Handbook – Health & Wellness

It is important for you to review and understand your Cultural Insurance Services International (CISI) plan and all exclusions to your coverage. Detailed coverage information and policy descriptions defining the coverage terms is available online. Your CISI coverage is in effect for the duration of your program and applies if you travel to other locations during the program dates.

CISI coverage can be used for emergencies, accidents, and illnesses that occur while away, as well as establishing necessary continuation of care for ongoing physical or mental health issues.

Your CISI coverage includes an online portal of tools and information as well as access to 24/7 medical, personal, travel and security support. Through this customized site, you can:

• View/print/email your ID card, coverage brochure, consulate letter and claim form so that you have phone numbers and instructions on hand in case you are injured or ill
• Purchase an extra month of insurance for a period of personal travel
• View/update your online account profile information
• Obtain contact information for emergencies and benefit/claim questions
• Search for hospitals and clinics

You can also find valuable travel-related information, such as:

• Contact information for English-speaking doctors
• Travel advisories as issued by the U.S. Department of State
• Country-specific information and profiles for every country of the world
• Links to overseas U.S. Embassy web sites
• Health and vaccination recommendations compiled by the CDC

Our office will enroll you in the CISI policy. Once you are officially enrolled in your CISI coverage by our office, you will receive an email from CISI with a link and login instructions. Print out your ID card and carry it with you at all times while on your program.

Students who are participating on programs run in conjunction with the Institute for Study Abroad (IFSA) are enrolled in CISI through them directly and not by UW-Madison. IFSA will provide policy information and online log-in information directly to you.

You should check with your current health insurance provider to see what coverage you may have while on your program. This is beneficial so you can have continuation of any ongoing medical/mental health services with your usual providers while you are on your program. If you need a full-time enrollment letter in order to maintain your current health insurance coverage, contact your Study Abroad Advisor.

Some countries require that foreign students participating in study abroad programs purchase local health insurance in that country. You are responsible for purchasing this insurance if it is a requirement for the country where you will be studying. Students participating on these programs are still required to have the CISI coverage.

You will submit  Health and Wellness Information in your MySA account. This is confidential information and does not affect your admission into a program.

Sharing this information is designed to:

• provide you with information about steps you can take to prepare for travel;
• allow our staff to best support you during an emergency situation.

Mild physical or psychological conditions may become more serious under the stresses of life away. It is important to disclose any pre-existing conditions, past or current treatment, and medications in your Health and Wellness Information. You can also update this information before departure, if there are any changes. Sharing medical or mental health condition information during the planning process will make it easier for our staff and UW-Madison to assist you in case of an emergency.

It is strongly recommended that you have a medical examination before you leave, especially if you are taking prescription medication or are in regular treatment for a pre-existing condition. Some locations may even require that you obtain certifications of health and/or immunizations in order to enter.  Regardless of where you are going, below are some recommended steps to help you prepare for travel:

• Educate yourself about health and safety in your travel destination. Consult the Center for Disease Control (CDC)  to learn about possible health issues, recommended and/or required immunizations, vaccinations, or precautions in the areas in which you will be studying or traveling. The World Health Organization also provides relevant health information.
• It is your responsibility to understand and abide by the vaccination requirements (including acceptable vaccine types and verification methods) for your specific program and location(s), as well as any country you may travel through or visit during your time abroad. Note that restrictions and regulations may change at any time. Any related delays, penalties, quarantines, self-isolations, program status changes or cancellations, and associated costs are the full responsibility of the student.
• Consult with your personal medical and/or mental health provider for pre-departure planning, especially if you have any ongoing conditions. Work with your provider to develop plans in the event that any conditions worsen, reoccur or change while away. Make arrangements for any prescription medications, medical supplies, and medical care you will need.
• Do a pre-travel visit (sometimes listed as “travel clinic” or “travel education”) with your health care provider and receive required or recommended preventive immunizations and medications (such as malaria prophylaxis or for traveler’s diarrhea) for your area of travel. Some recommendations may be based on personal health history. It is your responsibility to ensure that your routine vaccinations are up-to-date and to ask if there are recommended and/or required immunizations or medications for the locations you will visit.
• Allow as much time as possible for immunizations, as some may require a series or spacing for protection (as long as three months for a series of shots).
• Have optometry and dental check-ups and address any potential problems before you leave.

University Health Services (UHS) has a travel clinic that provides health services for students who are planning international travel, including vaccines and immunizations. Appointments should be scheduled 1-2 months prior to departure.

Whether you are currently being treated for mental health concerns or if you have in the past, you should know that preparing for and participating in this new experience can bring about a return or an increase in symptoms. Disclosing mental health information helps you plan with others so that the necessary support will be in place when you are away. Our insurance provider, CISI, can provide you with options for mental health services in your program location. Some students may be able to continue receiving support from a current therapist or counselor online while they are away. For more information, review our Mental Health Abroad Page.

Think carefully about any medications and/or travel health supplies that you want to bring with you. Consider making your own care package of the medicines you prefer when you are sick so you have some of those comforts from home easily available.

In addition, consider the following:

• Certain medications, including many mental health medications that are common in the U.S., may be limited in the amount that you can transport into and out of the country. Some may be considered illegal substances in other countries, even if they are regularly prescribed in the U.S. Check with the country’s Embassy or call CISI insurance to learn about any restrictions and if your medication will be legal abroad and consult with your healthcare provider and CISI if you need to make arrangements to work within such restrictions. This may include writing to the government where you will be studying to get permission to bring the medication into the country. Then follow up with our staff to confirm your plan.
• Bring all necessary medication with you for the duration of your program and bring it in your carry-on luggage only.  For some medications, you may need to carry a printed letter from your physician stating why you need the prescription medication. Print out copies of your medical prescriptions as well, including the name of the active ingredient(s) and keep medications in their original containers.
• If your insurance company asks for a letter certifying that you will be away, contact your Study Abroad Advisor.
• It is illegal to ship medication overseas and it will be rejected at customs.
• Consult with CISI about obtaining medication in your host country.  In order to fill a prescription, you will need to see a healthcare provider to obtain a new prescription in that location.
• Review potential side effects of your medications with your healthcare provider, as your body may react differently because of adjustment to new sleep habits, time zones, altitudes, activities, and diet. Maintain your usual dosage and pattern of taking your medication while you are away or consult with your healthcare provider about any necessary adjustments due to significant changes in time zones.
• If you have a medical condition that is not easily identified (diabetes, epilepsy, severe allergies), you should wear a medical alert bracelet and consider having it translated into the local language. Be sure to develop a plan with your healthcare professional before you leave home. Individuals living with diabetes are encouraged to bring a sufficient supply of needles and syringes with a prescription or doctor’s authorization.
• You may want to consider purchasing allergy cards created specifically for travel. These are customized to your specific allergies and the local language.
• The CDC has recommendations for packing a travel health kit.

McBurney Accommodations

Students with disabilities have successfully participated in many of our programs; however, not every program is a good fit from an accessibility perspective.

To properly prepare to travel, if you are a student with disabilities, you should start planning for accommodations a minimum of six months (preferably one year) in advance of travel, regardless of the type of disability. The key to success is early notification and planning. Learn more at Study Abroad for Students with Disabilities.

If you have any ongoing health conditions, you should consult with your personal health care provider prior to departure regarding your health and safety abroad.  University Health Services is a resource for students who would like to discuss any health issues and planned travel as well.

Talk with your Study Abroad Advisor if you need to establish continuation of care while on your program. Your Study Abroad Advisor will direct you to more specific sources of information about which local support services you can reasonably expect to find in your location. Some locations may not be able to accommodate all reported individual needs or circumstances.

While it is important the program is aware of any physical or mental health conditions, past or present, which might affect you during your travel, the University is not responsible for assuring your medical well-being and safety while away. It is ultimately your responsibility to meet your medical needs during your travels.

Create a Self Care Plan
Before you head to your program, think through ways you take care of yourself here and how those might be used on-site.  You can create a plan that includes categories like:

• My Helpful Coping Skills
• Supportive People I Can Talk To
• New or Past Self-Care Activities I Can Try
• My Communication Plan with My Support System
• On-Site Resources

The best way to avoid having a severe allergic reaction abroad is to prepare well in advance of your departure. There are many resources available to you as you prepare to study abroad, including your medical providers and study abroad staff, but remember that it is ultimately your responsibility to meet your medical needs during your program participation. As you prepare for your experience:

• Communicate your food allergy early to your Study Abroad Advisor, Program Leader, and program provider so that they can determine if accommodations are required, particularly if meals are provided as part of the program. They can help communicate this to your homestay family, on-site staff, etc. Be upfront about the nature and severity of your allergy, particularly if it might affect the actions of your entire study abroad group. You may want select your housing based on whether you wish to cook for yourself or not.
• Talk to your doctor. By getting a good understanding of what is best for you while traveling, you will be able to prepare for your program and focus on the other important things to know before studying abroad. Work with your doctor and study abroad staff to create your personalized plan of action should you need it. Consider getting a multilingual medical alert bracelet, in English and the local language, to wear while abroad.
• Talk to your family. Discuss your interest/decision to study abroad with your family. Share the factors you considered when choosing your program and your plans to stay safe and communicate with them regarding any concerns or needs.
• Pack medications, copies of prescriptions, and other supplies: Make sure that you have enough EpiPens, antihistamines, adrenaline injections, or any other medications you might need during your time abroad. Pack these in your carry-on to avoid losing them. It is essential to bring hard copies and digital copies of your prescriptions to present at immigration when you enter your host country(ies) to justify your possession of your medications and in case you need to get more during your program.
• Learn how to explain your allergy in the local language. Google Translate can be a great tool to communicate your allergy, but it is not fool-proof, so it will be important to try to learn how to explain your allergy.
  • Practice local manners and learn how to politely inquire or ask for things. Translations for words and phrases like excuse me, can you help me, please, and thank you. Kindness, especially while traveling, really does go a long way.
  • Work on your pronunciation of key words and phrases, including:
    • “I am allergic to X.”
    • “If I eat/am exposed to X, [what may happen in an allergic reaction]”
    • “I cannot eat…” vs. “I will not eat…”
    • “I am allergic to….”
    • “Does this contain…[ingredients related to your allergy]?”
    • “Was this cooked with…[ingredients related to your allergy, e.g. peanut oil]?”
    • “I need to go to a hospital.”

• Prepare an allergy card with the help of your doctor and a professional translator or native speaker. By carrying a card with your allergy perfectly translated and written down, you will be able to share it with restaurant staff, chefs, street vendors, etc. Use an index card or a quarter sheet of printer paper to briefly but clearly explain your allergy and any dietary needs. Consider including points like the severity of your allergy, specific foods you cannot eat, or how you need food to be prepared. Use polite language. Laminate a physical card to carry with you. Save a digital copy on your phone and to the cloud. Be aware that the same words and terminology may not necessarily be used (or understood!) in different countries even though they speak the same language.
• Download and learn to use apps that can help you navigate studying abroad with an allergy. Some examples include:
  • Food Allergy Card (translates food allergy information)
  • Allert– for food allergies (translates food allergy information including levels of severity or preferences)
  • Equal Eats (provides detailed information about specific allergies)
  • Find Me Gluten Free (finds and provides reviews of gluten free restaurants around the world; also provides platform to connect with others)

• Pack your own non-perishable snacks to bring with you for moments where it might be harder to find something that fits your diet.
• Review CISI health insurance policy, print your CISI card, and research local medical services. Understanding what is covered by CISI and which local providers are in-network will allow you to access medications and healthcare as well as submit associated claims more easily. If you plan to do personal travel before or after your program dates, be sure to work with CISI to extend your coverage to include your personal travel dates.
• Notify airlines of your allergy. When booking your flight, notify the reservation agent of your food allergy, and request that your information be forwarded to folks like the gate agent, food service, and flight crew. Some airlines may provide special meals and snacks to accommodate allergies, but it would be wise to pack your own just in case. You will likely also need to communicate your allergy with a gate agent for each flight as well as flight attendants. Airline policies and alternate snacks/options will vary.
• Read about past students’ experiences. You may find online blogs about individuals’ experiences abroad with a particular allergy in various locations, which might be helpful to read as you prepare for your own experience.
  • Help us build our resources to share with students. Did you write about your experience with food allergies? If so and you’re willing to share it with others, please send it our way peeradvisor@studyabroad.wisc.edu

Missing a unique cultural experience because you’re stuck in bed with a travel-related illness or injury is probably not part of your plan for a great experience. Prepare for a safe and healthy experience by following the Center for Disease Control (CDC) travel health recommendations. Recommendations are available by destination or topic at the CDC website.

The CDC provides various recommendations, some of which include:

• Eat well, exercise regularly, and get enough sleep. An important part of maintaining your health is eating and drinking properly to stay hydrated.
• Try not to take risks with your health and safety. Respect your host location and its people by following local laws and customs.
• Do not use illegal drugs and use good judgment if you consume alcohol.  Drugs usage can carry severe penalties. Alcohol may be legal in your destination, but it is important to consume it safely.
• Do not share needles for tattoos, body piercing, or injections, to avoid infections such as HIV and viral hepatitis.
• Use sunscreen with both UVA and UVB protection and take precautions to prevent mosquito and other bug bites.
• Avoid animal bites by not handling or petting animals, especially stray dogs and cats. If you are bitten or scratched, wash the wound immediately with soap and water and seek medical attention to determine if medication or anti-rabies vaccine are needed.
• Practice good hygiene by regularly washing your hands, covering your mouth when you cough or sneeze, and staying home if you are feeling ill.

Jet lag can be a problem for travelers who are crossing several time zones.  Although it is not a serious condition, jet lag can make it hard for you to enjoy your first few days. Here are a few tips you can take to minimize the effects of jet lag:

• Drink plenty of water before, during, and after your flight. The air on planes is extremely dry and it is easy to become dehydrated when not drinking enough fluids.
• Avoid large meals, alcohol, and caffeine during your travel.
• On long flights, get up and walk around periodically to stretch your muscles.
• Sleep on the plane if you can.
• After arrival, stay awake until the local bedtime. If you are sleepy during the day, take short naps (20–30 minutes) so you can still sleep at night. Eat meals at local meal times.

Unclean food and water can cause traveler’s diarrhea and other diseases.  Travelers going to developing countries are especially at risk. Reduce your risk by sticking to safe food and water habits, some of which include:

• Avoid uncooked food from street vendors.
• Avoid dairy products that are not refrigerated or pasteurized.
• Eat fruits and vegetables you have washed in clean water or peeled yourself.
• Do not drink water unless you know that it is safe for drinking; bottled water is recommended. Make sure the factory seal is intact. Consider bringing a Brita water bottle to help ensure the cleanliness of the water you are drinking.
• Avoid ice cubes in drinks unless you know that the ice was made from water safe for drinking.
• Do not leave drinks unattended or drink anything opened out of your sight.
• Wash your hands with soap and clean water or use an alcohol-based sanitizer before eating.

Vegetarians or students on special diets should be aware that their dietary needs might not be easily met in some locations. Discuss your needs in advance with your healthcare provider and your Study Abroad Advisor as necessary. You should list any special dietary needs in your Health and Wellness Information, as well as any housing or other program-specific forms.

While away, communicate your allergy(ies) to relevant individuals, carry medical essentials, and remain vigilant of potential risks in your food and environment. Seek out assistance and support when needed, but remember that it is ultimately your responsibility to meet your medical needs while a program participant. To that end:

• Communicate your food allergy to your Program Leader, on-site staff, host family, roommates, close friends, travel companions, restaurant staff, food vendors, etc. Be sure they are aware of its severity and how they can help keep you safe, but remember that YOU are your best defense against an allergic reaction. Teach relevant individuals how to administer an EpiPen. Use your allergy card and translation apps (Google Translate, Allergy Smartz) in addition to your own explanations.
• Always carry your allergy card, EpiPen, medications, prescriptions, and non-perishable snacks. Having these with you will allow you to travel more safely and can help prevent a severe allergic reaction.
• Trust your intuition. If something doesn’t feel right or you are unsure if a food is safe, don’t eat it.
• Build a routine. Find local grocery stores and restaurants that have ingredient lists and foods that meet your needs.

The “rules” of dating vary from culture to culture. It is important that you consider your behavior and inform yourself as best as possible about how dating and relationships generally function in the location. Students traveling should take appropriate precautions to avoid exposure to sexually transmitted infections (STIs). Some places in the world have a higher rate of sexually transmitted infections, including HIV and hepatitis. To protect yourself, do not have unprotected sex. Use a latex condom correctly, every time you have sex. Bring condoms with you, since those in other countries may not be up to the same standards as U.S. condoms, or be readily available. Overall, you are encouraged to be cautious about sexual activity while away.

You may want to talk with your healthcare provider or the UHS Sexual Health Clinic before departure for additional information.

Just as in the U.S., you should actively do things to help your wellness while you are abroad.  Consider the following:

• Aim for roughly eight hours of sleep each night.
• Be physically active for 30-60 minutes each day.
• Eat a healthy diet and a variety of foods.
• Drink sufficient fluids each day.
• Consider stress reduction practices. Do at least one thing to calm your mind and body like: deep breathing, meditation, yoga, imagery work.
• Set up your support structures. Identify key people you can rely on both in country and at home to provide support and guidance.  Your Study Abroad Advisor can also assist you with questions or concerns.

For more wellness suggestions visit UHS’s wellness page.

Self-Care Abroad: How to Manage Difficult Emotions on Site
While you are on your program, you will encounter frustrations and, at times, difficult emotions.  Here are some tips to help you manage those emotions:

• Acknowledge your feelings with self-compassion and recognize it is normal and ok to feel homesick, stressed, or overwhelmed. Practice patience with yourself.
• Reach out for support! Contact your support system back home, connect with a trusted fellow student on your program, or discuss your situation with on-site program staff.
• Take breaks and prioritize rest. Downtime is necessary for self-care.  Practice deep breathing, meditation, yoga, or other relaxation activities that bring you a sense of calm.
• Stay active as participating in exercise can help boost your mood! Be sure to pair exercise with proper nutrition and hydration to refuel your mind and body.
• Journal your thoughts! Journaling is a great way to stay grounded as you reflect on new experiences and emotions; it has been found to help reduce stress, improve mood, and assist in coping with emotions.
• Establish and keep a routine! Forming a new routine may contribute to a sense of stability in a new environment.
• Seek help if needed. If feelings persist, or get worse, reach out to your on-site program staff or connect with resources provided by UW-Madison study abroad.

If you are going to be adventurous, do so carefully and at your own risk. Safety policies, standards, and infrastructure vary around the world. If these are lacking, high-risk activities may be even more risky. Injuries sustained while taking part in certain high-risk activities are NOT covered by CISI insurance, including:

• bungee jumping
• parasailing
• hang gliding
• sky-diving
• mountain climbing
• operating an aircraft, watercraft, or automobile
• racing by horse, motor vehicle, or motorcycle

Doctors and hospitals outside of the U.S. often expect immediate cash payment for health services. Remember to ask for a receipt for any health service or medication. You may need to pay up front for medical expenses and send a CISI insurance claim form along with the original receipt to CISI for reimbursement. CISI insurance claim forms can be found in the CISI coverage details online.

It is sometimes possible for CISI to pay bills directly on your behalf if you are receiving expensive or ongoing treatment. Contact CISI or your Study Abroad Advisor directly for more information.

Marijuana Use

UW-Madison has a no tolerance approach to drug use while abroad. Students remain subject to the University of Wisconsin System Student Code of Conduct while participants on UW-Madison study/intern abroad or study away programs. Marijuana is illegal for recreational use in Wisconsin and under U.S. federal law, although it is legal under some other U.S. state laws. Airports and airplanes in the U.S. operate under federal jurisdiction, meaning they follow U.S. federal laws and not medical marijuana laws or cards of any state. If you are in possession of marijuana or other illegal substances, you can be detained and arrested when going through security on your way out or into the U.S. Possession of marijuana in a U.S. airport or airplane can result in a punishment of up to one year in jail and a minimum fine of $1,000 for a first conviction. Additionally, it is important to note that when you enter the U.S. at an airport or border, your social media accounts, texts, and emails are all subject to search. Any evidence of marijuana use, including photos or texts about buying or using, can be enough reason for agents to refuse entry into the U.S.

Drug laws abroad tend to be stricter than they are in the U.S.; therefore, do not assume that even if local people in your host country are using marijuana, that it is acceptable for you to do so. In countries abroad, students found in possession of marijuana, even with a valid U.S. prescription, may be detained, arrested, deported, fined, or even imprisoned. While abroad, you are operating under the laws and regulations of your host country; if you are arrested, the U.S. Embassy, IAP, and UW-Madison cannot help you.

Read more about the impacts of marijuana usage for students studying abroad according to the Centers for Disease Control.

Marijuana Withdrawal Information and Resources

Withdrawal from marijuana use can occur when people who use the substance regularly, stop usage abruptly resulting in possible psychological and physiological symptoms. Marijuana withdrawal symptoms typically begin within the first 24 hours after ceasing drug usage, leading to a peak in symptoms around the third day, and ultimately can last from 4 to 14 days, although psychological effects may persist longer. The intensity and duration of withdrawal symptoms may vary among individuals due to usage frequency, usage amount, and individual health factors. Marijuana withdrawal symptoms may include:

• Irritability and agitation
• Craving marijuana
• Anxiety
• Difficulty sleeping, including insomnia
• Mood swings
• Decreased appetite
• Nausea or stomach pain
• Headaches
• Body aches and chills
• Restlessness

Navigating marijuana withdrawal symptoms abroad may be difficult. Therefore, it is important to recognize some strategies for managing symptoms. Methods for mitigating withdrawal symptoms effectively may include:

• Healthy routines: establish a consistent sleep schedule to allow your body to rest, intake lots of nutritious meals and water, and engage in exercise.
• Stress reduction: practice mindfulness, meditation, yoga or other methods that work well for you to help manage mood swings, irritability, or anxiety.
• Support networks: engage with trusted friends and family to achieve emotional assistance and motivation.
• Avoid: steer clear from sugar and caffeine while your body processes this withdrawal as these can make symptoms worse.

UW-Madison University Health Services offers resources to students who may be looking for more support regarding their marijuana usage:

• eCheckup
  • Free virtual online assessment where students can learn more about their substance use habit and connect to helpful campus resources. Available to students 24/7.
• Badger Recovery
  • Connects and supports students in or considering recovery from addiction, offering various forms of support services.

Marijuana Testing: An Important Note

Many employers will make an offer for a job or internship contingent on a negative test for drugs and controlled substances. This test takes the form of a specimen analyzed for the presence of a substance. Be aware that this test may occur and be advised that failure to submit a drug test may end further employment consideration. Tests often need to be completed within 24-48 hours of the offer, or it may be withdrawn.