Emergency Management

HEALTH

Health Clearance Process

Prior to departure, participants are required to complete the Health Clearance Process. Education Abroad worked with NU Legal Counsel to develop this process to help students and their professional health providers make better decisions about program participation and to provide program leaders with the information they need to support students. We hope to inform and protect you and your students.
 
1) Confidential Health History Form

• The participant will complete the Confidential Health History Form.
• It is used for the participant to provide information about his/her health history to the health provider(s).
• The participant is not required to send the Confidential Health History Form to any office at the University of Nebraska-Lincoln (UNL).

2) Health Clearance Form

• The participant’s health provider will complete the Health Clearance Form.
• The participant is required to submit the Health Clearance Form to the UNL Education Abroad Office.
• This is the 2-page form you, the faculty leader, will receive. It verifies that the student has been cleared for your program and describes the student’s accommodations/services required, medications, and allergies.

“Requirements of Participation”
You will see on the forms: “In addition to meeting all specific requirements of the education abroad program chosen (as set forth in the program description), all participants must meet the following general requirements of program participation…”
Please note that students will take the program description (the MyWorld online brochure) with them to the health provider. Please review the general requirements. If there are any specific requirements or "essential eligibility requirements" (EECs) you would like us to add to your program’s brochure, such as "must be able to hike five miles," please let us know.
 
Deadlines:

• If a student does not need accommodations, the form is due no later than one calendar month before departure.
• If a student does need accommodations, the student must submit the form and apply for accommodations with the Services for Students with Disabilities (SSD) Office no later than two calendar months before departure.

Value of this process:

• The Education Abroad Agreement reads, “The Participant has disclosed to the education abroad coordinator and the program coordinator any health condition, to the extent that it may affect the Participant's safety and welfare or that of the other program participants.” Students now have a formal way to disclose, rather than us relying on them to informally disclose.
• We are putting the decision-making process of whether a student should participate in the hands of a professional health provider and the SSD Office (not the student’s or ours or the program leader's).
• We (Education Abroad and program leaders) will only see the information we need to know to help support the student.  We will not see any confidential information we don’t need to know.
• We will all be better prepared to accommodate students ahead of time (rather than unexpectedly on-site), when it is reasonable to do so, and to respond to health emergencies abroad.

Education Abroad will communicate with students about this process. Please let the Education Abroad Office know if you have any questions. Thank you for the role you play in keeping our students safe and healthy abroad!

Medications & Vaccinations

In MyWorld, all students are asked to read the Centers for Disease Control and Prevention’s guidelines, and to sign that they have read them. During the visit to a medical professional to complete the Health Clearance Form, students should ask about health concerns, medications, and vaccinations.

Students should research regulations regarding the transport and use of medications in the host country. Students may use HTH Worldwide's Drug Translation Guide to find out what a medication is called in the host country, and to find out whether that medication is available in the host country. If a psychiatric medication is not available, it is probably not legal in the host country. If a student or faculty leader has questions about pharmaceuticals not available on the Drug Translation Guide website, they may contact HTH's Global Health and Safety Services by email (globalhealth@hthworldwide.com) or calling 1-610-254-8771 or toll-free outside the U.S. 1-800-257-4823. They should include the name and dosage of the medication and the location. HTH will research the question and respond to the request.

At a pre-departure meeting, the EAO staff will remind students to ensure they have an adequate supply of properly labelled prescription medications for the duration of the program as permitted, as it can be difficult to refill prescription medications while abroad.

Faculty Leaders are strongly discouraged from providing medication (even over-the-counter) to students and may not request reimbursement for medication purchased on behalf of the student(s). Please encourage students to bring along over-the-counter medications they use on a regular basis, or expect to use abroad, and encourage them to purchase their own medications while abroad.

While leaders may prepare their own first aid kit, an important tip to keep in mind: "Don’t bring anything that you don’t know how to use." Ideally, first aid will be administered by local first responders in larger cities or well-trained guides in remote areas.

Student Mental Health Issues

Adjusting to another culture typically involves stress for any program participant, and stress is the number one cause of exacerbation of a pre-existing mental illness. If at all possible, become familiar with host country laws about involuntary hospitalization, as well as the general cultural attitudes regarding mental illness. Familiarize yourself with the warning signs of mental stress, to seek help for the student as early as possible. Behavioral warning signs include, but are not limited to:

• an inability to communicate clearly,
• an unusual or markedly changed pattern of interaction, such as totally avoiding participation, becoming excessively anxious when called upon, or dominating discussions when this was previously not the case,
• extreme behavior fluctuation within a relatively short time span,
• a depressed or lethargic mood,
• being excessively active and talkative (very rapid speech),
• swollen or red eyes,
• a marked change in personal dress and hygiene,
• being sweaty (when the room is not hot),
• or falling asleep inappropriately.

Even if unusual behavior is due to mere transient culture shock, it is important to follow up with the student and offer support. If desired, HTH Worldwide can help identify a mental health professional abroad. If a problem does arise, you should not attempt to make serious decisions alone, but should seek professional assistance and notify UNL Education Abroad. The Dean of Students and UNL Counseling and Psychological Services (CAPS) are excellent resources that are available to staff and students and can help coordinate a plan of action. CAPS has after-hours emergency service available, if you or a student needs to consult with them.

Health Emergency Planning

As a Faculty Leader, you are responsible for familiarizing yourself with health facilities in the host city. On-site coordinators are often helpful in orienting Faculty Leaders to local health resources. In preparation for any emergency, you should locate the office of a general practitioner and an ob/gyn and find a reputable hospital or clinic for emergency situations. If the host country is not English-speaking, locate at least one or two English-speaking physicians. During on-site orientation, discuss the procedures students should follow if they become sick. Become familiar with nearby hospitals and their procedures. Some may allow credit card payments for services, but others may require immediate cash payment.

The EAO will provide a list of local medical clinics and hospitals in the HTH Worldwide network prior to departure. To search for a doctor in the HTH Worldwide network, visit the HTH website.

HTH WORLDWIDE INSURANCE

Medical Coverage

UNL Education Abroad purchases HTH Worldwide Blanket Student Accident and Sickness coverage for each participant traveling outside the United States for all UNL Education Abroad programs. UNL Education Abroad arranges premium payment with HTH Worldwide directly. Students are instructed to log in to the website (www.hthstudents.com) to become familiar with the provider’s resources and download their electronic insurance card. Physical copies for the group are typically provided to the leader prior to departure. Active UNL faculty/staff members are covered by a comparable policy through GeoBlue.

Students and leaders may use the HTH and/or GeoBlue site to find a doctor in the network that allows direct billing. The website contains many other useful resources including translations for common conditions and medication names in your destination.

Claims for medical care may be submitted using the Claim Form or online at: www.hthstudents.com. A copy is also included in leaders' pre-departure packets. Each student is responsible for submitting his/her own claims, and should keep all receipts and medical documentation.

Emergency/Natural Disasters

The policy also offers Emergency/Natural Disaster services and evacuation coverage. In the event of an emergency, faculty leaders should contact DRUM for assistance. DRUM will then take all appropriate actions to assist the members in getting to the nearest safe haven. Contact DRUM by first calling HTH Worldwide collect from outside the US +610.254.8771.

SAFETY & SECURITY

Destination Information & Destination Safety

In MyWorld, all students are asked to read the U.S. Department of State Consular Information Sheet and the Centers for Disease Control and Prevention’s guidelines, and to sign that they have read these websites. While UNL Education Abroad will provide students with an orientation to general travel issues, it is up to you to inform students of any additional destination-specific travel issues, including, but not limited to, customs, duties, regulation, penalties related to Immigration and Customs, health and safety, food and water issues, and currency. To learn about any travel issues, see the U.S. Department of State Consular Information Sheet and the Centers for Disease Control and Prevention’s guidelines, and consult with your on-site partners.

You should communicate to students any risks associated with traveling to the destination(s) and provide systems (e.g., buddy system, mandatory disclosure of travel plans, etc.) to show due diligence in keeping participants safe.

EMERGENCIES & INCIDENTS

Pre-Departure

Emergency preparation

Recommended resources:
IES Abroad MAP for Student Health, Safety, and Crisis Management
NACUBO International Resource Center: Risk Management
SAFETI Adaptation of Peace Corps Resources: Crisis Management Handbook

Prior to your departure and immediately upon arrival, there are many things you must do to plan for student safety.  Here are some steps to take for emergency preparedness:

• Register all students and staff with the local consulate/embassy in your location using the US Department of State STEP. UNL Education Abroad offers this service to all UNL Faculty-Led programs.
• Assess the program logistics for safety. For example, how will students travel from their accommodation to the other program facilities? Are approaches to the residence well lit at night? Where are the closest telephones?
• Know how to communicate with and access other resources during a crisis. These include:

          Local police and fire departments
          Hospitals, clinics, and health and counseling professionals
          HTH Worldwide Insurance
          U.S. Embassy/consulate and pertinent embassies/consulates for all students on the program
          UNL Education Abroad Staff
          UNL Police
          UNL Counseling and Psychological Services (CAPS)
          Local and US travel agents
          Airport authorities; other transportation authorities (train station, bus terminal, etc.)
          International Red Cross Offices; UN Offices
          Other U.S. Education Abroad Programs/ Organizations or volunteer agencies
          Other local universities/colleges

• Keep hard copies of students’ Emergency Contact information with you on site. It is also available online via MyWorld.
• Keep hard copies of students' Health Clearance Forms with you.
• If hiring a bus or contracting with a local travel agency, be informed about their insurance coverage.
• Provide participants and UNL Education Abroad with an itinerary and telephone numbers for each accommodation site.
• Provide participants with site-specific information about potential health and safety dangers, preferably in writing.
• Provide participants with directions for direct AND operator-assisted dialing to the U.S. from site including access codes and acceptability of coins/telephone cards/calling cards.

UNL Education Abroad reminds students prior to departure to do the following:

• Make copies of your passport; leave a copy at home with someone you trust and pack additional copies somewhere apart from the originals (suitcase, jacket, etc.)
• Write down location specific telephone numbers for credit cards and traveler's checks. Write down account numbers and traveler's check serial numbers and pack them somewhere apart from the originals (suitcase, jacket, etc.).
• Leave copies of all the above information at home with someone you trust. Also be sure that someone will accept a collect call from you in case you lose the numbers.

Prior to departure, you should monitor the risks of destination:

In the months prior to departure, it is also important for you to monitor the security status of the destination country, for example by reading State Department travel advisories.

Be sure to inform students of potential risks, either in writing or in a mandatory group meeting (so that you will have witnesses to confirm that a warning was given). We recommend doing so in writing, because not everyone will be able to attend orientation meetings.

As a general rule, it is better (from both recruitment and liability standpoints) to inform students of any potential risks. It is especially important to respond to risks discussed in public forums such as the State Department travel advisories and to let students know why you think this risk does not necessitate canceling or changing the program, rather than to selectively discuss only some potential risks.

For example, if the State Department posts a warning about civil unrest in an area of your destination country which is not on the program's itinerary, it is a better idea to inform the students of the warning, to explain that the area is several hundred miles from where the program will be held, and to let them know that you personally feel this is not a serious risk but that you wanted them to be fully informed. Simply not mentioning it could invite student or parent complaints that they were not fully informed.

On-Site

Emergency Contact Information

Faculty leaders should be available to students by phone at all times. Provide on-site emergency contact information (Faculty Leaders, on-site coordinators, lodging contacts, embassy/consulate) to students and encourage them to keep the information in their wallet/purse at all times. The EAO will provide students and leaders with emergency cards that include the local phone number for the U.S. Consulate/Embassy in country, HTH Worldwide Insurance, UNL Police, UNL Education Abroad Office, UNL CAPS and any additional local contact phone numbers provided by the Faculty Leaders.

Local Emergency Plans and Meet-Up Locations

Create and communicate to participants a local emergency plan to include procedures and meet-up locations in case of emergencies. Communications systems may be down during a major emergency.
Choose a travel agent at your overseas site that could potentially help you make travel arrangements in an emergency.
Develop a rapid communication system to reach students once on site (email, cell phones, etc.); establish a phone tree. Develop a contingency plan in the event that students cannot be reached or are traveling.

Types of emergencies

In order to be prepared for any emergency, you must first understand the types of emergencies and their severity.

Perceived emergencies

Distinguishing between a real emergency and a perceived emergency is a crucial first step. Often loved ones at home will become alarmed by a perceived emergency — floods in Northern Italy, for example, though your program is hundreds of miles away; or government instability in Ecuador, though you are in Belize. Due to media attention and incomplete information, situations abroad may be perceived in the U.S. as more dangerous than they actually are. They can be as disturbing to program participants and their family members as real emergencies and require serious and prompt action on your part.

UNL Education Abroad will give strongest consideration to the on-site Faculty Leader’s judgment. Contact with UNL Education Abroad is essential and consultation with the U.S. Embassy/ consulate is advisable. For more information on communication protocol, see Communication Protocol section.

Emergencies can be categorized as routine or major.

Routine Emergencies vs. Major Emergencies

Emergency response

Because the safety of our students is our top priority, your first responsibility in an emergency is to safeguard the wellbeing of program participants. In order to do so effectively, you should thoroughly read and become familiar with the crisis management information outlined below.

The key during a crisis is to remain calm. You must help the students get through any difficult time. The UNL Education Abroad staff has experience dealing with crises and is here to assist you in any way before, during and after a crisis.

Emergencies are, almost by definition, varied, unexpected, and traumatic for those both directly and indirectly involved. Emergencies can include, but are not limited to, illness, accident, natural disaster, military coup, incarceration or deportation, transportation crisis, criminal assault, economic crisis, and even death. Whatever happens, your being prepared in advance and having procedures in place are likely to be critical to all involved. As the Faculty Leader, you are the person who must, inevitably, manage whatever emergencies occur on your program. Should you be rendered unable to carry out your duties, you will need a deputy. Please designate one in advance.

Although none of us likes to consider the possibility of legal action, it is increasingly likely in the aftermath of an emergency. Litigation cannot be prevented, but the effects of litigation can be lessened if one demonstrates one has been reasonable and prudent. Thoughtful emergency plans are evidence of both reasonableness and prudence. Obviously, we cannot plan for every eventuality. Most decisions will be made on the spot, in light of the particulars of the emergency that is unfolding.

Please provide UNL Education Abroad with detailed contact information about how the director can be reached at any time, including while on excursions.

Decision making during an emergency (General procedures for all emergencies)

There are four steps to be taken during ANY emergency. These include assessment, securing student(s), communication, and documentation. Depending on the emergency, each of these steps must be completed, but will vary in degree.

Be prepared to provide UNL Education Abroad:

• Name of caller and victim, if any and brief description of accident, injuries, and/or emergency
• Status of and location of any victims and all students/staff
• Phone and fax number where the caller is located
• Has rescue squad, local law enforcement, U.S. embassy/consulate been called? What is their advice?
• Any information released to media thus far?
• What impact, if any, did the emergency have on availability of food, water, shelter and medical supplies?
• What was the target of unrest, if political? Are there military or emergency personnel on-site?
• Is continuation of the program possible?

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