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DIALOGUE: Healthcare Needs-When Living and Travelling Abroad
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altAli Cannon has been the Clinic Manager for International SOS in Tianjin and TEDA, since January 2012. Prior to moving to Tianjin, Ali worked for International SOS for four years as a Coordinating Nurse in the Assistance Centre in London answering calls from clients about a range of health issues. In this role Ali provided medical advice and case direction from very simple cases through to complex emergencies and medical evacuations. As part of her role in London, Ali was also a flight nurse and part of a rapid deployment team that was dispatched to Cairo during the Arab Spring.
 
International SOS helps companies manage their international assignees and travellers. Can you explain how the company does this?
 
International SOS is a global company with a presence on six continents and in over 70 countries. Our mission is to pioneer the international medical & travel security risk services sector, by providing high quality medical and security assistance to those living and working outside of their home country. We offer companies peace of mind, knowing that their expatriate workforce is looked after no matter where they are.
 
Through a corporate membership program, expatriates and their families have access to 24-hour medical and security services that are provided from any of our 27 Assistance Centers. This will generally be the closest Assistance Centre to your location, meaning that both the medical and logistical staff have expert knowledge of the area and can give the most appropriate advice.
 
The doctors are well versed in the capabilities of the local hospitals and the logistical staff has knowledge of the area, including local ambulance and police details.
 
To illustrate how we help our clients, let me give an example:
An expatriate living in Luanda, Angola falls and breaks his leg. They immediately call International SOS, and the call goes to our Johannesburg Assistance Centre, which has expert knowledge of Angola. As the doctor provides medical advice over the phone to the patient and his wife, the logistics staff have called an ambulance and directed it to the patients location. They have also explained to the ambulance driver which facility they should go to as we understand the capabilities of the local hospital.
 
Once at the hospital, the International SOS doctor will speak directly with the treating doctor and make a decision as to whether the broken leg can be treated locally. If treatment is not recommended locally, normally in the instance that surgery is needed, we start to plan for immediate evacuation to the nearest centre of appropriate care with the necessary approvals from the patient’s employer and/or insurer.
 
The doctor will make travel recommendations, such as whether the patient can travel on a commercial air craft or whether air ambulance in needed, the doctor will also arrange hospital admission at the destination, ensuring there is no delay in medical care. The logistics staff liaise with the client’s insurance company to ensure that all medical bills are paid and no stress is passed onto the patient. They will also liaise with our travel team to ensure visas and travel requirements are in place for the patient and his wife. All of this will happen simultaneously and the patient will, in most instances, be moved within 24 hours.
 
This is a real life example of how International SOS looks after the medical needs of expats abroad. It does not always have to be so complex; much of what we do is simple advice and referrals. It is important that our members know that they can use us for the little things, not just emergencies.
 
As someone who has worked in the UK, do you find any similarities with the healthcare needs of people living in the UK and those in China? 
 
There are certainly similarities. No matter who you are or where you are from, people want to feel safe and understood. In our experience, patients want to know that the medical care they are receiving is on par with what they would get at home. That is the same for English people living in China and Chinese people living in the UK. Everybody wants a doctor they can trust with their whole family.
 
This is something International SOS is able to provide in the five clinics we manage throughout China and many more throughout the world. We employ internationally-trained, multi-lingual doctors. For example, in our Tianjin Clinic we are lucky to have a British-trained doctor who is also fluent in Spanish and French, a French trained doctor who is also fluent in English and Chineses doctors who are fluent in English. 
 
This gives people choice and in my experience, that is the biggest similarity you will find. People want and should have a choice in terms of which doctor they wish to see.
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What are the biggest differences between the needs of International SOS members in China as opposed to those living in their home countries such as the UK?
 
Expatriate life is very unique and I am sure that most of your readers will agree that the worries and concerns they have in China are not the same as those they have at home.
 
Medication is always a concern for expatriates; people want to know if the drugs and vaccines they are being prescribed are of the same quality as those you would get at home. Counterfeit medication is cause for concern due to news stories that have emerged on the topic internationally and locally. Specifically in China, as a community we have had some unique concerns in the last year. These concerns relate in particular to air pollution and the new strain of avian flu H7N9. 
 
As a community, many people were not used to such issues, nor did they  have the knowledge to truly understand the potential risks. This caused a lot of anxiety. 
 
At the Tianjin clinic, throughout this time we provided  seminars and information updates to the community to help people understand and hopefully alay some fears.  International schools showed tremendous support to the community through the education of the children on these issues.
 
During the recent avian flu H7N9 outbreak, International SOS worked very closely with the schools to provide updates to parents and other members of the community. This was a great team effort and really showed that when serious issues do arise, we are all able to work together for the benefit of the community as a whole.
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With the increased investment in the healthcare arena in China, why is there still a need for international clinics?
 
For the same reason that in London, where medical care is considered some of the best in the world, there is still a need for Chinese medical clinics. As I have mentioned earlier, people want medical care that they know and understand.
 
Healthcare in China is developing rapidly and we have seen a huge change in the last 5 years. Big investment in government hospitals, new equipment from Europe and Japan and more investment in medical training. This is apparent in Tianjin where we see many international students studying medicine.
 
In the first-tier cities such as Beijing and Shanghai, many of the doctors working at government hospitals can speak some English and have experience with international patients. However, when we look at the support staff such as nurses, language remains a huge barrier. This is equally true amongst some doctors in the second- and third-tier cities. Medicine is based on communication; if you can’t explain what’s wrong, how can you be treated effectively?
 
The style of medicine also remains very different and while for some that is preferred, for many it can be unnerving. For those reasons and more, it is still necessary to have international clinics.
 
As a nurse, I believe that one of the most important aspects of healthcare is for people to have a choice for themselves and their families. We are all unique and our needs vary, therefore more options for healthcare can only be seen as a great thing for our community.
 
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