Q: I worked overseas for five years doing business-skills training in Russia. I had to return to the United States because I contracted tuberculosis and couldn't get adequate medical care and follow-up there. My 10-month treatment has been a success, and I am healthy now.
My job search since I returned has been less successful, which I believe is directly related to my previous illness. During interviews, the questioning eventually gets around to why I returned to the United States. Normally, I try to be vague and say something like ''It was time to return home.'' If I'm pressed further, the truth usually comes out. The interview usually deteriorates from there, and I never hear from the company again. I have also tried being completely honest upfront, but the end result is always the same.
I have been in too many interviews -- 40 or 45 in the past year -- to believe it is only a coincidence. What can you recommend?
A: Lee Reichman, a physician who is executive director of the National Tuberculosis Center at New Jersey Medical School, said it was probably wise for the letter writer to return home from Russia for medical care.
But Reichman said that although the ''stigma of TB is very pervasive,'' he doubted it would preclude someone from finding a job. Still, he said that if he'd had the disease, he wouldn't volunteer that information because he considers it a confidential matter, particularly once it's cured.
''Untreated TB patients are dangerous, but not treated patients,'' Reichman said. ''He's the safest work colleague you can have.''
Longtime executive recruiter Gordon Silcox, senior vice president with Manchester Inc., a human resources consulting firm, suggested that the writer find a way to get around discussing the tuberculosis incident directly, though not untruthfully, perhaps by explaining he had a health problem that is now fully resolved. But don't be too secretive, he said.
Health problems are a growing issue because American companies are expanding their global reach in search of new business opportunities. They need workers willing and able to travel on a moment's notice, and many workers with adventurous spirits are more than happy to oblige.
About 9.8 million business travelers went abroad in 1999, up 9 percent from 1996, with the average road warrior taking flight to overseas destinations three times each year, according to national surveys.
But jet lag, unfamiliar microbes and unsanitary conditions can take a toll. According to the Western Journal of Medicine, about 65 percent to 75 percent of people who go to Asia, Africa or Latin America become ill within a month. And 30 percent to 50 percent of international travelers experience a travel-related illness or injury. Poor medical care can compound the problem.
''The average person has no concept of how stressful travel is or the danger of being exposed to new viruses and parasites,'' said physician Daniel Carlin, chief executive of WorldClinic Inc., which specializes in providing long-distance care for international travelers. He said older travelers who have health problems are at particular risk.
It's even worse when you're alone. Michael Ray of Oakley, Calif., now an international relocation specialist with Runzheimer International, fell ill with dengue fever while working as an English instructor in Taiwan about a decade ago. He remained in his apartment, too ill to venture outside, going without food for two days, before a student who stopped by to visit found him lying on the floor and took him to the hospital.
Horror stories like these make the rounds in airport waiting rooms all over the world. A new survey of 150 business travelers conducted by New Jersey-based Leflein Associates found that more than 80 percent expressed concerns for their health and wellness while traveling on business to emerging markets. How do they try to keep well on the road? The survey found that more than half drink only purified water, half exercise regularly, and 41 percent take additional vitamins and supplements.
Most experienced companies try to ensure that their expatriate employees have the best possible access to good medical care if it becomes necessary, and they have contingency plans that address health emergencies. But Ray said that some companies, particularly new technology start-ups, lack managers who understand the potential risks.
''There seem to be a lot of companies, like in Silicon Valley, that have money behind them, see opportunities overseas and they just put people on a plane,'' Ray said. ''The worst-case scenario is that you are sent over on an improvised assignment and you get sick. Employers need to address it, and if the employer doesn't, then you need to self-insure to make sure you are protected.''
Executive recruiter Silcox thinks the letter writer should consider other reasons he's having trouble finding a job, such as his appearance, interviewing techniques or job-search strategy. Sometimes support groups, organized through churches, local and state employment offices, or alumni organizations, can be helpful to workers who need unbiased and constructive criticism to hone their job search, he said.
A technical writer wrote to agree with a recent column on how job applicants should get formal employment-offer letters from their new employers before submitting resignations at their current jobs. But he also added that workers need to read any and all job-related documents they are provided as they begin a new job, and to be prepared to negotiate if the terms are too onerous. For example, rigid non-disclosure and non-compete agreements can leave workers blocked from pursuing occupations in which they have years of training.
''I don't begrudge my employers the necessity to protect themselves with NDAs and non-competes,'' he wrote. ''It is unethical for an employee to take another job in the same industry with a competitor within a year of employment. However, it is unreasonable for an employer to insist that I not work in my chosen profession for three years after leaving their employ.''
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