A Life-Altering Journey: Advocating for Change in Civilian Employee Healthcare Overseas, Part 2 of Heather’s Story

By Heather MacLeod

Nearly a year ago, what should have been a simple visit to a South Korean café turned into a life-altering medical crisis. A dislocated leg escalated into a severe, life-threatening emergency when a severed artery went unnoticed, leading to compartment syndrome and, ultimately, the loss of my leg above the knee. This experience exposed the harsh realities of navigating foreign healthcare systems as a civilian employee—delayed treatment, language barriers, and financial burdens compounded an already dire situation.

Through this journey, I learned the power of self-advocacy, the necessity of patient advocates, and the critical role leadership plays in supporting civilian employees during medical emergencies. Now, reflecting on the challenges I faced, I see an opportunity to improve the system and ensure others receive the timely, comprehensive care they need.

The Challenges of Navigating Foreign Healthcare Systems

Expatriates often find themselves facing unexpected challenges when seeking healthcare abroad, as I did during my treatment after the accident in a cafe in South Korea. A pivotal moment occurred when I had to undergo a leg reset without the aid of painkillers—a harrowing experience that was made even more difficult when an artery was severed during the procedure. This event starkly illustrated the cultural and procedural differences between the healthcare system in South Korea and the medical practices I was familiar with in the United States. Such experiences can be shocking and serve as a reminder that expatriates need to be prepared for differences in how care is delivered.

Another challenge is the bureaucracy and red tape that can surround healthcare benefits, particularly when it comes to using medical evacuation services. The time difference and logistical hurdles make it essential to tap into your network for support, whether it’s through your chain of command or reaching out to representatives who can advocate on your behalf. This proactive approach can make a significant difference when facing delays or complications in your care.

The road to recovery can be equally complex. After my leg reset, the lengthy process of obtaining a prosthetic leg was a battle with both insurance and the South Korean healthcare system. Negotiating through the differences in procedures and practices took months, highlighting the importance of being persistent and prepared for delays. Additionally, adapting to physical therapy in a foreign country can be a challenge, particularly when language barriers complicate communication with healthcare providers. Despite these hurdles, asking questions and using translation apps can help bridge the gap, allowing you to stay involved in your recovery.

The emotional and physical toll of being wheelchair-bound during this period added another layer of difficulty. As I navigated Korea’s streets, it became apparent that accessibility for individuals with disabilities was not always prioritized. This realization was a stark reminder of how vital it is to adapt to new environments and to find strength in the face of adversity. Yet, by embracing these challenges, I continued to live my life and build a new normal, learning that resilience is key to overcoming obstacles when navigating healthcare in a foreign country.

Advocating for Changes in Civilian Employee Healthcare Overseas and Emergency Care

The broader implications of this medical emergency demand attention. Healthcare leaders, particularly within military-affiliated systems, must find ways to empower their staff to act with compassion and flexibility in critical situations. Doing what is right should never come at the cost of an employee’s life or career—it should be celebrated and encouraged. I hope that this story can serve as a call for change, inspiring leaders to embrace compassion as a guiding principle in patient care.

The Army operates an Issue Management System where I am advocating for enhanced support and protections for civilian employees' services overseas. Despite our critical contributions as civilian employees, there is a lack of formalized and immediate protections for these civilians in the event of accidents or life-threatening scenarios. This gap is particularly concerning given the challenges mentioned with navigating healthcare in a country not our own. There is an absence of a standardized response framework to ensure civilians with medical emergencies are treated with dignity and respect as valued team members as part of the mission.

Civilian employees stationed on overseas military installations should not have to rely on grassroots advocacy or leadership fighting uphill battles to receive proper care and respect during such times of crisis. We need a streamlined, policy-driven response that ensures their well-being and reinforces their role as part of the Department of Defense team.

After careful consideration, these are the recommendations that I believe could make a difference:

Formalized Emergency Protocols: Develop and implement standardized emergency protocols to support injured or incapacitated civilian employees OCONUS. This should include immediate access to military healthcare services and support without delays caused by bureaucratic hurdles.

Advocacy and Case Management: Assign a dedicated case manager or liaison to assist injured civilians with navigating healthcare, administrative processes, and legal rights during recovery, ensuring they are treated with dignity and respect.

Command Support Enablement: Provide commanders with the authority and resources needed to support injured civilians effectively. Remove unnecessary bureaucratic barriers that hinder their ability to act in the best interest of their personnel.

OCONUS Civilian Employee Bill of Rights: Create a formalized document outlining the rights and protections of civilian employees OCONUS, emphasizing their inclusion as part of the military team and ensuring consistent treatment in line with Army Values. Adding this to the National Defense Authorization Act would be ideal as OCOUNUS civilian employees support the military mission abroad. 

Mandatory Training for Leadership: Require all military and civilian leadership OCONUS to undergo training on the unique challenges faced by civilian employees and the importance of immediate, respectful support in crisis situations.

Independent Oversight: Establish an independent oversight mechanism to ensure timely and effective responses to civilian injuries and accidents OCONUS.

Policy Review and Expansion: Conduct a comprehensive review of policies governing OCONUS civilian employees, expanding protections and aligning benefits with those of military personnel in similar situations.

Each civilian employee stationed overseas serves alongside our military and I believe we should all be treated with the same care and concern, especially our civilian employees who are veterans. We are one family, one team—it’s one mission. We are brought here for security and sustainment of peace in the Pacific. We pursue global peace, but sometimes personal peace and well-being during emergencies aren’t considered. In sharing my story, I hope to inspire others to find strength in the face of adversity. This journey has taught me to face each day with gratitude, knowing that my life, while different, is no less fulfilling or meaningful. 

If you are reading this and want to support this cause, share your story, or give insight into policy changes and advocacy, please reach out. Check back next month as I explore reasonable accommodations in the workplace.