Health and Wellness

Travelling abroad, meeting new people, and learning and living in a different culture are all part of a great experience. To ensure this experience is uninterrupted, you should be aware of your health and wellness.

Travel Health Insurance

To make an informed decision about your health insurance needs, you’ll need to familiarize yourself with the health care facilities, costs and potential health risks of your destination. Having sufficient, easy to use insurance is essential.

  • Understand your policy, know how your insurer’s system works and how bills are reimbursed.
  • Carry details of your insurance with you.
  • Tell a friend or relative at home, as well as a travelling companion, about how to contact your insurer.

 

Medical treatment in other countries can be costly if you do not have insurance. For that reason, you are required to provide proof of appropriate and sufficient travel health insurance coverage before leaving for your trip.


You may be wondering what is the difference between travel health insurance and the health insurance that you already have in Canada.

Provincial health insurance plans such as OHIP and international student health insurance plans such as UHIP provide basic health insurance coverage. These basic plans do not provide sufficient coverage outside of Canada, which can lead to extremely expensive hospital bills if you fall sick while travelling.

As of December 31, 2019 OHIP no longer provides out-of-country coverage to travellers. As a result, if you do not have travel health insurance while overseas, you will have to pay for everything yourself. These bills can quickly become very high: a single day hospital stay in the USA could average around $5,220 USD (approx. $6800 CAD)…assuming you will stay more than one day, you may end up paying more for your treatment than for your tuition.

As you can see, basic health insurance plans are not sufficient! For this reason, you are required to have sufficient and appropriate travel health insurance before leaving on university activity.


Useful Links:

www.utsu.ca/health

www.utgsu.ca/insurance 

www.studentlife.utoronto.ca/hwc/services-offered

www.studentlife.utoronto.ca/cie/myssp

Provincial health insurance (excluding Ontario) may provide some very limited out-of-country coverage. OHIP recently stopped providing funding for overseas healthcare. The University Health Insurance Plan (UHIP) provides only very basic travel health insurance. In short, these insurance plans are nowhere near enough to cover the costs of treatment overseas.

However, there is some good news!

As an undergraduate student, if you haven’t opted out of incidental fees, you may already be covered for 60 days of international travel through the University of Toronto Students’ Union (UTSU).

As a graduate student, if you haven’t opted out of incidental fees, you may already be covered for 120 days of international travel through the University of Toronto Graduate Students’ Union (UTSGU).

Make sure to confirm and/or ask how to activate this coverage with your student union. It may be a good idea to get a “letter of coverage” from the insurance provider. You can contact the Member Services Centre directly by calling the following numbers:

UTSU: +1 866 416-8706

GSU: +1 866 358-4436

Finding an Insurance Provider

If you are not covered by the UTSU/GSU supplemental travel health insurance plans then you will need to find an insurance provider. While the University of Toronto does not suggest specific providers, we can suggest some important things to consider while looking for one. Check out the “Know Your Destination” and “Choosing Insurance Plans” sections for more information.

No matter whether you will be travelling with student union insurance or with an insurance provider you found yourself, there are some important questions to ask yourself about your destination.

Indeed, before making an informed choice about what health insurance will be sufficient and appropriate, you’ll need to know more about the health care facilities, costs, and potential risks in the place you are visiting. Does your provider offer support in the country you are visiting?

Hospitals and health care workers in many countries may refuse to treat you without pre-payment or proof of funds available. Can your provider help you quickly demonstrate proof of coverage? If health care workers in your destination require cash, can the insurance provider send cash advances?

If you are a citizen of your destination country, even if you are a dual citizen with Canada, you should check with the insurance company to ensure you are covered. Many insurance companies do not offer coverage in the country of your citizenship.

When choosing a supplemental travel health insurance plan, you could consider these important points. A good travel health insurance plan:

  • has an in-house, worldwide, 24-hour/7-day emergency contact number in English or French and/or translation services for health care providers in your destination country
  • provides direct payment of bills and cash advances abroad so you don’t have to pay out of your own pocket;
  • covers pre-existing conditions (get an agreement in writing that you’re covered);
  • provides for medical evacuation to Canada or the nearest location with appropriate medical care;
  • covers emergency transportation, such as ambulance services

Some additional things to consider:

  • What treatments are covered? Are dental and vision included?
  • Does the plan pay for emergency flights for a family member or friend if you are hospitalized for a longer period of time?
  • How does the coverage compare to other plans? Does it seem appropriate to the location? (e.g. does it cover the risks that might arise in that region)
  • Can you extend the coverage if you choose to travel longer? Can this be done while abroad?
  • Do you require additional insurance in case of theft, or trip cancellation or interruption insurance?

Depending on your situation and your travel plans, you might also want to consider whether your plan has coverage for the following:

  • High-risk places (higher altitudes)
  • High-risk activities (caving, scuba diving, sky diving)
  • Coverage for travel to home country
  • Direct billing (if so, what clinics or hospitals)
  • Medical evacuation, emergency assistance
  • Pre-existing conditions
  • Natural disasters coverage

Please note that almost no standard travel insurance plans will cover injuries sustained in a riot or protest situation. Health insurance also generally does not cover intoxication (e.g. through drugs or alcohol).

Travel health insurance is considered supplemental insurance, and the majority of providers require proof of basic health insurance in order for you to access supplemental health insurance.

Make sure that your basic health insurance is extended for the period for which you are away.

UHIP is meant to have similar coverage to provincial insurance – at the University of Toronto, UHIP coverage for travel is quite similar to the coverage previously provided by OHIP (i.e. very limited). Check UHIP.ca for more information or read the coverage booklet here.

For OHIP:

If you have a valid Ontario Health Card, you have certain benefits while outside Canada, but the Government of Ontario recently announced that they are ending the Out-of-Country Travellers Program, which was already very limited (e.g. OHIP was only providing $50/day for outpatient visits to a hospital emergency room). The last day to submit a claim to OHIP for overseas expenses was December 31, 2019. As a result, you will not be covered by your Ontario health insurance while overseas, not even for a limited amount. Without travel health insurance, you will likely be paying for all expenses by yourself.

However, many travel health insurance providers require you to show that you have current basic health insurance coverage in Canada. You will also want to make sure your health insurance doesn’t expire while you are overseas. OHIP expires if you are outside of Ontario for more than 211 days.

If you are planning to be outside of Canada for more than 211 days, you will need to apply to OHIP for extended coverage before leaving Ontario. Check this part of the OHIP website for more information.

Note: if you have lived in Ontario for fewer than 6 months, your OHIP may expire earlier – make sure to check with the OHIP office.

Before travelling overseas, you should make sure that you leave your health insurance information with an Emergency Contact, who will be able to provide support for you in the case of an emergency. You should also plan how you will carry your health insurance information at all times – will you program it into your phone? Carry it on a card in your wallet?

Whichever plan you select, you should know in advance how to access your insurance if a medical emergency arises. Consider the following:

  • What are you covered for?
  • If you need to use the insurance, how do you show that you have coverage?
  • If you receive medical assistance while overseas, when and how should you inform the insurance agency? Do you have to call the insurance company before receiving treatment?
  • If you need to pay up front or in cash, what will you do? Does the insurance company offer a cash advance system to pay hospitals up front?
  • What documentation is required to make claims? (most insurers only want original documents, not photocopies) Do the bills need to be in English/Canadian dollars?

While overseas, make sure you understand your policy, know how your insurer’s system works and how bills are reimbursed. Carry the claims phone number and your policy number with you at all times.

When using your health insurance overseas, remember to:

  • Keep a written log of all communication with the company.
  • Keep copies of everything you send by mail, and make sure to note the time limits to submit claims (60 days? 90 days?).

Before leaving for your host country, it is important to be aware of travel health information such as rules and regulations related to medication and immunizations.


If you regularly take medication, whether prescription or over-the-counter, then you should consider how you will access medication while overseas.

  • If you regularly take prescription medication, be sure to bring your prescription and an adequate supply of the medication with you, provided that it is non-perishable and legal in your destination country.
  • You may also request a copy of your personal health record to carry with you throughout your travels and present it to attending physicians in case of an emergency.
  • You should consult a health care provider or visit a travel health clinic preferably six weeks before you travel. Use the GAC Vaccination Finder to determine whether you need immunizations for your host country.
  • If you’re unsure of where to start looking in preparation for your trip, call International SOS for support.

Useful Links:

https://studentlife.utoronto.ca/service/travel-immunizations-and-education/

http://www.studentlife.utoronto.ca/hwc/services-offered 

While planning your trip, you should consider what medications you would like to bring with you. Whether you are bringing prescription or over-the-counter medication with you, you should keep in mind:

  • The medications you want may not be available in the country you’re going to, and if they are, they may not be exactly like the ones you have at home.
  • Be sure to ask your doctor before leaving about the trade and generic names of your medication. If you purchase medication in another country, you likely will purchase medication with a different brand name, so it’s important to know any other names for your medication.
  • Is your medication legal in the destination country? Are there restrictions on the amount that you can bring with you?
  • If you are bringing the medication with you, make sure that everything is in its original packaging and that you have more than enough to last the entire period you are away. If the amount could be considered suspicious, ask your doctor for a letter to explain why you are carrying that amount, and make sure to bring your prescriptions with you.
  • Consider what you will pack in your carry-on and checked luggage. Are there any restrictions for how you should bring the medication?
  • If you have to purchase medication during your trip, think about identifying licensed pharmacies and make sure to get a receipt.
  • Ask the pharmacist whether the drug has the same active ingredient as the one you were taking.
  • Make sure the medicine stays in its original packaging.
  • If you bring medication back with you, make sure that you are following Health Canada’s regulations.

Useful Links:

https://travel.gc.ca/travelling/health-safety/medication

Health Canada Import Requirements

Depending on your destination, you may be required to get certain vaccinations in order to enter the country. For example, many countries require proof of Yellow Fever vaccine. Note: There is currently a shortage of Yellow Fever vaccine in Canada. If you require this vaccination, make sure to contact your health care providers early to request the vaccine.

You can check whether there are required and/or recommended vaccinations for your destination on Global Affairs’ Travel Vaccinations page.

It is also highly recommended that you visit a Travel Health clinic 6-8 weeks before travelling, in order to consult with specialists about any vaccinations or medications that you might need for your trip. Some vaccinations may require multiple doses, so it is important to make an early appointment. The University of Toronto’s Health & Wellness Centre is a certified Travel Medicine Clinic, or you can take a look at this alternative list of travel health clinics in Toronto.

When you visit the travel health clinic, remember to bring:

  • Your full travel itinerary (layovers can also bring additional requirements)
  • Your immunization record
  • Any other documentation as required by the clinic

If you are taking any medication, you should make sure the health care provider knows, in case of any possible interactions with the vaccinations.


Useful Links:

https://travel.gc.ca/travelling/health-safety/vaccines

https://studentlife.utoronto.ca/service/travel-immunizations-and-education/

http://www.travelhealthclinics.ca/Travel-Health-Clinics/Ontario/Toronto/Travel-Clinics-Toronto.aspx

When preparing to take medication overseas, remember:

  • Check whether the medication you would like to bring is legal in your destination.
  • Check ahead of time what to pack in your carry-on and what to pack in your checked baggage.
  • Do not try to save luggage space by taking medications out of their packaging.
  • Pack all medications in your carry-on baggage in their original, labelled containers.
  • Bring an extra supply of medication in case you are away for longer than expected.
  • Pack your prescriptions: Carry a copy of the original prescription and ensure you have both the generic and trade names of the medication. The Government of Canada also recommends bringing a doctor’s note describing why you are taking the medication, especially if it is not a common medication.

As it can be more complicated to purchase medical supplies while overseas, you may also want to bring a travel health kit. This travel health kit could include:

  • Basic first aid items such as bandages, antiseptic wound cleaner (e.g. alcohol pads), antibacterial cream, blister pads, latex gloves, gauze, rehydration salts, safety pins, scissors, sprain bandages, tweezers, a thermometer…
  • Medications that you regularly use (over the counter, prescription, allergy medications, etc)
  • Anti-diarrheal medication
  • Motion-sickness medication
  • Pain and/or fever medication
  • Any destination specific medications that you are recommended by a doctor
  • Sunscreen
  • A copy of your prescription for your glasses or contacts
  • Insect repellent
  • Proof of your insurance coverage
  • A copy of your immunization records

For more information about packing a first aid kit, see the “Physical Health and Wellness” tab above.


Useful Links:

https://travel.gc.ca/travelling/health-safety/medication

https://travel.gc.ca/air/what-to-pack

Travelling and studying abroad can trigger mental health issues such as stress, depression and homesickness. Learn how to take care of your mental health by recognizing symptoms and learning strategies to cope with mental health issues.


While overseas, you should be aware of some changes that may trigger mental health issues, so that you can better prepare to deal with them.

Support: For many students, going abroad represents their first real separation from family and friends, and thus from the regular support systems of home. When something negative happens or news from home is not good, you may not have the same level of support as before.

As well, if you are in a different time zone from home, you may find that your contact with your family and friends is more fragmented than before. You may begin to feel isolated and frustrated, especially if you feel unable to solve problems at home.

A good idea may be to pre-arrange a “check in” time with family and/or friends, when both of you will be free to call, video chat, or message back and forth about what is going on. Especially if you are travelling alone or feeling lonely, you should make sure that you have these pre-arranged times to talk with your support from home.

Environment: Adjusting to differences in housing, food, and water can cause significant adaptation strain, creating physical stress on the body that in turn can tax mental functioning (e.g., difficulty concentrating, remembering, etc.).

Along with physical stress, you may experience the effects of culture shock, as you adjust to a new linguistic and/or cultural environment. No matter whether the adjustment is physical or mental, both can place significant strain on your mental wellness, as you try to keep up with the changes.

Regular Routines: Part of the excitement of going abroad is that your regular patterns of living change entirely. Your sleep patterns, diet, and exercise routines may all change, which may in turn affect your mental health.

There are so many new things to do, so many new places to see, that you may find your schedule tightly packed, well into the night. However, sacrificing sleep or down time is never a good idea. Jet lag can further aggravate your sleep patterns and mental health, especially when time zone differences are large. Make sure that you are getting enough sleep and relaxation time, so that your body and mind can take a break and process what is happening.

Your physical health can also be affected by changes in diet and exercise. While travelling we tend to dine out more frequently, or our meals are increasingly irregular. Another issue with travel is hydration: you may be active for more hours than before, and as a result your body will require more water. Avoid dehydration by ensuring that you are drinking water regularly.

In short, if your schedule is a busy one, ensure that you still have adequate rest, hydration, and calorie intake.

Homesickness: Everyone who leaves familiar environments for a significant amount of time will experience homesickness, the sense of longing to return to the familiar. Feeling homesick is normal, and other exchange and international students, or expats, will likely be experiencing or have experienced similar levels of homesickness. Even if they appear completely confident, if you mention homesickness to them, they likely have similar feelings.

In many occasions, as you make more friends and begin to adjust, you may find your homesickness weakens. If, however, your homesickness reaches the level that you begin to feel more deeply unhappy, you can always access further resources to discuss your experience in more detail.


All of these issues can impact mental health, and if you find that your mental health is suffering or becoming increasingly worse, let someone know.

Check the Resources tab for a list of resources available to you both overseas and at the University of Toronto.


Useful Links:

https://studentlife.utoronto.ca/service/mental-health-care/

https://studentlife.utoronto.ca/service/myssp

Dealing with mental health issues is complex, and there is no one solution for all. However, there are some tips that can help you manage your mental health if issues start to arise:

  • Beware of signs and symptoms of stress that could range from behavioral signs to emotional outbreaks.
  • To cope with stressful situations, bring yourself something that reminds you of home.
  • Write a blog or journal describing your experiences and feelings. Sometimes writing something down can make you feel less stressed.
  • Stay active in your host country- join clubs, social circles and activities.
  • Familiarize yourself with people in the new environment.
  • Give yourself regular breaks and don’t be too hard on yourself. We are our own worst critics.
  • Make sure to stay hydrated, get enough rest, and ensure you are eating well and regularly.
  • In emergency situations, contact the CIE or the health and wellness unit at your host institution.
  • For immediate and/or ongoing support, MySSP (001-416-380-6578) provides confidential, 24/7 support in more than 140 languages. You can access help and advice by phone or by chat, either by downloading the MySSP app (Apple App Store/Google Play) or by calling 001-416-380-6578 (outside of North America). In North America, you can call 1-844-451-9700.

Adjusting to a new environment and culture takes time, and is not always easy. You will likely have difficult days. You may also react differently over time: when you first arrive you may enjoy the newness and excitement of an unfamiliar everyday life, but you may become more uncomfortable when you discover that you are unable to communicate, socialize, or feel as accepted in your new environment. This realization can lead to frustration, anxiety, or even rejection of a different culture.

This culture shock is completely normal, as adjustment to a new culture is generally seen to follow a curve.

An image of a graph demonstrating the information described in the text

(Source: https://en.wikipedia.org/wiki/File:Acculturation_curve_and_culture_shock.svg)

During the honeymoon period (1), the newness of the host culture is exciting and interesting. Every day you can experience things that you have never experienced before.

However, over time, differences between the host culture and home culture become increasingly apparent, and you may become increasingly frustrated. In this negotiation stage (2), you may withdraw from the host culture and feel homesick, anxious, and/or lonely. During this stage, many students struggle with language barriers and cultural differences.

After another few months, you will likely enter an adjustment stage (3), in which you have grown used to the patterns of life in your host culture and the host culture has become normal. By this point, you are probably used to navigating a different language and/or culture and have developed a regular routine.

Finally, when you return to Toronto, you may experience Reverse Culture Shock (4), in which the idealized image of home that you developed while away contradicts with the reality of returning to your previous everyday life. During this time, you may feel frustrated and wish to return overseas.

While culture shock (and reverse culture shock) are unavoidable, there are some things you can keep in mind to lessen its effects:

Be patient with yourself. Much of the initial frustration and anxiety from living overseas comes from the pressure we put on ourselves to fit in as soon as possible. Try to remain open-minded and willing to learn and adapt.

Don’t hesitate to reach out for support. If you see the following signs, reaching out might be a good idea:

  • Feeling “off”
  • Irritability
  • Feeling isolated or withdrawn
  • Change in eating and sleeping habits
  • Fatigue or depression
  • Negative stereotyping of the local people

Talk to fellow travelers, chat with your hosts, and call International SOS or Safety Abroad for support.

There is no way to prevent culture shock, but to reduce culture shock as much as possible:

  • Prepare: Research the customs and culture as much as possible, so that you can anticipate any challenges that may arise and develop strategies to adapt. Consider that you may also be part of different educational, work, or social cultures as well.
  • Be Open: Part of the reason that the difficulties you face increase over time is that you are experiencing more and more of the new culture. The more you get involved, the stronger affect any cultural differences will have.
  • Keep Mentally and Physically Healthy: Travelling puts a lot of physical and mental strain on you. Keeping a healthy lifestyle can be difficult when you are trying to combine study and fun, but try to get enough sleep, eat healthy, and give yourself some quiet relaxation time
  • Keep a Journal: try keeping a travel journal or blog. Recalling your goals can help put some challenges into perspective, and you have a great memento at the end!
  • Connect with Others: reach out to family and friends at home, find ways to build connections with locals or expats in your host country, and contact U of T Safety Abroad when you would like additional support

 

Additional Tips:

  • If you are feeling particularly frustrated, one method to reduce your frustration is to ask somebody local who has visited your country about what they found the most shocking. It may be that they found your culture just as shocking as you are finding theirs. Opening up such a conversation may help you better understand what has been frustrating you.
  • Keep a sense of humour! When you are making frequent mistakes, it can be very frustrating, but if you are able to laugh at the absurdity of not knowing or at such differences, you will be able to move beyond mistakes with a new perspective.
  • Remember that it is not just you – if you feel homesick or anxious, talk to others who are travelling with you as well. It’s highly likely that they are experiencing, have experienced, or will experience similar feelings.

As a student of the University of Toronto, you have access to many mental health resources, both at home and while overseas.

While overseas:

MySSP (001-416-380-6578) – provides immediate and/or ongoing confidential, 24/7 support in more than 140 languages. You can access help and advice by phone or by chat, either by downloading the MySSP app (Apple App Store/Google Play) or by calling 001-416-380-6578 (outside of North America). In North America, you can call 1-844-451-9700.

International SOS (+1-215-942-8478) – offers free counselling sessions and advice to University of Toronto students. Simply call and say that you are a U of T student. International SOS may also be able to help with finding a mental health professional in your area.

Campus Police (+1 416-978-2222) – call the 24/7 hotline to be put in touch with Safety Abroad and/or other resources at the University of Toronto.

Centre for International Experience (+1 416-946-3929) – during regular hours (9-5 weekdays, Toronto time) you can also call the CIE to connect with resources on campus. Please leave your name, student number, and call back number if you are unable to speak to someone immediately.

While at the University of Toronto, as well as the above resources, you can also access:

911 – if you are at immediate risk, directly call 911 for help.

MySSP (844-451-9700) – immediate and/or ongoing confidential, 24/7 support in more than 140 languages. You can also access help and advice by chat by downloading the MySSP app (Apple App Store/Google Play).

Good2Talk (1-866-925-5454) – free, confidential, 24/7 access to professional counselling and information for all post-secondary students in Ontario. You can also text GOOD2TALKON to 686868 to access support via text messaging.

(St. George) U of T Health and Wellness Centre416-978-8030 (9-5, business hours)

(Mississauga) UTM Health & Counselling Centre905-828-5255 (9-5, business hours)

(Scarborough) UTSC Health & Wellness Centre416-287-7065 (9-5, business hours)

Further resources if you are feeling distressed.

Travelling and studying abroad can put greater strains on our physical health – adjusting to changes in food and drink, possible time differences, and a sudden increase in activity and decrease in rest time can all affect our physical well being.


Part of the excitement of going abroad is that your regular patterns of living change entirely. There are so many new things to do, so many new places to see, that you may find your schedule tightly packed. If you are running between activities, you may find yourself sacrificing sleep, regular meals, or increasingly dehydrated.

Sacrificing sleep or relaxation time is never a good idea. Jet lag can further aggravate your sleep patterns, especially when time zone differences are large. As sleep is closely related to mental health, and as both your body and mind will be more active than usual while abroad, lack of sleep can have many negative consequences. Make sure that you are getting enough sleep and relaxation time, so that your body and mind can take a break and process what is happening.

Your physical health can also be affected by changes in diet and exercise. While travelling we tend to dine out more frequently, and our meals tend to be quite irregular. In fact, by not keeping a regular meal schedule, we can further aggravate the affects of jet lag. As well, your blood sugar levels may be affected, reducing your energy levels. While it may be tempting to skip meals, or rely on only one meal a day, try to keep to the same pattern of eating habits that you had at home.

Another issue with travel is hydration: you may be active for more hours than before, and as a result your body will require more water. Because you will be eating out more than usual, you are also likely to be eating foods with higher salt content. If you don’t get enough water, you will feel tired and you may have more headaches and sore eyes. Avoid dehydration by ensuring that you are drinking water regularly and eating water-rich snacks (e.g. fruit, vegetables, soups).

In short, while abroad, make sure to watch out for changes in your usual patterns of sleep, exercise, eating, and drinking. These changes are usually not negative, as long as you can find a way to compensate for them.

Resources: Staying Hydrated, Eating Well, Understanding Sleep

When travelling abroad, it is highly recommended to carry a travel first aid kit. You may not be able to easily buy first aid supplies and medications, or they may be different from those you are used to in Canada. As well, having basic first aid supplies on hand saves effort if you have a minor injury such as a graze or sprain.

A basic first aid kit generally includes:

  • Adhesive bandages (e.g. Bandaids) in multiple sizes
  • Alcohol-based hand sanitizer
  • Antibacterial creams to help wounds heal and prevent infections
  • Antihistamine cream/Hydrocortisone cream (to treat itchy skin, such as from bug bites)
  • Antiseptic wound cleanser (e.g. alcohol wipes)
  • Blister pads or bandages
  • Disposable latex or vinyl gloves
  • Gauze
  • Immodium salts or similar medication (for diarrhea, food poisoning)
  • Pain and fever medication (acetaminophen, ibuprofen, or similar)
  • Rehydration salts (especially if travelling to a hot region; travel health specialists often offer free samples)
  • Safety pins
  • Scissors (small)
  • Surgical tape (for holding gauze in place)
  • Tensor bandages for sprains
  • Thermometer
  • Tweezers
  • Your immunization record
  • Emergency information, such as emergency numbers and contact information for your family members in Canada
  • Your insurance provider’s contact information

You may also want to include some medications, such as:

  • Any medication (prescription or over-the-counter) that you regularly use
  • Allergy medication
  • Anti-motion sickness medication
  • Cold and flu medications (e.g. cough lozenges, decongestants)
  • Stomach and intestinal medication, such as antacids
  • Destination-specific medication (e.g. altitude sickness, malaria)
  • Any needles or syringes you may use for treatments – make sure to carry a letter or certificate from your health care provider explaining how you will use them

Make sure to bring enough medication to last your entire period overseas. Bring an extra supply in case you are away for longer than expected. If you are carrying an amount that border officials might consider suspicious, ask your doctor for a letter to explain it.

Depending on your destination and situation, you may also want to consider:

  • Suncream
  • Sunscreen
  • Condoms
  • Birth control medication
  • Ear plugs
  • Extra pair of glasses or contacts (and your prescription)
  • Insect repellant
  • Mosquito nets for sleeping
  • Eye drops
  • Water purification filters or tablets

Especially when carrying medication, make sure everything is in its original packaging. Check ahead of time if such medication is permitted in your destination – even regular over-the-counter medications in Canada can be considered illegal substances in other countries.


More information: the Government of Canada’s Travel Health Kit page

Water quality in other regions can be very different from what we know in Canada. Make sure to research your destination ahead of time and note any possible issues with water sources.

If you are travelling to a destination with poor water quality, you may want to ask if the tap water is safe. If tap water isn’t safe to drink, how about brushing your teeth or showering?

Locals may be less concerned about the water quality, unaware of the effect it has on their health, or may have built up immunity. In these cases, it may be better to rely on the advice of expats or fellow travelers.

Contaminated water does not just affect drinking water:

  • Ice cubes and crushed ice is frequently made from tap water – if you are ordering a drink with ice, make sure to ask whether it is made from purified water
  • Avoid eating raw fruits and vegetables, including salads – they could be rinsed in contaminated water and there is no way to sterilize them
  • Fruits that must be peeled are generally safe
  • Boiled water is generally safer, but must be kept boiling for at least two minutes. The temperature at which water boils changes by altitude, so the 100°C rule may not apply to your destination.
  • Keep in mind that smoothies, juices, and other drinks may be made with water
  • Ensure that cutlery and plates have dried before being used
  • When buying bottled water or drinks, check the source of the water – is it local?

Remember – even if somebody is offering you a drink, it is not rude to decline it with a polite “My stomach cannot handle it” or “My stomach is too weak”. Most of the time your hosts will understand that there is a difference between water in Toronto and in your destination. Do not feel you have to take the risk of drinking contaminated water in order to not upset your hosts. They will be more upset if you get sick!


Useful Links:

https://travel.gc.ca/travelling/health-safety/food-water

For better or worse, the food you find abroad may be quite different from what you are used to at home. Be curious and do some research! You should be able to try foods from almost any country at one of the many regionally specific restaurants in Toronto. Know in advance what typical meals consist of and the customs regarding dining.

If you have any specific dietary needs, you may need to be able to communicate them in the local language.

For example, if you are vegetarian or vegan, learn how to make clear what that means to you. For many people, and in many cultures, “vegetarian” has a different meaning, so make sure to clearly explain what you can and cannot eat.

If you have an allergy If you have allergic reactions to something, you should learn how to explain your allergy in the language of your destination. Knowing how to say “I am allergic to…” and “I can’t eat…”, as well as “Are there… (in this)?” could save your life.

  • If you have an Epi pen or other allergy medication, ensure you bring enough medication for the duration of your trip and/or for several emergency uses.

Be sure that the food you are eating is safe. Raw food, unpasteurized milk, fish and seafood can be dangerous if not prepared correctly. In general any fruit that you peel is safe. Well cooked, hot foods tend to be safer than uncooked foods such as salads.


Useful Links:

https://travel.gc.ca/travelling/health-safety/food-water

In many destinations, the air quality is the most unavoidable part of travelling. In some major cities, such as Beijing, Jakarta, Mexico City, or Mumbai, you can practically taste pollution in the air on bad air days.

If you have asthma or emphysema, you may wish to limit your exposure to cities with high levels of pollution. You will definitely want to bring an adequate supply of inhalers and other medicines. Before travelling somewhere with poor air quality, consult with your doctor.

While respiratory problems can worsen in bad air pollution, anyone can feel the effects of air pollution in a short period of time. Most major cities have public health warning systems in place – if you are travelling to a place known for its poor air quality, make sure to review these systems before leaving and subscribe to them (if possible) upon arrival.

Besides searching online for the air quality rating of your destination, you can also take a look at data maps such as those supplied by the World Air Quality Index.

In general, in areas with high levels of air pollution, you may wish to avoid too much outdoor activity. During times of high concentrations, you should avoid activities that involve deep breathing (e.g. cardio) and follow guidelines laid out in the local advisories.

You may find yourself in a location at an altitude to which you are completely unaccustomed.

Climbing to high altitudes has very specific health risks, and you should consult an expert before doing so. Use only reputable guides and do not rush yourself or push yourself further than your body can handle. In general, it is necessary to rest every 3,000 feet or so. Carefully monitor yourself for signs of altitude sickness, exhaustion, dehydration, and hypothermia.

Altitude sickness occurs when oxygen levels in the air are lower than the levels to which you are accustomed. The symptoms of altitude sickness may include headaches, vomiting, tiredness, trouble sleeping, and dizziness. The risk of altitude sickness is generally not related to your physical health, but rather to a rapid increase in altitude. As a result, if you begin to feel ill, you should notify your travel companions immediately, even if you feel confident in your overall physical health.

You may be at a higher risk of danger if you have had trouble with altitudes in the past, have recently gone scuba diving (in the 24 hours before climbing), or have other health problems. Consult with your doctor if you might be at risk.

If you begin to experience altitude sickness or other issues, you should talk to the guides or leaders of the climb. You may need immediate medical attention.

While reviewing the Travel Advisory for your destination, you will notice that there is a specific section for Insects in the Health section. Common illnesses related to insect bites include diseases such as dengue fever, malaria, tick-borne encephalitis, Yellow Fever, and Zika virus. The most prevalent disease will depend on your destination.

You may need to get vaccinated before leaving Canada for one or more insect-borne diseases, so you should check with a travel health specialist beforehand. For example, many countries worldwide require proof of Yellow Fever vaccination for entry.

You should also keep in mind what you will be doing at your destination. If you are frequently travelling to areas where insects are prevalent (e.g. the countryside), you may need to take additional precautions, including additional vaccinations.

In general, you should take precautions to avoid getting bitten by insects:

  • Learn what types of insects are common in your destination and the symptoms of any illnesses related to them
  • Know peak biting times when insects will be most active (both time of day and season)
  • Check where insects carrying diseases are commonly found and minimize your time in those areas
  • Minimize your outdoor exposure, and use insect repellents when travelling to areas where insects are prevalent
  • Wear light-coloured, loose clothing with tight weaves in the material
  • Wear long pants and long sleeved shirts, closed-toe shoes, and hats
  • For extra protection against crawling insects like ticks, tape the cuffs of your pants, or tuck them inside your socks or shoes
  • Choose the appropriate insect repellent for your trip and review how to use it safely
  • Remove any standing water (non-moving) near your accommodation to prevent mosquitoes from reproducing (mosquitoes lay eggs in standing water)
  • Read more about how to prevent insect bites

When sleeping outdoors or in unenclosed spaces:

  • Use a mosquito net without any holes or rips and tuck it underneath your mattress to prevent exposure at night
  • Avoid sleeping or spending time against the netting (to avoid getting bitten through the net)
  • Check nets regularly for any damage

When spending time in wooded or grassy areas:

  • Dress appropriately to reduce the risk of tick bites: wear long sleeves and pants, tuck your pants into your socks or shoes, and wear a hat
  • Know what a tick looks like – ticks are very small, and you may not be aware that you have been bitten
  • Review these helpful tips from the Government of Canada on preventing tick bites and what to do if you are bitten
  • Check for ticks on yourself, any children, and your equipment and clothing upon returning to your accommodations. When checking, remember that ticks especially prefer warm, moist environments.

Useful Links:

https://travel.gc.ca/travelling/advisories

https://www.canada.ca/en/public-health/services/diseases/insect-bite-prevention.html

https://www.canada.ca/en/health-canada/services/about-pesticides/insect-repellents.html

https://www.canada.ca/en/public-health/services/publications/diseases-conditions/lyme-pamphlet.html

After living in Toronto, you have likely experienced the freezing cold of winter, but if you are travelling to a location with cold weather, you should still be aware of the risks. In particular, you should know how to identify the symptoms of windburn, frostbite, and hypothermia.

Before travelling, research the climate in your destination and make sure that you bring appropriate clothing. Keep in mind that you will likely spend more time than expected outside, as you’ll be exploring.

A picture of a snowy road in the middle of a snowstorm.

Windburn is caused by cold winds blowing against your skin, resulting in excessive dryness, redness, soreness, and/or itchiness. To treat windburn, do not scratch or rub the affected area, and instead apply skin care products and lip balm to moisturize affected areas.


Frostbite usually begins in your hands, feet, nose, and/or ears. In mild frostbite, your skin turns yellow or whitish, but it is still soft to the touch. Normal colour will return once the area is warmed. Severe frostbite can cause nerve damage, loss of feeling in the affected area, discolouration, and blisters.

To warm yourself up, move to a warm area, wrap yourself in blankets, or share body heat with another person. You can also place the injured skin in water that is just above body temperature. DO NOT use hot water, or rub, massage, or shake the injured skin, as this can cause further damage. If you have severe frostbite, begin warming yourself up, but you should also call for help.


Hypothermia happens in three stages, as your body temperature drops:

  1. You begin shivering, get goose bumps, and your hands become numb. You may start shallow breathing, or feel tired and/or sick. If you suddenly begin to feel warm, without going into a warm environment, this indicates you are entering Stage 2.
  2. You have severe shivering. Your movements may be slow and laboured. You may experience mild confusion, become pale, and your lips, ears, fingers, and toes may turn blue. You can test if you are experiencing Stage 2 by trying to touch your thumb to your little finger. If you can’t, your muscles are not working properly.
  3. You have trouble speaking, thinking, and walking. You may even experience amnesia. At this stage, you need immediate medical attention.

At Stage 2 or 3, you should immediately call your local emergency number for help.  If you are experiencing Stage 1, or waiting for help, you should find shelter, keep your muscles moving, and try hard to keep your body warm. Make sure you are dry, wrap yourself in clothing, drink warm, sweet liquids, and/or reheat yourself through skin-to-skin contact with another person.


In short, do not ignore warning signs. If you find yourself shivering, or that you can’t feel your hands, feet, nose, and/or ears, you should take immediate steps to warm yourself

Read more about how to prevent cold weather risks.


Useful Links:

https://www.canada.ca/en/health-canada/services/healthy-living/your-health/environment/extreme-cold.html

Depending on your destination, you may be exposed to a hotter climate than you are used to in Toronto. Even if the climate is similar to Toronto’s, you are likely to be outside in the heat more than usual as you explore, so you should still be aware of how heat may affect your health.

Heat illnesses can affect your body quickly and can lead to longer-term health problems, or even death. Before travelling, you should make sure to pack clothing appropriate for your destination. If you are taking medication or have a health condition, you may want to ask if your medication increases your health risk in the sun, especially when exposed to UV rays.

A bright sun shining through the clouds, to represent the burning heat of summer.

Health Canada suggests 5 steps to prevent heat related illnesses:

  • Stay Prepared – Regularly check forecasts to plan ahead, make sure your air conditioning and fans work, or if you don’t have them, plan where you can go to cool off. Make sure you have a supply of cool drinks. If you are going out for the day, bring drinks with you to stay hydrated.
  • Stay Aware – Watch for symptoms of heat-related illnesses, including dizziness/fainting, nausea, headaches, rapid breathing and heartbeat, extreme thirst, or decreased urination. If you have any of these symptoms, move to a cool place and drink liquids (water is best). You can help other people by moving them to a cool place, applying cold water to their skin or clothing, and fanning them.
  • Stay Hydrated – Drink before you feel thirsty! Remind yourself to drink water regularly, eat more fruits and vegetables for their water content, and if you don’t feel like eating, try to drink even more water.
  • Stay Cool – Dress for the weather in loose fitting clothing and a wide-brimmed hat, take regular breaks from any physical exercise and don’t push your body too far. Keep the sun blocked out of your accommodation by closing curtains during the day, take cool showers, and try to spend time in cool places.
  • Stay Safe – Reschedule activities for cooler times of the day or other times, avoid sun exposure, wear sunglasses, and apply sunscreen with a SPF rating of 15 or higher.

Above all, stay hydrated, wear appropriate clothing for the climate, and pay close attention to what your body is telling you.

Read more about sun and heat safety while travelling.


Useful Links:

https://travel.gc.ca/travelling/health-safety/sun-tips

https://www.sja.ca/English/Safety-Tips-and-Resources/Pages/Heat%20Stroke/heat-stroke-symptoms-and-first-aid.aspx

https://www.canada.ca/en/health-canada/services/sun-safety/extreme-heat-heat-waves.html

Travel Health Insurance

Medical treatment in other countries can be costly if you do not have insurance. For that reason, you are required to provide proof of appropriate and sufficient travel health insurance coverage before leaving for your trip.


You may be wondering what is the difference between travel health insurance and the health insurance that you already have in Canada.

Provincial health insurance plans such as OHIP and international student health insurance plans such as UHIP provide basic health insurance coverage. These basic plans do not provide sufficient coverage outside of Canada, which can lead to extremely expensive hospital bills if you fall sick while travelling.

As of December 31, 2019 OHIP no longer provides out-of-country coverage to travellers. As a result, if you do not have travel health insurance while overseas, you will have to pay for everything yourself. These bills can quickly become very high: a single day hospital stay in the USA could average around $5,220 USD (approx. $6800 CAD)…assuming you will stay more than one day, you may end up paying more for your treatment than for your tuition.

As you can see, basic health insurance plans are not sufficient! For this reason, you are required to have sufficient and appropriate travel health insurance before leaving on university activity.


Useful Links:

www.utsu.ca/health

www.utgsu.ca/insurance 

www.studentlife.utoronto.ca/hwc/services-offered

www.studentlife.utoronto.ca/cie/myssp

Provincial health insurance (excluding Ontario) may provide some very limited out-of-country coverage. OHIP recently stopped providing funding for overseas healthcare. The University Health Insurance Plan (UHIP) provides only very basic travel health insurance. In short, these insurance plans are nowhere near enough to cover the costs of treatment overseas.

However, there is some good news!

As an undergraduate student, if you haven’t opted out of incidental fees, you may already be covered for 60 days of international travel through the University of Toronto Students’ Union (UTSU).

As a graduate student, if you haven’t opted out of incidental fees, you may already be covered for 120 days of international travel through the University of Toronto Graduate Students’ Union (UTSGU).

Make sure to confirm and/or ask how to activate this coverage with your student union. It may be a good idea to get a “letter of coverage” from the insurance provider. You can contact the Member Services Centre directly by calling the following numbers:

UTSU: +1 866 416-8706

GSU: +1 866 358-4436

Finding an Insurance Provider

If you are not covered by the UTSU/GSU supplemental travel health insurance plans then you will need to find an insurance provider. While the University of Toronto does not suggest specific providers, we can suggest some important things to consider while looking for one. Check out the “Know Your Destination” and “Choosing Insurance Plans” sections for more information.

No matter whether you will be travelling with student union insurance or with an insurance provider you found yourself, there are some important questions to ask yourself about your destination.

Indeed, before making an informed choice about what health insurance will be sufficient and appropriate, you’ll need to know more about the health care facilities, costs, and potential risks in the place you are visiting. Does your provider offer support in the country you are visiting?

Hospitals and health care workers in many countries may refuse to treat you without pre-payment or proof of funds available. Can your provider help you quickly demonstrate proof of coverage? If health care workers in your destination require cash, can the insurance provider send cash advances?

If you are a citizen of your destination country, even if you are a dual citizen with Canada, you should check with the insurance company to ensure you are covered. Many insurance companies do not offer coverage in the country of your citizenship.

When choosing a supplemental travel health insurance plan, you could consider these important points. A good travel health insurance plan:

  • has an in-house, worldwide, 24-hour/7-day emergency contact number in English or French and/or translation services for health care providers in your destination country
  • provides direct payment of bills and cash advances abroad so you don’t have to pay out of your own pocket;
  • covers pre-existing conditions (get an agreement in writing that you’re covered);
  • provides for medical evacuation to Canada or the nearest location with appropriate medical care;
  • covers emergency transportation, such as ambulance services

Some additional things to consider:

  • What treatments are covered? Are dental and vision included?
  • Does the plan pay for emergency flights for a family member or friend if you are hospitalized for a longer period of time?
  • How does the coverage compare to other plans? Does it seem appropriate to the location? (e.g. does it cover the risks that might arise in that region)
  • Can you extend the coverage if you choose to travel longer? Can this be done while abroad?
  • Do you require additional insurance in case of theft, or trip cancellation or interruption insurance?

Depending on your situation and your travel plans, you might also want to consider whether your plan has coverage for the following:

  • High-risk places (higher altitudes)
  • High-risk activities (caving, scuba diving, sky diving)
  • Coverage for travel to home country
  • Direct billing (if so, what clinics or hospitals)
  • Medical evacuation, emergency assistance
  • Pre-existing conditions
  • Natural disasters coverage

Please note that almost no standard travel insurance plans will cover injuries sustained in a riot or protest situation. Health insurance also generally does not cover intoxication (e.g. through drugs or alcohol).

Travel health insurance is considered supplemental insurance, and the majority of providers require proof of basic health insurance in order for you to access supplemental health insurance.

Make sure that your basic health insurance is extended for the period for which you are away.

UHIP is meant to have similar coverage to provincial insurance – at the University of Toronto, UHIP coverage for travel is quite similar to the coverage previously provided by OHIP (i.e. very limited). Check UHIP.ca for more information or read the coverage booklet here.

For OHIP:

If you have a valid Ontario Health Card, you have certain benefits while outside Canada, but the Government of Ontario recently announced that they are ending the Out-of-Country Travellers Program, which was already very limited (e.g. OHIP was only providing $50/day for outpatient visits to a hospital emergency room). The last day to submit a claim to OHIP for overseas expenses was December 31, 2019. As a result, you will not be covered by your Ontario health insurance while overseas, not even for a limited amount. Without travel health insurance, you will likely be paying for all expenses by yourself.

However, many travel health insurance providers require you to show that you have current basic health insurance coverage in Canada. You will also want to make sure your health insurance doesn’t expire while you are overseas. OHIP expires if you are outside of Ontario for more than 211 days.

If you are planning to be outside of Canada for more than 211 days, you will need to apply to OHIP for extended coverage before leaving Ontario. Check this part of the OHIP website for more information.

Note: if you have lived in Ontario for fewer than 6 months, your OHIP may expire earlier – make sure to check with the OHIP office.

Before travelling overseas, you should make sure that you leave your health insurance information with an Emergency Contact, who will be able to provide support for you in the case of an emergency. You should also plan how you will carry your health insurance information at all times – will you program it into your phone? Carry it on a card in your wallet?

Whichever plan you select, you should know in advance how to access your insurance if a medical emergency arises. Consider the following:

  • What are you covered for?
  • If you need to use the insurance, how do you show that you have coverage?
  • If you receive medical assistance while overseas, when and how should you inform the insurance agency? Do you have to call the insurance company before receiving treatment?
  • If you need to pay up front or in cash, what will you do? Does the insurance company offer a cash advance system to pay hospitals up front?
  • What documentation is required to make claims? (most insurers only want original documents, not photocopies) Do the bills need to be in English/Canadian dollars?

While overseas, make sure you understand your policy, know how your insurer’s system works and how bills are reimbursed. Carry the claims phone number and your policy number with you at all times.

When using your health insurance overseas, remember to:

  • Keep a written log of all communication with the company.
  • Keep copies of everything you send by mail, and make sure to note the time limits to submit claims (60 days? 90 days?).
Medication

Before leaving for your host country, it is important to be aware of travel health information such as rules and regulations related to medication and immunizations.


If you regularly take medication, whether prescription or over-the-counter, then you should consider how you will access medication while overseas.

  • If you regularly take prescription medication, be sure to bring your prescription and an adequate supply of the medication with you, provided that it is non-perishable and legal in your destination country.
  • You may also request a copy of your personal health record to carry with you throughout your travels and present it to attending physicians in case of an emergency.
  • You should consult a health care provider or visit a travel health clinic preferably six weeks before you travel. Use the GAC Vaccination Finder to determine whether you need immunizations for your host country.
  • If you’re unsure of where to start looking in preparation for your trip, call International SOS for support.

Useful Links:

https://studentlife.utoronto.ca/service/travel-immunizations-and-education/

http://www.studentlife.utoronto.ca/hwc/services-offered 

While planning your trip, you should consider what medications you would like to bring with you. Whether you are bringing prescription or over-the-counter medication with you, you should keep in mind:

  • The medications you want may not be available in the country you’re going to, and if they are, they may not be exactly like the ones you have at home.
  • Be sure to ask your doctor before leaving about the trade and generic names of your medication. If you purchase medication in another country, you likely will purchase medication with a different brand name, so it’s important to know any other names for your medication.
  • Is your medication legal in the destination country? Are there restrictions on the amount that you can bring with you?
  • If you are bringing the medication with you, make sure that everything is in its original packaging and that you have more than enough to last the entire period you are away. If the amount could be considered suspicious, ask your doctor for a letter to explain why you are carrying that amount, and make sure to bring your prescriptions with you.
  • Consider what you will pack in your carry-on and checked luggage. Are there any restrictions for how you should bring the medication?
  • If you have to purchase medication during your trip, think about identifying licensed pharmacies and make sure to get a receipt.
  • Ask the pharmacist whether the drug has the same active ingredient as the one you were taking.
  • Make sure the medicine stays in its original packaging.
  • If you bring medication back with you, make sure that you are following Health Canada’s regulations.

Useful Links:

https://travel.gc.ca/travelling/health-safety/medication

Health Canada Import Requirements

Depending on your destination, you may be required to get certain vaccinations in order to enter the country. For example, many countries require proof of Yellow Fever vaccine. Note: There is currently a shortage of Yellow Fever vaccine in Canada. If you require this vaccination, make sure to contact your health care providers early to request the vaccine.

You can check whether there are required and/or recommended vaccinations for your destination on Global Affairs’ Travel Vaccinations page.

It is also highly recommended that you visit a Travel Health clinic 6-8 weeks before travelling, in order to consult with specialists about any vaccinations or medications that you might need for your trip. Some vaccinations may require multiple doses, so it is important to make an early appointment. The University of Toronto’s Health & Wellness Centre is a certified Travel Medicine Clinic, or you can take a look at this alternative list of travel health clinics in Toronto.

When you visit the travel health clinic, remember to bring:

  • Your full travel itinerary (layovers can also bring additional requirements)
  • Your immunization record
  • Any other documentation as required by the clinic

If you are taking any medication, you should make sure the health care provider knows, in case of any possible interactions with the vaccinations.


Useful Links:

https://travel.gc.ca/travelling/health-safety/vaccines

https://studentlife.utoronto.ca/service/travel-immunizations-and-education/

http://www.travelhealthclinics.ca/Travel-Health-Clinics/Ontario/Toronto/Travel-Clinics-Toronto.aspx

When preparing to take medication overseas, remember:

  • Check whether the medication you would like to bring is legal in your destination.
  • Check ahead of time what to pack in your carry-on and what to pack in your checked baggage.
  • Do not try to save luggage space by taking medications out of their packaging.
  • Pack all medications in your carry-on baggage in their original, labelled containers.
  • Bring an extra supply of medication in case you are away for longer than expected.
  • Pack your prescriptions: Carry a copy of the original prescription and ensure you have both the generic and trade names of the medication. The Government of Canada also recommends bringing a doctor’s note describing why you are taking the medication, especially if it is not a common medication.

As it can be more complicated to purchase medical supplies while overseas, you may also want to bring a travel health kit. This travel health kit could include:

  • Basic first aid items such as bandages, antiseptic wound cleaner (e.g. alcohol pads), antibacterial cream, blister pads, latex gloves, gauze, rehydration salts, safety pins, scissors, sprain bandages, tweezers, a thermometer…
  • Medications that you regularly use (over the counter, prescription, allergy medications, etc)
  • Anti-diarrheal medication
  • Motion-sickness medication
  • Pain and/or fever medication
  • Any destination specific medications that you are recommended by a doctor
  • Sunscreen
  • A copy of your prescription for your glasses or contacts
  • Insect repellent
  • Proof of your insurance coverage
  • A copy of your immunization records

For more information about packing a first aid kit, see the “Physical Health and Wellness” tab above.


Useful Links:

https://travel.gc.ca/travelling/health-safety/medication

https://travel.gc.ca/air/what-to-pack

Mental Health and Wellness

Travelling and studying abroad can trigger mental health issues such as stress, depression and homesickness. Learn how to take care of your mental health by recognizing symptoms and learning strategies to cope with mental health issues.


While overseas, you should be aware of some changes that may trigger mental health issues, so that you can better prepare to deal with them.

Support: For many students, going abroad represents their first real separation from family and friends, and thus from the regular support systems of home. When something negative happens or news from home is not good, you may not have the same level of support as before.

As well, if you are in a different time zone from home, you may find that your contact with your family and friends is more fragmented than before. You may begin to feel isolated and frustrated, especially if you feel unable to solve problems at home.

A good idea may be to pre-arrange a “check in” time with family and/or friends, when both of you will be free to call, video chat, or message back and forth about what is going on. Especially if you are travelling alone or feeling lonely, you should make sure that you have these pre-arranged times to talk with your support from home.

Environment: Adjusting to differences in housing, food, and water can cause significant adaptation strain, creating physical stress on the body that in turn can tax mental functioning (e.g., difficulty concentrating, remembering, etc.).

Along with physical stress, you may experience the effects of culture shock, as you adjust to a new linguistic and/or cultural environment. No matter whether the adjustment is physical or mental, both can place significant strain on your mental wellness, as you try to keep up with the changes.

Regular Routines: Part of the excitement of going abroad is that your regular patterns of living change entirely. Your sleep patterns, diet, and exercise routines may all change, which may in turn affect your mental health.

There are so many new things to do, so many new places to see, that you may find your schedule tightly packed, well into the night. However, sacrificing sleep or down time is never a good idea. Jet lag can further aggravate your sleep patterns and mental health, especially when time zone differences are large. Make sure that you are getting enough sleep and relaxation time, so that your body and mind can take a break and process what is happening.

Your physical health can also be affected by changes in diet and exercise. While travelling we tend to dine out more frequently, or our meals are increasingly irregular. Another issue with travel is hydration: you may be active for more hours than before, and as a result your body will require more water. Avoid dehydration by ensuring that you are drinking water regularly.

In short, if your schedule is a busy one, ensure that you still have adequate rest, hydration, and calorie intake.

Homesickness: Everyone who leaves familiar environments for a significant amount of time will experience homesickness, the sense of longing to return to the familiar. Feeling homesick is normal, and other exchange and international students, or expats, will likely be experiencing or have experienced similar levels of homesickness. Even if they appear completely confident, if you mention homesickness to them, they likely have similar feelings.

In many occasions, as you make more friends and begin to adjust, you may find your homesickness weakens. If, however, your homesickness reaches the level that you begin to feel more deeply unhappy, you can always access further resources to discuss your experience in more detail.


All of these issues can impact mental health, and if you find that your mental health is suffering or becoming increasingly worse, let someone know.

Check the Resources tab for a list of resources available to you both overseas and at the University of Toronto.


Useful Links:

https://studentlife.utoronto.ca/service/mental-health-care/

https://studentlife.utoronto.ca/service/myssp

Dealing with mental health issues is complex, and there is no one solution for all. However, there are some tips that can help you manage your mental health if issues start to arise:

  • Beware of signs and symptoms of stress that could range from behavioral signs to emotional outbreaks.
  • To cope with stressful situations, bring yourself something that reminds you of home.
  • Write a blog or journal describing your experiences and feelings. Sometimes writing something down can make you feel less stressed.
  • Stay active in your host country- join clubs, social circles and activities.
  • Familiarize yourself with people in the new environment.
  • Give yourself regular breaks and don’t be too hard on yourself. We are our own worst critics.
  • Make sure to stay hydrated, get enough rest, and ensure you are eating well and regularly.
  • In emergency situations, contact the CIE or the health and wellness unit at your host institution.
  • For immediate and/or ongoing support, MySSP (001-416-380-6578) provides confidential, 24/7 support in more than 140 languages. You can access help and advice by phone or by chat, either by downloading the MySSP app (Apple App Store/Google Play) or by calling 001-416-380-6578 (outside of North America). In North America, you can call 1-844-451-9700.

Adjusting to a new environment and culture takes time, and is not always easy. You will likely have difficult days. You may also react differently over time: when you first arrive you may enjoy the newness and excitement of an unfamiliar everyday life, but you may become more uncomfortable when you discover that you are unable to communicate, socialize, or feel as accepted in your new environment. This realization can lead to frustration, anxiety, or even rejection of a different culture.

This culture shock is completely normal, as adjustment to a new culture is generally seen to follow a curve.

An image of a graph demonstrating the information described in the text

(Source: https://en.wikipedia.org/wiki/File:Acculturation_curve_and_culture_shock.svg)

During the honeymoon period (1), the newness of the host culture is exciting and interesting. Every day you can experience things that you have never experienced before.

However, over time, differences between the host culture and home culture become increasingly apparent, and you may become increasingly frustrated. In this negotiation stage (2), you may withdraw from the host culture and feel homesick, anxious, and/or lonely. During this stage, many students struggle with language barriers and cultural differences.

After another few months, you will likely enter an adjustment stage (3), in which you have grown used to the patterns of life in your host culture and the host culture has become normal. By this point, you are probably used to navigating a different language and/or culture and have developed a regular routine.

Finally, when you return to Toronto, you may experience Reverse Culture Shock (4), in which the idealized image of home that you developed while away contradicts with the reality of returning to your previous everyday life. During this time, you may feel frustrated and wish to return overseas.

While culture shock (and reverse culture shock) are unavoidable, there are some things you can keep in mind to lessen its effects:

Be patient with yourself. Much of the initial frustration and anxiety from living overseas comes from the pressure we put on ourselves to fit in as soon as possible. Try to remain open-minded and willing to learn and adapt.

Don’t hesitate to reach out for support. If you see the following signs, reaching out might be a good idea:

  • Feeling “off”
  • Irritability
  • Feeling isolated or withdrawn
  • Change in eating and sleeping habits
  • Fatigue or depression
  • Negative stereotyping of the local people

Talk to fellow travelers, chat with your hosts, and call International SOS or Safety Abroad for support.

There is no way to prevent culture shock, but to reduce culture shock as much as possible:

  • Prepare: Research the customs and culture as much as possible, so that you can anticipate any challenges that may arise and develop strategies to adapt. Consider that you may also be part of different educational, work, or social cultures as well.
  • Be Open: Part of the reason that the difficulties you face increase over time is that you are experiencing more and more of the new culture. The more you get involved, the stronger affect any cultural differences will have.
  • Keep Mentally and Physically Healthy: Travelling puts a lot of physical and mental strain on you. Keeping a healthy lifestyle can be difficult when you are trying to combine study and fun, but try to get enough sleep, eat healthy, and give yourself some quiet relaxation time
  • Keep a Journal: try keeping a travel journal or blog. Recalling your goals can help put some challenges into perspective, and you have a great memento at the end!
  • Connect with Others: reach out to family and friends at home, find ways to build connections with locals or expats in your host country, and contact U of T Safety Abroad when you would like additional support

 

Additional Tips:

  • If you are feeling particularly frustrated, one method to reduce your frustration is to ask somebody local who has visited your country about what they found the most shocking. It may be that they found your culture just as shocking as you are finding theirs. Opening up such a conversation may help you better understand what has been frustrating you.
  • Keep a sense of humour! When you are making frequent mistakes, it can be very frustrating, but if you are able to laugh at the absurdity of not knowing or at such differences, you will be able to move beyond mistakes with a new perspective.
  • Remember that it is not just you – if you feel homesick or anxious, talk to others who are travelling with you as well. It’s highly likely that they are experiencing, have experienced, or will experience similar feelings.

As a student of the University of Toronto, you have access to many mental health resources, both at home and while overseas.

While overseas:

MySSP (001-416-380-6578) – provides immediate and/or ongoing confidential, 24/7 support in more than 140 languages. You can access help and advice by phone or by chat, either by downloading the MySSP app (Apple App Store/Google Play) or by calling 001-416-380-6578 (outside of North America). In North America, you can call 1-844-451-9700.

International SOS (+1-215-942-8478) – offers free counselling sessions and advice to University of Toronto students. Simply call and say that you are a U of T student. International SOS may also be able to help with finding a mental health professional in your area.

Campus Police (+1 416-978-2222) – call the 24/7 hotline to be put in touch with Safety Abroad and/or other resources at the University of Toronto.

Centre for International Experience (+1 416-946-3929) – during regular hours (9-5 weekdays, Toronto time) you can also call the CIE to connect with resources on campus. Please leave your name, student number, and call back number if you are unable to speak to someone immediately.

While at the University of Toronto, as well as the above resources, you can also access:

911 – if you are at immediate risk, directly call 911 for help.

MySSP (844-451-9700) – immediate and/or ongoing confidential, 24/7 support in more than 140 languages. You can also access help and advice by chat by downloading the MySSP app (Apple App Store/Google Play).

Good2Talk (1-866-925-5454) – free, confidential, 24/7 access to professional counselling and information for all post-secondary students in Ontario. You can also text GOOD2TALKON to 686868 to access support via text messaging.

(St. George) U of T Health and Wellness Centre416-978-8030 (9-5, business hours)

(Mississauga) UTM Health & Counselling Centre905-828-5255 (9-5, business hours)

(Scarborough) UTSC Health & Wellness Centre416-287-7065 (9-5, business hours)

Further resources if you are feeling distressed.

Physical Health and Wellness

Travelling and studying abroad can put greater strains on our physical health – adjusting to changes in food and drink, possible time differences, and a sudden increase in activity and decrease in rest time can all affect our physical well being.


Part of the excitement of going abroad is that your regular patterns of living change entirely. There are so many new things to do, so many new places to see, that you may find your schedule tightly packed. If you are running between activities, you may find yourself sacrificing sleep, regular meals, or increasingly dehydrated.

Sacrificing sleep or relaxation time is never a good idea. Jet lag can further aggravate your sleep patterns, especially when time zone differences are large. As sleep is closely related to mental health, and as both your body and mind will be more active than usual while abroad, lack of sleep can have many negative consequences. Make sure that you are getting enough sleep and relaxation time, so that your body and mind can take a break and process what is happening.

Your physical health can also be affected by changes in diet and exercise. While travelling we tend to dine out more frequently, and our meals tend to be quite irregular. In fact, by not keeping a regular meal schedule, we can further aggravate the affects of jet lag. As well, your blood sugar levels may be affected, reducing your energy levels. While it may be tempting to skip meals, or rely on only one meal a day, try to keep to the same pattern of eating habits that you had at home.

Another issue with travel is hydration: you may be active for more hours than before, and as a result your body will require more water. Because you will be eating out more than usual, you are also likely to be eating foods with higher salt content. If you don’t get enough water, you will feel tired and you may have more headaches and sore eyes. Avoid dehydration by ensuring that you are drinking water regularly and eating water-rich snacks (e.g. fruit, vegetables, soups).

In short, while abroad, make sure to watch out for changes in your usual patterns of sleep, exercise, eating, and drinking. These changes are usually not negative, as long as you can find a way to compensate for them.

Resources: Staying Hydrated, Eating Well, Understanding Sleep

When travelling abroad, it is highly recommended to carry a travel first aid kit. You may not be able to easily buy first aid supplies and medications, or they may be different from those you are used to in Canada. As well, having basic first aid supplies on hand saves effort if you have a minor injury such as a graze or sprain.

A basic first aid kit generally includes:

  • Adhesive bandages (e.g. Bandaids) in multiple sizes
  • Alcohol-based hand sanitizer
  • Antibacterial creams to help wounds heal and prevent infections
  • Antihistamine cream/Hydrocortisone cream (to treat itchy skin, such as from bug bites)
  • Antiseptic wound cleanser (e.g. alcohol wipes)
  • Blister pads or bandages
  • Disposable latex or vinyl gloves
  • Gauze
  • Immodium salts or similar medication (for diarrhea, food poisoning)
  • Pain and fever medication (acetaminophen, ibuprofen, or similar)
  • Rehydration salts (especially if travelling to a hot region; travel health specialists often offer free samples)
  • Safety pins
  • Scissors (small)
  • Surgical tape (for holding gauze in place)
  • Tensor bandages for sprains
  • Thermometer
  • Tweezers
  • Your immunization record
  • Emergency information, such as emergency numbers and contact information for your family members in Canada
  • Your insurance provider’s contact information

You may also want to include some medications, such as:

  • Any medication (prescription or over-the-counter) that you regularly use
  • Allergy medication
  • Anti-motion sickness medication
  • Cold and flu medications (e.g. cough lozenges, decongestants)
  • Stomach and intestinal medication, such as antacids
  • Destination-specific medication (e.g. altitude sickness, malaria)
  • Any needles or syringes you may use for treatments – make sure to carry a letter or certificate from your health care provider explaining how you will use them

Make sure to bring enough medication to last your entire period overseas. Bring an extra supply in case you are away for longer than expected. If you are carrying an amount that border officials might consider suspicious, ask your doctor for a letter to explain it.

Depending on your destination and situation, you may also want to consider:

  • Suncream
  • Sunscreen
  • Condoms
  • Birth control medication
  • Ear plugs
  • Extra pair of glasses or contacts (and your prescription)
  • Insect repellant
  • Mosquito nets for sleeping
  • Eye drops
  • Water purification filters or tablets

Especially when carrying medication, make sure everything is in its original packaging. Check ahead of time if such medication is permitted in your destination – even regular over-the-counter medications in Canada can be considered illegal substances in other countries.


More information: the Government of Canada’s Travel Health Kit page

Water quality in other regions can be very different from what we know in Canada. Make sure to research your destination ahead of time and note any possible issues with water sources.

If you are travelling to a destination with poor water quality, you may want to ask if the tap water is safe. If tap water isn’t safe to drink, how about brushing your teeth or showering?

Locals may be less concerned about the water quality, unaware of the effect it has on their health, or may have built up immunity. In these cases, it may be better to rely on the advice of expats or fellow travelers.

Contaminated water does not just affect drinking water:

  • Ice cubes and crushed ice is frequently made from tap water – if you are ordering a drink with ice, make sure to ask whether it is made from purified water
  • Avoid eating raw fruits and vegetables, including salads – they could be rinsed in contaminated water and there is no way to sterilize them
  • Fruits that must be peeled are generally safe
  • Boiled water is generally safer, but must be kept boiling for at least two minutes. The temperature at which water boils changes by altitude, so the 100°C rule may not apply to your destination.
  • Keep in mind that smoothies, juices, and other drinks may be made with water
  • Ensure that cutlery and plates have dried before being used
  • When buying bottled water or drinks, check the source of the water – is it local?

Remember – even if somebody is offering you a drink, it is not rude to decline it with a polite “My stomach cannot handle it” or “My stomach is too weak”. Most of the time your hosts will understand that there is a difference between water in Toronto and in your destination. Do not feel you have to take the risk of drinking contaminated water in order to not upset your hosts. They will be more upset if you get sick!


Useful Links:

https://travel.gc.ca/travelling/health-safety/food-water

For better or worse, the food you find abroad may be quite different from what you are used to at home. Be curious and do some research! You should be able to try foods from almost any country at one of the many regionally specific restaurants in Toronto. Know in advance what typical meals consist of and the customs regarding dining.

If you have any specific dietary needs, you may need to be able to communicate them in the local language.

For example, if you are vegetarian or vegan, learn how to make clear what that means to you. For many people, and in many cultures, “vegetarian” has a different meaning, so make sure to clearly explain what you can and cannot eat.

If you have an allergy If you have allergic reactions to something, you should learn how to explain your allergy in the language of your destination. Knowing how to say “I am allergic to…” and “I can’t eat…”, as well as “Are there… (in this)?” could save your life.

  • If you have an Epi pen or other allergy medication, ensure you bring enough medication for the duration of your trip and/or for several emergency uses.

Be sure that the food you are eating is safe. Raw food, unpasteurized milk, fish and seafood can be dangerous if not prepared correctly. In general any fruit that you peel is safe. Well cooked, hot foods tend to be safer than uncooked foods such as salads.


Useful Links:

https://travel.gc.ca/travelling/health-safety/food-water

In many destinations, the air quality is the most unavoidable part of travelling. In some major cities, such as Beijing, Jakarta, Mexico City, or Mumbai, you can practically taste pollution in the air on bad air days.

If you have asthma or emphysema, you may wish to limit your exposure to cities with high levels of pollution. You will definitely want to bring an adequate supply of inhalers and other medicines. Before travelling somewhere with poor air quality, consult with your doctor.

While respiratory problems can worsen in bad air pollution, anyone can feel the effects of air pollution in a short period of time. Most major cities have public health warning systems in place – if you are travelling to a place known for its poor air quality, make sure to review these systems before leaving and subscribe to them (if possible) upon arrival.

Besides searching online for the air quality rating of your destination, you can also take a look at data maps such as those supplied by the World Air Quality Index.

In general, in areas with high levels of air pollution, you may wish to avoid too much outdoor activity. During times of high concentrations, you should avoid activities that involve deep breathing (e.g. cardio) and follow guidelines laid out in the local advisories.

You may find yourself in a location at an altitude to which you are completely unaccustomed.

Climbing to high altitudes has very specific health risks, and you should consult an expert before doing so. Use only reputable guides and do not rush yourself or push yourself further than your body can handle. In general, it is necessary to rest every 3,000 feet or so. Carefully monitor yourself for signs of altitude sickness, exhaustion, dehydration, and hypothermia.

Altitude sickness occurs when oxygen levels in the air are lower than the levels to which you are accustomed. The symptoms of altitude sickness may include headaches, vomiting, tiredness, trouble sleeping, and dizziness. The risk of altitude sickness is generally not related to your physical health, but rather to a rapid increase in altitude. As a result, if you begin to feel ill, you should notify your travel companions immediately, even if you feel confident in your overall physical health.

You may be at a higher risk of danger if you have had trouble with altitudes in the past, have recently gone scuba diving (in the 24 hours before climbing), or have other health problems. Consult with your doctor if you might be at risk.

If you begin to experience altitude sickness or other issues, you should talk to the guides or leaders of the climb. You may need immediate medical attention.

While reviewing the Travel Advisory for your destination, you will notice that there is a specific section for Insects in the Health section. Common illnesses related to insect bites include diseases such as dengue fever, malaria, tick-borne encephalitis, Yellow Fever, and Zika virus. The most prevalent disease will depend on your destination.

You may need to get vaccinated before leaving Canada for one or more insect-borne diseases, so you should check with a travel health specialist beforehand. For example, many countries worldwide require proof of Yellow Fever vaccination for entry.

You should also keep in mind what you will be doing at your destination. If you are frequently travelling to areas where insects are prevalent (e.g. the countryside), you may need to take additional precautions, including additional vaccinations.

In general, you should take precautions to avoid getting bitten by insects:

  • Learn what types of insects are common in your destination and the symptoms of any illnesses related to them
  • Know peak biting times when insects will be most active (both time of day and season)
  • Check where insects carrying diseases are commonly found and minimize your time in those areas
  • Minimize your outdoor exposure, and use insect repellents when travelling to areas where insects are prevalent
  • Wear light-coloured, loose clothing with tight weaves in the material
  • Wear long pants and long sleeved shirts, closed-toe shoes, and hats
  • For extra protection against crawling insects like ticks, tape the cuffs of your pants, or tuck them inside your socks or shoes
  • Choose the appropriate insect repellent for your trip and review how to use it safely
  • Remove any standing water (non-moving) near your accommodation to prevent mosquitoes from reproducing (mosquitoes lay eggs in standing water)
  • Read more about how to prevent insect bites

When sleeping outdoors or in unenclosed spaces:

  • Use a mosquito net without any holes or rips and tuck it underneath your mattress to prevent exposure at night
  • Avoid sleeping or spending time against the netting (to avoid getting bitten through the net)
  • Check nets regularly for any damage

When spending time in wooded or grassy areas:

  • Dress appropriately to reduce the risk of tick bites: wear long sleeves and pants, tuck your pants into your socks or shoes, and wear a hat
  • Know what a tick looks like – ticks are very small, and you may not be aware that you have been bitten
  • Review these helpful tips from the Government of Canada on preventing tick bites and what to do if you are bitten
  • Check for ticks on yourself, any children, and your equipment and clothing upon returning to your accommodations. When checking, remember that ticks especially prefer warm, moist environments.

Useful Links:

https://travel.gc.ca/travelling/advisories

https://www.canada.ca/en/public-health/services/diseases/insect-bite-prevention.html

https://www.canada.ca/en/health-canada/services/about-pesticides/insect-repellents.html

https://www.canada.ca/en/public-health/services/publications/diseases-conditions/lyme-pamphlet.html

After living in Toronto, you have likely experienced the freezing cold of winter, but if you are travelling to a location with cold weather, you should still be aware of the risks. In particular, you should know how to identify the symptoms of windburn, frostbite, and hypothermia.

Before travelling, research the climate in your destination and make sure that you bring appropriate clothing. Keep in mind that you will likely spend more time than expected outside, as you’ll be exploring.

A picture of a snowy road in the middle of a snowstorm.

Windburn is caused by cold winds blowing against your skin, resulting in excessive dryness, redness, soreness, and/or itchiness. To treat windburn, do not scratch or rub the affected area, and instead apply skin care products and lip balm to moisturize affected areas.


Frostbite usually begins in your hands, feet, nose, and/or ears. In mild frostbite, your skin turns yellow or whitish, but it is still soft to the touch. Normal colour will return once the area is warmed. Severe frostbite can cause nerve damage, loss of feeling in the affected area, discolouration, and blisters.

To warm yourself up, move to a warm area, wrap yourself in blankets, or share body heat with another person. You can also place the injured skin in water that is just above body temperature. DO NOT use hot water, or rub, massage, or shake the injured skin, as this can cause further damage. If you have severe frostbite, begin warming yourself up, but you should also call for help.


Hypothermia happens in three stages, as your body temperature drops:

  1. You begin shivering, get goose bumps, and your hands become numb. You may start shallow breathing, or feel tired and/or sick. If you suddenly begin to feel warm, without going into a warm environment, this indicates you are entering Stage 2.
  2. You have severe shivering. Your movements may be slow and laboured. You may experience mild confusion, become pale, and your lips, ears, fingers, and toes may turn blue. You can test if you are experiencing Stage 2 by trying to touch your thumb to your little finger. If you can’t, your muscles are not working properly.
  3. You have trouble speaking, thinking, and walking. You may even experience amnesia. At this stage, you need immediate medical attention.

At Stage 2 or 3, you should immediately call your local emergency number for help.  If you are experiencing Stage 1, or waiting for help, you should find shelter, keep your muscles moving, and try hard to keep your body warm. Make sure you are dry, wrap yourself in clothing, drink warm, sweet liquids, and/or reheat yourself through skin-to-skin contact with another person.


In short, do not ignore warning signs. If you find yourself shivering, or that you can’t feel your hands, feet, nose, and/or ears, you should take immediate steps to warm yourself

Read more about how to prevent cold weather risks.


Useful Links:

https://www.canada.ca/en/health-canada/services/healthy-living/your-health/environment/extreme-cold.html

Depending on your destination, you may be exposed to a hotter climate than you are used to in Toronto. Even if the climate is similar to Toronto’s, you are likely to be outside in the heat more than usual as you explore, so you should still be aware of how heat may affect your health.

Heat illnesses can affect your body quickly and can lead to longer-term health problems, or even death. Before travelling, you should make sure to pack clothing appropriate for your destination. If you are taking medication or have a health condition, you may want to ask if your medication increases your health risk in the sun, especially when exposed to UV rays.

A bright sun shining through the clouds, to represent the burning heat of summer.

Health Canada suggests 5 steps to prevent heat related illnesses:

  • Stay Prepared – Regularly check forecasts to plan ahead, make sure your air conditioning and fans work, or if you don’t have them, plan where you can go to cool off. Make sure you have a supply of cool drinks. If you are going out for the day, bring drinks with you to stay hydrated.
  • Stay Aware – Watch for symptoms of heat-related illnesses, including dizziness/fainting, nausea, headaches, rapid breathing and heartbeat, extreme thirst, or decreased urination. If you have any of these symptoms, move to a cool place and drink liquids (water is best). You can help other people by moving them to a cool place, applying cold water to their skin or clothing, and fanning them.
  • Stay Hydrated – Drink before you feel thirsty! Remind yourself to drink water regularly, eat more fruits and vegetables for their water content, and if you don’t feel like eating, try to drink even more water.
  • Stay Cool – Dress for the weather in loose fitting clothing and a wide-brimmed hat, take regular breaks from any physical exercise and don’t push your body too far. Keep the sun blocked out of your accommodation by closing curtains during the day, take cool showers, and try to spend time in cool places.
  • Stay Safe – Reschedule activities for cooler times of the day or other times, avoid sun exposure, wear sunglasses, and apply sunscreen with a SPF rating of 15 or higher.

Above all, stay hydrated, wear appropriate clothing for the climate, and pay close attention to what your body is telling you.

Read more about sun and heat safety while travelling.


Useful Links:

https://travel.gc.ca/travelling/health-safety/sun-tips

https://www.sja.ca/English/Safety-Tips-and-Resources/Pages/Heat%20Stroke/heat-stroke-symptoms-and-first-aid.aspx

https://www.canada.ca/en/health-canada/services/sun-safety/extreme-heat-heat-waves.html