The Immigrant Experience

It may come as a shock to some of you that I have been living and working in South Korea for the past four months. My husband and I decided that we wanted to get some experience living and working abroad (and frankly, I needed a change in career scenery), so after he graduated, we took an easy job teaching English at a private academy in South Korea.

Terribly cliche, I know.

Part of our “training” was watching a series of videos done by a sharply-dressed twenty-something from the academy’s corporate headquarters. (We call him “Frozen Man” because in two of the videos, the image of the perky, fast-talking Korean American man freezes about three minutes in and you are stuck listening to his obnoxious voice for the rest of the 45-minute presentation.) The curve that Frozen Man described in the “Culture Shock” presentation showed the initial “honeymoon phase” – the first few weeks in a new place where you are enchanted with everything – wearing off about two or three months after moving, and “culture shock,” defined as constant irritation at barriers encountered in everyday life, setting in. Joel and I didn’t really give it much thought until we went to the bank to open bank accounts after receiving our first paychecks.

I asked around at work, and all of our Western co-workers recommended us to the same bank. They assured us that there were multiple English-speaking customer service staff members who could help us open the account and even help us set up wire transfers to our bank in the U.S. So on Tuesday morning, armed with our envelope of cash, our passports, and our American bank account information (and, stupidly, not a dictionary or phrasebook), we walked into the bank.

me: Annyeong haseyo! (Hello!)
Customer Service Rep (CSR): Annyeong haseyo! (Hello!)
me: Yongo haseyo? (Do you speak English?)
CSR: shakes head
And then I freeze. And I look at Joel, who looks back at me. I look over to our right, where the bank employees in the office to the side are working with Korean customers. And then it occurs to me that we just walked into a bank in Korea with no preparation, expecting someone who speaks English to be able to help us. And then I feel like the world’s biggest idiot.
me: Uhm…
CSR: Ah, do you want…open an account?
Joel and me: Yes!
So we sit down and begin to fill out the paperwork. Our very polite and patient customer service rep puts everything into the computer, has us put in more PINs than we know what to do with, and hands us some kind of bank booklet. Then he indicates that we are finished.
me: Uh, how do we get bank cards?
And then another bout of broken English and hand-waving ensues, at which point we figure out that this very polite man has opened not one, but two checking accounts, one for each of us. And then I start to get upset. Not because we have two bank accounts, or because we only have one check card, or because no one spoke English, but because I realized that I assumed that this man would instinctively figure out what we wanted, even though – or maybe because – we couldn’t communicate it to him. It was the first time that it really hit me that I cannot do the most important things – financial things – here without help.

My biggest bout with “culture shock” by far was my epic battle to get information about our health insurance policy. When we got our first paychecks, I saw that there was no deduction for our policy, so I asked our head teacher about it, and she explained that the school was paying the entire premium. Fine, I said, but can I have some kind of proof of coverage?

And then the struggle began.

A simple request for a health insurance card, or even just a document with a policy number, turned into a mandatory meeting for all foreign teachers where a generic memo with an explanation of the coverage limits of our policy was handed out. They explained to us what was covered (and what was not) and asked if there were any questions. I raised my hand. “Can you give us our policy number?”
The school administrator stared at me. “Why do you need that?”
“Just to have,” I responded. “I want to have all of the information.”
“I don’t have it now, but if you need it, we can give it to you,” he said.
“You don’t need it,” one of my co-workers explained to me. “You just bring in your receipts and they reimburse you.”
They went on to explain that if we had a doctor or hospital visit, we would have to pay out of pocket. We would then bring them the receipts, and they would take care of filing the claim for us. I raised my hand again.
“Can we file the claim ourselves if we want to?”
Now I started to get some raised eyebrows. “You can if you want to,” the head teacher explained, “but we can do it for you. It is easier for you this way.”

Apparently the concept of privacy regarding health information has not been introduced here.

After some more nagging, I finally got our group policy number, and so one morning I tried to call the company and reach someone in customer service who could speak English and verify the policy. After pressing the button indicated on the phone menu for English language service, I waited.
Customer service rep (CSR): Yoboseyo? (Hello?)
me: Ne, yoboseyo! Yeongeo haseyo? (Yes, hello! Do you speak English?)
CSR: A little.
me: I need to speak to someone in English who can help me with my policy.
CSR: Wait please. [puts me on hold]
Different CSR: Yoboseyo?
me: Yes, do you speak English?
CSR: Yoboseyo?
me: (louder) I need to speak to someone in English!
CSR: Yoboseyo?
me: Sigh.

The following week, I tried again.
Customer service rep (CSR): Yoboseyo?
me: Do you speak English?
CSR: Yes.
me: Okay, I need to speak to someone who can verify my policy.
CSR: What kind of policy?
me: Health insurance.
CSR: Okay, hold please. [puts me on hold]
Different CSR: Yoboseyo?
me: Yes, I need to verify my health insurance policy.
CSR: Do you have the policy number?
me: Yes. [I read the policy number to him.]
CSR: Okay, I will transfer you to someone in that department. [puts me on hold again]
Yet another CSR: Yoboseyo?
me: Yes, do you speak English?
CSR: Yoboseyo?
me: (louder) I need to speak to someone in English!
CSR: Yoboseyo?
me: (louder still) Hello?
CSR: [click]
I stared at the Skype window for a few minutes, then got dressed and stormed off to E-mart (about a 2-km walk) to buy chicken and a jar of curry sauce. In the checkout line I realized I didn’t have my wallet…because I’d taken it out at home to pull out our health insurance policy number. It was everything I could do to not throw a fit in the store.

Equally frustrating has been trying to explain to people why these encounters make me so upset. I went from being a fully capable and independent adult in my home country to not being able to take care of simple things (like opening the kind of bank account I want) or get a simple piece of information (like details on my health insurance policy) on my own, because I don’t speak the language. Some days I feel as though I have been robbed of self-sufficiency and reduced to being a child, or a petulant teenager at best. While my employers are certainly well-meaning in offering to file my health insurance claims for me, it is all I can do to not feel bewildered. They simply cannot understand a desire for privacy when it comes to my health, or my insistence on having the policy information (rather than just trusting them that it is provided), or even just wanting to be able to do things on my own. Never has it been more abundantly clear why immigrant advocates consider things like multi-lingual resources and translation services to be issues of human rights.

I ultimately found my answers at the city International Center, a non-profit center staffed by volunteers that provides services for expats living in the city. When I explained my dilemma to the coordinator (a very nice Vietnamese woman), she instantly understood. A Korean volunteer took my written questions and policy number, got on the phone, and in about 15 minutes had all the information I wanted and had been struggling to get for weeks.

Being in a strange land far from home has made me do a lot of thinking about the “immigrant experience.” Growing up, I always thought of myself as sympathetic to their struggles, at least on principle. After all, my mother is an immigrant; I went to school with immigrants, including several who were not permanent and sometimes even illegal; and I even dated a few. I tried to be patient with people that didn’t speak English very well and respect those who were trying to eke out a living – aren’t we all doing that in some form or fashion? – but beyond that, I didn’t think much about it unless I was embroiled in some kind of political debate with my college classmates. Back home we argue about immigration reform and government policies and border security, but until now I had no idea what it felt like to actually walk in those shoes.

Now all of the stories that I laughed about growing up – the one where my mom went to Bering’s asking for hookers (when she was looking for hooks to screw into the wall), or the one where my father’s Peace Corps Brazilian host family waved spoons in his face and screamed the words in the hopes that he would somehow absorb them – come flooding back to me. I remembered standing in line at the post office at my university while the Chinese grad students struggled to understand the forms they had to fill out to send packages home while the postal clerks yelled at them and abused them. I remembered Joel’s stories about standing in line for almost an hour at the post office in Italy for stamps, only to discover at the front that it was the wrong line, or my friend Krystal’s tales of navigating the Chinese postal system and having absolutely no idea what was going on. I thought about how Joel and I struggle to distinguish Korean vowels from each other for our language classes while remembering people back home complaining about immigrants not learning English. In a short amount of time it has become very clear to me why immigrants form their own enclaves in foreign countries with doctors, bankers, lawyers, waiters, and employers that they can communicate with both linguistically and culturally. Without help from someone, we are exposed to an alien (and often hostile) system, we are unable to communicate what we need and are therefore helpless, and we are utterly alone.

Obviously, our situation here doesn’t come anywhere close to the migrant worker, or the refugee, or the undocumented alien who has just crossed the river or allowed his visa to expire to try to find a better life. But now we have real insight into what it means to be at the mercy of your employer (however benevolent and well-intentioned) not only for your livelihood and your health insurance, but also for the roof over your head and your right to be in the freaking country. It’s terrifying, and we don’t even have a family or anything major on the line.

But at least now we have not one, but two bank accounts.

Global Health Weekly News Round-Up

Politics and Policies:

  • The Health Protection Agency (HPA) (England) has warned heroin users that the drug may be contaminated with anthrax spores.
  • The New York health board approves ban on large sodas. It is a move to combat obesity and encourage people to live healthier lifestyles.
  • New circumcision law by the state of New York to prevent the spread of Herpes infection to the child.
  • Norway upholds ban to display of tobacco products in shops as a measure to maintain a healthy lifestyle.

Programs:

  • Early childhood health projects by PATH, in South Africa and Mozambique is funded by a donation of R200m by BHP Billi4on.
  • A memorandum of Understanding was signed by Apollo Hospitals with AfroIndia Medical Services to set up 30 telemedicine units in East and West Africa.
  • UC Davis center to fight child obesity in Latinos.  $4.8 million study funded by U.S. Department of Agriculture aims at identifying effective approaches to combat this growing problem among them.

Research:

  • According to a study nicotine not only in cigarettes but in nicotine replacement products like gum or patches harms sperm.
  • A study found that South African wine is good for heart. It protects against heart attack by reducing cell death and increasing contractility of heart.
  • A survey shows that about two thirds of men in Indonesia above the age of fifteen years smoke. It also revealed that large numbers of people are also exposed to the second hand smoke in work, home and in public places.
  • According to a study, mothers of Mexican origin are more nurturing than white females.
  • According to a charity drink related harm costs Scotland’s councils £2bn annually. The figures are based in Scottish government data.
  • A research study showed that lung transplant approval rates depend on the socioeconomic status of people.
  • According to the researchers at the University of Kentucky academic success of Latino immigrants is dependent on the school teachers and its climate.
  • In a study done by Cornell University researchers it was found that parents immigrants status affect their access to care and hence their children’s health.
  • A study published in the journal Applied Physiology, Nutrition and Metabolism states that swim training with healthy diet play a crucial role in fighting against cancer.
  • A research done by University of Michigan Medical School showed that it is possible for the people who are not able to smell things will be able to do so by gene therapy.
  • Massachusetts engineers have found a way to increase the permeability of skin to drugs using the ultrasound waves.
  • According to a study analgesics commonly used to relieve pain may cause hearing loss in females.
  • According to the researchers at Seoul National University in South Korea, Er:YAG laser microjet transdermal device could replace needle jab.
  • According to a study job strain might affect cardiovascular health.
  • A study showed that acupuncture works for head and neck pain, osteoarthritis and chronic headaches.
  • According to World Socialist Web Site UK politicians gain from privatizing National Health Service.
  • Scientists find insulin sensitivity gene, may lead to new diabetes treatments.
  • Scientists in Ohio have created artificial memory in brain tissue, in vitro for the first time.
  • According to a study, intrauterine exposure of nicotine either passive or active might affect the neurobehavioral development of infants.
  • A study showed that the Electronic Health Records Data (EHR) for research is often incomplete, inaccurate and unreliable.
  • A study found that peanut allergies are rising among the people of developed nations.
  • A study showed that healthy diet and lifestyle not only affects the growth of a tumor but also its metastasis.
  • A study found that traditional Chinese medicinal mushroom can help to cure cancer.

Diseases and Disasters:

  • Chinese health authorities are investigating whether children were tested for genetically modified (GMO) rice as a part of a Sino-U.S. research project.
  • Chicken pox outbreak reported in South Malawi (Africa). The health authorities have instructed to close schools to prevent the spread of this disease.
  • KwaZulu Natal (South Africa) Department of Health in crises.
  • Nearly half of Indonesians live without sanitation, clean water. Country’s health minister says it requires $5.9 Billion USD to improve access to sanitation and clean water.
  • The National Food Health, Safety and Quality Service (Mexico) said that the country’s poultry farmers slaughtered 22.3 million birds between June and August to stop the outbreak of avian flu.
  • Nepali workers in Malaysian palm industry face health risk caused by pesticides. They spray it without using any safety equipment’s.
  • The staff work in emergency department at Forth Valley Royal Hospital in Lambert (Scotland).
  • Eight infants were exposed to tuberculosis in a hospital in California. According to the health officials it’s unlikely that they will contact the disease.
  • Tewksbury’s West Nile Virus risk rose to ‘High’ by Massachusetts.
  • Superbug kills 7th person in Maryland National Institute of Health Clinical Center.