Surviving abroad – type 1 diabetes in a foreign land

by Elizabeth Snouffer on 06/13/2012

Earlier today I received an email from an American friend who has been living in Hong Kong for over six years.  She attached a photo of a suitcase dedicated solely to diabetes supplies bound for the US for an 8-week summer stay and then she’ll return when school resumes.  Two years ago her son Ned (a 4th grader today) was diagnosed with Type 1 diabetes in a hospital here in Hong Kong.

Diabetes Supplies for a child - 8 weeks worth

If you think having a child with diabetes is difficult, multiply your experience by a dozen or so because living in a foreign country with a diagnosed Type 1 child can be very difficult indeed.  What is difficult?

  • Language barriers
  • Different Medical systems (different is a relative word – it can mean not the same or substandard)
  • Backward technology or perspectives (say, pumps aren’t used regularly)
  • Products can “go out of stock” at whim or become unavailable
  • Big cities in Asia are expensive and currency values can inflate prices against the dollar (especially in the UK) (Most expensive cities in the world 2012 article here)
  • Cultural values about illness can be unusual or just different to that of your home country.  Sometimes children are more restricted, sometimes less so
  • Insufficient nutrition labels or no labels at all
  • Isolation, lack of support or just generally less fellow patients/families to meet

Resilient families and individuals adapt and make the most of it.  Sarah deals with every new challenge related to her son’s diabetes with aplomb and caution.  She is sincere and tough without being morose.  In fact, she laughs a lot aloud.  Ned is given every opportunity to be a kid.  That’s not easy – I can tell Sarah doesn’t want him to feel burdened.  Ned will thank you later in life, Sarah!

Sarah and her son, Ned

The other day I was sitting with a few moms and dads while the children swam in a pool. I heard Ned’s pump alarm in a duffel bag and Sarah and I turned to each other nodding our recognition at the sound.

Real support is feeling familiar solidarity.

This post is dedicated to all the families living abroad,  far away from home with Type 1 diabetes, whether you are facing spitting rain on the streets of Edinburgh, fighting the crowds on the sidewalks of Hong Kong, or feeling the heat of the sand in Qatar.  We know you are out there!  Please contact us if you would like to share your experiences.

There are reportedly 3 million Americans who expatriate every year, and approximately 5 million British Nationals who live abroad.   In total, there are 200 million Expatriates (people who leave their native country, but retain their home country status) according to the United Nations.

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{ 6 comments… read them below or add one }

Carole Hoffman June 14, 2012 at 11:30

My son Benjamin was diagnosed at age 8 when we had just arrived for a four year stay in Moscow, Russia. He had to be medevac’d out to Helsinki, Finland, because there was no medical facility in Russia that had the necessary equipment and insulin to stabilize his condition (diabetic ketoacidosis). Today Benjamin is 24, almost 25 and a wonderful, thriving young man. I am so proud of him. THose early days in Moscow were horrible, and our first glucagon experience still haunts me…but we managed somehow. Good luck to anyone living overseas with Type 1. I know what you are going through.

Ivy June 15, 2012 at 21:39

I should have taken a photo of us two years ago leaving Walgreen’s with one year’s supply – yes, one year! – of pen needles, syringes, test strips, glucagon (11 for good measure), Novolog and Lantus, right after my daughter’s diagnosis. We were in Chicago for the birth of my son and she was diagnosed soon after, and we had to fly back to Tokyo. We had back-ups of back-ups (meters, etc.) Thankfully, we were not questioned at customs. It’s harder to travel with milk than with insulin! Took us months to find the “right” endocrinologist. Gary Scheiner’s Integrated Diabetes Services was a lifesaver!

Dave November 23, 2012 at 18:57

I was diagnosed with type 1 diabetes at the age of 7 in Hong Kong. My parents were (are) amazing. But I can’t put it just down to them. We also had a fantastic doctor at Queen Mary’s Hospital called Professor Low. He made a real difference and it meant that there was no language barrier (because he studied in Scotland). I guess what I was trying to say is in the end, as a parent, I think that your efforts are appreicated and that when your friends son gets older he will always feel like he couldn’t have got to where he is with out you.

I am now 23 and have moved back to Hong Kong from the UK.

P.S. Great blog by the way!

Elizabeth Snouffer November 29, 2012 at 23:14

Thanks David! I know Professor Low, and I also know a few people who grew up with diabetes in HK just like you. Who do you use for your diabetes care in HK today?

Alice Trepstow April 5, 2013 at 08:53

I am 27 years old and have been diabetic for 11 years (type 1). I am moving to Hong Kong in August to work for at least 2 years and am terrified about looking after myself out there, mainly in terms of access to medication. (But am determined not to let anything stop me from going!) I still do not know whether my employees health care provider will cover the costs of mess and any related health problems (the joys of PRE-existing medical conditions!) I’ve found getting information about the public system difficult (and I will not be able to afford to pay for private care. I am sure it will be fine but any advice is very welcome!

Amanda Barton September 9, 2013 at 07:17

I have just moved to Hong Kong and am here for 2 years. I have had type 1 diabetes for just over 11 years, I am now 28. So far I have been surviving off supplies I brought with me (I brought a lot), but having settles ina bit am now looking for a doctor. I have private health care, but it will not cover the full cost of all the medication I will need so I am going to get myself into the public system. I’ve been referred to Queen Elizabeth hospital. Does anyone know of a particularly good doctor there? Or have any other advice?
Alice, it seems like we’re in a similar situation. If you want to get in touch please do!

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