Fluent In Foreign Travel™
Every year, Deloitte releases a survey of venture capitalists from a dozen countries. As emerging markets tech investors, the question that always stands out to us is: “What is your overall confidence in investing outside of your home country…?” Year after year, U.S. VCs express the lowest confidence level.
This reluctance is especially surprising given certain well known trends, not least of which is the globalization of the Internet. Today, nine out of 10 Internet users reside outside of the United States. The rise of smartphones is set to tilt this balance yet further. Mozilla’s upcoming $25 handset will put smartphones within reach of all but the most impoverished consumers.
There are several possible explanations for U.S. venture capitalists’ reluctance to look outside of their domestic market. Tech investors may simply be succumbing to the same home bias that afflicts investors across asset classes.
However, certain venture-specific constraints may be at play as well. Many investors believe that physical proximity to their portfolio companies improves their ability to add value to them. It can also take months or even years of effort to build a network in a new market.
Logistical constraints are a factor too. It takes at least 10 hours to reach most notable international ecosystems from San Francisco. Finally, the United States has historically accounted for two-thirds of venture-backed exits. Thus, investors often have legitimate reasons to feel more comfortable in their own backyard.
Why, then, should Silicon Valley investors go through all this trouble to consider new markets?
In short, U.S. tech investors may miss the next wave of major exits. Ernst & Young recently asked global tech executives where they plan to focus their M&A efforts next year. Two-thirds of them expect to allocate the majority of their acquisition capital to emerging markets. When asked why, they said their overwhelming motivator is the desire to gain market share in these fast growing regions. This makes sense. After all, 86% of users of the top 10 Internet properties (Google, Facebook, Yahoo, etc.) now come from outside of the U.S.
This growing relevance is intensified by the positive feedback that exits can create for startup ecosystems. After selling their companies, successful tech executives become angel investors, mentors, and leaders of the next generation of great companies. Silicon Valley serves as the best example of this phenomenon. 400 companies and VC firms here can trace their roots back to Fairchild Semiconductor. More recently, early PayPal employees have gone on to found Linkedin, Tesla, Palantir, YouTube, SpaceX, Yelp, and Yammer, among others.
The lack of cross-border investment leaves both investors and entrepreneurs shortchanged. Entrepreneurs from Mexico to Dubai frequently tell us that Silicon Valley knowledge, expertise, and resources are in high demand in emerging markets. Silicon Valley VCs have an opportunity to leverage this need in order to access high quality entrepreneurs and help them scale their businesses. The resulting outcomes serve both parties well.
The economics of venture capital are set to shift as emerging markets look towards game changing exits. The ramifications of these exits on local ecosystems will be significant. Whether most venture capitalists are positioned to capitalize on this opportunity is less clear.
Follow them on Twitter at @martyged and @zfinkelstein.Travel Safely with IMG in your corner
The Emergence of Azerbaijan’s Ancient Capital City, Baku
After decades of repressive Soviet rule, Baku is experiencing warp-speed modernization—and translating its rich cultural heritage into the language of the 21st century
HISTORY LESSON | A typically Bakuvian view: the 15th-century Shirvanshah’s Palace, with communist housing blocks beyond and the city’s Flame Towers, completed in 2012, in the distance Photography by Jamie Hawkesworth for WSJ. Magazine
ON THE SECOND FLOOR of Yay contemporary art gallery, a two-story sandstone structure in Baku, the artist Faig Ahmed is peeling bubble wrap off several medium-size carpets hung in frames. The top half of one rug resembles the centuries-old weaving tradition that’s helped make his native country, Azerbaijan, famous across the Caucasus. Outside, vendors are hawking similar patterns to tourists in the Ichari Shahar, or Old City, a nest of cobbled streets, mosques and caravan stops at the capital’s medieval center. In 2000, the entire walled area was designated a UNESCO World Heritage Site, though gazing toward the palace of the Islamic Shirvanshah dynasty—the gallery’s terrace overlooks the ruin of the royal hammam—one can also see the 600-foot Flame Towers arcing up from the hills ringing the city, three curvilinear structures outfitted with 10,000 LED lights that blaze, at night, like enormous licks of fire.
Ahmed, 31, has a pointy beard and almond-shaped eyes. Scanning down the carpet, something interesting begins to happen. Each decorative flourish—ancient symbols, he explains, for horses, birds, dragons—begins to pixilate and then dissolve into blurred blocks of color. The artwork turns out to be a clever deconstruction of traditional craft, incorporating digital disruption into the literal fabric of its design. (Ahmed spent months finding artisans who would undertake the laborious process of hand-weaving his tradition-meets-tech designs.) With its provocative blend of rich historicism and hyper modernity, the carpet is also a potent symbol of Baku itself. Pointing at the rug, he says, “There are some things we are used to seeing, and when they change you can feel how strange it is—suddenly, change is here.”
Photos: Baku to the Future
Click to view slideshow.
Azerbaijan’s ancient capital curves along a crescent-shaped bay on the Caspian Sea. If the country has a single defining characteristic, it’s an ability to harmoniously absorb diverse cultural influences. Its tangled traffic is comprised of Soviet-make Ladas, Mercedes S-Classes and purple London-style taxis nicknamed “aubergines.” Women like to wear their hair waist-length while men opt for western jeans paired with traditional flourishes: a beard, a skullcap, prayer beads. (Like its southerly neighbor, Iran, the country is predominately Shia Muslim.) Baku’s spate of recently opened luxury shops—Céline, Dior, Tom Ford —are clustered along a waterfront byway called Neftchilar Avenue that’s also home to fin de siècle oil-boom mansions, Soviet government buildings and an imposing 12th-century stone landmark known as the Maiden Tower.
Situated at the base of the Caucasus Mountains, Azerbaijan has been conquered over the millennia by Alexander the Great, the Mongols, the Ottomans, the Persians and the Russians. It has been squeezed between East and West, old and new, Islam and Christianity, Europe and Asia for so long that to say it exists at a cultural crossroads—as people have for centuries—is to resort to cliché.
Only during its very recent history has Azerbaijan’s cross-cultural flourishing been put on hold. In 1991, along with most of the former USSR, Baku emerged from more than 50 years of repressive communist rule, an era that replaced the city’s syncretic broadmindedness with monolithic totalitarianism. Since the thaw—and for the second time in its long history—Azerbaijan has been applying its petro dollars to become an economic engine for the region. Its cultural capital is rising, too.
Ruled for the past decade by President Ilham Aliyev, who inherited the presidency from his father and one-time KGB general Heydar Aliyev, the current government has been accused of corruption, holding unfair elections and limiting free speech. “Unfortunately, corruption exists in every society around the world and the government of Azerbaijan is making every effort to address this problem in Azerbaijan,” says Fakhraddin Ismayilov, press attaché at the Embassy of the Republic of Azerbaijan. Rights groups and analysts say that much of the country’s corruption is related to revenues from the state-run oil industry—some of which Aliyev uses to fund the ongoing Nagorno-Karabakh War with bordering Armenia. (Other potentially hostile neighbors are Iran and Russia, which has become increasingly assertive in its sphere of influence.) Azerbaijan has taken several concrete steps toward democratic reform, such as joining the Extractive Industries Transparency Initiative, a global coalition of governments, companies and NGOs working to create accountability for revenues stemming from natural resources.
It’s impossible to overstate the importance of oil to Azerbaijan. At the turn of the last century, when Baku’s population growth outpaced that of London and New York, the city was a heady blend of European metropolis and Wild West frontier. It was known for its Philharmonic Hall, inspired by Monte Carlo’s grand casinos, which housed the first opera house in the Muslim world. The Rothschilds and the Nobel brothers built opulent mansions underwritten by fortunes made from Azeri oil, as did dozens of Muslim “oil barons,” who aspired to transform Baku into the grandest city in the Islamic world through civic philanthropy. As the writer Tom Reiss details in The Orientalist, Azerbaijan thought of itself as Europe’s easternmost outpost—even if the rest of Europe didn’t necessarily know it. “Even today it is possible to imagine that one has wandered into some unusually sooty Right Bank neighborhood in Paris, mysteriously abandoned by its inhabitants,” writes Reiss.
Though efforts to restore the country to its pre-Soviet stature began immediately after the Iron Curtain lifted, the pace of regeneration has hit warp speed in the last few years. On the one hand, the government is pouring millions of dollars into civic improvements, much of it tellingly centered on cultural infrastructure like the recently opened Zaha Hadid–designed Heydar Aliyev Center. The concert hall and exhibition space resembles a swooping space-age Bedouin tent perched on a hill, its sinuous design a reference to Islamic calligraphy. There’s also the soon-to-open relocation of the State Museum of Azerbaijan Carpet and Applied Art, the design of which evokes a massive rolled-up rug.
While architectural pyrotechnics like the HOK-designed Flame Towers and the Heydar Aliyev Center—both completed in 2012—serve as bids for international attention, the not-for-profit arts organization Yarat is the force behind the city’s nascent but fast-growing contemporary art scene. Since its founding in September 2011, Yarat has produced an astounding 42 projects, from “Love Me, Love Me Not”—a special pavilion at the 55th Venice Biennale of art from countries that share a border with Azerbaijan, including Iran, Turkey, Russia and Georgia—to a site-specific exhibition of 29 emerging artists housed inside the Baku Air Condition Plant. It has produced a pop-up film festival; collaborations with galleries in New York, Paris and London; and an annual Public Art Festival that last year brought the Dutch artist Florentijn Hofman’s giant globe-trotting rubber ducky, previously moored in Hong Kong’s Victoria Harbour, to Baku.
“The idea was to have a group of artists who support each other, a platform that puts everyone together,” says Yarat’s founder, Aida Mahmudova, who plans to move Yarat’s current headquarters in the Old City to a multistory former Soviet naval base in 2015. “You gather, and it’s power already.”
Part of Yarat’s mandate is to promote Azerbaijani artists internationally as well as at home. In September 2012, it helped organize the first Christie’s exhibition in Baku. “It was a combined exercise which showcased international art alongside a very vibrant local art scene,” says Paul Hewitt, managing director of growth markets at the auction house. “It was an important first step of a developing relationship.” Held at the Four Seasons, one of several brand-new five-star hotels in the capital, the show featured works by Picasso, Warhol and DeLempicka and was attended by a troop of high-powered collectors from Mexico, China, Switzerland and India—a bellwether for a city on the verge of becoming an art-world destination for the private jet set. At the same time, Yarat opened the exhibition “Commonist,” with works by its artists, including Ahmed and 18 others.
NEW TRADITION | Aida Mahmudova, founder of Yarat, an organization dedicated to the support and promotion of Azerbaijani artists Photography by Jamie Hawkesworth for WSJ. Magazine
AT THE CENTER of this transformation is Mahmudova, a 32-year-old with a slight gym-toned frame and a broad smile who has become the link between official culture and subculture in Baku. Her aunt Mehriban Aliyeva is the country’s first lady. Her cousin Leyla Aliyeva (Mehriban’s daughter) is the editor-in-chief of the Condé Nast–ownedBaku magazine, a glossy dedicated to all things luxurious in the capital. “The idea [for Yarat] came to me a long time ago, way before I founded the organization,” she says. With her familial wealth and desire to help artists of all generations, she approximates a very young, very glamorous godmother of art.
Mahmudova is herself a commercially successful artist. After earning a degree in fashion merchandising from the American InterContinental University, she studied painting at London’s prestigious Central Saint Martins. She says her time in the British capital shaped her sense of how an arts organization in Baku might be structured. But it wasn’t until after she’d finished school in London, married an Iranian entrepreneur and had a daughter, now 3 years old, that she focused her energies on getting the organization off the ground.
Moving back to Baku in 2010, she became close with other young artists—such as Ahmed and Farid Rasulov, who creates life-size installations out of carpets and surreal plastic animals. Together, they realized there was no single organization in Baku for artists looking to show work or collaborate—much less gain international traction. Furthermore, any such organization would have to actively generate a homegrown audience for the kinds of abstract or conceptual art they make, which looks radically unfamiliar to most Azerbaijani eyes. “I wouldn’t call it a plan,” she says of Yarat’s early days. “It was a dream and a passion and then it turned into a reality. It was spontaneous, based on an emotional level. Now, of course, we make plans two or three years ahead of time.”
“I think I’m really at the right place at the right time,” she adds. “The whole country is emerging, for the West especially. It’s opening up and it’s growing, and Yarat is growing at the same time.”
Though she surely benefits from her family connections, Mahmudova is not involved in politics—and given the controversy surrounding her aunt’s husband, she has every reason to downplay her political connections. She structured Yarat as a not-for-profit, with a creative board made up of artists. Money is raised by petitioning local businesses like banks and telecommunications companies for support, typically for specific projects, like the Public Art Festival, a citywide event that lasts six months and showcases several dozen works of art. Yay gallery serves as the commercial wing of the organization, with half of the profits going to the artist and the other half to Yarat, which employs seven people full time.
Last December, Yarat held its first general fund-raiser, a presentation followed by cocktails at the JW Marriott Absheron hotel. According to Davud Gambarzade, Yarat’s international program director, Azerbaijani companies are beginning to recognize that being associated with the arts can have a positive branding effect. Money that once went to chess competitions or sports like wrestling—both popular in Azerbaijan—is now funding artistic patronage.
In 2012, for the Public Art Festival, Mahmudova made an artwork installed in the Seaside Boulevard, a landscaped promenade that runs between the Caspian Sea and Neftchilar Avenue. The work is derived from the ornate window frames of an abandoned building across the avenue. Mahmudova rescued the frames and repurposed them in a fragmented, paisley-like pattern, replacing the glass with reflective material. The artwork, called Recycled, now shows a splintered version of the new Baku. “Four years ago, I wasn’t changing as fast as I’m changing now. Everything was slower. It’s crazy. And it’s difficult,” says Mahmudova. “Sometimes I don’t like the fast changes, even inside myself—but I can’t help it because I change my surroundings and my surroundings change me.”
In 2013, Mahmudova was appointed curatorial director of the four-year-old Baku Museum of Modern Art. Next year, she plans to narrow the scope of its rotating exhibition space to focus on Azerbaijani artists, particularly emerging ones, like the 34-year-old painter Rashad Babayev. Babayev’s large-scale canvases use color and shadow to create powerful abstract forms. Schooled as a lawyer, he considers himself “street educated” by an older generation of artists such as Rasim Babayev (no relation), a Soviet-era painter whose politically provocative work became nationally recognized only after his death. “I spent a lot of time speaking with the artistic community, talking with other artists, so I have a kind of training,” says Rashad Babayev. He has been working with Yarat since its inaugural group exhibition, “On Soz”—meaning “forward” in Azeri.
The museum is perhaps the least ostentatious example of Baku’s drive to build blue-chip architecture. Though the city’s construction frenzy draws comparisons to Dubai and Abu Dhabi, Bakuvians recoil at the implications: Where those Emirate cities often import a kind of rootless western architecture, Baku’s structures reference the country’s cultural heritage. Even the glittering Flame Towers are a nod to the country’s past as a spiritual center for Zoroastrians—practitioners of Persia’s pre-Muslim religion, who were drawn to the flames that still spontaneously erupt from the landscape thanks to natural gas leaks.
Gas is unavoidable in Azerbaijan. The world’s first mechanized rig struck big here in 1871, and by 1901 the country’s fields pumped half the world’s crude. The most powerful gushers were given names, such as Wet Nurse and Golden Bazaar. During Soviet rule, the industry languished, but in 1994, Heydar Aliyev signed the so-called Contract of the Century, a series of deals with multinational energy companies that paved the way for Azerbaijan’s offshore oil fields to be developed, and returned vast, if unevenly distributed, wealth to the county. The opening of the Baku-Tbilisi-Ceyhan pipeline in 2006 and a gradual shift in resources from oil to natural gas are helping to keep the industry strong. Early this year, Yay gallery showed a series of paintings calledGirls Prefer Oilmen by the Russian-born painter Irina Eldarova. The works depict candy-colored versions of Marilyn Monroe demurely flirting with Azerbaijani rig workers.
MODERN MARVEL | The Heydar Aliyev Center, designed by Zaha Hadid and completed in 2012 Photography by Jamie Hawkesworth for WSJ. Magazine
THE AVERAGE ART STUDENT in Baku will graduate with excellent technical skills, learning to sculpt from life or paint in the Soviet Realist style that still dominates academic art. What’s not on offer, however, is the kind of conceptual art that most western schools have favored over the last 50 or so years—art that considers process and ideas and may not even look like art to someone outside the field.
Yarat tries to address some of these gaps through its educational initiative, Artim (“progress” in Azeri). Artim offers workshops, lectures and master classes that are open to the public. “We try to add something that’s missing,” says Mahmudova. “Photographers have to take workshops outside of university, so we teach that.” Yarat also hosts international artists residencies, luring working artists and professors from institutions like the Wimbledon College of Art and the Royal College of Art in London. Last November, Mark Dunhill, the dean of art at Central Saint Martins, held a four-day sculpture workshop at the arts academy with his partner, Tamiko O’Brien. “What I think is good about the Yarat foundation is that they are really serious about education and trying to bring about change through changing the way people think about things,” says Dunhill. “Culture is a powerful force, and while it may not be overtly political, I think that encouraging people to open their eyes to different ways of seeing things is good, and I’m keen to support that.”
There have been unmistakable successes for Yarat: The Venice pavilion; “Fly to Baku,” a traveling exhibition of Azerbaijani artists’ work co-organized by the high-profile Swiss auctioneer Simon de Pury ; “Merging Bridges,” a 2012 show at the Baku MoMA of work by Yarat-supported artists and international names like James Turrell, Idris Khan and Olympia Scarry; and Ahmed, who last year was short-listed for the Victoria and Albert Museum’s Jameel Prize 3 for artists inspired by the Islamic tradition. This month, the exhibition “Love Me, Love Me Not,” which includes work by New York–based Ali Banisadr and the international collective Slavs and Tatars, travels from Venice to the Heydar Aliyev Center’s tiered galleries. At the same time, Yarat will travel to Art Dubai as part of its Marker section, focused this year on Central Asia and the Caucasus.
One chilly afternoon, Mahmudova visits the crumbling three-story studio space she shares with Ahmed, Rasulov and other friends. “I’m just very tired constantly because we’ve been working so hard for the past two years,” she says. There are dark stains on the floor where rainwater has overflowed from wineglasses placed beneath leaks in the skylight. Canvases tilt against the graffiti-covered walls. The voice of a man reciting passages of the Koran drifts up from the street outside, where a Muslim funeral is taking place.
This is an older, less gentrified section of Baku, where the streets are narrow and difficult to navigate. Mahmudova doesn’t come here very often anymore. She’s set up a studio in her apartment across town, where she can paint in the evenings when the mood strikes her and see her daughter anytime. It’s just as well. Soon, much of the neighborhood will succumb to modernization, making way for a new highway or parkland or gleaming office towers—monuments to Azerbaijan’s future.
An Often Overlooked Pitfall of International Business Expansion
Before traveling abroad, make sure you obtain Travel Medical Insurance from IMG
If you’re visiting the Fluent In ForeignTM Blog and reading this post, more than likely, you are a business owner or manager preparing to expand into foreign markets or looking to grow your business internationally. You are probably acutely aware of the risks and hurdles that come with expanding into the international market; dealing with foreign governments and trade agencies, language, currency and cultural gaps, choosing the right local partners, etc. However, there is another major issue you may not have considered: Medical Coverage.
Does your current domestic policy cover you during international business trips? How will your employees working around the globe access the medical care they need? Can your current provider coordinate care for you and your employees in distant corners of the world? Unfortunately, many travelers overlook the importance of having quality medical coverage that travels with them; many times, not realizing the gaps in their coverage, until it’s too late. The truth is, while traditional plans may offer adequate domestic coverage, they are not designed for international travel. Without even realizing it, you may be putting your health – and that of your employees at risk.
You have enough to worry about when it comes to your international expansion. Don’t let medical coverage be one of them. To help you avoid this pitfall, Fluent In Foreign has partnered with International Medical Group® (IMG®) to offer a selection of international travel medical insurance plans specifically designed to provide you and your employees the coverage you need, as you expand into the international marketplace.
IMG is a leader in the international health insurance market providing medical security to hundreds of thousands of individuals, families and groups traveling and living abroad in more than 170 countries worldwide. For over 20 years, IMG has provided top-tier global health insurance benefits and has developed a reputation of excellence in the international community. With its around-the-clock medical management services, multilingual claims administrators and highly trained customer service professionals, IMG is confident in its ability to provide the products international travelers need, backed by the service they want. The partnership between Fluent In Foreign and IMG will allow you to, quickly and conveniently, select a policy that fits your needs and one that will travel with you, wherever the growth opportunities demand.
Moving onto the international stage and expanding your business into new markets can be an exciting and possibly daunting process. Make your medical security, and that of your employees, one less thing to worry about, by getting Global Peace of Mind® from IMG.
Turkish Airlines Caters to Investors with In-Flight Startup Pitches
A graphic from the video explaining how flyers in Turkish Airlines’ Business Class can watch startups pitches in-flight. / Turkish Airlines “If frequently flying businesspeople can answer emails in the air, why not take pitches as well?”— Samantha Shankman
Turkish Airlines will soon launch an initiative that delivers hand-picked, in-flight startup pitches to investors. The Invest on Board program will be run by eTohum, a platform launched in 2008 that will vet and choose participating startups.
Flyers seated in Turkish Airlines’ Business Class can watch the videos on their in-seat TVs.
Turkish Airlines is not officially announcing the platform until next week. Project manager of the Invest on Board project Feray Uysal says, “We will launch it soon, but the date is not certain now.”
There are currently eleven videos on the Invest on Board website, where founders can also apply to have their pitch shown to Turkish Airlines’ customers.
Watch the video from Turkish Airlines below for more details:
http://www.youtube.com/watch?feature=player_embedded&v=7AhJLEKIN3w
Top tips for business travel the geek way
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As writers for an international blog we travel a lot. We hold our conferences in Amsterdam, Sau Paulo and New York now but have also held smaller events in lots of countries across Europe and South America. We’ve seen our fair share of airports and hotels and have our own little tricks and tips for geek traveling.
(Disclaimer: I happen to be a Mac user so some of the tips are more useful for Apple users than non-Apple users. Sorry about that).
When I travel I bring a laptop, my iPad and my iPhone. Every device has a charger that needs to be plugged in somewhere. You can buy the Apple World Travel Adapter Kit, but that is expensive and has a bunch of adapters you will likely never use.
Years ago I started collecting these little thingies you can attach to your power adapters. I got a few British ones, about 5 US ones and a bunch of European ones. Now when I travel somewhere I find out what power sockets are used for that country and then replace all my adapters with the right add-on.
Another smart option is to bring a basic 5-Outlet Power Bar Strip Splitter with you with just one international converter. That way you can keep your local power sockets attached and use just one plug. Many hotel rooms only have one power socket near the bed, so this is a very efficient way to connect all your devices, and not worry about finding a converter for every device you carry.
If you end up forgetting your adapters (it happened to me) just go and talk to the hotel reception. Ask them to check the ‘Lost & Found’ basket if they don’t keep an extra adapter behind the desk. A lot of travelers forget theirs (it happened to me) when they leave the room, so usually they have a whole basket filled with these things somewhere.
The other thing I always bring is an ethernet cable. If you have a newer MacBook Pro or MacBook Air, you might need an extra Thunderbolt adapter, so get one of those too. Some hotels offer free wired networking and paid WiFi, so then an ethernet cable comes in handy. I’ve also had instances where the WiFi was down but the network still worked.
If I’m traveling longer I bring my own Airport Express station which I can connect to any network and then use to set up my own WiFi network. This is handy for hotels that have ethernet but no (or bad) WiFi network in your room. I name the network ‘TheNextWeb.com’ for some extra guerrilla marketing.
These days the better hotels all offer a large LCD TV in your room. So far I have always been able to reach the back of these things and attach my own Apple TV via an HDMI cable. In the US, you can also order a Google Chromecast which is even cheaper and works just as well for streaming.
Image credit: Alliance/Shutterstock
WOULD YOU TRAVEL ABROAD… NAKED?
No, you probably would not. Yet, if asked “Would you travel abroad without travel healthcare/medevac insurance?” a good number of you would also say “NO”. Not having medical insurance when traveling abroad certainly leaves you exposed and vulnerable. Yet, just having medical travel insurance is often not enough….
What happens if while abroad you become very ill, are involved in an accident, or suffer food poisoning, heat stroke, or severe allergic reaction. Chances are doctors treating you would want to access your health information prior to treating you. More often than not, business travelers are not accompanied by their family members who know their medical history and very few of us carry our medical records while traveling. Until recently, only folks with chronic medical conditions or severe allergies or wore bracelets which alerted emergency medical workers in the event patients could not communicate as result of accident or illness. The rest of us mostly left things to chance.
Conversely, and much more likely than getting seriously ill, or being involved in an accident, how many of us get stomach flu, catch colds or contract an untold number of travel related ailments from heat strokes, mosquito bites and food poisonings, while traveling abroad. How many times you wished you could easily communicate with your Doctor despite the time zones and get some much-needed advice and informational therapy?
Over the last few months we have been testing a brand new platform called HealthKnight™ as the way to leverage technology for international travel. At this point it is an invitation-only full-blown social network and information platform designed exclusively for healthcare and wellness management.
Starting August 15th, Fluent In Foreign™ will have an exclusive group on the HealthKnight® platform dedicated to the needs of international business travelers (www.fluentinforeigntravel.com ). Members will be able to store their health records in a secure HIPAAA compliant manner, yet easily access or share them while abroad. Members will also be able to easily and privately communicate with their own healthcare professionals, or reach out to other doctors in various countries. The Group’s members will also be able to share own experiences and speak online to guest moderators – experienced travelers, doctors, insurance professionals. and celebrity personalities Best of all the entire service is free of charge. International business is difficult enough and we need to minimize risks every place we possibly can. You would not travel abroad naked, but why would you play Russian roulette with your life and travel unprotected?
To receive an invitation to join the Fluent In Foreign Travel group please email rsigalus@fluentinforeign.com or fill out the form below
Hello, We set up a Fluent In Foreign Travel™ group on HealthKnight™ to be able to store our medical records and other critical information in a way that may be accessible to Doctors and emergency personnel during travel abroad. It is FREE, HIPAA privacy compliant and cutting edge. Also, this group is a good way to stay in touch with your medical providers back home, when on travel, and to swap to international travel tips with likeminded folks. Please join me at the Fluent In Foreign Travel Group™ on HealthKnight! Alexander Gordin
TO JOIN THE GROUP VISIT: https://healthknight.com/registration/YToxOntzOjEwOiJpbnZpdGVyX2lkIjtpOjI1ODt9
| CHAPTER 16Medical Care Abroad |  |
Key Points:
What do you do if you are suddenly taken ill or have a serious accident in a foreign country? How do you find an English-speaking physician? Or locate a reputable hospital? Where do you turn for help and advice? The first step in avoiding disaster is prevention. This means careful pre-trip planning as outlined in this Health Guide. But what if an unexpected illness or accident occurs? Statistics show that 25% of travelers develop some type of medical problem over a 2-week period. Most accidents and cases of medical illness are relatively minor. The problem may be self-evident. Most conditions resolve by themselves or can be treated with simple first-aid measures or with the medication you have on hand. But what if you need a physician’s treatment or hospitalization? When an emergency happens far from home, even a seasoned traveler may have trouble coping, especially if medical care is urgently needed. What starts out as a routine vacation or business trip could end up as a real nightmare. How to Cope When Illness or Injury Suddenly StrikesStay Calm You may be able to solve the problem yourself. You may already have medicine with you to treat a minor infection, a rash, a cut, a bruise, or a sprain. If diarrhea should occur, follow the treatment guidelines for travelers’ diarrhea in Chapter 6. Check to see what’s in your medical kit. Home health-care guides and first-aid manuals are sources of useful advice, so you may wish to bring one of these with you. Serious Accidents or Illness Demand Immediate Attention If you sustain a more serious injury, such as a deep laceration or a fracture, or have bleeding, unremitting chest or abdominal pain, or trouble breathing, don’t waste your time trying to find a local physician. Go immediately to the nearest hospital. If you are in a large city, go to a hospital associated with a medical school if possible (these hospitals usually have English-speaking doctors as well as qualified specialists on staff). You can ask for directions or assistance from your hotel, your tour guide, a taxi driver, or the police. A taxi or private car may be faster than waiting for an ambulance. Remember, in an emergency, minutes count. Don’t delay! Note: If you think you are having a heart attack, early diagnosis and treatment are critical. Administration of a thrombolytic (clot dissolving) drug, or angioplasty, will greatly improve your chance of survival. Less Urgent Illness This can usually be treated during a daytime visit to a doctor’s office, but some doctors will make an after hours hotel “house call.” Your hotel can usually provide the names of one or more English-speaking physicians. Better yet, if you have friends, relatives, or business associates who are residents of the area, ask them for a referral to a doctor they know is qualified. Colds, sore throats, ear aches, bronchitis, diarrhea, most urinary infections, and the flu are some of the conditions that usually don’t require emergency attention, but do require monitoring and possible physician follow-up. You won’t find overseas the widespread availability of over-the-counter drugs there is in the United States and Canada; so bring your own supply of antibiotics, pain medication, diarrhea pills, etc. The medication you bring may cure or sufficiently ameliorate the problem or make you feel better while waiting to see a physician. You can take levofloxacin (a standby antibiotic for travelers’ diarrhea) for painful, frequent urination (urinary tract infection?) or a cough with fever (pneumonia?) pending further medical evaluation. Self treatment with an antimalarial drug is a good example of how self medicating can be potentially life saving. However, if you do have a fever that might be from malaria, be sure you are examined within 24 hours. Request that all medications you receive from the doctor be identified or labeled with the generic as well as the trade name. This is important if you have drug allergies and must avoid certain medications or if you develop a drug-related reaction or have to see another doctor for ongoing care. That doctor will need to know what drugs you have been taking. Note: Familiar drugs will have different brand names in other countries, but generic names may also vary. For example, acetaminophen (Tylenol) has another generic name, paracetamol, in some countries; and meperidine (Demerol), is sometimes generically identified as pethedine. Bring a Medical Kit and First-Aid Manual You can often save yourself a trip to the doctor if you are able treat cuts, abrasions, and other minor injuries yourself. Be sure your routine immunizations are up-to-date so you don’t have to go to a hospital for a tetanus booster. Carry a Phrase Book A phrase booklet or pamphlet that provides medical words and phrases in various foreign languages, or the KwikPoint medical visual language translator (www.kwikpoint.com), can be invaluable when a language barrier prevents the adequate communication of immediate medical needs. Find an interpreter as soon as possible. Contact Your Doctor in the United States Bring a mobile telephone with you on your trip. If you are hospitalized, a consultation with your own physician back home can be invaluable. Hopefully your doctor, or an associate, will be available at the time you call. (Leave your number, or another call back number, if necessary.) Describe the history of your illness, your symptoms, what the diagnosis is, and what treatment you are receiving. Let your doctor know if you are in a country where there are tropical diseases. Have your own doctor discuss your case with the local doctor caring for you. Obviously, for certain conditions, treatment is standard and straightforward—surgery for appendicitis, casting for fractures, etc.—and your treatment may have already been rendered. However, for more serious or life-threatening problems, this consultation can be important. Your diagnosis may be in doubt, and the hospital and physician may not have the expertise to provide adequate care. Your physician can help assess the situation and reassure you that you are receiving proper care and that there’s no need to worry, or your physician may feel that a second opinion is warranted or even that transfer to another facility is advisable. Locating Physicians AbroadIn many cases, finding good medical care abroad is not a problem—maybe even less of a problem than back home where you may have to wait for hours in an ER! You have many options when it comes to finding a physician to care for you. The American and Canadian embassies and consulates maintain referral lists from which you can choose. The embassy or consulate, however, won’t officially recommend individual doctors on the list. Other options to consider include the following: Travel Insurance/Assistance Companies If you have purchased a travel health policy, call the 24-hour hotline number and you’ll be connected with an assistance center that can give a physician referral. Companies such as International SOS Assistance and Shoreland, Inc. (publisher of Travax EnCompass), provide corporate and travel physicians, for a fee, with a list of worldwide medical facilities and contact information. International Medical Clinics Because of globalization, there is a growing market for Western-style medicine* to serve the medical needs of the employees of multi-national corporations, visitors, expatriates, and insured travelers. These clinics, usually part of a chain, are found in large cities and may provide the best first contact for any medical problem. One such provider is the American Medical Centers that maintains clinics in Moscow, St. Petersburg, and Kiev. International SOS and MEDEX run clinics in Beijing and many other locations throughout the world. IAMAT The International Association for Assistance to Travelers (IAMAT) is a Canadian foundation that publishes a booklet listing hospitals and English-speaking physicians who have agreed to adhere to a standard schedule of fees. Physicians are not listed by specialty. Contact IAMAT (www.iamat.org), 417 Center Street, Lewiston, NY 14092; 716-754-4883; in Canada, 40 Regal Road, Guelph, Ontario, N1K 1B5; 519-836-0102; no charge, but a donation is encouraged. Cardholder Assistance Credit-card companies provide 24-hour emergency medical hotlines available to many of their cardholders, usually those in the “gold card” or “platinum card” category. Typically, the hotlines can refer you to English-speaking doctors and dentists and to hospitals with English-speaking staff members, arrange for replacement of prescription medicines, and help you charter an air ambulance. If you are an American Express cardholder, call the Global Assist hotline at 800-554-AMEX (301-214-8228 collect from overseas). If you are an American Express Platinum cardholder, call your special assistance number, 800-345-2639 (202-331-1688 collect from overseas). Visa Gold and Classic cardholders can call 800-332-2484 (410-581-9994 collect from overseas). MasterCard cardholders can call 303-278-8000 (collect from overseas). Hotel and Resort Doctors Most large hotels will refer you to a local doctor or to a doctor who will come to your room to render treatment. Be warned, however, that the main qualification some of these doctors have is a payback arrangement with the hotel management. They may be helpful in providing referrals. The Telephone Book You may find many doctors and clinics listed in the “yellow pages” of the local telephone book. These physicians often mention their qualifications and some may indicate that they have received specialty training in the United States, Canada, the United Kingdom, or other medically advanced country. Personal Recommendation A time-tested method of locating a qualified physician (assuming time allows it) is to find a satisfied patient. Ask locals for personal recommendation. Contact employees of multi-national corporations or expatriates such as schoolteachers, relief workers, or missionaries who may have received medical care in-country. They are often familiar with high-quality private general hospitals or specialty clinics. Foreign PhysiciansBecause of cultural differences, the attitude of physicians toward their patients in foreign countries is often different than in the United States or Canada. Physicians abroad are often perceived as being more autocratic and authoritarian. This can make patient-doctor communication difficult. The doctor caring for you may not want you to question his or her care and may not be available to answer your questions (to be fair, this can sometimes be said of American physicians also). This does not mean that your care is substandard. In fact, the doctor caring for you may have more knowledge of local diseases than your own physician and be perfectly well qualified to diagnose and treat your illness. Nevertheless, you should seek a second opinion if you have doubts about the quality of your care. Foreign HospitalsForeign hospitals can range from basic to the most advanced, but the quality of your medical care shouldn’t necessarily be judged by your surroundings. If you’re hospitalized in a less developed country, you might wonder if you should be moved to a “more modern” facility. This question faces hospitalized patients everywhere, not just travelers overseas. An analogy to being hospitalized in the United States might be appropriate. In the United States, the smaller community hospitals are adequate for almost all medical care. Occasionally, however, a patient requires transport to a specialty center for advanced, sometimes life-saving treatment. The same is true overseas. You may be in a small, seemingly inadequate facility that may, in fact, be perfectly adequate for your medical needs. Having someone available, in serious situations, to assess your diagnosis and treatment will help you or your family know when transfer or medical evacuation may be indicated. Assessing Foreign HospitalsIf you need emergency care and minutes count, go to the closest facility. However, if the situation is not immediately critical—and there’s more than one hospital nearby—use the following checklist to get a basic idea of what level of care is available to you. The checklist will also help you tell your doctor at home, if the occasion arises, what services are being provided.
FACTORS DETERMINING EMERGENCY MEDICAL EVACUATION
*Western-style medicine has three main components: (1) evidence-based medicine; (2) quality assurance; and (3) patient- centered delivery of care. Evidence-based medicine means practicing medicine using diagnostic and treatment protocols that have been developed through research, not handed down from generation to generation. ©2008 Travel Medicine, Inc. |
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Fluent In Foreign Business 