But…is it a healthy place to live?

When choosing a school for your next career move, it’s well worth the effort to research potential long-term effects a location may have on your health. Whether it’s air quality issues, the very real potential to contract malaria in areas that don’t practice vector control, heavy-metal poisoning from bathing in/consuming lead-tainted water, pesticide-laden produce, or exposure to spit on the sidewalk, the lack of environmental consciousness in both developed and developing nations can have serious, long-term effects on your health. And, of course, the resulting problems are especially potent in children, pets, and those with compromised immune systems.

Tainted water or the potential to become mosquito bitten will keep very few of us from accepting an overseas teaching position. But the air we breathe, the tainted food that’s the only food available, streets littered with garbage and its attending vermin, are most definitely causes for concern and reconsideration. Air pollution, such as seen in China and even Los Angeles, has been positively linked to higher instances of asthma, respiratory complications, skin problems and some forms of cancer. And we all know the problems associated with lead plumbing and mercury found on produce.

ISR recommends researching more than just a school and the local tourist sights. We’re all concerned about our health and each have a different threshold for what’s considered an acceptable/tolerable environmental situation. Air quality index, pesticide regulations, water quality standards, sanitary practices and pollution levels may be more than just potential inconveniences for some —- they could have major, long-term health consequences for both you and your family.

We invite you to use this Blog to ask questions and share information on the health concerns associated with living in locations around the world.

33 thoughts on “But…is it a healthy place to live?

  1. Can anyone speak to the following places regarding pollution/health conditions/living long term, etc.. thanks!

    *South Africa


    1. So, you don’t have to worry about air quality at international schools in China-just everywhere else over there.

      Not exactly a strong selling point.


  2. I spent a few months working in Mynamar in Yangon. I was sick most days with respitory problems from the lead used in the fuel of the million of cars that jammed the roads. My school supplied apartment had mold growing everywhere which didn’t help and dusty old sofas and mattresses. There are few pavements to walk on and cars will drive right at you. The air quality is awful and it was hard to find really fresh vegetables and meat. the expat supermarkets were grossly overpriced and life was highly stressful. Back to Bangkok which is paradise in comparison.


  3. I spent 1year in Beilun, China. It is a nasty industrial area with a huge port. Apart from the lethal air and strange and toxic smells emitted from factories and dust from endless building sites, there was also the worry of food being tampered with, vegetables grown in toxic soil and fish from polluted water. Not worth dying to live in such a toxic place and work for a 5th tier school… also toxic.


  4. Earlier this decade I taught at a brand new international boarding school in the far, far north of Thailand. The campus was beyond fabulous in layout; it looked at first glance like a holiday resort. The classrooms were all totally modern, tech-connected and fully functional while the grounds provided everything one could wish for in regard to sporting facilities. All-in-all, a wonderful place to teach.

    What’s more, the city where this pedagogical paradise is located very quickly became my favourite city in all of Thailand, and I’d lived all over that country during my long-running love affair with Pathet Thai. Not too big as to cause traffic or other irritations, yet big enough to find everything one might wish for.

    A picturesque river hosting a range of casual riverside diners winds lazily through the city, wherein cultural intrigues and architectural wonders abound. Furthermore, this relaxed city is surrounded on all sides by spectacular countryside; a verdant patchwork of rice paddies splashes its emerald tints across the lowlands right up to the foothills of forested mountains, many of which still shelter and provide fruitful homes to a plethora of authentic hill-tribe villages.

    On top of all this glory, each successive day brought more balmy weather, unlike pretty well everywhere else in the country it never got terribly steamy hot. On the contrary, this particular region features an atypical (for Thailand) genuine cool season; an actual winter, dare I say, December temperatures plunge as low as seven delicious degrees Celsius! It certainly seemed, after too many years wandering semi-lost around the tropics, that I’d finally stumbled upon the perfect place to live, work and raise a family.

    And it was. Until… the burning season! Beginning at the end of the cool season in late January, when rice farmers start burning off the previous growing season’s stubble, the fires intensify throughout February. While sunsets become prettily tinged by psychedelic pink purples and outrageous orange hues announce the dawn, the sky overhead is muted blue-grey. By March, however, all poetic metrics are dashed by an inescapable pall of smoke pollution, now hanging low and brutally thick.

    Stinging red eyes and a raw parched throats, backed by hacking coughs and mysterious rashes, a direct result of exposure to the constant air pollution, plagued our two year old daughter. Didn’t do a whole lot to improve the health of my wife or myself, I might add. Everyone suffers the same, but we at least could take care of ourselves. How many burning seasons dare we put our child through? How much should one tolerate before the damage outweighs the attractions of the place?

    We decided one was enough. Paradise lost, health regained…


  5. To paint with a broad stroke:

    China, Mongolia, they’ve got some brutal air. With that, airborne diseases like TB are making a huge comeback. Pneumonia and bronchitis run rampant in the wintertime. You’re well advised to invest in an air purifier.

    SE Asia on the whole tends to have cleaner air than E Asia. Slash-and-burns or trash fires are the exception. Food and water borne illnesses are more commonplace than E Asia though. Everyone inevitably contracts a case of Malaysia belly / Indonesia belly / Vietnam belly, etc. Though it’s rare to get anything more serious than a few days tied to the bathroom, don’t be surprised if you wake up with typhoid or amoebic dysentery one morning. Sanitation can be abysmal outside of major cities. Dengue comes with the mosquito clouds — won’t kill you, but it can take you out of action for a week or more.

    S Asia, specifically Nepal, Bangladesh, and parts of Pakistan and India, you get the worst of all worlds. Massive air pollution from traffic and coal-powered industries. You learn to stop breathing through your nose, for all the ambient foul odors. Lax regulatory oversight and lack of infrastructure leads to tainted water that no amount of boiling or chemical additives can fix. Plenty of tasty food, but at some point it will make you sick. In the tropical climes, mosquitoes can literally kill you. Another fun fact to consider: all these environmental problems are linked to long term health issues like heart disease, cancer, and stroke.

    The Middle East is much more tolerable, environmentally speaking, but certain other factors (corrupt leadership in gov’t and schools, spoiled students) may give foreign teachers second thoughts.

    That said, for all the difficulties, I’ve had the best years of my life in these places. Made pretty good money too. If I wanted life without challenges (and with that, ADVENTURES!) I’d have stayed home.


    1. I live in Oman but visit Dubai and Abu Dhabi frequently throughout the year: all these places have no air or water pollution. The only concern is the extreme heat 8 months of the year (April – November) but everywhere is air-conditioned, so it’s manageable.


    2. There were some serious problems with sewage on Dubai’s beaches some years back. The treatment facilities were unable to keep up with the breakneck construction. Feb 2009, beaches were ordered closed. Has this been resolved?


    1. I taught there. Cairo seemed to go back and forth. I did experience some issues with my stomach, as did many of my colleagues. Air quality, many grey days but also many days of clear sky. The final month of my contract, I did become quite ill. Cause unknown but severe allergic reaction (swollen feet, red rash all over my legs, arms and neck). When I arrived at work with this mysterious reaction, no one seemed to bat an eye. When I left the country, my health seemed to improve. My partner, who has asthma, found the air heavy depending on the time of year but manageable with his inhaler.


    2. Thanks for this reply! Yes it will be interesting as my husband has asthma but he thinks it will be manageable with his inhaler too. What school did you teach in Cairo? Were you living in Maadi? We will be living in Maadi and working at CAC so hopefully this area is nice to live in. Thanks again for your reply, very interesting to read and share with my husband. Happy New Year to you too! 🙂


    3. CAC is the one school we would go back for! Congrats! Maadi is great. Fairly safe. Join the ACE club (local expat club) and be picky with your apartment. For my husband, he increased his usage of his inhaler to twice a day. We also left on breaks to cleaner air. Good luck – I am envious!


    4. Hi – thanks so much for your lovely reply. Yes we are excited about our new adventures in Cairo to come and working at CAC. My husband and our 2 girls plan to leave and travel parts of Europe on our breaks so like you said hopefully this will be a good break into some cleaner air while we are there. Good luck to you for the rest of the school year and wherever you may be for your next adventure! 🙂


  6. Man, this thread is making me feel good about living in Queretaro, where every day of the year I enjoy sunshine, blue skies, clean mountain air (we’re on a plateau at 6,000 feet), invigorating breezes, daytime temperatures between 70 and 85 F, and evening temperatures between 60 and 70 F. No monsoons, no hurricanes, no earthquakes. The city is clean, safe (remarkably so for Mexico), beautiful, affordable, economically vigorous (tons of international investment), manageably sized (metro area population of one million), historic, sophisticated, friendly, and culturally vibrant. Heaven on earth, in short; the best city I’ve ever lived in, better even than San Francisco, because so much less costly. Absolutely optimal for both physical and mental health.


  7. I lived in Dhaka, Bangladesh, for several years. For an Asian capital, the city is surprisingly clean in terms of air quality. Many engines run on compressed natural gas (CNG), which takes away a lot of problems. Some issues in the dry season (October through March/April) with dust, but altogether not bad. Still, there were some pretty strong concerns:

    – water quality (I broke out in hives every time I showered…)
    – arsenic contamination of wells
    – water-borne illnesses: you name it, they have it
    – dengue fever (a real ass***e of an illness!)
    – Dhaka belly: diarrhea/vomiting/nausea, many times a year
    – tropical rashes (jungle rot/crotch rot)
    – all kinds of traffic accidents
    – ill-tempered crowds
    – insects: mozzies, roaches, flies–nasty stuff
    – Malaria is an issue in some parts of the country but not in Dhaka

    It’s not a place I’d recommend going unless you’ve prepared well, both physically and mentally. Then again, medical care is not actually too bad, and medications are widely and freely available, including for chronic conditions like diabetes (which is very common in the ‘desh) and hypertension.

    Interesting place for sure.


  8. I have been working in Ulaanbaatar for two and a half years. One of the things I always do is leave the country for the breaks. Usually in December the pollution is the worst. This year though, the pollution was really bad in November. I live in Zaisan which is basically above the city, so the pollution tends to be better there. Although it has been creeping up there to. I find that if I am downtown at night you can literally see the pollution sink down into the city. The best answer is if you have to go into the city, do so during the day and avoid it at night. The other thing is to wear a mask. Many people do and it helps.


  9. After reading the previous post I would also like to make a comment on living in Shanghai. In my case I have been working here for 7 years so from what I’ve seen it really does depend on whether your body has the ability to cope. I’ve had 7 years free of any issues but have seen other teachers suffer with eye infections, inability to wear contact lenses, various chest infections… And this is really from an age range of 24-50. I can only say that try it and see. You will find out within 3 months if you can cope. Overall, there is no ‘one shoe fits all’ with how pollution will affect your time here. On a final note, would I consider living in Beijing?,,never.. Now that’s too much even for me


  10. I am working in Shanghai and worked in Bangkok.
    Everyone says Shanghai air quality is worse although I definitely felt it more in Bangkok.
    Bangkok has a higher concentration of cars and loads of dust. Additionally there are many open spaces where it is shady to deal with heat but doesn’t address air pollution.
    In Shanghai, yes there is more PM2.5 but my house has air purifiers, as does my car and school. The amount of actual time spent outdoors when air is bad is very limited. We also have reverse osmosis water so very clean. I have a spent a lot of time with different types of monitoring devices for air quality and it seems to me that here in Shanghai at least they are much more aware of this and putting things in place to address health issues. When it says the air is let’s say “harmful” does it mean for the guy who works outside all day or my exposure of 30 mins?
    I never even heard of an air purifier in Thailand.
    Having said this some other cities such as Beijing pollution look scary.


    1. I actually like living in China.

      I’ve lived in Beijing for four years so far and I haven’t had any major health issues. Sure, there are bad days, but the majority of the time the air is fine. The air quality has been getting progressively better since I moved here, and even though there has been a lot of negative press this month, it has actually been a beautiful year in Beijing. I, by nature, don’t spend a lot of time outside, so it may be easier for me than someone who really enjoys running, hiking, etc.

      Living in such large city, I have access to loads of imported things, so food safety isn’t a major concern either. I can get filtered water, salmon from Norway, free range chicken, beef from Australia, organic produce, and American vitamins and supplements. The weather is no harsher than any other city I’ve lived in. My salary is twice what I’d be making in my home country and I take about five international vacations per year, while saving more than I could have ever imagined saving while working in the States.


    2. “I’ve lived in Beijing for four years and I haven’t had any major health issues.” You mean you haven’t had any health issues yet.

      As for the rest of your post, some observations:

      The effects of air pollution are also cumulative, and not necessarily immediate. Just because you may not have burning eyes and/or throat it doesn’t mean your health isn’t slowly being damaged at a greater rate over time than if you lived in an area with a lower airborne particulate ratio. If you think that, you’re simply being naive.

      As for the employment end of it, if your salary is twice what you made in the US I’d say you must have had some pretty crap teaching gigs.

      China is not a desire able place to live long-term for a variety of reasons, least of all environmental ones that have long-term health impacts.


  11. My husband and I spent 2 years in China and the only thing keeping us from going back is the air pollution. We looked forward to the heavy rain days because that meant the next day would actually be clear and we’d see blue sky. We can literally count the number of blue sky days we saw on one hand. One of our students ended up in the hospital with pneumonia and others had persistent coughs. I had watery eyes and a sore throat almost the entire time there. Loved the country, people, and school, but not going back until the air is better.


  12. Lived in Beijing 3 years. I had a smoker’s cough the entire time I lived there (although not a smoker) and eventually wound up with pneumonia my last year there. I still have respiratory problems–frequent attacks of chronic bronchitis. I loved living there, but the air drove me away.


  13. Living in South America was great for my throat problems because it was always very humid. When I returned to the States I had endless sore throat problems. It got so bad I went an ENT. He told me to go back to South America. Once back in South America my throat was fine again. I lived near the ocean so the winds kept the pollution to a low level.


  14. I found the high humidity of Malaysia wreaked havoc on my eczema, I saw out my contract but I spent most of that time on a steroid cream trying to cope with the itching and bleeding. The climate didn’t suit me at all. Yet the dry of the Middle East was great for my skin, I didn’t have one flare up.


  15. Like the poster above, I was Ulaanbaatar and it was horrible. Some areas of UB ‘exceed index’. There is a combination of burning coal, tires, and old engine fuel used to heat the gers ( yurts). On top of the pollution, which comes second according to WHO, the meat can be deadly to eat and TB is not uncommon.


  16. There is no way that I would teach in China – for a variety of reasons, but health concerns are high among them. We’ve all seen the news reports and photographs concerning the dangerous air in Beijing, and I’ve had numerous reports directly from friends as well. A couple who had to spend two weeks in Shanghai for an adoption told me they didn’t take a single pleasant breath the entire time.

    China will eventually put pollution controls in place, and might be habitable in 30 years – too late for me!

    I’ve taught in Changwon, Korea, and in Culiacan, Mexico City, and Queretaro, Mexico, and have had almost no health issues – certainly none that I couldn’t have experienced in the U.S. A few bouts of stomach distress over five years, but far fewer than I expected. The altitude in Mexico City takes a bit of getting used to, but the pollution levels there have really improved a lot. Changwon gets a little of the “yellow dust” from China at certain times of year. That’s about it.

    Oh yes, and watch out for the uneven sidealks and high curbs in Mexico, or you could take a tumble.


  17. Unfortunately, whether or not a city has tolerable health conditions depends on your particular body. I loved Shanghai, but my body could tolerate the P.M. 2.5 of the city only for 2 months 😦


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