Recently, our son - the older of our 2 children - started at a new nursery school and I'm so pleased to know that he loves it and is well looked after. After a long, hot summer of juggling work and kids, I feel like it's time to focus on some of those issues that have been on my mind. With 2 children and already about 4 hospital runs under our belt, I think it's now time to help all of you with this nagging issue: what would I do in the case of a medical emergency?

The number of times I have been asked this question from friends and clients is beyond me. For foreigners who either speak no Hungarian or very little, it's a huge challenge without an easy answer. This September issue of Expat Success will try and prepare you for certain scenarios that we don't really want to think about. Whether it's little Sophie falling off the swing and breaking her arm or Aunt Jane having pains in her chest during a visit, we have tried to compile as much information about emergency care in Hungary as possible.

In addition to these articles, we've also included some information on upcoming events in the Budapest expat community as well as the latest news from ERC's Hungary headquarters and our other regional offices.

Indeed, ERC is a company with a regional presence and in the future we aim to provide similar information on emergency care options for expats living in the other Central-Eastern European countries we operate in. In the meantime, if you want to find out about urgent care options in the rest of Central-Eastern Europe please feel free to contact us.

From all of us here at ERC and Move One, we hope your September is enjoyable and accident-free.

Best Regards,

It's not the type of situation that one likes to dwell upon but medical emergencies can happen anytime and anyplace. However, many expats living in Hungary haven't a clue on how to get in touch with the proper medical authorities should an emergency occur.

For expats who don't speak Hungarian and require access to English-speaking emergency operators and medical staff there are options out there. To give you an idea of what's available, ERC has compiled a list of 24-hour, on-call medical services with English speaking staff. Click on the link below to download the file. It's suggested that you print out these contacts and keep them in your purse or wallet so you have quick access to them should an emergency arise.

An additional link below provides directions for getting to Szent Janos Korhaz, one of the pediatric emergency wards listed on the emergency contacts sheet.

In life-threatening situations such as major trauma from a car crash, a baby that has turned blue, etc., dial 104 to summon an ambulance. When calling from a land-line, the operator will be able to to tell the address from which you are dialing. The emergency number on the cell phone is also 104, however, your geographic location will not be automatically registered. If the operator does not speak English, he or she will find someone that does. The ambulances are staffed by physicians, not emergency medical technicians. There are eleven advanced life support and 25 basic life support vehicles in Budapest. There is no charge for the services provided by the primary responder team.

Alternatively, there are private ambulances that provide the same services but for a fee. Fonix SOS Ambulance, will send a doctor with the ambulance. Call 200-0100 or 275-1535. The telephone dispatchers of these services speak English so you avoid the risk of having to initially go through an operator who speaks Hungarian only.

If hospital services are deemed necessary, the ambulance will transport the patient to the appropriate hospital, depending on the type of problem (trauma, heart attack, woman in labor), and the age of the patient (pediatric or adult.) Medical institutions in Budapest have a very complicated rotating call system for emergency services, and the doctors in the ambulance will know to which hospital the patient should be transported. Foreign citizens are expected to pay the hospital bill in cash, unless they have a TB card from the Hungarian authorities (analogous to a public aid or medicare/medicaid card), which entitles you to services in state-run institutions.

Urgent health care issues, which are not immediately life-threatening (like a broken arm or severe diarrhea and vomitting) are best handled by contacting your personal physician for advice. It is of utmost importance that you have a pre-existing relationship with a doctor who speaks your language well, whose philosophy of medicine is comparable to yours, and who is available 24 hours a day. Your physician should be able to triage and refer you to the appropriate health care setting, and help you navigate the world of the Hungarian Health Care System in as efficient and pleasant a manner as possible. It would behoove any expatriate family to familiarize themselves with the choices available. At Telki private hospital, one can expect to be treated in a spanking clean, brand-new facility, with excellent nurse to patient ratios, and English-speaking doctors. Shopping around for the best outpatient clinic is also a good idea. Several private clinics provide both primary care and subspecialty services in English, from Western-trained doctors. Outpatient facilities that specialize in serving the expat community can also arrange to bill foreign insurance companies directly.

In the end, the best way to tackle a medical crisis is to be familiar with your resources before disaster strikes. Having access to a doctor who is well acquainted with your family's medical history is the first step you can take to ensure that you are prepared for the unexpected.

The Roszakert Medical Clinic has just reopened with newly expanded facilities and services. For more information about the clinic contact 391-5903.

Dr. Sue McGladdery of American Clinics International reminds us that being prepared for an emergency is particularly important for those residing in a foreign country.

Accessing emergency care in Hungary - What you should know

Despite the best efforts of parents, children will have accidents (currently the leading cause of death for children in the U.S.A) and we should be prepared for this especially when we live in a foreign culture. Adults are more likely to need emergency assistance for a medical problem but can also be seriously injured by accidents.

Typical emergencies that families in Budapest may have to deal with include accidents resulting in head injury and/or broken bones. Common reasons are falls in the home, injuries from biking, skateboarding and participating in winter sports, choking, swimming pool related near drowning incidents and accidental poisoning (ranging from toddlers sampling household cleaning agents to older children experimenting with alcohol). Hopefully it will never happen to you but statistics warn us that it may.

What can you do now?

• Many accidents can be prevented by the use of safety devices - stair guards, seat belts, cycle helmets, home smoke detectors, child proof electrical sockets.
  
  
• Establish safety rules such as never swim alone and ensure adequate supervision of children at play.
  
  
• Take a course in first aid training (Hungarian Red Cross offers certification courses and American Clinics International has First Aid classes for parents). Do you know how to perform CPR (cardio pulmonary resuscitation) and how to help a choking victim? It could save your child's life.
  
  
• Know what's available. Check the services that your local doctor or clinic offers ahead of time. Find out now what the after hours service includes. Program the appropriate emergency number into your mobile phone and keep this number easily accessible at home.
  
  

First, do not panic. Help is available.

The options are to go through the local system (for ambulance call 104) and local hospital. Although medical staff are skillful, local hospitals are often busy, crowded and in poor repair. Many foreigners find this disturbing when compared to the standard of hospitals in their home country. There may be few staff available who speak English. There is often a complicated registration process to go through, cash payments may be needed and direct insurance billing is not possible.

The alternative option is to contact a private doctor or call a 24 hour clinic such as American Clinics International (ACI). For a list of 24 hour clinics in Budapest view the "Emergency Contacts" sheet that is linked to this newsletter

Decide in advance what is best for your family. Make sure everyone knows the plan (including child minders) and knows how to get help.

For further information about American Clinics International in Budapest contact info@americanclinic.hu or visit www.americanclinics.com.

To find out more about this Budapest-based travel agent go to www.chemoltravel.hu.

The Move One Prague office sponsored a table at this event where they doled out balloons, key chains, and, to the lucky winners of the draw, their very own Move One wooden toy truck. It also provided the perfect opportunity for local ERC/Move One representatives, Laura Wade and Jason Cahill, to get acquainted with new members of Prague's expat community and explain our services.

Pictured above are Olivia and Madeline Soultz with Jason Cahill. Olivia, Madeline and their family were relocated to Prague by Move One and the Expat Relocation Center.