Looking After Your Mental Health Abroad

One thing I can tell you from living in parts of the world that are considered ‘developing’ there are many challenges you don’t have to face in a First World country. All of us expats agree that it’s not for the faint hearted.

mental

Lack of freedom would be the biggest loss you face. Not traveling far when it gets dark. Locking your car doors and not putting your windows down. Security checks for bombs and weapons to get into a mall, mosque, government office. Not to forget getting your bags checked several times a day. It’s a hassle but it’s life here and there are other places that are way more strict than Kenya.

The separation from family is a daily challenge. We’ve got it lucky though because of technology. But when you’re reminded how many birthdays and Christmases you miss, milestones in your grandkids and the fact that they only know you through a computer. It is 8 years since we have had Christmas with our kids. A few years ago we made the decision that 2018 we would get together and after much saving and scrimping, it is only a few weeks away.

christmas

One thing people aren’t aware of is the loneliness that can eat away at you. I’ve got expat friends who move every few years because of their spouses work. It’s hard for them to connect with people as they know they’ll be gone soon. It’s also hard to find info about basic things like where to buy stuff and how the system works here. It’s okay if you’ve got kids and work but what if you’re the trailing spouse?

It’s expensive. There’s the assumption that Africa is cheap to live in. Sure, the local fruit and veges are a good price but pretty much everything is as expensive as in Aussie, but mostly twice the price. For us our funds come from New Zealand and Australia and we lose about one third of our income because of the exchange rate. Some expats who are employed here get bonus packages (housing, travel, insurance etc) which makes it very attractive for them. Not in our case as development workers.

Some companies send out their expats every 3 months on a 6 day paid holiday. We saw that and totally understand why. The pressure of being a foreigner and the daily living conditions put on you a pressure you that you don’t have to face in your home country. A few times a year we try to get out of Nairobi, grab our tent and get among the wildlife. It’s really good therapy.

wild

A really big challenge is not having someone to talk to about the issues you face within your marriage, family or life. A local doesn’t understand what it’s like for foreigners and have those pressures. I’ve come to the thought that the challenges you might have in your home country and you get through them, become really big cracks when you are in a developing country. We’ve had good friends who didn’t really have issues until they went to another culture but through the pressure of having to come up with the finances of putting their kids through international schools (super expensive), trying to set up their work in a place where people didn’t understand English too well and struggling to get an income, was just too much for them. Some returned to their home country pretty quickly, while others separated.

Broken Relationship

Looking after your mental health is really important, anywhere in the world. So, if you’re out on foreign soil for a long time, here’s some of my suggestions to help you last the distance:

 

  • There’s nothing wrong with taking time out! Our Christmas break is actually an investment into our mental health. I’m calling it my mental health break after a really challenging year.

 

  • It’s okay to get out and have some fun every now and then. A missionary over here said to us ‘Don’t let people see you’re out having a coffee or people will think you’re mis-using their donation’. That’s ridiculous! You have to have an out. I go to the movies a few times a year (only $4 here) and Pete indulges in a bought coffee. Anywhere there’s nothing wrong with that. You have to live a real life.

 

  • Enjoy the journey, don’t endure it. You are in a unique part of the world so go and experience the things you can only do there. A few years ago I went white water rafting on the Nile. Who else says they’ve done that? We have got to know some absolutely amazing people that we wouldn’t have if we’d stayed back in Aussie.

 

  • Mostly, remember why you’re here. I say to Pete when he gets over something ‘We chose to live here and have to put up with the crap that comes with it’. Stay focused on why you chose to come here and remember that no one forced you to do it.

 

Have you lived in a developing country before? What we’re some of your challenges?

 

When You Break A Bone

This last week has been an interesting one in the Crean household. We had visitors staying overnight who we were taking to the airport the next day. That night Pete (who didn’t put down the bathmat) slipped on the floor as he came out of the shower. He made the biggest bang I’ve ever heard in my life.

Then there was silence.

It doesn't look broken but it is.

It doesn’t look broken but it is.

After yelling 3 times Pete finally answered. He knew right then that he had broken his arm/wrist. I wasn’t convinced and mandatorily put on a packet of frozen peas to see if the pain would subside. It didn’t and so off to the hospital we would go.

Two weeks ago our insurance ran out and we didn’t have the funds to renew it. We put out the word to everyone on our social network sites – nothing. We just hoped that nothing would go wrong until we magically found the money.

Part of the waiting room at A&E.

Part of the waiting room at A&E.

Because he’s a man’s man, Pete insisted on driving the 15 minutes (at 11pm) to Nairobi Hospital. I tried to convince Pete to go to a cheaper one but he was insistent on going there. Nairobi Hospital was the place we went to when he broke his leg on Mount Kilimanjaro. They did a great job, but the insurance was paying for it – $12,000.

I was thinking it wouldn’t be busy getting close to midnight. What a fool I was. The place was packed.

Because Pete had been a patient before they had him on record so I was saved from filling in a registration form. First step – pay to see the doctor ($26). Typically you have to pay for every step along the way before it’s done. Naturally, the staff thought that our insurance would pay for it and wanted to dole out anything they wanted. Till they found out it was a cash job.

Waiting for the first cast.

Waiting for the first cast.

Second step is to go to a nurse to have a look at the wound, take your blood pressure, temperature and weight.

Then you wait once again.

Everything was moving slowly and there was the worst movie on TV. Mind you we had the choice of 3 TV’s in the waiting foyer – a Swahili program, an old cartoon or a movie about a prostitute. At midnight, what you want to do is go to sleep.

There were only a few people left and at 12.30am we were called in to see a doctor.

The next day we returned to get a better cast on.

The next day we returned to get a better cast on.

I’m not sure why doctors ask you “So how are you this morning?” when you wouldn’t choose to be there if you didn’t have to. After I had paid another $57 Pete was given a jab in the butt and we were sent off to the X-ray department. I was thinking it was going to be another hour wait.

Actually there was no one there for a few minutes. I reckon half the staff were sleeping at 1am as no one was around. The x-ray didn’t take long and Pete’s arm just above his wrist had a small crack. Thankfully nothing major (says she who has never broken a bone).

Back to the small curtained area to wait for the attending doctor to give us her final word.

A much happier Pete Crean

A much happier Pete Crean

She had a 5 second look at the x-ray and told us they may want to wire it. No way was that going to happen, there was no money for that. We would have to see the orthpeadiac surgeon in the next couple of days but meantime they would put a cast on it.

Another $93 later, it begins. I had to go out of the room because it was too small for 4 people. Meantime I was instructed to go and get his medicine. I was thinking to myself ‘it better not be just Panadol, as I’ve got stacks of it at home.’

At the beginning of our hospital visit I had asked if all the charges could be put once on a card, thus trying to avoid several international transaction fees. Looked like it wasn’t going to happen.

What infuriated me was the last bill I had to pay was only for $23 for the medicine.

It was 2am before we were able to get out of the hospital. Again, his royal highness insisted on driving home. Pete’s one crazy guy.

Overall the hospital visit wasn’t tragic. Nairobi Hospital is one of the best in town, and it’s the closest to us. You don’t have to pay for parking but like other medical places, you have to wait a long time to get seen. I’m glad it wasn’t something life threatening like a heart attack and you’d die while waiting to be seen.

Nairobi Hospital has a lot of high tech medical devices, it’s just whether you can afford to use these. I was surprised how helpful and polite the staff were in the early hours of the morning.

The medication is working, the heavy cast has been replaced by a much better support cast, after spending another $200.

Dr. Atinga repaired Pete's broken leg 4 years ago. Now he's done the arm.

Dr. Atinga repaired Pete’s broken leg 4 years ago. Now he’s done the arm.

All up the slip coming out of the shower cost $400. Insurance for a year is $1,400. Go do the maths.

The next day we returned to visit Dr. John Atinga who put Pete’s leg back together after he broke it on Mount Kilimanjaro. Unlike the doctors the night before he took a quick look at the x-ray, never mentioned surgery and gave us the simple option – a lighter support cast or 3 weeks and then a review. I wish he was on the night before as it would’ve been a much cheaper and simple option in the first place.

Here’s hoping we can get covered soon as Kenya isn’t exactly the safest place to be in (even without slipping). There’s a high terrorist threat at the moment, the roads are crazy and personal security even walking around isn’t good.

Here’s also hoping we don’t visit a hospital for a long time. Meantime, if you feel you could help us be covered by insurance you can donate online HERE.