Do you suffer from springtime allergies? Spring is a beautiful season in South Korea, with an array of different types of flowers blooming and temperatures warming up after a long, cold winter. However, for many people, spring also brings seasonal allergies. Understanding the types of allergens that occur in Korea may help you manage your allergies throughout the spring season. Listen to the BlogCast Don’t want to read? Listen to the South of Seoul BlogCast which provides accessible content through the use of AI technology. We don’t have time to read each article but we do our best to make more of our content accessible. If you would like to join our Accessibility Team apply to volunteer with South of Seoul. Allergies Differ from Country to Country Seasonal allergies can vary in severity and symptoms depending on the location and time of year. The primary triggers of seasonal allergies are typically pollen from trees, grasses, and weeds. However, the types of plants and the timing of their pollination can differ from country to country, leading to differences in the prevalence and severity of allergies. For example, in the United States, the spring season is commonly associated with tree pollen allergies, while in Europe, grass pollen allergies are more prevalent during the summer months. Additionally, some countries may have different plant species that produce pollen, leading to variations in the types of allergies experienced. Therefore, it is important for individuals who suffer from seasonal allergies to be aware of the specific allergens in their region and to take appropriate measures to manage their symptoms. Let’s explore some of the most common types of spring allergens in Korea. Types of Spring Allergies in Korea Korea has a few categories of allergens that surface during the spring season. These allergens include fine dust/yellow dust, tree pollen, grass pollen, ragweed, and mold spores. Fine Dust Fine dust, also known as particulate matter, is a type of air pollution that may have serious effects on those with allergies. These tiny particles, with a diameter smaller than 2.5 microns, can penetrate the lungs and cause irritation and inflammation. If you live in or near urban and industrial areas in Korea, you may be particularly vulnerable to the effects of fine dust. Such areas tend to have higher levels of pollution. The spring season in Korea tends to be windy, causing fine dust particles to become more easily airborne. Exposure to fine dust can worsen existing allergies, such as hay fever, or even trigger new ones. Yellow Dust Yellow dust, also known as Hwang Sa in Korea, is a type of particulate matter or fine dust. This phenomenon occurs because winds carry particles from China and Mongolia into South Korea. The severity of yellow dust in Korea can vary throughout the year with the highest concentration typically occurring in the western and central regions of Korea, particularly in Spring. Yellow dust can cause respiratory problems and worsen allergies, leading to symptoms like sore throats, itchy skin, and excess phlegm. Inhaling yellow dust can also damage the nose’s mucous membranes, exacerbating existing allergies and conditions like asthma. Tree Pollen During spring in Korea, trees release pollen into the air, which can trigger allergies for some. A robust scientific study found the peak months for tree pollen in Korea are March to June. The study also found that during that time, the most common tree allergens are alder, oak, cedar, or elm. The amount of allergen by tree type changed significantly area by area across South Korea. Of all the tree allergens in Korea, the ones known to cause the worst allergy symptoms are cedar, birch, and oak. This means that other trees may give off more pollen, but people tend to get sicker from cedar, birch, and oak. Different tree allergens may affect individuals differently depending on their immune systems and the concentration of pollen in the air. Since tree pollen concentration can vary by region in Korea, some individuals may experience varying symptoms depending on their location and how accustomed to the allergen their immune system may be. Grass Pollen Grass pollen is also a common allergen in Korea during the spring season. The most common grasses that cause allergies are Timothy grass, Bermuda grass, and ryegrass. If your immune system is not accustomed to these types of grasses, you may be more susceptible to such allergic reactions. Much like any seasonal allergen, the concentration of grass pollen may vary depending on the region of Korea you live in causing varying levels of allergic reactions. Ragweed Ragweed is a type of weed that grows in Korea and releases pollen in the fall season. However, some people may experience allergic reactions to ragweed during the spring season as well. Ragweed is one of the most common allergens in Korea. Its pollen can travel long distances in the air, causing allergies to flare up in individuals who may be nowhere near where this plant grows. This extremely lightweight pollen can remain airborne for days, increasing the risk of exposure to those who suffer from allergies. Mold Spores As the weather warms up and humidity increases, mold spores become more prevalent in Korea during the spring season. Mold spores can grow in damp areas, such as bathrooms, basements, and kitchens. Mold can also accumulate inside air conditioners that go unused over the winter months. These tiny fungal spores can easily travel through the air, causing allergic reactions when inhaled. How to Manage Your Spring Allergies in Korea Here are 4 ways to manage your spring allergies. 1. Check the Air Quality Before Planning Outdoor Activities Before planning an outdoor activity, checking the air quality is always a good idea. High pollen and dust level days can severely exacerbate allergy symptoms. Download air quality apps like Air Matters or Mise Mise to stay informed about the current dust and pollen levels in your area. These types of apps tells you what the Air Quality Index (AQI) is in realtime. Good AQI falls between 0-50, moderate AQI is between 50-100, and anything above 100 AQI is labeled as unhealthy and may affect allergy sensitive individuals. Taking preventive measures and being aware of the air quality can help you manage your allergies and enjoy good air quality days outdoors. Fun Indoor Activities for Bad Air Quality Days On poor air quality days, consider engaging in indoor activities to limit your exposure to pollen and dust allergens. Here are some indoor activities to try: Watch a movie at your local CGV, Megabox, or Lotte Cinema Relax at a cafe Spend time at a local cafe where you can do things like play board games, read books, enjoy coffee, or play with animals. The following South of Seoul blog posts offer cafes options in Pyeongtaek-si: Get your game on at an arcade or PC Room If you love computer games, you may also want to try a computer room known as a PC Bang or visit a gaming arcade. Here are some ideas of where to go or how to find such places. Visit an indoor sports theme park Sing your heart out at Noraebang (aka Karaoke) Go shopping at a local mall/department store 2. Wear a Mask to Filter Out Dust and Pollen While Outdoors Masks are a versatile tool that serve multiple purposes other than COVID prevention. Masks can be worn to manage respiratory illnesses, for protection against cold and weather, for cosmetic purposes, as well as for dust and pollen protection. Wearing a mask outdoors on poor air quality days is a great way to mitigate your exposure to allergens. Allergenologists recommend using the FFP2 face mask for allergies due to their tight fit and high filtering capabilities. However, the KN95, KF94, and N95 masks work just as well. These types of masks can be purchased online from Coupang or GMarket by searching “KN95 Mask (KN95마스크)” or “FFP2 Mask (FFP2마스크).” 3. Do Some Spring Cleaning Spring Cleaning can be an effective way to manage allergies and reduce your exposure to allergens in your home. Dust, mold, and pet dander are common allergens that can accumulate throughout your home. A few important tasks to incorporate into your spring cleaning agenda include: For a comprehensive guide and list of resources, read the South of Seoul Spring Cleaning in Korea to help you get started on your spring cleaning! 4. Visit the ENT (Ear Nose Throat Clinic) When your spring allergies in Korea start to set in, visiting your local ENT may be the best option for you to manage your symptoms. Going to a medical clinic in Korea can seem challenging due to potential language barriers. However, tools and resources like translation apps and free interpretation call services like BBB Korea are available to help get you through your appointment if you don’t speak Korean. ENT visits don’t generally require an appointment. However, during peak allergy or flu season, they can get busy. Additionally, most clinics in Korea, including ENTs will close during the lunch hour. Therefore, calling ahead to check on their wait times, to make an appointment, or to double-check that they are open is a good idea. Use BBB Korea for interpretation assistance if needed when you call. The cost of an ENT visit may vary depending on the treatment you receive. However, don’t let the fear of high cost deter you from making a visit if you need to. ENT visits are quite affordable. I recently went in for a check-up after waking up with a migraine and half of my head swollen due to allergies and left with a 5,000 KRW (about $3.70 USD) bill. ENT visits are covered (about 70-80% of the cost) by the Korean National Health Insurance (NHIS). Medication is also covered under NHIS (between 60-65% depending on where you live). At my ENT visit, I was prescribed 5-days worth of migraine medication, an anti-inflammatory, and a digestive medication (typically given to help your body process other medications that may cause nausea). My pharmacy bill totaled 8,700KRW ($6.51USD). If you would like to skip the ENT and purchase over-the-counter allergy medication, ExpatHealthSeoul has a list of medications you can purchase at your local pharmacy in their “A Guide to Allergy Medicine in Korea” blog post. To find an ENT or a pharmacy near you, copy and paste the following Korean terms into Naver or Kakao Maps: Conclusion To conclude, spring allergies are a common problem for many people living in Korea. Fine dust, yellow dust, tree and grass pollen, ragweed, and mold spores are the most common allergens that people may encounter during the spring season. The concentration of these allergens may vary depending on the region of Korea, causing varying levels of allergic reactions. To manage spring allergies, individuals can take various preventive measures, such as checking the air quality before going outside, engaging in indoor activities on bad air quality days, and taking medications prescribed by a doctor. With appropriate precautions, individuals can enjoy the beauty of spring in Korea and manage their allergies effectively. Follow SOS Public Health for More Resources Follow us on Instagram or Facebook to stay updated on SOS Public Health Initiatives. If you have questions about healthcare in Korea, visit the Health and Wellness in Korea Facebook Group, or feel free to message SOS Public Health via Facebook messenger with any questions or concerns. Lisa Peck, MPH, CPHMs. Peck graduated from the University of Utah Asia Campus (UAC) in Incheon with a Master’s in Public Health and her Certification in Public Health (CPH). Ms. Peck also holds a Bachelor’s Degrees in Linguistics and one in International Studies with a Global Health emphasis. Ms. Peck is Korean American and speaks both English and Korean. She has moved between the US and Korea since childhood, finally settling in Korea after graduating from UAC. In 2021 Ms. Peck founded the South of Seoul Public Health Program which focuses on research and initiatives regarding the health and wellness of multinational residents in South Korea. Additionally, Ms. Peck oversees the SOS Public Health...

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In April of 2022, SOS Public Health launched the Maternal Health Initiative with a baseline survey to understand the experiences and needs of the English-speaking multinational maternal community in South Korea. This initial blog post about such a survey will explore the demographics of respondents in order to understand the diversity within the multinational community. Listen to the BlogCast Don’t want to read? Listen to the South of Seoul BlogCast which provides accessible content through the use of AI technology. We don’t have time to read each article but we do our best to make more of our content accessible. If you would like to join our Accessibility Team apply to volunteer with South of Seoul. Please note that the pronunciation of some Korean words may be inaccurate due to AI technology’s limitations. What is the Maternal Health Survey? In April 2022 SOS Public Health launched the Maternal Health Initiative aimed at the multinational community who experienced pregnancy and childbirth in South Korea. The purpose of the survey was to analyze the experiences of the community when accessing maternal health care information and resources in South Korea. In addition, the goal was to find any challenges or obstacles individuals face when searching for information on pregnancy and childbirth support. The results of this survey will provide a baseline and guidance for the SOS Public Health Maternal Health Initiative. Read more about this initiative here. Thank you to all the participants First of all, thank you to those who participated in the 2022 Maternal Health Survey. Such a survey may provide insight into maternal health needs within the English-speaking multinational community in South Korea. SOS Public Health will share the survey results in the upcoming weeks and months. The image below shows the number of participants based on administrative district in South Korea. Individuals from 15 of the 17 administrative districts in South Korea participated. The majority live in Seoul (28%), Gyeonggi-do (20%), and Incheon (10%). Having respondents from many different administrative districts in South Korea is an important part of the 2022 Maternal Health Survey. South Korea uses an agile form of governance with many public health and wellness programs managed locally within administrative districts. It’s important to understand how maternal health care occurs in all areas of Korea as it may not be the same in Seoul as it is in Jeju. Who participated in the 2022 Maternal Health Survey? The 2022 Maternal Health Survey had a strong turnout with 87 responses from individuals who have been pregnant or who have given birth in South Korea within the last five years. There was diversity in the responses, with respondents coming from 19 countries and living in 15 of the 17 administrative districts in Korea. Eighty-nine percent of respondents currently reside in South Korea, while just over 10% previously lived here. About one-fourth were pregnant at the time of the survey and more than 80% had previously given birth in South Korea. Respondents lived in South Korea for an average of 7 years and were, on average, 34 years old. Nationalities and Race/Ethnicity The 2022 Maternal Health Survey reflected the diversity of the multinational maternal community residing in South Korea. As shown in the chart below, respondents from 19 different countries across five continents participated in the Maternal Health Survey. The largest number of respondents came from the United States of America (55%). This was followed by the United Kingdom (~7%) and South Africa (~6%). This survey was only available in English, therefore a larger number of respondents from English-speaking countries was expected. This means that there are some nationalities that may be underrepresented in this survey due to the language barrier. Furthermore, a variety of races and ethnicities were represented in the survey. About 67% of respondents identified as white, followed by 10% who identified as mixed race. Additionally, respondents included those who identified as black or African American, Hispanic and Asian, such as Filipino, Indian, Vietnamese and Korean. Languages A variety of different languages are spoken according to the 2022 Maternal Health Survey. Because the survey was in English, all respondents speak at least some level of English. Almost 80% of respondents answered that English was one of their fluent languages. However, other fluent languages spoken totaled 18 among respondents. Socioeconomic Status The 2022 Maternal Health Survey showed that respondents held one of 12 different visas. Almost half of the respondents reported holding an F-6 visa (Spouse of Korean National) followed by the A-3 visa (Military affiliated; 11%), and F-3 Visa (family dependents; 10%). The majority of respondents held a Bachelor’s degree (47%) or a Master’s degree (38%). And the majority of household income was between 25,000,000 KRW – 49,999,999 (29%), and 50,000,000 – 99,999,999 KRW (41%) Experiences The demographics of the SOS Maternal Health survey reflected a certain level of diversity within the multinational community in South Korea. Such information may infer how different the experiences related to maternal health care may be due to the many different cultural backgrounds. Using these demographics, SOS Public Health will delve deeper into the experiences reported by survey respondents in accessing maternal health care information and resources. Such research will allow SOS Public Health to compile information on possible resources and information on navigating pregnancy and childbirth in South Korea. Follow SOS Public Health for more resources Follow us on Instagram or Facebook to stay updated on SOS Public Health Initiatives. If you have questions about healthcare in Korea visit the Health and Wellness in Korea Facebook Group or feel free to message SOS Public Health with any questions or concerns. Apply for an SOS Public Health Practicum Opportunity Are you a graduate student looking for practical experience in public health? Apply for a an SOS Public Health Practicum! Click below to learn more about the SOS Public Health Practicum Program. Research Design & Implementation Team Survey UX/UI Supervisor & Editor Research Compliance Supervisor & Editor Primary Researcher & Author Denise Feurer, MSc PHDenise Feurer holds a Master’s of Science in Public Health and a Bachelor’s in Nursing. Ms. Feurer is a public health researcher and advisor living and working in South Korea. Mrs. Feurer founded the Maternal Health Initiative for the South of Seoul Public Health Program in 2021. Her first research project or SOS Public Health launched in 2022. Prior to joining the South of Seoul Public Health Program, Ms. Feurer volunteered for the London School of Hygiene and Tropical Medicine’s (LSHTM) award-winning endeavor, the “Rapid Data Project”, to code and organize worldwide Covid-19 policies for WHO decision makers, student ambassador program representative, and UK Model WHO Academy.

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Want to support improvements in information related to the maternal health of international residents living in South Korea? Take the SOS Public Health Maternal Health Survey. This blog will tell you how.

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A Need for Mental Health Campaigns on University Campuses If you attended a college or university, you may understand the mental health struggles that students face. Factors such as academic/social/financial stress, uncertainty about the future, and lack of sleep contribute to increased mental health challenges among students. Throw in a dash of COVID and a sprinkle of language and cultural barrier to the mix, and stress increases exponentially, especially for students studying abroad. Students who experience high stress are prone to developing depression, anxiety, and eating disorders among other mental health challenges. A 2020 study done in France found that 42.8% of students (nearly 30,000 individuals) reported having at least one mental health disorder (Wathelet, Marielle, et al, 2020). Another 2020 study in the U.S. revealed that 48.14% of students suffer from a moderate-to-severe level of depression, and 38.48% suffer from a moderate-to-severe level of anxiety (Wang, Xiaomei, et al, 2020). In South Korea, the mental health and wellness app Gidep, shared that 25% of Koreans experience mental health concerns. In addition to factors that cause mental health challenges, the stigma surrounding mental health often deters individuals from seeking help. Gidep also shared that only 9.6% of people in South Korea report seeking professional help. Realizing the importance of mental health awareness, former Masters in Public Health (MPH) student, Greta Gokey took it upon herself to address the issue for her own university campus in South Korea. Listen to the BlogCast Don’t want to read? Listen to the South of Seoul BlogCast which provides accessible content through the use of AI technology. We don’t have time to read each article but we do our best to make more of our content accessible. If you would like to join our Accessibility Team apply to volunteer with South of Seoul. Please note that the pronunciation of some Korean words may be inaccurate due to AI technology’s limitations. Mind U: Mental Health Week Background How Mind U began In the Fall of 2019, Ms. Gokey, implemented Mind U: Mental Health and Wellness Week at University of Utah Asia Campus (UAC) for her graduate program practicum. This Utah Asia Campus event brought awareness to campus faculty and students regarding mental health challenges that the university community faces. The event allowed students to connect with one another while building a small community of support. Ms. Gokey developed the Mind U: Mental Health and Wellness week to be sustained on campus for future years to come. Unfortunately, when COVID-19 struck full force, Mental Health Week faced many hurdles. COVID restrictions made event implementation difficult as campus navigated new policies to keep the community safely socially distanced. Such changes on the University of Utah Asia Campus impacted students. The University of Utah Asia Campus (UAC) has a population of over 400 students (~85% Korean, ~15% International). The international students mostly live on campus in the dorms while the Korean students live both on and off campus. Due to COVID, UAC implemented online classes which left many UAC students isolated with little opportunity to interact with their classmates. Such isolation added to the difficulties some students already faced. According to the 2021 SOS Public Health Mind U Survey, 42.9% of students reported having experienced a mental health challenge. How ‘Mind U: Mental Health Week’ was revived In 2021, SOS Public Health became aware of student mental struggles and sought to support students at the UAC. SOS Public Health recommended continuing the Mind U program and took up the torch to re-ignite Mental Health Week in collaboration with UAC and Ms. Gokey. In addition, SOS Public Health added practicum opportunities for UAC Public Health graduate students to sustain MindU Mental Health Week. In October 2021, Mind U: Mental Health and Wellness Week was brought back to the UAC campus. The following will chronicle the details of such an event. Mind U: Mental Health and Wellness Week Although May is technically designated as ‘National Mental Health Month‘ (in the U.S.), mental health requires regular attention and care. In addition to this, being an international university, UAC has high student turnover each semester. For these reasons, the UAC and SOS Public Health program organizers felt it necessary to implement events for both the fall and spring semesters. SOS Public Health is currently in the planning stages for the Spring 2022 Mental Health Week activities, but for now, let’s talk about what went down this past fall. Mind U: Mental Health and Wellness Week fell on October 12-15 in the Fall 2021 semester. Because Monday, October 11th was a holiday, the event occurred over a 4-day period. The event also coincided with UAC’s midterm schedule which afforded some pros and cons for scheduling. Mind U focused on two main events with a few smaller stress-release activities included. Such activities encouraged community building throughout the week. To accommodate for COVID restrictions and to include students living both on and off campus, the main Mind U events were held in a hybrid format (in-person and online via Zoom). The smaller activities were scheduled in waves to meet South Korea and UAC’s social distancing policy. The event details are as follows: Tiding Tuesday, Big Event #1 For the Mind U Tiding Tuesday Event, the program coordinators invited three speakers to answer student questions about mental health in a panel discussion. The speakers included: During the two weeks leading up to the event, students submitted questions related to mental health via a Google survey form. This strategy allowed students to submit questions anonymously. The inclusion of speakers with varying levels of mental health certification and backgrounds brought diversity to the Q&A responses. This diversity helped students learn about different approaches to mental health. The Tiding Tuesday event had a low RSVP count prior to the event. However, the final attendance surpassed the RSVP count by 392% for in-person and online events combined. In an on-going mental health survey implemented by the program coordinators, many students, as well as staff and faculty expressed gratitude for this particular event. Woke Wednesday, Small Event #1 The Woke Wednesday event was hosted by UAC’s Student Leadership Consultants. The Student Leadership Consultants host an event called Café U every week on campus to bring the student community together to discuss specific topics. The UAC leadership graciously worked with our coordinators to focus on mental health stigma for Café U during Mental Health Week. Student leader, Eunice Kim, put together an excellent presentation on mental health stigma. Through Ms. Kim’s guidance, this event provided a safe space for students (and staff and faculty) to participate in an open discussion about mental health stigma. The event began with a collective group discussion. Then, Ms. Kim broke the group into smaller teams to discuss a specific mental health stigma-related topics in more detail. Café U events typically turn out about 7 student attendees each week on average due to busy student schedules and COVID restrictions. As with the Tiding Tuesday, RSVPs for the Woke Wednesday event were quite low (6 RSVPs). However, the Woke Wednesday event turned out a 314% increase in attendees on the day of the event for in-person and Zoom attendance cobmined. Such a great turnout seemed to reflect the importance of open discussions about mental health. Thoughtful Thursday, Small Event #2 + Big Event #2 Thoughtful Thursday included two events: (1) a lantern making activity and (2) an open mic night. For lantern making, students gathered in a shared space on campus to craft paper lanterns. This activity provided students an opportunity to connect with their fellow classmates. The event also gave students a break from their rigorous midterm study sessions. Mental Health Week coordinators prompted students to write a mental health challenge that they experienced (if they were comfortable doing so). Then, these lanterns were used to “shed light” on mental health challenges the community faces during the Thursday evening event. The evening event titled, Open Mic Light the Night, brought students together for a more intimate gathering. The event opened with a few student performances followed by an open mic session where students could take the stage and share their mental health experiences. As with previous events, the event had a very few RSVPs for both events combined. Fortunately, 259% more students showed up to the actual event than had RSVPed! Students reported that they enjoyed the Thoughtful Thursday evening event. Several students even expressed interest in performing or speaking at the 2022 Fall Mental Health Week Open Mic Night Event. Feelgood Friday, Small Event #3 To close out the week’s events, UAC and SOS Public Health hosted a chill get together for students to destress with some stress-free slime making and slushies. UAC’s wonderful Program Coordinator, Molly Kinder, led this slime making event. Students reported really enjoying this event. This event offered another opportunity for students to connect with one another and make new friends. Feelgood Friday attendance increased 208% above the RSVP count. The overall lower participation rate for this event was due, in part, to many students traveling for the weekend. However, the event turnout still came out excellently for an in-person event in the midst of COVID. SOS Public Health’s continued support for Mental Health Awareness on campus Community support is important for individuals, especially during COVID. Support is especially important for students living in a world with COVID while studying abroad in an unfamiliar country. When asked if Mental Health Week had any value for this international campus community, 97.1% of students expressed that the Mind U Events offered a level of value. SOS Public Health and UAC are dedicated to the continuation of Mental Health Week on not only at Utah Asia Campus, but also at other universities within South Korea. How can you get involved with improving Mental Health Awareness on school campuses? Special Thanks and Recognition SOS Public Health would like to recoginze the efforts of all UAC volunteers and participants involved in bringing togeher the UAC community during the Mind U: Mental Health and Wellness Week. This event wouldn’t have been possible without the help of our amazing Mental Health Week Volunteer Team. Special Thanks go out to: Lisa Peck, MPH, CPHMs. Peck graduated from the University of Utah Asia Campus (UAC) in Incheon with a Master’s in Public Health and her Certification in Public Health (CPH). Ms. Peck also holds a Bachelor’s Degrees in Linguistics and one in International Studies with a Global Health emphasis. Ms. Peck is Korean American and speaks both English and Korean. She has moved between the US and Korea since childhood, finally settling in Korea after graduating from UAC. In 2021 Ms. Peck founded the South of Seoul Public Health Program which focuses on research and initiatives regarding the health and wellness of multinational residents in South Korea. Additionally, Ms. Peck oversees the SOS Public Health Graduate Student Practicum Program which provides mentorship and training for Master’s in Public Health students. The program works with two students a semester with a focus on ethical UX research design, survey development, and initiative implementation. www.southofseoul.net

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The 2021 South of Seoul Public Health Survey found that putting effort into developing cultural competence may improve your perceptions of your own healthcare in South Korea. Let’s talk about this. Listen to the BlogCast Don’t want to read? Listen to the South of Seoul BlogCast which provides accessible content through the use of AI technology. We don’t have time to read each article but we do our best to make more of our content accessible. If you would like to join our Accessibility Team apply to volunteer with South of Seoul. Please note that the pronunciation of some Korean words may be inaccurate due to AI technology’s limitations. The Hard Parts of Ex-Pat Life Living in a foreign country can sometimes be difficult, frustrating, and lonely. It can feel like ‘everyone’ is working against you. Feelings of intense anger toward yourself and/or the culture around you may surface. You feel that you may never fit in or feel at home in the foreign country. You may find that this sentiment is common among ex-pats around the world and it has a name: culture shock. Culture shock might not be the only hurdle you face, but you can take action to overcome it. Therefore, addressing culture shock is a great place to start when tackling your integration journey. South of Seoul founder, Lanae Rivers-Woods, who has lived in South Korea for over a decade, detailed some tips she uses to overcome culture shock in her excellent blog (5 Tips for Conquering Culture Shock). Nobody needs to do it alone. The barriers that you face with culture shock can affect not only your day-to-day activity but also your ability to access healthcare in Korea. For this reason, building cultural competence is a vital skill to overcoming such barriers. What is ‘cultural competence’? Cultural competence. This technical term may invoke feelings of belittlement. Reading the term, ‘competence,’ in certain contexts may make you feel like your intelligence is being challenged. However, ‘competence’ is simply a term. If we remove the negative connotations that surround this term, we can be more open to understanding the full concept of cultural competence. Definition Many people have cultural knowledge, cultural awareness, and cultural sensitivity. These traits, however, should not be confused with cultural competence. Cultural knowledge, awareness and sensitivity make up only a part of the definition. They lack a key aspect that truly defines cultural competence: action and structural change. The CDC has a great definition of cultural competence. They define cultural competence as: “…a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations. ‘Culture’ refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. ‘Competence’ implies having the capacity to function effectively as an individual and an organization within the context of the cultural beliefs, behaviors, and needs presented by consumers and their communities.” Centers for Disease Control and Prevention. (2020, October 21). Cultural competence in health and Human Services. Centers for Disease Control and Prevention. https://npin.cdc.gov/pages/cultural-competence. Human Services Edu has a more concise definition that reads: “The term cultural competence describes a set of skills, values and principles that acknowledge, respect and contribute to effective interactions between individuals and the various cultural and ethnic groups they come in contact with at work and in their personal lives.“ Admin. (2021, July 8). Cultural competency: Human services education. Human Services Edu. https://www.humanservicesedu.org/cultural-competency/. Both of these definitions imply that, to build cultural competence, you must take action or make structural changes to your belief system. Stepping outside your cultural beliefs for a moment to understand another’s allows you to have effective interactions with your community. This, however, doesn’t mean you need to give up your own cultural identity. Application Building cultural competence means taking a break from your personal thoughts and emotions to view your interactions from another perspective: putting yourself in someone else’s shoes, so to speak. Although it may come easily for some, building cultural competence takes time and practice. For instance, customer service differences between cultures remain one of the biggest points of contention for many foreigners in South Korea. Some foreigners have trouble practicing etiquette that seems rude in their home country but is not considered rude in Korea. Personally, I struggled with calling out across the room to waitstaff. This action felt horrifically rude until I took a second to look at the situation from the Korean waitstaff’s perspective. Korean restaurants (particularly small local ones) have very few waitstaff, if any. If the waitstaff had to check up on each table every five minutes (as they do in many U.S. restaurants), they would never get anything done. Calling to waitstaff when we need something allows them to efficiently do their jobs while serving their customers. Even now, I feel weird calling out, but I do it anyway because that is what the culture calls for, and I am able to get what I need more quickly. Why is cultural competence important for accessing healthcare in South Korea? Minor cultural adaptations such as my restaurant experience above can be handled fairly easily and improve the quality of daily life. Our recent SOS Public Health Survey confirmed a correlation between an individual’s level of cultural understanding, their level of integration into Korean society, and their accessibility to healthcare in Korea (shown in the below table). Where cultural competency gets spicy is when you have to deal with the high-stress experience of healthcare. In a healthcare setting, like a doctor’s visit, we deal with our own culture shock and cultural competence but also the Korean healthcare providers’ culture shock and gaps in their own cultural competencies. So, building cultural competence is a team effort. We will talk about our own cultural competencies in this blog since working on ourselves is what we have the most power over at any given moment. If we can increase cultural competence among patients and healthcare providers alike, we can increase equitable access to healthcare. In other words, if you build trust and respect regardless of the differences between you and your healthcare provider and vise versa, then you each will feel more comfortable interacting with each other. If you and your physician are able to work beyond your cultural differences, this can lead to: Cultural Competence in the West Countries designated as part of the “Western World” such as Australia, England, and the U.S. have very diverse populations. These countries have had quite some time to adapt to diversity and cultural issues (though many places in the Western World still have some ways to go on this). Due to the high levels of diversity among demographic populations (i.e. race/ethnicity, socioeconomic status, etc.) in the ‘West,’ healthcare providers have adapted cultural competence trainings as part of their onboarding process for new employees. Now, not all healthcare providers require this training which is unfortunate. Nonetheless, the implementation of cultural competence training continues to grow and evolve in the ‘West.’ Cultural Competence in South Korea Before we dive into cultural competence in Korea, we need to understand the makeup of the international population living here. In Korea, globalization is still a fairly new thing. Korea has experienced enormous growth among its international population over the last 20 years. In 2000, the foreign population count was at 491,234. By 2020, the population reached over 2 million. It can be difficult to keep up with the growing health needs of the international population with this kind of growth rate. Furthermore, the diversity that we see in Korea cannot be compared with the diversity seen in the West. In Western countries, diversity is high, but the majority of cultural groups tend to be members of the same nationality (i.e. Korean American, Black American, Mexican American). The culturally ethnic groups may differ, but each group shares some sort of base understanding of American culture as a whole. Therefore, Korea has to deal with not only people of varying racial/ethnic backgrounds but also people of varying nationalities. Each country has its own healthcare culture. The difficulty of managing patients from all these different cultural backgrounds can be overwhelming. Although it may not be fun or easy for any of us, it will take time for the South Korean healthcare system to learn how to manage this social shift; we all have to still manage our healthcare through this difficult time. Korea is known for making great strides for the growth of the country. I have no doubt that Korea will find ways to adapt to the cultural changes. However, they can’t do it alone. Healthcare workers need our patience and understanding. It is up to us to make the first move by building on our personal cultural competence about Korea and advocating for our health needs. When we practice conscious, cultural competence it allows others around us to more easily reciprocate. The fact of the matter is that this sounds easier than it is. Being present and aware of our own cultural competencies during vulnerable interactions, such as healthcare, feels overwhelming, and often we will fall off the wagon. The feeling of anger may overwhelm us. Fear may lead to our perceptions being skewed. Frustration may make us unwilling to observe things objectively. However, all is not lost when you find yourself buried by culture shock. Feel those feelings. Address those feelings. Explore what experiences caused those feelings. Advocate for yourself by learning what cultural differences could have caused this, and advocate for change where change is needed. In short, build up your cultural competence a little at a time. How do I build cultural competence to improve my comfort level in South Korea? You can build cultural competence in a variety of different ways. Here are a few tips on how I started when I first moved to Korea. Tip # 1 Learn the language Learning a new language, especially one like Korean which uses characters that look nothing like that of your native language, can be daunting. However, don’t let the Korean language scare you. It is more straightforward than you might expect. You also don’t have to become fluent. Just learning how to read can change how you view the world around you. Many people are able to get by in Korea using translating apps and interpreters. Even knowing how to speak Korean, I still use Papago occasionally for more difficult language exchanges. However, this method of communication is less personal. When you learn the local language, even if only a couple of useful phrases, it shows that you are making an effort to understand the community. When the local community can see your efforts, they may be more open to connecting with you and lending a helping hand. Furthermore, in a health setting, learning a few technical health-related words and phrases can help you navigate your hospital visits with more ease. Even in your native language, medical terms can be difficult to understand and explain, right? Understanding a few Korean medical phrases can help reduce some of the stress that results from misunderstanding. I know I feel more comfortable visiting a doctor when I at least know some of the basic medical terminology my doctor uses. As a testament to the importance of language, our SOS Public Health survey revealed that a high level of language proficiency is correlated with a high level of integration and access to healthcare. The survey results are listed below. More to come on language barriers and healthcare access in a future blog. Tip # 2 Make at least one local friend This tip is a major one that I will always recommend no matter where in the world you live or travel. Making local friends opens up so many doors. A local friend can show you their culture from a “behind-the-scenes” perspective by giving you the exclusive scoop on how to interact with other Koreans. Moreover, learning about...

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Why is self-advocacy important? Self-advocacy is an important skill that empowers you to take control over your life decisions, such as decisions based on healthcare. Your experiences are unique to you. Therefore, YOU know what you need best and YOU should advocate for your needs when possible. However, advocating for yourself is not always easy, especially when you live in a foreign country. So, what are some ways that you can build your self-advocacy skills? Listen to the BlogCast Don’t want to read? Listen to the South of Seoul BlogCast which provides accessible content through the use of AI technology. We don’t have time to read each article but we do our best to make more of our content accessible. If you would like to join our Accessibility Team apply to volunteer with South of Seoul. Please note that the pronunciation of some Korean words may be inaccurate due to AI technology’s limitations. How do I advocate for myself with a problem-solving mindset? Having a problem solving-mindset is key to self-advocacy in healthcare. According to the Knowledge Network for Innovations in Learning and Teaching, “people that have a problem solving mindset are conditioned to not give up on a problem, they have a sense of confidence and self-esteem when faced with adversity.” In order to maintain this mindset you must stay informed about your situation, know your rights, find support in your community, have self-determination, and speak up in a constructive way. Practicing these techniques will give increase your confidence in your ability to access healthcare while living abroad (and even in your native country). But how do you do this in South Korea where you may be unfamiliar with the language, culture, and may also lack community? Well, it isn’t always easy but it also isn’t impossible. We are here to connect you with your stepping stones toward self-advocacy. Stay Informed Doing research about the area you live in and learning about the resources available is a great way to start advocating for your health. When you move to a new city or town, do an online search via Naver Maps or Kakao Maps for nearby hospitals and visit those hospitals. Research important phone numbers to call in case of an emergency. Doing these small tasks will allow you to decrease stress and build confidence in your ability to navigate your area in the case of a medical emergency. There are also several online resources that help the international community in Korea stay informed about current events and information. A few of the resources include but are not limited to: Know Your Rights Have you ever avoided getting medical care in Korea for fear of receiving poor care and not being able to do anything about it? Have you ever avoided seeking medical care because you didn’t know whether you even had access to health insurance? Understanding your healthcare and legal rights as an international resident in Korea is a great way to advocate for yourself in these situations. All registered international residents who have lived in the country for 6 months or more have a right to National Health Insurance Service (NHIS) and basic medical care. If you are curious to learn more about NHIS, check out Expat Guide Korea’s blog, “Everything You Need To Know About The Korean National Health Care System.” Furthermore, if you ever find yourself in a situation where your rights are being violated, Korea provides free legal services and resources, such as where to file complaints as well. Knowing your rights can really help you build autonomy and give you the ability to self-advocate for your health. Stay informed about your rights as an international resident of Korea and increase your confidence in your ability to navigate Korea’s healthcare system. Find Support For some, finding support in a foreign country is as easy as pie. For others, it can be the most difficult task on the planet. Building your own support system in a foreign country can be daunting, especially if you don’t know where to look. In Korea, many reach out for social support online. A recent survey by South of Seoul Public Health discovered that about 60% of respondents utilize social media for social support. South of Seoul is an online community that focuses on supporting the international public in Korea. This South of Seoul Blog breaks down social support systems and their importance, especially in times of crisis. A solid support system allows you to self-advocate by validating your experiences and challenges accessing healthcare in a foreign country. Knowing that others face the same challenges and are working together to create positive solutions boosts morale and motivation. Self-Determination This may go without saying, but self-advocation requires a level of self-determination. Self-determination is the process of taking control of and making decisions that affect your life instead of letting others do it for you. With self-determination, you can choose to stay informed about your rights and access to healthcare in Korea; you can choose to have a problem-solving mindset; you can choose to reach out to your community for support; or you can choose not to. The choices you make impact how you integrate into the society you live in and your access to resources. Self-determination doesn’t mean making choices all on your own. Here are some ways to build up your self-determination: Easier said than done, right? Understand that building self-determination is a process. Many factors can affect your ability to make choices about your life, especially while living in a foreign country. For example, mental health can be influenced by culture shock and derail your efforts towards building self-determination. English-language options for online counseling services that address culture shock and improve mental health are available in Korea. Taking care of your mental health is the first step in the process to self-determination. Speak Up What better way is there to advocate for yourself than to speak up. Speaking up for yourself and your right to healthcare is the obvious path to self-advocacy. Nevertheless, speaking up is not always a simple task. Because we live in a world of varying cultures and opinions, voicing your opinions and experiences may be a challenge. There may also be a lingering fear of rejection from your community for speaking up about your situation. That said, you may be surprised by how supportive and understanding your community (expat and Korean) is to your experiences. Remember, you are not alone. Others in your community may also be waiting for someone to speak up so they can openly discuss their situations, too. Be that someone. Here are some constructive ways to speak up: What other resources are available to help me self-advocate? Staying informed, knowing your rights, finding support, having self-determination, and speaking up are just a few ways to practice self-advocacy. When you want to advocate for yourself, knowledge is your friend. Research online, explore your community and connect with local friends to build your confidence in the healthcare system in Korea. Utilizing available resources and your community will help you become the best advocate for yourself. Below are some additional resources that can help you get started on your journey: Self-advocacy is not about doing it alone. It is about connecting with community and articulating need! Follow SOS Public Health for More Resources Follow us on Instagram or Facebook to stay updated on SOS Public Health Initiatives. If you have questions about healthcare in Korea, visit the Health and Wellness in Korea Facebook Group, or feel free to message SOS Public Health with any questions or concerns. Apply for an SOS Public Health Practicum Opportunity Are you a graduate student looking for practical experience in public health? Apply for a an SOS Public Health Practicum! Click below to learn more about the SOS Public Health Practicum Program. Research Design & Implementation Team UX/UI Supervisor & Editor Primary Researcher & Author Lisa Peck, MPH, CPHMs. Peck graduated from the University of Utah Asia Campus (UAC) in Incheon with a Master’s in Public Health and her Certification in Public Health (CPH). Ms. Peck also holds a Bachelor’s Degrees in Linguistics and one in International Studies with a Global Health emphasis. Ms. Peck is Korean American and speaks both English and Korean. She has moved between the US and Korea since childhood, finally settling in Korea after graduating from UAC. In 2021 Ms. Peck founded the South of Seoul Public Health Program which focuses on research and initiatives regarding the health and wellness of multinational residents in South Korea. Additionally, Ms. Peck oversees the SOS Public Health Graduate Student Practicum Program which provides mentorship and training for Master’s in Public Health students. The program works with two students a semester with a focus on ethical UX research design, survey development, and initiative implementation. www.southofseoul.net

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