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stay or go home

We thank Natalie Tollenaere, life coach and cross-cultural trainer who has lived in multiple countries.


Don’t be mistaken – whether we like it or not, our body comes with us when we relocate. You are probably saying, “Yes, of course it does,” but simpler said than done. In the tropics, or on snow-covered peaks in the Andes, at sea, on mountains, in Lima or in Kinshasa, our bodies must also get accustomed to the new environment – and change. Yet, it is our greatest possession. Without it, obviously, the rest doesn’t exist.

So, what do we do when sickness strikes, an accident happens or we get pregnant again?

Our physical health is linked to our emotional health. If one is touched, so is the other. The body responds to stress, depression, anger and sadness through physical symptoms.

During expatriation, when being far from our medical and social bearings or familiar cultural habits may challenge our health, we can quickly lose our common sense. Either we tell ourselves “I’ll get this checked out when I go back home (which can be in 8 months’ time)” or we panic: “this headache might be brain cancer”.

A happy medium between negligence and panic can be reached if we ask ourselves the following questions. The important thing is to ask the questions without self-judgment. This could help put the situation in perspective as well as to live in our desired manner, our way.

  • How do I physically feel about this illness? This accident? This pregnancy?
  • How am I emotionally or psychologically affected?
  • How does this illness affect my loved ones, my partner, my family?

Once this reflection is complete, we can then seek the necessary support.

  • What support do I need – material, moral, physical, family?
  • Is it important for me to seek medical advice from a doctor from my own culture, from my country who speaks my language? Where can I find one?
  • Do I need my extended family or my nuclear family? Do I need both of them?
  • How can I create a situation where I feel surrounded by them and what I need?

These questions can help us to recognize what we need or what we want. The answers will be the basis on which to make necessary decisions, including whether to stay or go home. Ignoring them will simply lead to denial, which can be accompanied by anger, resentment, sadness and depression. Don’t be mistaken, though, we’ll always be confronted by judgment from others: “My operation here was fine, why does he want to go back?”, “I had a good birthing experience here, why would she want to go back?” or “She is not responsible – she dared to be operated on here.” Remember that illness is linked to the body, spirit, our socio-cultural baggage, our finances and our family situation. We are all unique and have unique needs….

My heart goes out to all those who are facing an illness, an accident or a pregnancy outside their normal points of reference, and have to decide whether to stay or go home.

Some practical information:


In April, I helped a young guy with his repatriation following a serious motorcycle accident. It was impossible to treat him in Kigali. Repatriation was essential. But he didn’t have insurance… he had to pay for 6 airplane tickets for the stretcher, one for a nurse (as it happened, me), one for his wife and another for his son… 9 plane tickets…. This hurts a family budget… so, check your repatriation insurance, especially when the country you live in has uncertain medical care.


To all women over 40: do not forget to get your routine mammograms. Mine saved my life! (Do not make the excuse of living in a country without this facility, plan months ahead for your appointment while you are back in your country.)

Kigali, Rwanda
November 2012
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