Job Discussion Forums

[Kent Golding]

Anybody got any first-hand knowledge about this?
I have Crohn's, and I want to teach ESL in China. According to my research, I am well-qualified to get a job (have experience in ESL in the USA, have a university degree, and will soon have a TESOL cert.) And I should have no problems getting a visa.
But my health condition could still be a dealbreaker, for me, at least. I'm fairly confident it wouldn't scuttle my chances with employers and immigration, especially if I don't tell them. But I'm leery of living in a foreign country, having a flare-up and finding myself in some nightmare scenario in which the local medical system can't treat me.
Here's my plan, to the extent I have one: Get traveler's insurance, get on the Chinese health system, square things away with my docs before I leave, take a healthy supply of my most basic meds with me and prescriptions for more. And, finally, try to get by without my Remicade medication, which is very expensive and could be impossible to get in China.
If I live a healthy lifestyle (I'm not a big drinker,) I could likely avoid a flare for some time. I had one last spring, but it was the first one in more than three years.
Not sure what the food and the stress of traveling could do to my system. So, I would like to start with a temporary job, maybe a camp for a month or two, or a different kind of shorter-term teaching job. If all goes well, I could then try to re-up for a year-long position.
Local food-wise, which cities or regions might be the most gastro-friendly? I'm leaning toward a slightly-more Westernized city on the east coast of the country. Which have best access to Western medicine?
I would love first-hand advice from a FT who has been in that situation, if there are any. What was your strategy (if you had one?) Did you have a flare-up? How did you handle it?

[Kent Golding]

"I'm fairly confident it wouldn't scuttle my chances with employers and immigration, especially if I don't tell them."

Perhaps I should clarify: It seems like this won't come up on the health check. I'll say what I'm legally required to say, but won't make a big deal of it (or mention it at all) if I don't have to.

[LanGuTou]

To be frank, if you mention any kind of health condition at all to a Chinese employer, it is very likely to be a deal breaker. They are unlikely to understand the extent that it may or may not affect your ability to carry out your duties correctly and live safely in China. The easy route for them is to simply refuse the application.

[xi.gua]

With something like this, do you really want to risk having a nightmarish flare up?

You'd be coming here and subjecting yourself to completely different food and germs which even for the average person coming here has a massive effect on our digestive system for at least a month. With such a huge change in diet I would think that your body wouldn't handle it so well. Hell, my body didn't when I first came here. Seems like it would drastically increase your chances of a flare up.

But, I don't know everything or even close to a lot about Crohn's Disease so that might not even matter. You know yourself and your body, but if it were me, i'd really think twice about moving somewhere like China.

[Kent Golding]

Would I even have to tell the employer? Do employers ask about those kind of things? What if I "neglect" to mention it?
I've heard that Western ideas of health privacy don't apply in Korea. Doctors there are under no restrictions to keep a patient's information private. What about China? Is it the same?
My understanding of the health check is that the biggest concerns are major STDs and communicable diseases. I don't have those, and Crohn's is not contagious.

[Kent Golding]

@ Xi Gua: Maybe I could eat as little as possible for a while, and stay with bland foods as much as possible. But you are right that this could be a major risk. That is why I am "thinking twice" about this. A Western or European country might be a better choice for my circumstances, but I imagine ESL jobs are much harder to get in those places.

[Zero]

Kent,

You mentioned that you would "get on the Chinese health system." There is not anything I would call a system. Coming down with a Crohn's flare-up in China is a nightmare scenario. Western care will likely be prohibitively expensive for an ESL teacher. International health insurance is available, but I don't know how a pre-existing condition might play in. At any rate, you would need to live near international-level health care facilities, such as in Shanghai and Beijing, in order to really derive the benefits.

Barring that, you will probably have to go to a Chinese hospital/clinic. (There aren't private, freestanding doctor's offices, by the way.) You take a number and go through a bunch or rigamarole that is hard to navigate unless you have a Chinese person along with you. You must pay cash at the time of service. If not, you stand a high chance of not getting care. In a true emergency, good luck. There are ambulances, but whether they'll come, how long they'll take to get there, whether they will even pick you up if you don't have cash on your person -- all in question. Oh, and if you are unconscious, it is entirely possible that no one will even call for help.

Also, when you are recovering in the hospital, your family is supposed to do much of what a nurse would do in a western country, such as bring you food.

The Chinese health care "system," such as it is, is set up for Chinese people who have lots of family and friends around. When you are really sick, as in too sick to register at the hospital and fill out the forms, they do that for you. They make sure the cash gets paid at the counter, whether it is your cash or theirs. When you are a foreigner on your own, a large part of the "system" is missing and you might have to depend on a kind hospital worker going out of his/her way to help you. I've heard of it happening, but I would NOT want to bet my life on it.

Hong Kong has world-class health care, and I believe they even have something like a "national" health care system that you can join as a foreigner. It should be a much safer environment for someone with Crohn's. Maybe you should look into it, though the requirements are higher and so is the cost of living.

[Miles Smiles]

Kent Golding,

It's good that you ask these questions, because had you come to China not knowing the risks, you could have found yourself in some pretty serious trouble.

As you well know, Crohn's is not a trifle. You don't indicate the severity of your problem, but if your condition is such that you have had surgery and now wear a colostomy bag, you'll have major problems sometime after you arrive.

Under the best of conditions, you will occasionally experience bowel problems. Even those whose bowels are normal occasionally experience the trots. Why? Because some restaurants have poor sanitation practices, use Olestra (the cooking oil that guarantees lower GI problems), and serve dishes that may cause you problems simply because your body can't tolerate them.

How's your weight? Have you had your kidney and liver functions checked? If you aren't required to undergo a liver function test before you arrive, you will be required to have on done after you arrive when you undergo the battery of HIV, AIDS, and HEP A,B,C tests.

[Kent Golding]

@ Miles Smiles: I have not had the surgery for a colostomy bag. Hopefully that is far away, or never. I want to do as much world traveling as I can before I get to that point
My weight is below average. I am a pretty skinny person, and can't seem to gain weight despite my best efforts. My doctor checks my liver panels regularly, and they've always been fine.
As you and others have mentioned, the foreignness of the food could be a big concern. It is easy to say that I would eat little and eat bland food, but I'm sure my Chinese hosts and friends would want me to eat the food they cook, or eat with them at a restaurant, and I would not want to appear rude by turning them down.
Besides, who wants to survive on soda crackers alone? (If such a thing is even available at Chinese markets.)
I was hoping some FT with Crohn's might have some reassuring advice. Anyone???

[daCabbie]

What is Crohn's? What are your symptoms/problems? What is a worst case scenario?

What do your doctors say? Have you tried a Crohn's website and seen where others with the disease have traveled and their problems?

Where have you traveled to in the past? How old are you?

Do you have someone at home who can mail you medicine? Do you have a safety net of cash to return home unexpectedly?

Why not just travel to China and then consider working here?

Sorry, I have no answers.

[rogerwilco]

I am not sure why you keep focusing on the "bland food" aspect.

What about new and strange germs, viruses and bacterias ?
Could you handle having more frequent diarrhea ?
Sanitation and food handling habits in China are not the same.

What about the greater exposure to infections ?

Who would check your liver panel in China ?

[starlight]

Kent, you don't say if Crohn's flareups are triggered by stress, but if they are, you should seriously reconsider China as a work destination. Dealing with Chinese administrators and students -- or the Chinese population at large -- can be extremely stressful for some people.

A former colleague of mine had IBS (not the same as Crohn's, I know). She was almost in 'constant flareup' mode having to deal with the university administrators and some of the university students. Her health situation became so bad, as a result of her stress, that she eventually had to return to her home country 4 months before the end of her contract. By the time she left, she was even thinner than when she'd first arrived. For her, burn-out had set in very early and taken a huge toll on her.

Other posters are correct: getting medical care from Western-run medical facilities is very, very expensive. Chinese medical facilities do not offer the same level of care as Western-run facilities do nor are they run in the same manner.

You take a number and join the crushing crowds all waiting to see a doctor. Sometimes you can wait up to 4-5 hours to see a medic. Bear in mind, that 'queues' are almost unknown in China, so if others push ahead of you, despite your having taken a number, you could wait much longer. In some Chinese hospitals, the term 'privacy' is unknown, and examinations/treatment can take place amid an audience.

Furthermore, if you access any health care plan the schools/universities DO offer, then you can be sure that all the details of your condition will be sent to that school or university. (It's actually a requirement at many schools.)

It is also correct that if school/university administrators get wind of any health problem you have, you can kiss the job goodbye. Former colleagues of mine have had their health problem 'discovered' by university administrators and have been turfed as a result.

You might want to consider another destination.

[rogerwilco]

[xi.gua]

[kda213]

I have celiac disease which isn't quite as complicated as what you have going on, but obviously I can't have anything wtih soysauce which has proven difficult. It's impossible to know ingredients in most of the food that you're eating, but you could certainly stick with simple vegetable foods and rice in restaurants and just don't eat anything that you're not comfortable eating. People don't seem to understand issues of food here, nobody has any idea what I'm talking about when I say I have a disease that prohibits me from eating certain foods, but you just have to be firm. Never compromise your health for anything, no matter how nice your hosts are!

Cooking for yourself is always an option, too, there is plenty of fresh fruit, vegetables, rice, etc.