My final thoughts

The date today is July 5, and my daughter was supposed to be returning home in two days. If you have read the last few posts, you know that she came home almost three months early due to sickness. Certainly, my view of high school study abroad has changed dramatically over the last year, and I am going to end this blog with my final thoughts.

A year is a long time to send a teenager to another country to live with another family. I have asked myself multiple times, "would I still send my daughter knowing what I now know?" and the answers have been different depending on the day. The experience was good - in fact, life-changing - for her, but so many obstacles that could have been avoided were thrown at her.

Your child's experience will pivot on the quality of and fit with his/her host family. Therefore, you want to do everything possible to ensure that your child gets a host family that is able to support him/her during the entire experience, even if the unthinkable (like serious sickness) happens.  I would encourage you to find a program that has reasonable expectations for their hosting families. A year is a long time to have a teenager from another country in their home. Look for a program, such as Rotary Youth Exchange, that provides several host families over the course of the year. It may be hard to switch families, but each family is more likely to do a better job with your child if they know it is a shorter commitment. Another option is a true exchange, such as the Sister Cities or States exchanges. Families have a direct, one-to-one exchange, with your child staying with a family whose child will also come to stay with you. In my opinion, families in this situation are more invested in supporting your child because they know their child will be on the receiving end at some point. If neither of these options appeal to your child, consider a semester-long option. My daughter was psychologically ready to be gone a year, but a semester would have been much more reasonable given that so much is out of your control.

I would also encourage you to ask about the preparation students receive before going abroad. Youth For Understanding's (YFU) pre-departure orientation was minimal, of questionable quality, and often optional (like the pre-departure orientation in Chicago). Orientation needs to be standardized and required, so that each student gets the same information no matter the quality of their local volunteers. AFS does online orientation and in-person orientation in departure cities in the few days before leaving the USA. I would also ask about the preparation that host families receive. I want to know that families have a good idea of what they are signing up for.

If you cannot find an option that meets all your criteria, consider waiting until your child is in college. Study abroad options (and scholarships) abound in college, and your child does not have to be dependent on a host family.

High school study abroad programs advertise their success stories, but you should be aware that the success stories do not always match the experience your child will have. Programs will tell your child not to have expectations about what his/her experience will be like. I think you can stack the odds in your child's favor by carefully selecting the program your child travels with.

Health Insurance

Recipients of the Congress-Bundestag Youth Exchange scholarship were provided with health insurance through Hanse-Merkur the year my daughter stayed in Germany. An insurance information packet was sent to us about a month before she left. The packet was in German and English and about as easy to read as most insurance policies. What was generally clear to us is that emergency health care was available to our daughter during her trip, but that care for pre-existing conditions and routine/preventative care were not covered.

We also called our local health insurance company to see what coverage was provided through that policy. My understanding is that every company is different about providing coverage while abroad, so you should definitely call and ask. Our company would provide emergency coverage only. We would have to submit the bills, translated into English and converted to dollars in order to file a claim.

Prior to the flare of her Crohn's disease that sent her home, my daughter had seen a German doctor for an unrelated issue. She was expected to pay the doctor bill and then had to submit her claim for reimbursement to Hanse-Merkur.

The Crohn's flare was a different matter entirely. It involved two doctor's visits, medication, and 3 nights in a hospital. Because this incident could be blamed on a pre-existing condition, responsibility for paying the bill was unclear. About two months after her return home, a representative from YFU USA contacted us and asked what we wanted to do about the medical bills. They had been sent to her host family, who had forwarded them to YFU Germany. Hanse-Merkur wanted more information as they felt they were not required to cover these bills as part of a pre-existing condition. We did file a request for them to pay the bills since my daughter had been in remission for years before living in Germany. After waiting about one month, we received the news that Hanse-Merkur agreed to pay.

We learned a couple of important things during this process that may be useful if your child finds himself/herself in a similar situation.

1. Save all medical paperwork. Our daughter saved every piece of paper that was handed to her in the hospital or doctors' offices, and we needed every single one when we filed the request.
2. Your YFU rep in the national office will be your main (only) source of information. This person is the one who can provide translations of documents and explain procedures. Answer that person's emails.
3. Submit the request, even if you don't think they will pay.
4. Hospital stays in Germany are not nearly as expensive as they are in the USA. If your request for payment is denied, you will need to pay YFU USA (who will pay YFU Germany, who will pay the creditors) and then submit your bills to your health insurance (YFU USA said they would provide translated and converted documents if needed). We were anticipating over $10,000, but when we finally saw a total, it was slightly less than 3000 Euros (about $3,300 at the time).  

I sincerely hope that you never find yourself in this situation. However, it is better to be forewarned and prepared in case you do. Also, it is reassuring that YFU USA will help you out to the best of their ability. The answers may not come quickly, but they will work with you to resolve the issues.

Managing a chronic illness while studying abroad

In all honesty, I don't feel like the best person to address this topic since my daughter's Crohn's disease was not well-managed while she was in Germany. However, I can tell you what I wish we had done in the hopes of helping other students with a chronic disease who want to study abroad.

In the medical forms that need to be filled out as part of the application process, you will have to disclose any pre-existing medical conditions. A YFU representative contacted us before a host family was assigned to ask what special accommodations my daughter needed. We talked a bit about how she managed her disease at home (which was minimal), and we decided that she didn't need anything that the typical host family couldn't provide. My thought was, "it's Germany. They have doctors there, too."

I really wish I could go back and re-do that conversation. If I could, here is what I would say:

"She needs an experienced host family."

As many chronic illnesses are exacerbated by stress and change, a host family familiar with and able to mitigate the stress an exchange student faces would have helped a lot. Having to change host families after a month got her off to a shaky start. A host family who could recognize and deal with culture shock (as opposed to recognizing something "different" that might indicate a health issue) would have helped.

"She needs to live in a city with easy access to a specialist."

My daughter was living in a rural area, and when she became really sick, getting her to the specialist was unrealistic for her host family. If she could have easily gotten to the doctor, she would have felt like less of a burden.

"She needs a host family who understands a healthy lifestyle for someone with a chronic condition."

This includes knowing what a "bland" diet is (evidently difficult for many Germans to understand), exercising regularly (if appropriate for your child), and getting enough sleep. Many Germans (and indeed most Europeans) stay awake (in my opinion!) unreasonably LATE. Getting more regular sleep would have helped my daughter a lot. ( . . . and you telling them that by Skype tends not to be very effective.)

Being an exchange student is stressful, and removing the stress completely is impossible. However, we could have done more to ensure that she was adequately supported during the stressful times. I would also consider asking for a school placement where your child will have the opportunity to take many classes in English (unless your child is completely fluent in the language of the host country). A placement in an English speaking high school will not do much to help his/her language skills, but the stress would be lower, and that may mean the difference between successfully completing the exchange year and having to come home early.

Coming home. . . early

You may notice the large gap between this post and the last. There is a reason. The main purpose of this post is not to scare you with the possibility of your child returning home for medical reasons but rather to let you know what happens when it has to happen. We, as parents, all hope and pray that this situation does not happen to our kids, but I think the possibility lurks at the back of our minds at all times.

My daughter was diagnosed with Crohn's disease as an 11-year-old. It was very mild, and she was in remission for a long time. Because she had never had the typical Crohn's symptoms, we all missed the early warning signs of what was happening. The various stresses of being an exchange student caught up with her about mid-March. She was on her mid-trip seminar in Dresden when she began vomiting uncontrollably and had to be hospitalized.

She was surrounded by YFU staff at the seminar, so it was the best possible situation. They took her to the emergency room, helped her fill her prescription, and then sent someone with her to the hospital when it became obvious the medication was not working. A YFU staff person stayed with my daughter for the majority of her hospital stay, where they were able to get her symptoms under control.

We were on vacation during this time and were not checking emails. We had left phone numbers for emergencies, and YFU had these numbers. However, we were never contacted. We do not know if this was YFU's fault or the hotel we were at. We returned home to several messages from our daughter to call her immediately.

After her hospital stay, she was sent home to her host family by bus. She was comfortable doing that by herself. Her host family wanted her to leave Germany immediately, but we asked that they wait until she had a follow-up doctor's appointment and some time to recover before getting on an international flight. The doctor officially recommended that she return home and wrote a letter documenting his decision. Once this decision was relayed to YFU, they asked us (her natural parents) and my daughter to write a letter communicating her wish and our approval to return home. Once they received this documentation, they looked for flights leaving within 2 days. Both families (host and natural) had to approve the flights home, and they were booked.

She was already booked to return to Chicago's O'Hare airport on July 7. YFU made all the travel arrangements, including buying an additional ticket from O'Hare to our nearest airport in Minneapolis. We had hoped to go to Chicago to meet her and pick her up, but there were no reasonable flights at such late notice, and driving down (12 hours round trip) to get her did not seem like a viable option. Having YFU book this additional flight meant that her luggage was checked all the way to Minneapolis (she still had to pick it up and go through customs in Chicago, but she did not have to pay for luggage on an additional flight). We reimbursed YFU $200 for the flight from O'Hare to Minneapolis, which was cheaper than anything we were able to find.

She arrived home safe and (mostly) sound. Even now (a week later), she feels her decision was the best decision for her to have made. YFU offered to find her another host family able to deal with her medical situation, but she was too tired and sick to feel like she could make that option work. Sometimes, you just need to go home.

Blogging while abroad

When I went abroad in high school, I kept a journal, written in pen on paper. Twenty-six years later, most high school students will opt for the digital version of recording their experiences. While posting on Facebook is a less popular option for high schoolers these days, keeping a blog is actively encouraged by the different high school study abroad programs. Most programs have a webpage with links to students who are currently blogging about their experiences. Check out the YFU, AFS, and CIEE webpages with blog links.

Why blog while abroad?

The benefits of blogging while abroad are numerous. Besides posting pictures and efficiently sharing their experiences with family and friends, students have an online account of what they are doing. All of the posts are more condensed and organized than on Facebook, which is often clogged with advertisements and only accessible to “friends.” A blog is accessible to anyone who can find it.

A word of caution

Keep in mind a blog is also accessible to the program staff and your child’s host family. A blog is not the place to air grievances or blow off steam. A staff person does monitor those blogs, and your child will be asked to take down any posts that may be seen as offensive or critical. My daughter’s friend changed host families after just two weeks; her post merely stated that she was glad that, –if they were going to ask her to leave - they had asked “sooner rather than later.” The host family saw the post, reported it, and she was asked to take it down.

We did send a paper journal with my daughter, but the intention was more for her to have a place to put her paper “souvenirs” (like movie theater tickets and concert programs) than for her to write down her experiences. She shared the other day that she regrets not blogging during this year, but she also questioned if she would have had the time anyway. You will notice many of the students start their blogs (with good intentions, I’m sure) during those first exciting weeks, and after a few posts, there is nothing.

At the very least, take some time to read a few of the more complete blogs from previous years with your child before he/she leaves and discuss the possibility of recording his/her experience on a blog. 

Program Options: Sister Cities and States

Sister State exchange programs

One frequently under-advertised option for high school study abroad is through sister city or sister state programs. Many cities and states across America have agreements with multiple cities and states in other countries for mutually beneficial exchange programs at all levels. Sometimes, delegations simply visit to promote tourism or cross-cultural understanding. Teachers visit and often teach at a sister school. Colleges have agreements pertaining to semester or year-abroad programs. High school students can experience short edu-tourism trips or extended study abroad opportunities. Since these extended study abroad opportunities are often one-to-one exchanges (your child lives with a family who then sends their child to your house) and supplemented through the sister cities (or states) program, the price for these experiences can be a real steal.

One such program I recently found out about is the Wisconsin-Hessen Exchange Program. Wisconsin and Hessen are sister states and offer many of the exchange possibilities listed previously. If your family lives in Wisconsin and your child has had some German language training (German II or higher), this option may be ideal.

The basics

The cost is $450 + airfare to Frankfurt. Students have to provide their own spending money, but the program provides a monthly allowance during their stay.

This program is a one-to-one exchange. A German student will live with your family from September through January. Your child will live with that German family from February through April. The website says that the “stay may be extended if all parties agree,” an option that is not available through most high school study abroad programs.

Students must be at least sophomores during the year of their exchange.

Your child will receive academic credit as determined by local school district policies.

The Department of Education in the sister states provides the staffing support.

The application process

The application is four pages (the shortest I have ever seen) and could probably be filled out in a few hours. No teacher recommendations are required, but your child will need signatures from a few school personnel, including his/her German teacher. Applications are due in mid-February of the year the exchange would start.

Students will be notified in April if they have been accepted.

Overall impression

The family I spoke with had a daughter participate in this program several years ago. After being accepted to the program, they had to travel to Madison, WI, for orientation with the other participants. The director of the program was helpful and accessible throughout the year. In their opinion, one of the strengths of the program is that the hosting family has a significant investment in the visiting child’s stay because their child will be staying with the other family. Their daughter and the German exchange “sister” became very close. She considers her host family to be her German “family” and stayed with them frequently when she studied in Germany again during college. 

Other states

Finding these types of programs requires a bit more digging than the highly publicized options. Start by searching your state’s Department of Public Instruction website for high school exchange programs.

Program option: AFS-USA

Program Options: AFS-USA

The majority of our family’s experience has been with RotaryYouth Exchange, NSLI-Y, and Youth For Understanding (YFU). A few other organizations dominate the high school exchange programming in America. Two of these programs are the Council on International Educational Exchange (CIEE) and AFS-USA. Since I don’t have personal experience as a mom with these organizations, I interviewed a mother whose daughter is in Austria through AFS-USA. She graciously answered my questions about her daughter’s experience with AFS-USA.

The Basics

AFS-USA is a non-profit organization formerly known as the American Field Service. They have been exchanging students internationally for over 70 years and offer programs in over 40 countries.

Program duration varies from 2 weeks to one year, including summer, one-semester, and one-year options.

The cost varies depending on the destination, but one year (2017-2018) is about $15,000, which includes airfare, placement with a host family, secondary medical insurance, and pre-departure orientation.

Airfare is from assigned “departure cities,” and families will need to cover the cost of transportation to that departure city.

Students live with a host family in most of the programs.

The Application Process

The application process differs greatly depending on if your child is applying for a scholarship or not. AFS-USA administers many generous scholarships, including the fully paid year in Germany through the Congress-Bundestag Youth Exchange (CBYX) in some regions of the USA. Application deadlines will be much earlier if your child is applying for these scholarships. Additionally, AFS-USA places students on a first-come, first-served basis. The earlier your child applies, the more likely he/she is to get his/her first choice destination.

According to the AFS-USA website, the application can take 2-3 weeks to fill out, but they also say your child could “plow through” in as little as 48 hours if super-motivated. The mother I spoke with recalled that her daughter had to provide her high school transcripts, write several essays, submit pictures, request two teacher recommendations, have a dental and physical exam (which included mental health screening), and complete an interview at home that included a home visit in which one parent must be present. They had to provide a secondary physical “sign-off” from her doctor a few weeks before leaving that stated there had been no changes to her physical or mental health.

Their Overall Impression

AFS-USA has a central office staffed professionally and local chapters staffed by volunteers. This mother found the program to be very organized and efficient. She felt they received helpful information in a timely manner. Compared to my daughter’s orientation with YFU, I was astounded at the amount of information they were given and how standardized the experience would be across all regional chapters of the organization. AFS-USA participants do not seem to be nearly as dependent on the quality of volunteers as we were with YFU. 

AFS-USA sent a pdf of the orientation booklet for both parents and participants. The staff used this booklet during their pre-departure orientation as a workbook and resource. During the pre-departure orientation, several presentations were made to families, and then parents and students divided for separate activities. Parents were given adequate time to ask questions, and they received quality, helpful information. Additionally, the daughter had to complete several online “Culture Trek training modules” before her departure date. Finally, she participated in a day and a half orientation in New York before flying to Austria.

This family has been less impressed with the level of support their daughter has received in Austria. There was some tension with the host family, and the daughter did not feel she could confide in the assigned liaison. Whereas we were not impressed by our local YFU organization, my daughter’s liaison in Germany has been supportive. This situation illustrates what I suspected before; you can’t predict your child’s experience based on the quality of your program’s local organization.