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Objective. To determine whether experience of emergency medical and/or security evacuations influences expatriates to terminate international assignments. Design. Quantitative, observational, retrospective, cross-sectional, descriptive survey, conducted by e-mail questionnaire. Setting. Indonesia and Russia. Participants. Expatriate personnel of foreign firms operating in Russia and Indonesia in 1st quarter 2001; 207 individual replies from 296 companies surveyed. Main outcome measures. Likelihood of premature departure, nationality, and being subject to an emergency evacuation for medical and / or security reasons. Results. Likelihood of premature departure increases if expatriates have been evacuated for medical and/or security reasons during assignment in Indonesia or Russia. There was no significant difference in premature departure whether the evacuation was for medical or security reasons. There was no significant difference with respect to country of origin or country of expatriation (Indonesia or Russia), nor was there any effect of a combination of history of evacuation and nationality. The combination of employment alternatives, family pressures and better pay being available elsewhere (‘salary effect’) is a significant predictor of the likelihood of premature departure; of these, family pressures have the most impact on the likelihood of premature departure. Conclusions. Involvement in medical and / or security evacuations does increase expatriates' likelihood of prematurely terminating international assignments. Introduction This study examines two factors that may predict the likelihood of expatriates to prematurely terminate their international assignments - emergency medical evacuations and forced security evacuations. Globalisation is a simple word to describe a complex tangle of economic, ethnic, political and financial transactions, attitudes, adjustments and relationships. These can be profitable as well as exciting for both people and companies, but to be competitive, corporations have to export not just expertise but employees to unfamiliar countries and under alien circumstances. The relocation of expatriates to support globalisation is expensive and disruptive for all parties. Should the assignment be prematurely terminated, the expense increases but the disruption is very much worse; and the psychological, financial and health effects on employees and their family members are considerable, damaging, and may be permanent. Due to force majeure, many expatriate assignments already end prematurely by mutual agreement, and the employee is relocated without loss of income, seniority or prestige (although not necessarily without problems). But other assignments, especially in ‘difficult’ countries, are terminated unilaterally by the employee when the employer would prefer these to continue; and medical and security emergencies are two high-profile ‘triggers’ for such termination. There is good evidence from both the literature and anecdotally that the outcomes from this latter situation are personally worse for the employee (and more expensive for the employer). Premature repatriation has been called "expatriate wastage", and it is a waste when career prospects are damaged, self-esteem is lost, health is damaged and family relationships are irreparably harmed. Accordingly, even though many physicians and companies take great care to ensure support services for expatriate assignees' health and security exist and function well, it seems timely to examine the effects on the overseas tenure of employees and families who have had to utilise medical and / or security evacuation services under emergency circumstances and to ask the question, is what is being done, enough?
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