In Nigeria, very few medical services are free of charge, and if you can’t pay your hospital bill you may not be allowed to leave. Who will help? In this deeply religious society, many stranded patients hope for divine intervention.

Zeal Akaraiwai does not have the wings of an angel – he has a sleek black Mercedes, all purring engine and deep leather seats. This 40-something financial consultant – trim and neat – steps out of his car in a potholed government hospital car park in Lagos. He is greeted warmly by a team of social workers, and gets straight to business. He asks them for “the list”.

Neatly printed on A4 paper are the names of patients who are well enough to go home. But they are not going anywhere, because they cannot pay their medical bills.

Zeal has met people who have been forced to stay on the ward for six – or even eight – weeks after they have been discharged. Some Nigerian hospitals set up instalment plans, but even the first instalment might be too onerous for those earning a pittance, or nothing at all.

Heading along crumbling walkways to the wards, Zeal listens intently to the social workers’ running commentary about those he is going to meet. In a male ward the tiles underfoot are scuffed, the paint peels, and 20 beds line the walls. Ancient fans whirr overhead, and the nurses wear epaulettes on the shoulders of starched white uniforms. An orderly is sweeping up with a dustpan and brush. Everybody is doing their best in challenging circumstances.

The social workers guide Zeal to the bedside of a patient with a heavily bandaged thigh. He bends down close, and speaks in a low voice: “What happened to you?” The young man, a barber, says he was shot by he-doesn’t-know-who.

“So how’re you going to settle your hospital bill?” asks Zeal. “I’m praying to God,” the man replies.

Zeal chats to him for a while – the man does not ask who Zeal is, and Zeal does not tell him. Then, out of earshot of the patient, Zeal checks the man’s story with the nursing staff. The bill is $250. And the barber is in luck – Zeal will pay it. Later today, the patient will go home.

Zeal does not keep in touch with any of the people he helps. He does not even want to be thanked. But there is one thing he would like in return – that one day they might tell a story about him: the story of how when they were in hospital, an angel came, paid their bill and left.

“That’s why I call this the Angel Project,” he says. “Be the angel you hope to meet.”

Paying the fees of hospital patients who are not able to settle their bills is one of the ways that Zeal realises his Christian faith. He says he wants to show people that everyone can do something to help someone else. Zeal’s friends and family also give him money for the project, and he keeps receipts in a neat black book, together with details of the patients whose bills he’s paid.

In the women’s ward, Zeal is taken to see a patient in her 60s who is unconscious and on oxygen. She has had a serious stroke. The social workers want Zeal to pay the bill she has run up so far, so she can be moved to an intensive care unit for specialist treatment. He shakes his head, and moves away from her bedside.

Outside in the corridor, the woman’s daughter joins him. She is young – and resigned. Zeal quizzes her about the health of her mother. It seems that even if the bill is paid here, it will be just the first step on a very long haul – if indeed the patient survives. Zeal speaks kindly to the young woman, and says he is sorry. She thanks him, smiles, turns, and goes back to watch over her mum.

Paying for this woman’s treatment would mean breaking Zeal’s own, self-imposed, rules – he does not generally help anyone with a serious, on-going condition. The Angel Project pays for those who are well enough to go home immediately.

“Of course, sometimes I digress,” he says.

He remembers Montserrat – a woman who bled for 11 months because she needed a hysterectomy. Zeal paid $400 for her operation. And on today’s visit to this public hospital, there is a good deal more digression.

The Angel Project picks up the tab for a patient who needs a leg ulcer operation, and Zeal wants to know about the progress of a 10-year-old who is awaiting further intestinal surgery. He has paid for her treatment so far, and will continue to do so until she returns home. The social worker says the child is doing very well.

Zeal has met this little girl, but he does not want to see her again. “She has my son’s eyes,” he remembers.

Today, Zeal visits everyone on the social workers’ list. He heads out to the cashier to settle the bills of eight patients. His hospital philanthropy always makes him feel sad, and he is angered by the failure of government.

“The mere fact an individual, like me, has to go into a hospital to pay the bills of people who are stranded speaks volumes about the injustice in the system,” he says. “There’s no reason why we cannot have proper health insurance. We have clever people who can think of schemes that can work.”

In Nigeria only 5% of the population is covered by health insurance. There is scepticism about how a universal scheme might operate, given the huge disparities of wealth, and the millions of poor people whose contributions would have to be covered by the state. But Zeal is impatient.

“Every week I see the impact of not having compulsory health insurance, and people die. So where do you want to put the price of a human life?”

 

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email marketing@relocationafrica.com, or call us on +27 21 763 4240.

Sources: Linda Pressly via BBC  [1], [2]. Image sources: Grace Ekpu [1], [2].

UK immigration minister, Caroline Nokes, recently made a number of surprising announcements as the country prepares to make visa reforms.

Below, Breytenbachs Immigration Consultants broke down some of the most important changes and what they will mean for South Africans.

Tier 1 Entrepreneur visa to be replaced by innovator route

The current Tier 1 Entrepreneur route will be replaced by a new Innovator route, for more experienced business persons.

It will have a “similar emphasis on endorsement by a business sponsor, who will assess applicants’ business ideas for their innovation, viability and scalability”.

“We subsequently encourage applicants who still want to apply under the current Tier 1 Entrepreneur route, to contact us without delay,” Breytenbachs said.

New start-up visa route

Earlier in 2018, the UK Government announced that it will establish a new Start-up visa route. This route will build on the Tier 1 Graduate Entrepreneur route.

Applicants under this new route will have to be endorsed by either a business or higher education institution sponsor.

No clarity on Tier 1 investor route

The UK Government announced on 6 December 2018 that the Tier 1 Investor route is suspended.

It added this route will from 7 December 2018 no longer be open for applicants to apply, and that new rules will be put in place sometime during 2019.

However, the Home Office has since released an official statement to the Immigration Law Practitioners’ Association (ILPA) stating the following:

“The Tier 1 (Investor) visa is not currently suspended. However, the Government remains committed to reforming the route. A further announcement will be made in due course.

“Any suspension would be implemented through changes to the Immigration rules.”

Tier 1 exceptional talent extended to architects

The Tier 1 Exceptional Talent route will be expanded to provide for the inclusion of leading architects.

These architects will have to be endorsed by the Royal Institute of British Architects, under the remit of the Arts Council England.

Tier 5 religious and charity workers

Tier 5 Religious Workers and Tier 5 Charity Workers will in future have a cooling off period.

This cooling off period will prevent them from returning to the UK for 12 months, on another Tier 5 visa. This step is taken to underpin the fact that this is a temporary route.

 

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email marketing@relocationafrica.com, or call us on +27 21 763 4240.

Sources: [1], [2]. Image sources: [1], [2].

The reversal of the unabridged birth certificate rule is just one of the many changes implemented by the Department of Home Affairs.

South Africa will implement some changes to its visa system in December 2018 which will likely impact tourism and immigration procedures.

This was revealed by the Department of Home Affairs, which recently published its regulatory amendments pertaining to the Immigration Act of 2002. This official government notice, published on 29 November, has been reported on by Business Tech in the wake of former Home Affairs Minister, Malusi Gigaba’s, disgraced exit from the department.

No more unabridged birth certificates

While Gigaba’s dubious tenure came to an abrupt halt following serious allegations of corruption, mismanagement and Constitutional violations – his time as Home Affairs minister will forever be stained by the unabridged birth certificate debacle. This rule, which required minors entering or leaving South Africa to produce an unabridged birth certificate, has been overturned.

The controversial rule, implemented by Gigaba during the start of his term, allegedly cost South Africa R7.5 billion due to a noticeable drop in lucrative the tourism sector.

The reversal of the unabridged birth certificate rule is just one of the many changes implemented by the Department of Home Affairs, due to take effect on 1 December. Let’s look at some other revised regulations which will affect the visa system in South Africa.

Spousal visa for entering South Africa

Visa applications concerning spouses in a “permanent homosexual or heterosexual relationship” have been revised in the latest amendment of the Immigration Act. The adjustments to the regulatory act define new policies relating to the rights of spouses entering South Africa. The notice makes a few important points:

  • Applications need to prove to the Director-General that the applicant is a spouse to a citizen or permanent residence permit holder.
  • Applicants need to sign an agreement stating that the permanent homosexual or heterosexual relationship has existed for at least two years before the date of application for a relevant visa and that neither of the parties is a spouse in an existing marriage.
  • Documents detailing the financial support the partners provide to each other need to be provided.
  • Both partners to a permanent homosexual or heterosexual relationship may be interviewed separately, on the same date and time, to determine the authenticity of the existence of their relationship.

Travelling with a child

Revised regulations relating specifically to children in transit have been noted in the Department of Home Affairs’ document. In addition to no longer needing an unabridged birth certificate, here are some points for parents and guardians to be aware of when travelling to and from South Africa.

Parent(s), legal guardians, or any other person travelling with a child who is a South African citizen, must produce the following before departing or entering South Africa:

  • a copy of a birth certificate or passport containing the details of the parent or parents of the child
  • a letter of consent from the other parent or parents of the child authorising such person to depart from or enter South Africa with the child he or she is travelling with
  • a copy of the passport, or identity card in the case of South African citizens, of the parent or parents or legal guardian of the child
    the contact details of the parent or parents, or legal guardian, of the child
  • a copy of a court order granting full parental responsibilities and rights or legal guardianship in respect of the child

An unaccompanied child must produce the immigration officer with the following:

  • a copy of his or her birth certificate
  • a letter of consent from one or both his or her parents or legal guardian, as the case may be, for the child to travel into or depart from South Africa
  • a copy of the passport of the parent or parents or legal guardian of the child
    the contact details of the parent or parents or legal guardian of the child
  • a letter from the person who is to receive the child in the country, containing his or her residential address and contact details in the country where the child will be residing
  • a copy of the identity card or valid passport and visa or permanent residence permit of the person who is to receive the child in the country

General work, business, and corporate visas

Visa revisions have also been made concerning foreigners who intend to establish a business or invest in a business that is not yet established in South Africa. These revisions include providing detailed account information and registering with various state institutions, including SARS and the Unemployment Insurance Fund.

Applications for general work visas have also been revised and must include a letter issued to the prospective employer by the Department of Labour stating that:

  • despite a diligent search, the prospective employer has been unable to find a suitable citizen or permanent resident with qualifications or skills and experience equivalent to those of the applicant
  • the applicant has qualifications or proven skills and experience in line with the job offer
  • the contract of employment stipulating the conditions of employment, signed by both the employer and the applicant, is in line with the labour standards in the Republic and is issued on condition that the general work visa is approved.

Corporate visas also need to pass through the Department of Labour, following a similar process by engaging integral state institutions.

To make use of the Department of Home Affairs’ e-services, click here. To find your nearest Home Affairs office, click here.

 

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email marketing@relocationafrica.com, or call us on +27 21 763 4240.

Sources: [1], [2]. Image sources: [1], [2].

Special thanks to Mandi Schmitt (Go Overseas) for the below insights.

The minute you land in your new study abroad country, you’re busy taking in the newness around you. You’re smiling at the street vendors selling fruit on every corner. You’re captivated by the sudden openness of the people around you. Or perhaps you’re noticing a discreet segregation of genders, ages, or confused by why your host mother shies away from some of your questions. This, brave study abroad student, is called culture shock.

Many people who have traveled more extensively than a brief vacation have heard the term. Whether you’ve just long ago been bitten by the travel bug, or are heading off on your first time abroad, you’ll need to understand culture shock and how to cope with it on your study abroad trip.

What is Culture Shock?

Photo credit: Rod Waddington via Flickr.

When you study abroad, your daily routine, culture, and the attitudes of people around you are no longer familiar. The process of recognizing, understanding, and adapting to these changes is called culture shock.

In our normal environment much of our behavior, like gestures, tone of voice, how we wait in lines (or don’t wait), and interact, rely on collectively understood cultural cues. However, we don’t actively pay attention to these — they’re our unspoken norm.

In a new country, we become more aware of these cultural subtleties because they are different from our norm.

You may not literally be shocked, but this act of feeling disoriented and processing new ways of life, attitudes, and cultural norms is by definition culture shock. There are four stages of culture shock:

  • Initial Euphoria / The Honeymoon Stage – After first arriving to a new place, you’ll likely be caught up in all the wonderful things your new chosen home has to offer. During this stage, you are more likely to recognize cultural similarities and be charmed by the differences.
  • Irritation and Hostility / The Negotiation Stage – Gradually, the euphoria will diminish. You’ll get lost. You’ll get mad at the apparent “disorganization” of things. You’ll become overwhelmed with all the things you have to adjust to and either feel irritated or compelled to make things go “your way”.
  • Gradual Understanding / The Adjustment Stage – You’re finally able to relax. You’ve come to terms with your new home and have achieved a balance of emotions. Instead of feeling irritated, you’re understanding of differences. You’ll start to have a more positive outlook, interest in learning more about your host country, and make more effort to fit in.
  • Adaptation or Bi-culturalism / The Mastery Stage – Reaching a high level of comfort in your new home is the final stage of culture shock. The order of things makes sense, you can talk to strangers with ease, and you understand cultural nuances. Your routine is more natural. Sure, you still miss your friends and family, but your new friends and activities have become part of your daily life.

Culture Shock and Depression

In some cases, culture shock can resemble or trigger study abroad depression. If you fear you are on the verge of or already in this state, don’t try to get through it alone. Talk to your study abroad directors or volunteer coordinators. Don’t isolate yourself.

Tips for Dealing with Culture Shock

Photo credit: Nicolas Vollmer via Flickr.

So you understand what culture shock is and how to recognize it. Lets get down to real strategies and tips for dealing with culture shock.

1. Learn as much about your host country as possible
Read through travel forums, guidebooks, news reports, or novels. Talk to people who have been there or — better yet — are from there.

Get to know as much as you can about what’s considered polite or rude (for example, did you know it’s rude to step over someone’s bag in Madagascar?) and prepare yourself for some of the differences before you go.

2. Ask study abroad coordinators for advice
Specifically, ask them what other students have had a hard time adapting to and what they’ve done to cope. Each country has it’s own nuances, so you’re going to face a different situation in France as you would in Thailand. Ask those who know best!

3. Set learning goals for your study abroad trip
This may be obvious, but make sure you have goals for your study abroad trip, and make sure they include learning about your host culture. Do you love food? Make it a goal to learn how to cook a local dish.

4. Write down what you love when you first arrive, and look back later
During the honeymoon phase, write down all the things you love about your new host country (maybe even in your new study abroad blog?). Later, when you’re feeling frustrated or irritated, use this list to remind yourself of all the good things about your host country, instead of the things that annoy you.

5. Find a healthy distraction
Especially in stage two, when you may have negative feelings towards your host culture, find a healthy distraction. Take some time to yourself, watch an episode of your favorite TV show, cook a meal from home, or have a solo dance party in your house.

It’s OK to feel overwhelmed and need a break from your host country – just make sure it’s a healthy distraction.

Photo credit: The Visionary Agency via Flickr.

6. Talk to other students about how you feel
You’ll likely know other students who are studying abroad with you. Talk to them about how they feel about your host culture. Ask them about how they feel, strategies they’ve used to cope with cultural differences.

Also, learn from them. They may have figured out something you’re still confused about — like why everyone keeps saying a particular phrase or how to politely say “no” when your host mom insists you finish everything on your plate.

7. Push yourself to make local friends
Of course, you’ll learn even more if you make local friends. They’re experts in their own culture and will be able to explain all the crazy little questions you have. And if they’re a truly good friend, they’ll pull you aside and tell you if you’re unwittingly doing something offensive or weird. *Phew*!

8. Try to see things through your host culture’s eyes
Put on your anthropology hat, kiddos. After all, your anthro class is likely where you first heard about culture shock, right?

Throughout every stage of culture shock, try to put your own worldview in your pocket and try to understand the world the way your host culture does.

Maybe you don’t agree with some philosophies, and maybe it doesn’t make sense within your own cultural context, and it doesn’t have to. Just try to understand where they’re coming from. Ask questions, be non-judgemental, be an anthropologist!

9. Get involved with the local community
Part of your feelings of culture shock may be because you feel like too much of an outsider, so get involved in your local community as much as possible. If you went to church at home, go to church there. If you volunteered at home, find a volunteer project in your host city. Join a sports team, go to major festivals, and make this new home a home!

10. Make an effort to learn the local language
Even if your program is in English, make an effort to learn a few basic phrases (or more!) in the local language. It’s not just a way to understand more of the culture (language and culture are linked), but also to make friends, feel more included, and hey — it’s just fun!

So How Exactly Will It Affect Me?

Photo credit: Johnny Silvercloud via Flickr.

Culture shock affects everyone differently, and can manifest itself in a variety of ways. Largely, this depends on:

  • The countries you’ve previously traveled to … if any. Have you experienced new cultures before?
  • The country you’re now traveling in. How different is it from your own culture?
  • The purpose and structure of your current trip. Do you have someone to help you understand the new culture? Are you willing to learn and adapt?
  • How well you adjust to new situations. How do you generally react to being outside your comfort zone?

If you visit multiple countries that have similar cultural practices, over time, you may get more used to these, and your past experiences could help you adapt to the new cultures quicker.

Don’t Let Culture Shock Stop You from Studying Abroad

Study abroad isn’t all weekend getaways and late night parties. It’s a challenge, an introduction to a new culture, and an emotional roller coaster at times. However, it’s one worth taking. It’s an opportunity to come home with treasured memories, new friends, and a better understanding of who you are.

 

For information as to how Relocation Africa can help you with your Mobility, Immigration, Research, Remuneration, and Expat Tax needs, email marketing@relocationafrica.com, or call us on +27 21 763 4240.

Sources: Mandi Schmitt (via Go Overseas) [1], [2]. Image sources: Vitaliy Lyubezhanin (via Unsplash) [1], [2].