1. How to Avoid Health
Risk Horror Stories
for your Business
Travellers
insideMOBILITY Conference
Shangri-La, Pudong, Shanghai
November 30 2016
Dr. Greg Jakubowski, Regional Medical Director, Asia, International SOS
Dr. Carrianne Ewe, Chief Medical Officer, China, International SOS
2. INTRODUCING MYSELF
AND MY COLLEAGUES
DR. GREG JAKUBOWSKI
Regional Medical Director,
Corporate Solutions, Asia,
International SOS
DR. CARRIANNE EWE
Chief Medical Advisor, China,
International SOS
SALLY NASH
Marketing Manager, China,
International SOS
4. 4
The world we live in…
Terrorism
Hijacking
Kidnapping
Lawlessness
Piracy
Travel-related infections
Threats
Imprisonment
Opportunistic Crime
War
Insurgency
Coups
Civil Unrest
Natural Disasters
Extreme Weather
Hepatitis
Typhoid Fever
Dengue
Air Quality
Rural Isolation
Language and cultural barriers
Vehicle Accidents
Airline Catastrophes
Immigration & Visas
Medical Illness
The Medical Risk Landscape
Not a Matter of If… But of When…
5. 5
The world we live in…
The Medical Risk Landscape
• VolatilityV
• UncertaintyU
• ComplexityC
• AmbiguityA
6. 6
5 Key Takeaways
ACCIDENTS &
INJURIES
are the biggest risk
PREPARATION
is the most
important thing
KNOW
the country you are
travelling to
HAVE A CALL
NUMBER
with you & ready
ANYTIME, from ANYWHERE, and EARLY
that is how to get information
7. 7
Agenda
WHAT can happen?
WHY should you prepare?
WHEN would you need help?
HOW to get help?
The ‘Bottom Line’ for Safe Assignments
Q&A
8. 8
Agenda
WHAT can happen?
WHY should you prepare?
WHEN would you need help?
HOW to get help?
The ‘Bottom Line’ for Safe Assignments
Q&A
11. 11
Agenda
WHAT can happen?
WHY should you prepare?
WHEN would you need help?
HOW to get help?
The ‘Bottom Line’ for Safe Assignments
Q&A
12. 12
Classification Of Travel Health Risk
Obvious & Not So Obvious…
12
• Occupational
Exposure
• Chronic Diseases
• Accidents
• Natural Disasters
• War & Terrorism
• Infectious Diseases
• Environmental
• Cultural
• Institutional
• Corporate
• Individual
• Family
Internal External
ContinuousEmergent
13. 13
1. Reality of Health Risks
Health Trends For Assignees & Travellers
Out of 100K individuals
travelling to developing country
for 1 month
50,000 will develop health problem
8,000 will see a doctor
5,000 will be confined to bed
1,100 will be incapacitated in work
50 will be admitted to a hospital
30 will be evacuated
1 will die
Source: Steffen, R. et al.: "Health Problems After Travel to
Developing Countries", Journal of Infectious Disease
(1987) 156, 84
14. 14
2017 TRAVEL RISK MAP
International SOS & Ipsos MORI survey of 1,099 travel risk managers in 75 countries,
October 2016:
72% say travel risks have increased
over past year.
1 in 3 organisations have updated
their travel policies in past year.
57% say health and travel security
risks will increase over next year.
16. 16
BUSINESS TRAVELERS A HIGH RISK
BUT THE RISK IS UNDERESTIMATED IN CHINA
“Business travelers’ health
risks not a key focus.
This risk is underestimated
& under-reported in China,
given the frequency of road
accidents etc.”
What about business travelers???
17. 17
1. Reality of Health Risks
Top 10 Health & Medical Threats
Business Travelers
# Cause
% of serious
cases
1 Accident & Injury 21%
2 Cardiovascular & Circulatory
System Diseases
15%
3 Gastrointestinal Disorders 15%
4 Ill Defined Symptoms - Minor 9%
5 Infectious Diseases - Major 8%
6 Musculoskeletal Disorders 7%
7 Urinary System Disorders 4%
8
Gastrointestinal Infectious
Diseases
4%
9 Nervous System Disorders 3%
10 Referrals, Tests & Checkups 3%
Assignees/ Expatriates
# Cause
% of serious
cases
1 Pregnancy 13%
2 Gastrointestinal Disorders 12%
3 Ill Defined Symptoms - Minor 12%
4 Accident & Injury 12%
5 Infectious Diseases - Major 8%
6 Cardiovascular & Circulatory
System Diseases
8%
7 Musculoskeletal Disorders 7%
8 Gynaecological & Reproductive
System Disorders
4%
9 Referrals, Tests & Checkups 4%
10 Urinary System Disorders 4%
17Source: International SOS
18. 18
Latest Mobility Research from PwC
Source: PwC International mobility database – sample 900 companies
-Mobile population in large
organizations increasing
- Assignee levels increased
> 25%
- Predicted further 50%
growth by 2020
- Companies are hosting
assignees in more
countries than ever before
2. Reality of Global Trends
20. 20
3. Reality of Benefits
20
Increased
Productivity
Decreased
Absenteeism
Increased
Retention
Decreased
Impact of
Accidents
Minimized
Negative
Media
Increased
Reporting &
Visibility
Compliance
with
Legislation
Decreased
Medical
Costs
Control of
NCDs
Motivation
&
Well-Being
EMPLOYEE
Inward
COMPANY
Outward
ROP
=
Return on
Prevention
Your Drivers
21. 21
• Published by Prevent
• Focused on academic work to improve
occupational safety & health practices
• Unique in it’s kind in the world
• Fully independent & non-governmental
• Use of global data from health programmes
run by Intl.SOS for its clients
• Including figures from a partnership with a
world-leading oil and gas supplier
4. Reality of Costs
Study: Return on Prevention
Source: www.prevent.be/en/knowledge/research-project-on-the-benefits-of-osh
22. 22
4. Reality of Costs
i. Cost Of Failure: Expatriation & Failed Assignment
$570-950k
Cost of failure
The cost of failed assignments ranges somewhere between US$570,000 and $950,000.
$311k
Average cost of an international assignment
The cost of assignments ranges somewhere between US$103,000 and $396,000.
Costs breakdown
•The cost per assignee varies according to work position and status > salary is a considerable factor
• Direct costs are measured; including salary, training costs, travel and relocation expenses
• Indirect costs e.g. loss of market share, reputational damage, etc. may be invisible
• May be much more expensive than direct costs
23. 23
4. Reality of Costs
ii. Prevention Programmes
Preparing the traveller is the key element of travel risk prevention:
38% travellers suffer health impairment
14% travellers incapacitated
Source: Annals of the ACTM, an International journal of tropical & travel medicine
Impairment ranges from minor to major health issues.
Incapacity ranges from short to long term sick leave.
Base for healthy journeys
• Assessing employee health before departure
• Providing sufficient supplies of medicine required by employee
• Selecting vaccines
• Providing information, education and training about prevention
24. 24
$2.53 return for every $1 invested
Medical check programme for travellers and international assignees:
Cost-benefit analysis showed that US$1 invested returns a benefit ranging from
$1.6 (minimum scenario) to US$2.53 (maximum scenario).
4. Reality of Costs
iii. Pre-travel Health Screening
Source: Dr M Druckman & C Spitznagel, Measuring the benefits of global employee health assessment programmes, Intl.SOS 2011
Programme scope
• Identifying pre-existing medical issues before assigning employees to foreign country
• Ensuring employees were fit-to-work for proposed job & work conditions
• Identify general & work-related health problems before departure
25. 25
4. Reality of Costs
Summary: 4 Key Metrics
ROP
=
Return
On
Prevention
26. 26
Agenda
WHAT can happen?
WHY should you prepare?
WHEN would you need help?
HOW to get help?
The ‘Bottom Line’ for Safe Assignments
Q&A
27. 27
Stages of Assignment or Travel
Need to manage Your travel risks at each stage
2. During Assignment/
Trip
3. When Emergency
Happens
4. Post-Assignment/
Trip
1. Pre-Assignment/
Trip
28. 28
Agenda
WHAT can happen?
WHY should you prepare?
WHEN would you need help?
HOW to get help?
The ‘Bottom Line’ for Safe Assignments
Q&A
29. 29
Stages of Assignment or Travel
Information & Communication is Key!
2. During Assignment/
Trip
3. When Emergency
Happens
4. Post-Assignment/
Trip
Where do I to get updates?
How do I get help?
How do I get home?
Who informs my family?
What do I look out for?
How can I follow up?
1. Pre-Assignment/
Trip
How should I prepare?
What do I need to know?
30. 30
Criteria
• Standard & accessibility of healthcare & dental care
• Availability of quality medications
• Infectious disease risk
• Safety of food & water
• Quality of emergency services
• Cultural, language & administrative barriers to accessing healthcare
• Risk of motor vehicle accidents
www.internationalsos.com/risk-outlook
1. Know Your Destinations
Travel Risk Map 2017
FREE
TOOL
31. 31
Albania, Algeria, Angola Anguilla (UK),
Armenia, Bahamas, Bangladesh,
Belarus, Belize, Bermuda (UK),
Bolivia, Bonaire (Netherlands),
Bosnia and Herzegovina, Botswana,
Cambodia, Cameroon, Côte d'Ivoire,
Cuba, Curacao (Netherlands), Djibouti,
Dominica, Egypt, El Salvador, Ethiopia,
Gabon, Georgia, Ghana, Grenada,
Guatemala, Guyana, Honduras, Jamaica,
Kosovo, Laos, Lesotho, Macedonia, Malawi,
Marshall Islands, Mauritania, Mauritius,
Moldova, Mongolia, Mozambique,
Myanmar, Nepal, Nicaragua, Nigeria,
Northern Mariana Islands (US), Pakistan,
Papua New Guinea, Rwanda, Saba
(Netherlands), São Toméand Príncipe,
Senegal, Seychelles, Solomon Islands, Sri
Lanka, St Eustatius (Netherlands),
St Kitts and Nevis, St Lucia, St Martin
(France), St Maarten (Netherlands), St Vincent
and the Grenadines, Suriname, Swaziland,
Tajikistan, Tanzania, Turkmenistan, Turks and
Caicos Islands, Tuvalu, Ukraine, US Virgin
Islands (US), Uzbekistan, Venezuela, West
Bank-Gaza Strip
Afghanistan
Benin
Bhutan
Burkina Faso
Burundi
Central African Republic
Chad
Comoros
Congo (DRC)
East Timor
Equatorial Guinea
Eritrea
Gambia
Guinea
Guinea-Bissau
Haiti
Iraq
Kyrgyzstan
Liberia
Libya
Madagascar
Mali
North Korea
Niger
Palestinian Territories
Sierra Leone
Somalia
South Sudan
Sudan
Syria Togo
Uganda
Yemen
Zambia
Zimbabwe
35
~ 75
1. Know Your Destinations
Some Places are More Dangerous than Others…
FREE
TOOL
32. 32
1. Know Your Destinations
Medical Risk Ratings: The Implications
33. 33
Instant & Focused
• Aggregate & search travel data worldwide, preferably click of mouse
• Comprehensive snapshot of travellers at any one time
• Assesses risk exposure, identify travellers at risk, send alerts
2. Know where your employees are?
34. 34
3. Create Awareness
Educate, Educate, Educate!
• Prevention is Key!
• Inform & educate employees
– Travel risk awareness classes
• Evaluate risks of trip en-route
– Prepare a plan
• Promote responsibility and/or
security rules for travellers
– Company procedures
37. 37
4. Get Info in Real-Time
Communication Portal
Find Out About
• Pre trip medical & safety advice
• Vaccinations
• Medical Risk Rating
• Emergency contact numbers
• Cultural tips
• Voltage and plug information
• Weather
• Road safety
Medical &
Security
Support
38. 38
4. Get Info in Real-Time
Use an App
38
One-click call for
assistance
Link to country
summary
Saving favorite
countries
Current active alerts
Select Country
HAVE A CALL
NUMBER
with you & ready
39. 39
5. Get Advice in Real-Time
24/7 & Anywhere
Ready to assist 24/7
• Any emergency medical or security issue
• Management of simpler conditions
• Provision of guidance on when to seek medical
advice
• In employee’s language
Call ANYTIME…
Can’t Stress this Enough!
ANYTIME, from ANYWHERE, and EARLY
That is how to get information
40. 40
6. Have Access to Preferred Providers
Global Assistance Network
• Site Audits
• Formal Credentialing
• Data maintenance process
• Follow up of Credentialing
• Cost Containment - discounts
• Quality & Complaints management system
• Not just a database!
• Personalization of each referral
• Matching medical/ communication/ cultural needs
42. 42
Agenda
WHAT can happen?
WHY should you prepare?
WHEN would you need help?
HOW to get help?
The ‘Bottom Line’ for Safe Assignments
Q&A
43. 43
‘The Bottom Line’
For Safe Assignments
43
• You may need objective information on where you are being assigned
• You may need to get help when you have an emergency
• There are some concerning health trends while being assigned
• There is increasing mobility of employees
• There is clear Return on Prevention (ROP) in terms of costs saved
• Get information before or during assignment, not just in emergency
• Get information anytime, anywhere, & again & again
1. Know your destinations: many countries are high & extreme medical risk
2. Know where your employees are, focused by location & status
3. Create awareness: preparation classes, pamphlets, ‘culture shock’?
4. Get info in Real-Time: web access, App on handheld
5. Get advice in Real-Time: anytime, anywhere, early, again & again
6. Have access to Preferred Providers: right person, right environment
7. Have access to Webinars/ talks etc
WHAT?
HOW?
WHY?
WHEN?
44. 44
5 Key Takeaways
ACCIDENTS &
INJURIES
are the biggest risk
PREPARATION
is the most
important thing
KNOW
the country you are
travelling to
HAVE A CALL
NUMBER
with you & ready
ANYTIME, from ANYWHERE, EARLY
and AGAIN & AGAIN & AGAIN…
That is how to get information
45. How to Avoid Health
Risk Horror Stories
for your Business
Travellers
Thank you
Dr. Greg Jakubowski, Regional Medical Director, Asia, International SOS
Dr. Carrianne Ewe, Chief Medical Officer, China, International SOS
