Expatriate health: invisible illness and how HR can help

An invisible illness is a sickness or disability that may not be immediately noticeable to others. It can greatly reduce a person’s ability to take part in normal day to day activities and often impacts their ability to focus at work. If managed well, the effect of an invisible illness can be minimal. If not, the consequences can be serious. The World Health Organisation (WHO) reports that invisible illnesses are responsible for over 40 million deaths around the world each year.    

There are a wide range of chronic conditions considered to be invisible illnesses. Chronic illness like depression, heart disease or diabetes, can be long lasting or incurable, a result of a combination of genetic, environmental and behavioural factors.

As a HR manager, there are things you and your company can do to help expats who may struggle with an invisible illness while on assignment:

Depression and anxiety are two of the most common mental health disorders in the world today. The World Health Organisation estimates 300 million people globally suffer from depression. It is a major contributor to absenteeism from work. Maintaining good mental health can be tough while living abroad and expat depression is a common cause of expat failure. Supporting expats who are struggling with depression is beneficial for individuals and is also in the best interest of your business.

There are a range of wellbeing initiatives HR can put in place to help expat employees with anxiety or depression:

Employee Assistance Programme: ensure your international health insurance policy contains a robust expat assistance programme. This can help international employees access the help they need with expat depression.

Training: provide employees with training on spotting depression in themselves or a colleague. This may work best as part of pre-departure training.

Wellbeing initiatives: encourage employees to arrange or take part in activities that have a positive impact on mental health. If you can arrange them during the working day, even better.

Cardiovascular disease, including heart disease, causes the deaths of 18 million people a year globally. Although there are some genetic factors that can lead to heart disease, many of the causes are lifestyle related. A sedentary lifestyle, poor diet and smoking increase the chances of a person developing a cardiovascular illness of some kind.

Provide a check-up: ensure employees have access to a full check-up before moving abroad. This should include a cholesterol test so (if needs be) they can work on lowering it while abroad.

Encourage healthy eating: encourage managers and event organisers to consider healthier options when catering for employees. Provide facilities for employees to bring in their own lunch. Hold healthy ‘potluck’ events where employees can share their healthy recipes.

Encourage exercise: organisations may approach this differently depending on where expat employees are located. Encouraging exercise could be a subsidised membership of a local gym or classes during lunch.

Medical treatment: ensure they have access to medical treatment. Diabetes of any kind requires careful medical management to avoid damage to kidneys, eyes and feet.

Privacy: provide a private room for insulin injections and safe disposal of needles.

Support a healthy lifestyle: provide low-sugar or sugar free alternatives during meetings and events with food.

There are two forms of diabetes type 1 and type 2. Type 1 diabetes is an autoimmune disease, usually inherited, that requires lifelong use of insulin injections. Although genetics play a role in the onset of type 2 diabetes, it is often caused by unhealthy lifestyle choices. There has been a significant rise in the instances of type 2 diabetes in the last thirty years linked to the increase in obesity globally.

When it comes to musculoskeletal issues, prevention is better than cure:

Ergonomic assessment: every employee should have an ergonomic assessment with a certified professional. Recommended equipment should be provided.

Manual handling course: if physical lifting is part of a role, ensure expat employees are certified in manual handling. Always opt for machine lifting if available.

Injuries to the back or limbs are a major cause of absence from work and in some cases, can lead to loss of earnings or early retirement. The most common musculoskeletal issue is back pain. In some cases surgical treatment will be required, but this is often a last resort.