Going to the Doctor Abroad: Saudi Arabia

by Gigi Griffis

Welcome to my new Going to the Doctor Abroad series—a series of interviews with expats living abroad about how healthcare differs in their adopted country. The experiences below belong to the interviewees and may not be representative of every person’s experience. Love it? Hate it? Find it useful? Let me know.

First, tell us about you.

My name is Kristine. I’m nurse by profession and currently an expat living in Saudi Arabia. I’m originally from Canada, but have spent most of my adult life living outside of Canada, mostly in the US and now (for the second time) living and working in Saudi Arabia. I am hopelessly addicted to traveling and working in Saudi provides me with nearly two months of paid vacation time, which has only furthered my passion for travel. I’m also a travel blogger.

Talk to us about average run-of-the-mill doctor visits. How do they work in Saudi? How are they different from the US?

I’d say the first major difference in Saudi Arabia is that everything is segregated between the sexes. There are female waiting areas (which are often tucked around a corner or barricaded from view) and male waiting areas. Women can and do see male doctors, but the local women are often fully veiled when doing so. Depending on what I need, I have the option of scheduling an appointment for non-urgent things or going to the walk-in clinic which would be similar to an urgent care clinic in the US.

Let’s talk about specialists. How do you get in to see a specialist if you need to?

I need a referral to see a specialist, but often that’s easily obtained with a visit to my regular doctor or at the walk-in clinic. Often the wait time can be a few weeks to a couple months depending on the specialist, which is pretty similar to the US system.

Are there any other ways visiting a specialist is different in Saudi?

I do feel that I have to be pretty proactive and persistent with any health-related issues here in Saudi Arabia. It’s not very often that I get to see a Western doctor. Many of the doctors are trained in the west, but even if they are trained elsewhere, their country/culture of origin can have implications for how women are treated and viewed. This has not really been an issue for myself, but I have co-workers who have encountered issues with male physicians not taking them seriously.

Any tips for finding English-speaking doctors in Saudi? How usual is it for doctors to speak English?

As long as you are in a major city, you can easily find an English-speaking doctor. The large hospitals are all supposed to be English-speaking. And there are several expat websites with forums where people can figure out which specialists speak English as well.

Let’s talk about pharmacies and prescriptions.

The major difference between Saudi and the US is that many medications that you need a prescription for in the US, you don’t need one for here in Saudi Arabia. I can literally walk into a pharmacy here and decide to put myself on antibiotics, blood pressure medication, and maybe even a blood thinner. Any type of controlled substance requires a prescription (sleeping pills, narcotics). Also, narcotics are rarely prescribed here (whereas in the US I felt like we gave them out like candy).

Sometimes it’s hard to find certain North American brand-name medications. Last year, I hurt my back and tried to find a mild muscle relaxant and all the pharmacy had were medications I had ever heard of. Often they get medications from European countries or India.

In an emergency situation, what is the protocol in Saudi Arabia?

Well, the best protocol in Saudi Arabia is not to have an emergency situation! Saudi Arabia has one of the highest rates of vehicular deaths in the world. The traffic in the capital city is really insane and, trust me, no one moves out of the way for an ambulance. I dread thinking about being in an emergency.

That being said, I think expats are advised through their employer and medical insurance companies as to which hospitals they should contact in an emergency. The hospital I work at has its own paramedics who are English speaking. (Paramedics in Saudi Arabia are trained in English in general, though I image that outside the major cities language would be an issue). Also, I have heard that ambulances here have very poor response times and, coupled with the fact that streets and houses are not labeled or easily identifiable, a high number of patients are driven to the hospital by their families in emergency situations.

How is a hospital visit different than in the US?

The hospital that I work at is based off the US healthcare system, so equipment is modern and health standards are on par with the US. Most of the hospital rooms are private and have TVs which is pretty similar to the US. One major difference is that five times a day the call to prayer is piped through the intercom system.

Another difference is that you are treated by the most internationally diverse staff you could imagine. The unit I currently work on has nurses from Canada, the US, New Zealand, Britain, Finland, the Philippines, Malaysia, India, South Africa, and Lebanon. And when you add that to the physicians, physical therapists, house keeping and dietary staff there are likely at least 20 – 30 different countries represented. This is far higher than any large hospital in the US.

The other major difference is that in Saudi Arabia, there is a huge VIP culture and this rolls over into healthcare. Our hospital has an entire floor dedicated to VIP patients (the royal family and the uber wealthy). They also have their own clinics, x-ray area, and emergency services. I’ve never encountered anything like it in a US hospital.

What about homeopathic practitioners, acupuncture, and other non-medical treatment options? Are they accessible? How do you go about finding them? How are they different from the US?

For this kind of thing, start by looking at expat websites and forums. Homeopathic medicine isn’t widely recognized here, but I did a quick Google search and was able to find links to both acupuncture and homeopathic practitioners. The local Saudis have their own versions of therapeutic cultural healing practices which included cupping, cauterizing, and the use of camel urine. I personally wouldn’t recommend any of these, but they are still being practiced, though mostly in the desert areas.

What about health insurance? What kind of insurance is available to expats in Saudi? Would you recommend it? What’s the cost?

Since the only way you can be living in Saudi Arabia is on a work visa, medical insurance is arranged through your employer. Since I am employed at a large hospital, I have access to all the doctors at that hospital. Expats are informed on arrival which hospitals or doctors are covered under whatever insurance is provided to them. Your insurance is determined by your employer as part of your employment package. I don’t pay anything directly for my insurance.

Does health insurance cover everything or is it a co-pay system? If so, how much are you generally paying for things?

Doctor visits, prescriptions, and hospital visits are free for me. That said, my employment contract is a single contract (meaning that I am a single person). Were I to get pregnant (which, since I’m not married, would be a big issue here in Saudi) none of my prenatal care would be covered.

(If I was married, it still wouldn’t be covered because nurses are almost always brought in on single contract visas and cannot bring a husband or children unless your husband has his own job and visa. Expat women who are not working, but with a husband who is would most likely be covered for prenatal care under his contract and insurance. Of the thousands of nurses I work with, many of whom are married, all must pay out of pocket for prenatal care and almost all deliver their babies in their home countries and come back to Saudi after they deliver. Unless their husband is also working in Saudi, the children are not allowed to live in Saudi, so they end up being raised by family members in the home country.)

Also, I reckon if I had a major medical problem that I would likely not recover from or would result in my being unemployable, my contract would likely be terminated and I would be without insurance here in Saudi or in my home country.

What about the cost of pharmaceuticals?

Since my prescriptions are covered within my hospital, I pay nothing. The few times I’ve gone to a pharmacy to pick-up something without a prescription, it’s very cheap compared to the US.

Anything else people should know about going to the doctor in Saudi?

As with anywhere, it’s important to be assertive with your health-related issues. If you aren’t satisfied with one doctor you should change doctors or seek a second opinion.

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