a host of other travel advice. They even have a special section for families traveling with children. If possible, speak to someone already living in your COA as soon as possible and preferably before you even make the decision to go. Ideally, a reconnaissance trip is the best way to get a good feel for the environment.

Be sure to register with your embassy or consulate as soon as you arrive in the country. If an unexpected event turns troublesome, your embassy will know how to contact you, will keep you informed and will provide emergency instructions. You don?t want to be left behind in case of an evacuation! They will keep you posted in the case of terrorist activity in your COA or real threats. Your embassy is also an excellent resource for finding useful information such as which hospitals, physicians, dentists are approved for treating expatriates.

Road deaths are a very common cause of death among expatriates. Know the rules of the road! Every country is different as to how they communicate on the road. For some, flashing lights mean you have the right of way. In other countries that may mean the driver is preparing to pass you. Honking the horn before a blind curve is common courtesy to let oncoming vehicles know there is traffic around the bend. These are just a few examples.

Animals and stalled methods of transportation may be found abandoned across the highway. Be cautious and expect anything. Be aware of posted speed limits and the custom for observing them. In Italy never get in the furthermost outside lane unless you are traveling at least 160 km/hour!

Always keep an emergency kit and a flashlight in your car. Depending on your COA, you may want to keep bottled water in the car for unexpected delays on the road. Wear your seat belts at all times. A major cause of HIV infection acquired abroad is from having received a blood transfusion as the result of a motor vehicle accident. If contacted, your embassy will be able to help find safe donors among the expatriate population.

Try to learn as much about your country of assignment as you can before you leave. Learn and respect the rules and customs of the country, specifically in regards to alcohol use, traditions for dress (especially for women in Muslim countries), greetings (may be insulting to wave or hand something to someone with your left hand). Remember that you are a guest in someone else's country.

International Family Transitions: (1) 781-439-8490

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