B. Returning home
1. Medical checkup
You should seek medical consultation and treatment promptly if you have signs of any illness or injury following deployment. Of particular concern are persistent fever, coughs or abdominal upsets with diarrhoea, as these may be due to a disease contracted during deployment.
Many tropical illnesses do not exhibit symptoms for months after being contracted or may be confused with the exhaustion and stress of the move. In order to rule out tropical illnesses, it is advisable to consult a doctor with experience in tropical medicine.
If you had any sexual contact during your deployment or if you lived in an area strongly affected by HIV/AIDS, you should get tested for HIV/AIDS and venereal disease. HIV tests may not be positive until about three weeks after exposure to the virus.
If signs of stress persist after returning home from deployment, you should consult a professional mental healthcare provider.
You should continue to take medication according to the regime established by the manufacturer of the medication even after departing from the deployment location. This information may be found in the packaging of the medication and applies especially to anti-malarial drugs.
2. Reintegration: work and family
Reintegration with family and former colleagues can turn out to be difficult. After coming home from your deployment you may want to talk about your experiences, while others do not want to listen. Equally, it may prove difficult if you do not want to talk about your experience when others keep asking. Understanding what sorts of reactions to expect from yourself and your next of kin when you return home is important in making your reintegration less stressful.
Prepare yourself for a range of emotional reactions, such as excitement, disorganisation, resentment and frustration. Things may not be as easy-going as you had imagined. Some things may have changed while you were away and you yourself may have changed in your outlook and priorities of life. You may also miss the excitement of the mission for a while.
Reverse culture shock
Classically experienced as a period of depression or apathy, this stage can be very challenging. Feelings of isolation and confusion are common. The lowest periods normally occur during the second and third month home, and ease off approximately six months after you return. Reverse culture shock is often not well understood. The lack of tolerance and patience displayed at home may make you feel displaced or misunderstood, and could reinforce feelings of depression that you may be experiencing.
There are many reasons why reverse culture shock occurs, but the major contributing factors are:
- The reality of home differs from the home you remember. Over the course of your assignment you may have idealised or romanticised home. It is easy to forget or minimise the issues that were once sources of stress in your everyday life.
- Things change. Change has occurred to everyone and everything. Learning about these changes and adjusting to them can be very stressful.
- People may not react to you or your experiences in the way you expected. Many returnees find it difficult to connect with people and society in the ways they used to or may be frustrated by people’s limited attention span for their experiences.
As with every aspect of the reverse culture shock, the way in which you overcome the challenges you face will be highly personalised. Simply being aware that reverse culture shock exists will already ease the process to some extent. Some possible strategies are outlined here:
- Start mentally preparing for the adjustment process before ending your assignment. Ongoing reflection is useful in terms of clarifying your thoughts and feelings.
- Take your time when coming home, both physically and mentally. Go easy on yourself and avoid setting deadlines for major life decisions.
- Cultivate good listening practices. One of the best ways to ensure that you have an audience for your stories is to show that you care about their stories. Being a good listener will reinforce mutually respectful and beneficial relationships.
- Learn about what has changed with regard to family members, friends, politics, job markets and so on.
- Re-negotiate your roles and responsibilities at work and at home – the workload can be shared again, but perhaps in a new way.
- Seek support networks. Many people find that the biggest challenge of returning home is finding people who are like-minded or with whom they can share their experiences. In order to overcome this, you may want to maintain contact with colleagues or find other outlets that attract people of a similar mind-set.
- Find ways to incorporate your new interests and cross-cultural skills into your life at home.
Be aware that it is possible that you will experience post-deployment stress after returning home. You may suffer repercussions or delayed after-effects, particularly if you coped successfully during the actual crisis. Typical reactions may be similar to those encountered during the mission. Some symptoms of post-mission stress are:
- sleep disturbances
- restlessness and anxiety
- re-experiencing events
- feelings of emotional emptiness
- self-reproach and feelings of guilt
- aggressiveness and hatred
- problems concentrating
- physical complaints
Be patient and make time for recovery. It takes time to adjust to your new environment both physically and mentally. Following stressful experiences, it is natural to require more than your usual rest and sleep. This may be difficult because you have been away from family and loved ones who will also need attention. Recognise that you may need more time alone than usual to process your experiences and impressions, as well as to adapt to daily life at home.
Communicate your experience. Talk about your experience, but keep in mind that others may not share the same interest in your mission experience or may lose interest sooner than you expect.
Seek help if necessary. Although it is natural to experience post-deployment stress, you should seek help in the recovery process if necessary. If post-mission stress symptoms last longer than 30 days or become more intense, it is advisable to seek assistance from a trained professional.