Early in 2020, NBC reporter Vicky Nguyen let us know she’d relocated from her Bay Area NBC affiliate to studio headquarters in Manhattan. For five years, Ros and I had had periodic conversations with her, though no news stories materialized. Now Vicki was a correspondent for the Today Show. “Maybe I can help you,” she said.
After preliminary conversations, we decided to meet at Ros’s upstate New York home, where filming would occur. Though Ros and I had been interviewed before, never like this—with a producer, cameraman, sound man, thousands of pounds of equipment, hours of set up, the recognizable face of a national news figure, and Congressman Sean Patrick Maloney, the original sponsor of our bills.
As Protect Students Abroad (PSA), Ros and I viewed Vicky’s interview as critical to the organization’s goal, mandated reporting of student safety incidents abroad. If we could connect the deaths of our sons, Thomas and Ravi, with other study abroad student deaths, we could explain PSA’s reasoning.
But much to our dismay, questions weren’t shared beforehand. We were meant to “sound unrehearsed” and have “natural facial expressions.” So, the night before, Ros and I barely slept. We were that nervous.
The next morning, NBC’s team arrived in succession. First came camera and sound, then food, the producer, Vicky, and Congressman Maloney. People fanned out over the entire main floor. For the congressman, a well-lit location was chosen, with winding stairs in the background, while Ros and I were seated in a cozy den, two chairs pushed side-by-side.
Vicky started her interview with us. Right away, questions were difficult, not intellectually as much as emotionally. Toward the end, she asked Ros, “Knowing what you know now, would you let your son go on this study abroad?”
“No!” Ros responded without hesitation, listing the program’s failures.
I thought to myself how this was so like my colleague. One of the first stories Ros had shared about herself was how Ravi referred to her as “the junkyard bulldog,” fiercely protective, quick to act, and 100% clear. How I wished Vicky would not ask me the same question.
But as Ros ended her critique, Vicky’s head slowly swung in my direction, eyes establishing contact, “And you?”
I felt a thousand possibilities scatter, like rocks down a jagged path. Contingencies diverged into what-ifs, even as Thomas’ death made every single one of them fiction. Nothing would bring him back.
“I don’t know,” abruptly I felt sure this was a test, and I’d failed.
“I mean, I would do anything to have Thomas back. But to tell him ‘you can’t choose—I’ll choose for you’?”
I paused, wishing to claim no. But too late, I’d already turned in another direction. Instead, I took a breath and continued, “Parents walk a line between giving children guidance and freedom. The missing piece is good information. Better facts would help everyone—including the schools.”
Did I imagine flitting confusion across Vicky’s face? Maybe I hadn’t stated PSA’s case succinctly? But the cameras were still going, so I attempted to illustrate.
“For example, on the day Thomas died, risk was piling up. Rain. Diminished light. Exhaustion. Absent supervision. All these things are linked to fall-injuries. They are the small risks that add up to catastrophic risk.”
I could feel my pace of words gain speed, “This is why PSA asks for data. How can we expect students to make good decisions when the programs themselves do not have good information?”
We were less than an hour into what would be a day-long endeavor. NBC’s goal was a few good minutes of tape, and I’d already covered the essence of PSA’s position. I should have felt satisfied. But I didn’t. Vicky’s question had assumed space inside of me and would live there for months.
Why didn’t I just say no?
Student deaths are rarely accidents
Following a study abroad student death, program leaders and education experts may issue a public statement. Often, the event is referred to as an “accident” or a “tragic accident.” The media will then repeat this language until it is everywhere. Explanations arrive on the authority of education professionals, despite the typical lack of independent investigation.
Tragic, but an accident, becomes the public view of student travel deaths. Death occurs due to bad luck, unknowable mystery, or possibly, someone’s fault—though unless blame belongs to the victim, this, too, will likely remain a mystery. An accident is understood as a mishap, misfortune, or mischance, rather than a mistake requiring inquiry and correction. Sadly, devising death-prevention strategies is not feasible when comprehensive information about previous deaths doesn’t exist.
It is nearly impossible for parents of a suddenly deceased child to describe early efforts to integrate what has happened. The level of shock is so great that mothers and fathers could hardly explain what is taking place inside them, though assembling a coherent understanding of events is usually an early goal. After all, making sense of the senseless is essential to holding on to one’s existence.
Ultimately, however, bereaved mothers and fathers reintegrate and cope in different ways. Like Ros and me, some pursue advocacy. Some embark on a spiritual journey. Others focus on what remains of living—family, friends, work, and other interests. Some find a new community, whether through grief groups, religious or social organizations, or a cause connected to their child. Extroverts may become introverts. Thinkers may become feelers. Some may keep their child’s room the same. Others may relocate. Radical change often follows sudden child loss, though it may manifest inside only.
While no two children are alike, their deaths contain similarities
Much of our interview with Vicky ended up on the cutting room floor. What made it onto the Today Show was filmed later that morning. The producer placed us near windows high over the Hudson River. PSA’s binders of the dead had been spread across the kitchen table. We slowly paged past familiar faces, recalling news stories, knowing that other mothers and fathers are also grieving. We remembered how surprised we were when news reports of student demise began to seem like versions of one another. While no two children are alike, their deaths contain similarities.
Student travel safety defies straightforward explanations. When study abroad goes well, learners benefit from what has been marketed as a life-changing experience. They thrive in ways that wouldn’t have been possible without study abroad, even as they barely recognize how many operations have come together to create such experience.
It is only in tragedy’s aftermath that one sees the intricate relationships that inform opportunity and risk—multiple schools, multiple countries, multiple landscapes, multiple jurisdictions, not to mention multiple people, often unfamiliar. Risk factors, such as fluctuating weather, time of day, nutrition, hydration, fatigue, transportation, infectious disease, crime, and so on, add to student travels’ complicated nature. When chance accumulates, and a tipping point occurs, life-changing takes on an entirely different meaning.
Given the magnitude of devastation that ripples through grieving families and communities, Ros and I expected higher ed to join our call for evidence-based information. But Thomas and Ravi have been gone nearly a decade, and though PSA has made inroads with particular professionals, industry advocacy for transparency has not taken hold. If anything, news reports of student deaths and injuries are increasingly difficult to find.
The irony of Covid
One week after NBC filmed, the Centers for Disease Control (CDC) issued guidance recommending American study abroad students be returned home. Covid cases were rising globally, though just how fast was unclear.
Within a day, study abroad membership organizations issued a public response to the CDC. Their statement revealed frustration with the guidance. While these organizations claimed expertise, they stopped short of claiming authority. I read and heard bravado, but underneath, fear. Covid had the potential to eliminate jobs, even departments, and associated businesses.
Indeed, over the following months, Covid did just that. A public health crisis spawned an economic crisis. Within higher education, this was especially true for international education and study abroad. Six months later, Michelle Tolan Tomasi, former associate director for strategic engagement at the Institute for Study Abroad (IFSA), said, “The education abroad field has been decimated. It’s an unrecognized casualty of the pandemic.” Professional membership organizations have called for economic relief. They have also called for better information, as in better Covid data.
Ultimately, educators, parents, and learners all want the same thing—educational travel opportunities from which students will benefit and safely return. On the other side of Covid, PSA hopes that new partnerships will emerge, with the goal of better health and safety information. Evidence-based knowledge will serve students and also guide the programs that teach them.
Knowing what you know now…
Vicky’s question still echoes in my head, though over time, I’ve gradually understood what stunned me. It was the qualifier, knowing what you know now. The very idea triggered enormous waves of guilt and anxiety. As parents, above all else, we are primed to safeguard our children.
Catastrophic experience, as child loss is, carries complex feelings and ideas. While sudden death may be received as fact, it is only over time that profound bereavement reveals itself as having two features, scope and duration. The scope of change is massive. And the duration of that massive change will exist for the rest of one’s life. However, comprehending this takes time. One word joins two, then a phrase, until profoundly true sentiments emerge.
The deepest part of me still struggles with should-haves. Inside me, the fact of Thomas’ death lives like wildfire. Illogical as it may seem, I carry what happened to him as my failure. I was Thomas’s mother; I should have protected him. If I could turn back time, of course, I would. And I would tell my child, “No. I love you so much. You cannot leave me, or us, or any of the precious world we have built together.”
But bending time is not an option. My only choice is forward. To carry the dead, tell their stories, and mobilize for change; this is why PSA was created. This is why Ros and I go on.
With gratitude to Vicky Nguyen, Chemene Pelzer, Debby Murphy, and NBC.
In 2007, I embarked on a study abroad program to China with the Hotchkiss School. What I expected to be an adventure full of cultural and language immersion quickly turned into a nightmare for me. After hiking down Mount Panshan in China, I developed Bell’s Palsy, which progressed to full paralysis, all from an encephalitis-carrying tick bite. I was left unable to speak, something that I still struggle with to this day. Something less noticeable, but again recognized as a deficit, was my ‘executive functioning’ or planning skills. Of course, there were other deficits, such as fine motor movements. Speech is considered a fine motor movement, but we’re talking more about hands and fingers. My hands were balled into fists and turned inward.
My parents flew to China. They found me in a local hospital, highly confused, even incoherent. I didn’t recognize them at all, nor understand what had happened to me. My last memory was of celebrating the 4th of July with Hotchkiss students and faculty, then nothing but my body’s fight for survival.
Two-and-a-half weeks after my parents arrived, we flew from China to a hospital in New York City. I ‘woke up’ there. I understood two things: the people standing next to me were my parents, and something terrible had happened to me because now I was paralyzed and unable to speak.
In the following days and weeks, I quickly discovered how encephalitis had impacted my body. For example, once my hands were opened or closed, it was hard for them to move either way definitively. I used one hand to open the other, and vice versa. My handwriting was, and still is, a struggle. But in today’s digital world, it’s becoming less of a necessity. Typing is the new issue for me since two fingers on my right hand stubbornly refuse to bend unless manipulated. This leaves me to type with only 3 fingers on one side and 5 on the other.
In 2008, my parents and I filed a joint negligence lawsuit against Hotchkiss. The case wasn’t fully settled for ten years. Hotchkiss fought tooth and nail to win. However, in the end, to the credit of a great lawyer and my own positivity, we won the second-largest payout in Connecticut history.
The outcome of Munn v. Hotchkiss School was a historic moment for sure, but it was more of a relief for my parents and me. A relief that I wouldn’t have to be dependent on my parents for the rest of my life. A relief that I would have enough money to pay for therapy for the rest of my life if needed. Of course, many people with disabilities have to work; had I not won the lawsuit, I would probably be working, as well. However, as the months and years have gone by, the difficulty of obtaining a job with my particular disability has become more evident: why hire someone with a speech disability when you can hire someone without one?
Given the publicity around my case, I have wondered how it has impacted schools. Might they be motivated to collect and share better safety information with students? When I spoke with my lawyer about this, he emphasized the student’s age at the time of their injury or death. I inferred from our conversation that, if a student is under 18, winning a case is more likely. (I was 15 when I attended the Hotchkiss program in China.)
When I spoke with Protect Students Abroad (PSA), a non-profit that advocates for transparent and comprehensive safety data collection from academic travel programs, cofounder Elizabeth Brenner said, “Aside from two narrow Minnesota bills, regulatory oversight of high school or higher ed study abroad is non-existent. No other state requires schools to report deaths or injuries during academic travel programs, no matter the student’s age.” Attempts at New York state and federal legislation, such as the Ravi Thackurdeen Safe Students Study Abroad Act, have met stiff resistance from schools. It is impossible not to conclude that high schools and colleges have done little to improve safety information for education abroad students and their families.
As the years have passed, I am increasingly aware that I wouldn’t have survived without my parent’s ability to travel to China and bring me home. Especially in today’s climate, I recognize that I’ve benefited from that privilege. After hospitalization and rehabilitation, I was able to attend college. Actually, I attended two colleges, the first Trinity College and the second Barnard College of Columbia University in New York City.
I found that some professors didn’t know what to do with me. They even seemed upset by my situation. Once, when I used my computer’s text-to-speech app to ask questions, the professor said, “Oh, I see—you can’t talk.” She said this to a lecture hall of 200 students, which was just as embarrassing and insensitive as it sounds. Others adapted better and were much more caring; this tended to be in smaller seminar courses where professors could get to know me. Socially, as you can imagine, it was exceedingly hard for me to make friends and form lasting bonds with people who I couldn’t talk to without my cellphone.
Given my issues with typing, it was also very tough for me to take notes. Though I sometimes received notes from classmates, there were times when they forgot, which often led to me not having notes for several classes at a time.
In the two years after college, I slid into a lackadaisical attitude about practicing speech; it took place in the course of everyday conversation, and that was it. I didn’t have much interaction with others. I mostly spoke with my mother and occasional visitors. I viewed myself as unlovable, so dating was something that I shied away from. Whenever someone didn’t understand me, the text-to-speech app was something I used as a crutch. Then, in January of 2018, we won the lawsuit.
Winning emboldened me to make changes in my life. I decided to try online dating and met I.M. on Hinge. I used the text-to-speech app for the entirety of our first date. Needless to say, I was surprised when I got a second date. That was two years ago, and I.M. is now my boyfriend.
I.M. tells me that there’s not a day where he doesn’t see me just waking up and talking again. And then, of course, when I do wake up, reality hits me that I’m not able to speak as I did before. In my boyfriend’s mind, practicing every day yields results. He has worked with me tirelessly on getting my speech back to 100%.
My boyfriend came into my life and said that I needed a schedule, a set time to practice every day, and a Google Sheet to help me be accountable. He told me that I’d hear it from him if I didn’t practice and enter time spent. Over these last two years, my speech has taken off, and I think it’s primarily because of the sheet he set up. I can now pronounce my name—something that I couldn’t do when I first met I.M. Today, my boyfriend told me that he is proud of me for the improvements I’ve made in my speech. He noted that we hadn’t used the text-to-speech app at all on our daily walks.
I have done everything throughout these 13 years to carry both difficulty and good fortune with grace. Advantage brings responsibility, which is part of why I give back to two of the educational institutions I attended (Sacred Heart and Barnard). I want to support them taking good care of their students during study abroad.
As my life moves forward, I see myself as I.M. sees me: a courageous human spirit who has a penchant for positivity, someone who will not let a virus destroy her light but will use what has happened to shine even brighter. I am thrilled to tell you that, this August, I.M. and I moved in together!
Cara Munn is currently writing a self-help memoir.
By PSA_Admin|2020-08-11T13:59:48+00:00August 11th, 2020|Uncategorized|Comments Off on 13 years after China by Cara Munn
The Forum on Education Abroad, also known as “the Forum,” is a large U.S.-based institutional membership organization and standards setting body for the education abroad industry. The Forum’s website states their purpose, to “disseminates comprehensive standards of good practice, resources and training, advocates for education abroad and its value, and engaged the field in critical dialogue to benefit students,” including “health, safety, security and risk management.”
In March of 2016, the Forum released a report that purportedly analyzed education abroad student deaths for the year 2014. The question that framed their analysis was this, which is safer, study on-campus or study abroad? The resultant “key finding” was widely announced by the Forum: “College students studying abroad are less likely to die than college students studying on campuses in the U.S.” Thereafter, in press coverage of subsequent student deaths, news stories were accompanied by a restatement of the Forum’s key finding.
Two years later, the Forum asked the same question, though this time they considered seven years of data (2010-2016). Again, they came to the same conclusion: “College students studying abroad are less likely to die than college students studying on campuses in the U.S.”
In order to determine on-campus risk, both Forum reports used data from what they refer to as “the Turner study.” In 2013, Turner and colleagues published the results of a pilot study, a small-scale study intended to better understand potential issues with conducting a larger one. Their objective was to identify leading causes of death and mortality rates for students attending U.S. institutions of higher education. To accomplish this, Turner sent out 1154 surveys to institutions of higher education.
Survey research is always challenging, and there are significant challenges with the Forum using Turner’s study. For one thing, only 166 surveys were returned. Turner rightly dropped nine of those surveys, for a final total of 157, which at a below 15% response rate must have been disappointing. That this study relies on a self-selected convenience sample with a low response rate limits the ability to make inferences and raises concerns about sampling error, mistakes in statistical analysis due to using a subset population that does not adequately represent the whole. Moreover, since there’s no standardized methodology for schools to track and report student death, survey information arrived in widely variable formats. Turner never did conduct a larger study, so there exists no expanded response rate, nor has the definition of student death been standardized.
To obtain information about deaths during study abroad, two large insurers confidentially shared claims data information with the Forum.* This information represented insurance claims made by bereaved families for the cost of repatriating their child’s body. (Issues with these two data sources have been previously discussed in PSAs’ blog “Scientific Research Versus The Forum Report.”**)
Table 1 of the 2018 Forum report lists decedents from 2010 through 2016, by gender, country of death, and cause of death. When comparing this information against Protect Students Abroad ad hoc data, we surmised students who were included and not included. For example, my PSA colleague, Ros Thackurdeen’s son was not included. His program did not carry insurance. My son was also not included. Though his program was insured, the program’s carrier did not participate in the Forum’s data project. Also, Thomas’ body was never found, making a repatriation claim a non-issue.
Though personal, these examples are not exceptional. We are aware of other education abroad students who have died, but are not a part of the Forum’s claims data. This may be because not every bereaved family makes a claim, or they may make a claim through a different insurance policy or carrier, or the program might not be insured at all. All of these possibilities represent missing data, which is why insurance claims data is generally not considered high quality information for assessing risk.
In summary, datasets used by the Forum have weaknesses that were inadequately addressed in their reports. Much to the disappointment of PSA, the 2018 report asked the same hollow question they asked in 2016, a question that undoubtedly means more to the education abroad industry than to student safety advocates and bereaved families. It uses the same qualitatively weak data, the same researcher and the same flawed methodologies. The final product reads as if criticism should be limited by simply supplying larger numbers.
Improved understanding of risk can never result from replicating flawed numbers with more flawed numbers. This approach can only result in a larger version of itself, which inevitably will remain deficient. So for the remainder of this blog, PSA will focus on four specific weaknesses with both Forum reports. These weaknesses fall under the heading of bias, ways in which systematic error can be introduced into a research project to damage the validity of conclusions.*** We will discuss reasons why Turner data and insurance data are not comparable, which ultimately compromises the Forum’s key finding.
Students who engage in study on their home campus likely have many differences from those who engage in education abroad. Examples of such differences include a student’s age, gender, academic standing, disciplinary issues, physical health, mental health, socioeconomics, previous travel experience, and so on.
While research methods can sometimes allow for comparing disparate groups, the Forum offers no information about these differences. This suggests that no attempts were made to understand, account for, or control for confounding factors. In a sense, by using Turner data and insurance data, the Forum compared apples and oranges, claiming that because both are “fruit”—that is, both groups are made up of students—they’re comparable.
As previously discussed, one of the most basic problems with comparing Turner and insurance data is that there’s no standardized definition of student death. This is true both for student death on the home campus and student death during during study abroad.
Perhaps this seems like a frivolous point; after all, even if students are different from one another, death is still death. Nevertheless, how student death is defined has enormous implications for what researchers count and what they do not count. Given the distinct differences with which Turner and the insurance companies collected their data, and given the aforementioned problems with both of these data sets, we can rightly suspect that who Turner did and did not count was different than who the insurance companies did and did not count.
Healthy traveling student effect—
The “healthy worker effect” is a type of selection bias that occurs when the subjects being studied (population groups of workers) are not like the comparison population with regard to overall health. Likewise, the “healthy traveling student effect” is a type of selection bias that occurs when subjects being studied (population groups of students) are not similar to a comparison population with regard to overall health.
It is reasonable to assume that students with pre-existing conditions would be less likely to study abroad than students without pre-existing conditions. In other words, less healthy students probably are more likely to stay put, while healthier students may be more likely to venture out. Furthermore, students with marginal behavioral health may be less likely to study abroad than those who are behaviorally strong. Thus, the general population of students on study abroad may have overall better health than the general population of students on campus.
This type of self-sorting can impact research results in a significant way, by some estimates reducing measures of mortality in the healthier group by fifty-percent. For this reason, when comparing Turner and insurance data, the Forum should have considered the pre-death health of both groups. However, they did not.
The term all-cause mortality is used by researchers to indicate all deaths that occur in a particular population experiencing a particular exposure during a particular period of time. For the purposes of the Forum reports, exposure is either being a student on a college campus (Turner data) or being a student on study abroad (insurance data). The value assigned is measured in number of deaths per 100,000 subjects (students) per year.
Turner found an all-cause mortality rate of 22.4, which the Forum annualized to account for the variability in study abroad program length. This shifted Turner’s death rate up to 29.4 deaths per 100,000 students per year. In contrast, insurance data from 2014 yielded an all-cause mortality rate of 13.5, while the 2010-2016 insurance data resulted in an all-cause mortality rate of 17.6.
All of these numbers seem low. For comparison, it may be useful to consider scholarly studies of youth deaths around the world. For example, in 2012, Gopal K. Singh published “All-Cause and Cause-Specific Mortality among U.S. Youth.” Singh found that youth between the ages of 15-24 had an all-cause mortality range of 23.1 (Hong Kong) to 167.1 (Russia), with the United States at 80.1.*****
In light of this information, if the Forum’s 13.5 and subsequent 17.6 all-cause mortality rates do not make sense, what’s going on? Is their analysis being impacted by healthy traveling student effect? Ascertainment bias? Both? Surely healthy traveling student effect would account for a lowered mortality rate for study abroad students. As for ascertainment bias, under ascertainment in both student groups seems likely.
To their credit, the 2016 Forum report seems to understand the weakness of their data, for they state, “With such a small number of deaths it is very difficult to infer anything to the general population of students studying abroad.” And yet, the Forum leaps ahead to do just that, calculating a confidence interval of 99% that their key finding is accurate.
But determining confidence intervals only works if the numbers being compared have validity. The Forum report has calculated a 99% confidence interval of what? That the two populations (campus and study abroad) are different? This means nothing if the all-cause mortality rates are implausible in the first place. The Forum has not only produced apples and oranges, they’ve produce apples and oranges that are rotting with flawed methodologies.
The Forum’s all-cause mortality rate is so low that, if it is to be believed, it suggests that U.S. students on study abroad are literally the safest youth in the world! At the very least, the reasons for such outlier numbers should have been interrogated in the discussion section of both Forum papers. But they were not. This failure to stringently examine begs many questions, from professional competence to motivation.
There is no way to soft pedal our conclusion. Bad studies can be worse than no studies. Both the 2016 and 2018 Forum report are not true academic research. Their findings are weak, at best, and misguided, even manipulative, at worst. They provide no scientific information upon which to draw conclusions about education abroad student safety, risk and risk mitigation. Rather, these are industry reports, written by the industry for the industry. Sadly, their loose resemblance to research allows media to pick up and repeat the “key finding” like a tagline, thus sending an inaccurate message to students and their families.
While the first Forum report may have represented an attempt by the organization to move their membership toward shared safety data, their persistence with the same question, the same data, the same researcher and research methods, represents something else. In spite of proclamations by both the Forum and the education abroad industry that student safety is priority #1, a difficult truth is revealed by the failures of the second Forum report, as well as the industry’s unquestioning acceptance of these results, despite their persistent refusal to share safety data.
Survivor families understand that student safety risks during education abroad are unique and challenging, as are safety risks on campus. Before our children-as-students leave home for the world, they deserve safety information built upon the best academic scholarship. We continue to hope for and work toward the day when the education abroad industry recognizes transparent safety data and true scientific research as in everyone’s best interest.
* Cultural Insurance Services International (CISI) and GeoBlue (GEO, formerly known as HTH)
PSA’s data project began in 2012, with deaths and injuries identified via the Internet, and then ever more systematic collection. At present, our data goes back to the early 1900’s. As future safety incidents occur, and historic incidents continue to be identified, we anticipate we will be continually updating our dataset.
While our project is not yet complete, we are about to begin publishing on this website information gathered and organized. Information will be uploaded in batches, starting with 2000-2017, and will progress chronologically backwards, with deaths published first, and eventually also a separate dataset of non-lethal injuries.
PSAs dataset is not about establishing culpability; it is about creating conditions for death and injury prevention. With this blog, we hope to anticipate questions and respond to concerns.
What principles motivated PSA’s data project?
Every student is a child-as-learner and every student is someone’s child.
When students are placed in a new and unique environment, their biological and experiential immaturity can be problematic to their safety.
Currently, pre-travel education abroad safety advice (based on a combination of institutional experience, common sense, and federal recommendations) is inadequate.
No federal, professional or educational entity counts and collects education abroad deaths and injuries in a transparent database.
Without comprehensive transparent education abroad safety data, education abroad leadership is unable to advocate for student safety based on scientific evidence.
High quality data can be aggregated and examined for death and injury patterns, which can inform education abroad program safety.
PSAs #1 goal is comprehensive transparent education abroad safety data.
Students and their parents have a right to make fully informed educational decisions, including accessible and comprehensive science-based safety information from all education abroad programs.
Students and their parents have a right to expect that education abroad programs will uses every possible means, including evidence based science, to protect the lives of learners.
Students are our country’s future workers, earners, voters, leaders, and parents of the next generation.
Education abroad is a terrific experience—but only if students safely return.
What is studenthood?
All over the world, societies have constructed a unique role for those who are no longer children and not yet adults. We define this period of time as studenthood, a passage between youth and maturity, marked by social and psychological pressures, high expectations and hopes, expanding experience, experimentation, and formalized learning.
Who is a student?
Perhaps this seems like a silly question. However, a student will mean one thing to a grade school teacher teacher taking classroom attendance. It will mean something else to a college admissions officer counting how many students will be in the freshman class.
In a way, both the teacher and the admissions officer are collecting data. When different data collectors count for different purposes they will end up with different datasets. And that is OK, so long as the data collector’s definition of whom they are counting (in this case, “student”) is clear and consistently applied.
Well-articulated definitions are particularly important to scientific research. From the outset, one must understand who is being counted and who is not being counted.
Who are the students PSA does and does not count?
We count high school students, undergraduates, graduate students, post-docs conducting research for their doctoral dissertation.
We count students of any age traveling under the auspices of federal programs, such as Fulbright.
There are two categories of students we debated about and ultimately included. The first were American students who directly enrolled with education programs overseas.
Also, though we initially removed post-undergrads, we re-added two groups: students who were on educational abroad programs and/or internships in preparation for continued education, such as grad school; students who were continuing as a direct enroll an education abroad experience that had that begun as a formal education abroad.
All of these students we counted door-to-door, from the time they left home until their deaths. This means we included student deaths during pre, post, and interim travel, as well as deaths that occurred during what education abroad professionals call “free time.”
We removed from our dataset students whose travel was not education-related. In other words, we did not include tourists who also happened to be students.
Why did PSA count so broadly?
Students are a distinct population. They’re no longer children, and not yet adults. Rather, students are moving through a transition marked by increased physical capability, but also (as science has demonstrated) incomplete neurological wiring. While young brains are primed for learning, they are also primed for less developed decision-making, including an emphasis on peer group affiliation over cautious risk-taking.
Placed in an unfamiliar location, a student’s instincts for reading that landscape can be challenged. American students who have never traveled outside the U.S. may be particularly vulnerable if they view the rest of the world as being more similar to the home than is true.
During education abroad, though students may aspire to function like experienced grown-ups, many depend on their “guides” (teachers, field staff, administrative faculty, and the field of education as a whole) for the wisdom they have not yet attained. If quick decision-making becomes necessary, particularly without the input of experienced adults, catastrophe can ensue.
Moreover, if field staff, themselves, do not have a solid understanding of a particular location—and here, I’m not talking book knowledge, I’m talking about enough practical knowledge to read landscape as a local person would—any situation involving an inexperienced student can quickly devolve from safe to risky.
Unfortunately, when students die during study abroad, their deaths are not collected and studied. Oh yes, insurance companies will count students they insure, especially if survivors file a claim. And yes, a couple of education abroad professional membership organizations ask for voluntary counts of certain data, while programs themselves presumably collect safety data, which they keep for themselves.
However, none of this information is transparent and available to the public. Nor is any of it comprehensive (meaning institutions measure the same things, then share information to create a significantly large dataset). This means that there’s no high quality safety science informing education abroad—which is regrettable, for surely both students and on-the-ground faculty would benefit from such knowledge.
For all of these reasons, we deliberately counted broadly, in order to capture the ever-expanding student population that reflects trends within the student travel industry. As a result, our dataset represents a count that will not be matched by any current organization.
How did PSA gather information?
In 2012, Ros started using the Internet to collect news stories about education abroad deaths and injuries. She placed these stories into a two-inch binder. Currently, Ros has filled seven binders.
In 2014, Congressman Maloney’s staff began placing Ros’s information into an Excel spreadsheet. Information was arranged by state, which was useful for Maloney’s staff when identifying legislative support.
Both compilations presented issues for PSA. Neither was chronological. Also, students who were travelers, but weren’t specifically traveling as students, had been mistakenly included.
Once PSA’s student population was determined, what information was gathered and how was it formatted?
Since chronology is essential to our objective of an historic narrative, information has been arranged in a five-column format, beginning with the first column, date of death.
Basic information—name, age, and home state—forms the second column.
In the third column, we list the student’s home school and education abroad program (sometimes the same, but often not). We include “student status,” i.e. whether the student was in high school, undergrad, graduate school, post-doc, or between programs. When this information is available, we identify the type of program the student was on. We also noted what country the program was located in.
In the fourth column, we identify location of death (not always the same as country of study). We also indicate cause of death, including a brief narrative and news links.
Adding an “About this student” column was a late inclusion. However, without it we’d become concerned that a neutral reader might see these students as sad stories, but not necessarily track their deaths as a tragedy for America. Many of these students were deeply thoughtful and kind, on their way to productive, even brilliant lives.
What challenges did PSA encounter?
Relying on news stories poses all sorts of difficulties. But it is the only source of information currently available to the public, so this is what we used.
Stories of education abroad death can be hard to find. For one thing, most deceased education abroad students die one-at-a-time. This means that the death of a student rarely generates more than a day or two of news, and this coverage is generally local, not national.
Older news is hard to find. We think we were able to track the majority of education abroad deaths within the past decade or so. Pre-Internet stories were not reliably available. And even links to stories that Ros had found during her early searches were occasionally no longer active.
News stories can be inaccurate. We found this to be particularly true when reporting was based on the earliest published information, where that original version was incomplete or inaccurate.
News stories can be inconsistent. In this case, our best guess is that later reporting contradicted early because of fact-checks. However, one noteworthy distinction is that local reporting (from the place where death occurred) sometimes differed from U.S.-based reporting, with local reports focused on community knowledge of location specific risks.
News stories can be incomplete. We found this to be especially true with two categories: “Student Status” and “Cause of Death.”
Why was “student status” a challenging category?
Journalists usually distinguish whether a student is a high schooler or grad student. Most often, a newly deceased adolescent is reported to have been traveling with his/her home school, a religious organization, or an independent program provider. In contrast, a newly deceased graduate student is reported to have been conducting research or attending a conference.
However, with undergraduate students, journalists don’t necessarily track that a student may have been from University W, but studying with Program X, or Professor Y, or even independently enrolled in foreign University Z.
Most students, parents and reporters believe undergraduate student travel programs to be synonymous with “study abroad.” However, to the field of international educators, this is not accurate. Education abroad professionals distinguish between study abroad and education abroad.
One of the reasons for this public misunderstanding is that undergraduate education abroad program options are vast. Yet, all of these options may appear on the home school’s website and at recruiting forums, often with the promise of academic credit. This can create the impression that all programs are connected to the home school, or at least have undergone vetting by the home school.
Until something goes terribly wrong, families will not comprehend that most education abroad programs are not connected to their child’s school, nor have they been evaluated by their school. Too often, it is only after catastrophe that parents comprehend the complicated network that made their child’s education abroad possible.
What is the difference between “study abroad” and “education abroad”?
Study abroad is regarded as for-credit coursework that generally occurs during a student’s undergraduate years. Study abroad can include college or university programs, professor programs, partner programs and independent programs.
Education abroad is a wide umbrella, and includes study abroad, plus non-credit options, such as internships, humanitarian missions and research projects.
Why was “cause of death” a particular challenge?
Again, we were relying on news reports. With the exception of our own children, in no case did we have access to official cause of death information.
How did PSA categorize specific causes of death?
With the help of various content experts, and after a yearlong project working with our student population, we settled on eight cause-of-death categories.
What special considerations did PSA give each cause of death category?
Researchers called epidemiologists generally divide injury-related deaths into two categories, unintentional injury and intentional injury. Unintentional injury is defined as “damage to the body by an external force.”
Drowning, falls and vehicular accidents are usually, though not always, classified as subcategories under unintentional injury. However, in our population, these three types of death occur frequently enough that we gave them their own respective categories.
The remaining unintentional injury deaths form their own category. Examples of unintentional injury death include accidental overdose, exposure to weather, fire, and natural disaster. To the extent that news accounts suggest that inadequate treatment played a role in death, we note this in our narrative.
Intentional injury includes homicide and suicide. We define homicide as “intentional harm of one human being to another.” In our population, homicide occurs as a result of crime, terrorism or civil unrest.
Suicide is rarely disclosed, presumably at the request of the family. From 2000-2017, we have one confirmed suicide.
When available, illness is separated by pre-existing condition versus acute illness. Again, to the extent that news accounts suggest inadequate treatment as a contributor to death, we note that in our narrative.
The “Not Available” category has four sub-categories. Cause of death is: not disclosed by the family; not reported by the press; not known; or speculated on, but with no definitive voice.
Finally, as we worked with PSA’s data, we recognized within Not Available a subcategory we’ve separated into its own group. When a bereaved family believes their child died from one cause, while the host country and/or the education abroad program maintains another, we consider cause of death to be in dispute. For such students, we list cause as “Disputed,” followed by two (or more) potential causes.
One of the reasons why we believe this group requires its own category is that, in all cases examined thus far, the bereaved family believes their child died from intentional injuries inflicted by another human being—in other words, homicide (by any number of means). In contrast, the host country, and sometimes the education abroad program, maintains cause of death to be unintentional injury.
Is there any information PSA did not include in death narratives?
We did not include the possible role of alcohol or drugs in our narratives. We believe this information has been used for too long to blame the victim, shame families into silence, and exempt programs from responsible self-examination.
That said, for the purpose of our own data collection, our Excel spreadsheet maintains this information. Furthermore, with some students, it was impossible to find news stories that did not focus on alcohol, drugs, and their alleged role. So this information may be available in our news links.
In making PSA’s death data public, what has been our greatest concern?
Initially, we worried about repercussions from the education abroad industry. However, gradually we’ve grown confident in the simple rightness of our goal, transparency.
At the same time, we’ve become more concerned that publishing this information may cause further pain for already bereaved families, especially with regard to cause of death.
Why has cause of death been such a specific concern?
When a child leaves home for education abroad, he or she is usually quite happy, and the entire family has high expectations. A joyful return is anticipated, even expected, with child-as-student filled with interesting stories and new learning.
Instead, there’s sudden, often violent, death.
Since student death happens far from home, there will likely be a struggle to get the body returned, and even more, to get a thorough accounting of what happened. While the U.S. embassy may be involved in death notification, it is the host country that will conduct whatever investigation (if any) takes place, while the student’s education abroad program may be the main communicator. In other words, several institutional entities may be involved with post-mortality protocol, each with distinct interests.
Meanwhile, for suddenly bereaved families, one question, How did my child die?, runs on a continuous loop. Parents are desperate for truth, as in facts. They are looking for logic and meaning. In this context, opinions will never substitute for honesty.
If parents think authorities are being less than 100% transparent, every instinct will be alarmed, and one question—How?—will spin into thousands.
Who was with her? What had he been told? Where were her teachers, her friends, and any authorities? When did he know he would most certainly die? Why did I let her leave home? How did he feel at the moment of death?
Ros and I have traveled this hard loop over many years, and we always land in the same place: no matter the answers, Ravi and Thomas never come home. They are no longer living, breathing children. They have become memory. What remains of them is story—a beautiful life, a horrible death. And now, that narrative lives inside us.
Learning to simultaneously hold the beauty and horror of their lives has been a relentless task. Gradually, Ros and I have built a new relationship with our sons. Beginning to end, they have been taken inside us, even as we realize this new relationship is not only with our deceased child, but also with our own living self.
The rest of this life is the hardest work we’ll ever do. Mapping life to death to life to death, over and over again, ours is a deeply personal, nearly sacrosanct journey, as we build a complex, nuanced connection with our deceased child and the world that took him. There is no rainbow moment where the truth of what happened gets easier. Reality only gets clearer.
In publishing PSA’s death data, what if we make more painful a bereaved parent’s process of grief? What if we are inaccurate? What if we emphasize certain details? Or gloss over others? What if we use a “wrong” word? A strong word where a tender word might be better? Or a tender word where a strong word might be better? Might simply including these students in our dataset be too much for some families?
Especially with death narratives based on news stories, the possibilities for misstep have felt innumerable.
Given our concerns, why is PSA sharing this information anyway?
We believe that most parent-survivors are ultimately motived by one common goal: This cannot happen to another family!
Stopping preventable deaths is about understanding incident patterns. And we believe there are patterns of death and injury during education abroad. Moreover, we believe these death and injury patterns are unlike patterns of death and injury on home campuses.
With PSA’s data, we hope to advance the conversation and motivate specific action on the part of education abroad professionals, their supporting institutions and organizations, global health specialists, injury prevention researchers, and state and federal authorities.
Why is transparency important to all student safety issues and urgently needed now?
America prioritizes her students; they are America’s future.
Ros and I grew up imagining this two-part statement to be true. It was only after Ravi and Thomas’s death that I realized the second part is true—probably not the first.
Sexual assault. Hazing. Gun violence. Safe and adequate student housing. Student debt. Under-training and subsequent under-employment.
In doing the work of PSA, Ros and I have met other communities of survivor students and families. We’ve learned their stories and noted the similarities. They, too, believed the safety of students to be America’s highest priority. They, too, have come to believe that this is not the country we are.
From our vantage, it appears that the wellbeing of American commerce supersedes the wellbeing of American students. And so, we wonder what rights our children-as-learners ever had? Surely when the needs of students collide with the needs of business, students rarely win.
A broad hard conversation about America’s priorities is long overdue. With epidemiologists, student health and campus safety experts framing death and injury prevention strategies, and impacted students and families as honored stakeholders, precisely what is at risk must never again be forgotten.
A final note to bereaved families, survivor students, and education abroad professionals:
PSA’s death data is based on news stories as primary source information. Relying on media can impact accuracy and detail.
Where we have gotten information wrong, please contact us. We will do our best to add, delete, and amend.
A few years ago, I was invited to a meeting of “study abroad stakeholders”, the topic, student traveler safety. Attendees would include international education program providers and security officers, professional membership organization personnel, insurance executives, and federal officials, including Homeland Security, plus me, a parent.
Frankly, I felt surprised to have been invited. These were stakeholders, after all, experts, insiders who understood the inside of international education. My child had died during his study abroad. Except for knowledge from a broken heart, what were my credentials?
I asked this question of the gentleman who’d phoned to extend the invitation.
“You might be able to say what no one else will say,” he replied.
I’d never been a brave person, so I doubted my inviter’s words. But I was curious, and curiosity won. I agreed to attend.
On the day of the meeting, our group filled one long conference table. At one end, a facilitator who periodically asked questions, steering the conversation, but not directing it. At the other end, a note taker.
Mid-afternoon, nearing a long day’s conclusion, one of the program directors said, “Well, you know, most of ‘em are drunk.”
Them. Study abroad students. Especially the dead ones.
I’d heard this line of thinking before. I was pretty sure everyone in the room had heard it before. In fact, if I’d not been present, perhaps some would have nodded their heads, mumbled agreement.
Instead, stillness, silence. What could anyone say? The dead kid’s mom was in the room.
For me, inside, it was a strange moment. Hard words had been spoken, but I was not filled with anger, or even resistance. Not fear, though surely sadness. Mostly, questions rumbled through me.
What is this program provider really saying? That the role of alcohol makes a child’s death less painful for loved ones? That the role of alcohol absolves the industry from addressing student death? Why does this person’s comment feel like a defense against something else?
“Show me,” I said.
“Show you what?” the director replied.
“Show me the research that proves what you say.”
Sitting across the table, the professional eyed me. Of course, this person couldn’t show me research. Real research is based on real numbers. The student travel industry doesn’t count and report much bad news.
“You know what, I don’t believe what you say—that most students are drunk—at least not across the board. Perhaps by city. Or country. Perhaps by school or some other grouping. But why wouldn’t you want to know where alcohol-related risk is highest? Why wouldn’t you want research to inform your programs?”
I paused, “…As long as you don’t count and report, you don’t know…so you can say anything you want,” and then, suddenly, this, “And so can I.”
Perhaps no one in the room understood what had just happened. Thomas’s death was making me brave.
Still, it would take time to meet the right people. Ros, a woman who knows bereavement from the inside and still manages to get up every morning and find the children of others, young learners whose “life-changing educational experience” included death or injury. It would take months and years for us to forge an alliance built upon one goal, transparency.
It would take time to try solutions and fail. Write some letters? Prepare to be ignored. Press your legislators? Expect roadblocks, not to mention the gutting of a law’s intent. Identify interested reporters? Know that any day’s news will circumvent you.
How did we end up in this place where the ideals of education—inquiry and fact-based truth—are shed for ambiguity?
Yes, it would take time for Ros and me to understand the core issue with student traveler safety.
The study abroad industry keeps secrets.
For suddenly bereaved parents, horrible as it is to lose your child, death during study abroad brings a particularly complicated grief. Of course, we want our son or daughter alive and returned. But short of this, we want facts. We want facts placed in a context, and we want to be able to trust the people who are telling us those facts. After all, details from our child’s last-lived moments are all that is left.
For programs aspiring toward the highest levels of professionalism, three virtues should be indispensible. Truth. Justice. Humanity. But in a world where success is measured in recruitment numbers and quarterly budgets, is virtue even possible?
Since student safety incidents occur off American soil, the things we expect would happen do not. Though eventually there will be a death certificate, there’s usually no independent investigation. This means that an event narrative can be slanted in whatever way boots-on-the-ground need it to slant. Families are literally out of their minds with grief. And every one else has an agenda. Study abroad programs. Home universities. Host countries. The State Department. Insurers. Lawyers. Even professional membership organizations.
Facts get sorted. Some step forward, some step back, or even disappear. Opinions are formed, too, and an account that supports those opinions. All of this happens quickly, so that by the time a family returns to some measure of lucidity it’s too late to get at fact-based truth, much less justice or humanity.
After Ros and I had spoken with enough families, academic experts, industry insiders, and legislators, we realized the only way forward would be through Ros’s growing stack of three ring notebooks filled with news stories from the Internet. For one thing, legislators and reporters, but really anyone we spoke with, wanted to understand the scope of the problem, which meant producing one thing, a death count.
In 2013, Congressman Sean Patrick Maloney (D-NY), in advance of writing transparency legislation, put a couple of interns on data entry. These young people were given access to Ros’s work. Since Maloney’s office was looking for cosponsors, they entered her information onto an Excel spreadsheet and organized it by Congressional districts. Wide pages, filled with narrow rectangles and the tiniest font, student deaths and injuries state-by-state, were the resulting product.
Once Maloney’s sheets were formed, Ros continued putting safety incidents into an Excel spreadsheet. As she’s often said, “One student led to another and another and another.” So subsequent students were entered in the order in which they were “found”, which was rarely chronological. The upshot? Ros’s binders and Maloney’s spreadsheets mixed up years, as well as incident type.
As the years have passed, as incident numbers have continued to increase, the structure of both binders and spreadsheets has become unwieldy. Recently, Ros and I have begun a massive reorganization, sorting incidents from present to past, then by incident type, as in “lethal” and “non-lethal”. In doing so, we’ve become certain that we’re counting students who would never be counted by the industry.
For example, the widely reported 2016 Forum on Education Abroad report, counted four student deaths that had generated insurance claims during the year 2014. Their tabulation contrasts ours, which included fourteen deaths, including whole categories of students we believe The Forum Report missed. Graduate students; high school students; students traveling through federal grant programs; students who are foreign-born, but attending a US educational institution; students studying abroad for internships, mission trips, religious trips and performance trips; students doing pre, post, and intra-program travel; students whose program is not a Forum member, and more. *
Please understand, this is not meant as a criticism of The Forum’s efforts as much as a caution. The study abroad industry should anticipate an undercount from membership organizations, simply because such organizations inevitably focus on certain populations and not others.
“Great. Just what we need. A couple of sad moms collecting newspaper clippings…”
So read Internet responses to a recent Associated Press article about PSA’s work.
Another said, “They count high school students!”
One went on to recommend that we should “let professionals do their work”, while the other referred to student categories PSA includes, as if we do not understand how to think about tallies.
As consumers, most of us have an intuitive grasp of commerce. For example, many of us would not be surprised to learn that many industries resist transparency, especially around safety.
However, what is surprising is this industry’s rejection of transparency, particularly with regard to safety data. For one thing, the business of education is meant to be about students, our children, our nation’s future.
Indeed, the dominant narrative of education is one of service, a noble, even sacred mission, with international education perhaps the noblest sector of all. The student travel industry not only educates our young people, they foster human connections around the world, including the possibility of world understanding, with students as “American ambassadors”.
We believe this to be the study abroad industry’s preferred narrative, a current and fabulous spin. It allows for a number of unexamined ideas to be conflated with growth-enhancing messages.
Study abroad students are crucial to America’s image around the world.
The safety of America’s study abroad students is priority #1.
The student travel industry must grow.
The student travel industry must continue without impediments, particularly laws.
For those of us on the loss side of study abroad, branding, marketing, enrollment, and budgets are easily recognized as industry priorities. Safety, not so much. As a whole, the industry has powerfully resisted calls for transparent comprehensive safety data.
It is worth noting language from The 2016 Forum Report. In spite of many methodological failures, the report opens with these words: “The chief conclusion of this report provides a measure of comfort in concluding that, at the very least, study abroad does not carry a greater risk of death than does domestic education in the U.S.”
Really? Or instead, is it this? Without transparency, anyone can say anything.
The experience of becoming bereaved arrives abruptly. Understanding arrives gradually. For Ros and me, what we know now is straightforward and devastating. What happened to our sons is not unique. Study abroad deaths are always horrific, often preventable, rarely counted, and never transparently examined. Why did we ever imagine the student travel industry to be different than any other industry?
Now, when I recall that long ago stakeholder meeting, the program provider’s comment, “most of ‘em are drunk”, actually makes sense. Comforting the industry. Comforting legislators. Comforting future students and families. How seamlessly this stakeholder had shifted from student safety to comforting the industry to blaming the dead.
Pro-growth messages require comfort. Real data might not be so comforting.
Over the next months, PSA will work with our web developer to publish a history of lethal and non-lethal incidents during study abroad.
For PSA’s website, we will not use Excel. Instead, we’ll use what we hope is a user-friendly five-column format that allows for narrative. The first three columns will be filled with basic information (death date, name and basic demographics, home university, study abroad program, and country of study). Biographical and death information will occupy the last two columns. Thus far, we have formatted student deaths from 2011-2017.
To all readers, we believe that study abroad is a 24/7 exposure. Therefore, we will count broad categories of students, from the time they go until the time they do or do not return.
To bereaved families, where our work falls short, please email us so we can make corrections, including additions and deletions.
To the study abroad industry, we say the same, though with one caveat—student categories will remain broad.
Reframing student travel to include safety transparency will mean adjusting the narrative about international education. This shift will be uncomfortable for many. Please know, at PSA we will do our best to keep foundational principles to the fore.
Each study abroad student is someone’s child.
Transparency is critical to student safety.
Those of us who know the dark side of study abroad can no longer expect the study abroad industry to voluntarily disrupt their preferred narrative.
In the truest sense of the word, bereaved families are study abroad’s stakeholders. Like no other, we understand precisely what is at stake. It is time for our dead and injured to tell their stories.
* For more information, please see PSA’s Blog “Scientific research versus The Forum Report” (March 13, 2017): https://protectstudentsabroad.org/to-begin-again-3-2/
When working with newly bereaved families, please understand the following:
(1) Someone’s child left home on hope and a promise and instead died or was injured far from home.
Understand this to your core and express your sympathy
Be always mindful that, simply by offering your program, you are part of a devastating chain of events
Many of the ways that student death or injury could have been prevented will be obvious with hindsight
For families and survivors, the horror of this event will be physically and psychologically experienced, over and over again without warning, for days, months, and years—this is one of the hallmarks of trauma
The lives of the immediate family, extended family, and even entire communities will be forever altered
For the survivors, the extreme level of grief and trauma results in emotional, physical and financial damage that will never end
Understanding these basic facts about grief is not about admitting culpability—that is an entirely separate question—understanding these basic facts is about retaining your own capacity for compassion
In the face of someone else’s suffering, your first priority must be to remain faithful to your own humanity, which should cause you to prioritize those who are newly bereaved
When expressing your deepest sympathy to the newly bereaved, you must know that this child could have been anyone’s child, even your own
(2) “We are doing everything in our power to gather the truth of what happened to your child, and we will share this information with you as soon as it is available. ”
Say this and mean it
Death during study abroad brings together particular details—the student, far from home, may have suffered a violent death, with no possibility of an intact body—under these circumstances, the grief of survivors is “complicated”
Psychologist Dr. Pauline Boss has described this type of complicated grief as “ambiguous loss”
The absence of truth about what happened to a family’s child will only amplify the complicated nature of grief
Do not run a study abroad program that claims integrity if you cannot be truthful and transparent about every detail that led to student death
(3) Study abroad programs often proclaim, “Student safety is our first priority.” Bereaved families respond, “Really?!”
Given this industry’s fondness for growth, and yet its resistance to transparency, it’s difficult for those of us on the loss side of study abroad’s ledger to believe that student safety is priority #1
Bereaved families believe that student safety is a priority for the study abroad industry—just not #1
What value should we believe this industry places on student safety, when it willingly counts and reports students as they go, but will not count and report students if they do not return
The study abroad industry must expect that bereaved families will suddenly see through industry claims of safety to recognize something else: on the front end, marketing, and on the dark end, lawyers, insurers, and boards
The study abroad industry must understand that for a student’s family, on the front end, we believed we were giving our child a precious gift, the world—on the dark end, there’s a corpse in a box, ashes in a can, or no body at all
For bereaved families, conclusions about what to do with this sudden reality will arrive quickly—for others, more slowly
(4) Post-death and injury protocols must include superior communication, program changes, and continued help for survivors.
It is likely that an entire group of students has been placed at risk
It is also likely that an entire group of students has been traumatized
If the program is meant to continue, expect to make radical programming changes for surviving students
Death has become your subject—to ignore this fact strips survivors of their reality
To ignore death also strips program professionals of their humanity
Facilitate communication between the bereaved family and surviving students and instructors
Facilitate travel for bereaved parents and pay for it
Do not pressure bereaved families to sign legal agreements in exchange for information or travel
Expect to follow up with the dead or injured student’s family and peers indefinitely
(5) When issuing public statements about a study abroad student’s death…
Someone’s son/daughter/grandchild/cousin/friend has just died and this person’s life and death are now your subjects
Because many newly bereaved families initially believed their child to be study abroad’s first death, and because we gradually learn of other families like ours, we come to understand that students and families have never had the benefit of truly informed consent
We also gradually comprehend that your industry has profited from this lack of transparency
So, in this context, words matter—
We’ve raised our sons and daughters to the point where they are no longer children, nor are they adults—they exist in transition between childhood and adulthood, a passage marked by intense schooling, high expectations, and psychological pressure
Our newly dead and injured sons and daughters, as students, should continue to be called “students”—and your study abroad program should continue to be called “study abroad”
When issuing public statements, do not shift your language from “student” and “study abroad” to “traveling man” or “traveling woman”
Suddenly referring to your student as a “man” or a “woman” sounds calculated
Suddenly referring to your student as a “traveler” sounds calculated
Suddenly referring to your student as “an American traveler who died” sounds calculated
Do not use a compound sentence joined by the word “but”
For example, never say “this is obviously a tragic occurrence, but one that is rare during study abroad”
We hear this type of language and recognize it as abrupt, awkward, convenient, manipulative, disingenuous and designed to gain an early spin on the narrative
Do not shift your public statements to quasi-related material
For example, do not use concurrent media interest to instruct readers about how to shop for “good” programs—this information is useful, but not now
Do not list ways to minimize risk, such as not drinking alcohol while abroad—again, useful, but not now
Do not make weird and unproven analogies, such as “students are more likely to die on their way to the airport than on study abroad”
Setting aside the methodological deficiencies of the 2016 Forum report, do not cite this report and claim “study abroad is safer than studying on campus”
Do not make statements about how many students your program has educated—as if to imply that the tragedy of this student’s death can be lessened by large enough enrollments
We the bereaved understand that the aforementioned categories of public statement are not for the benefit of newly bereaved families
Such statements reveal the spokesperson’s wish to shift the subject from a specific student’s death or injury to a more general pro-growth message
Ask yourself, “Who are these statements being made for?”
The aftermath of student death is never the time to issue public reassurances to your industry
Speak to boards, donors, insurers, prospective students and their families elsewhere
(6) The study abroad industry must understand that bereaved families are not the enemy. We remember how much our sons and daughters believed in the transformational potential of student travel. We remember how we believed, too.
Our child’s death necessarily means we view your industry in a way that we never imagined
Our changed perception will likely spill over into how we view you—and this may be uncomfortable for you
In your efforts to deal with us, you may feel misunderstood—this impression may or may not be true
In your efforts to deal with us, you may feel that you, too, are a victim—you are not
We understand that you are concerned about liability, and this may cause you to feel fear
Resist pressure to become the mouthpiece for your institutional employer, whose worry about liability may be significantly greater than your own
You have a personal choice to make: defensiveness or compassion
A student’s death should change you—this change will be how you know you’ve retained your humanity
Please choose your humanity
By PSA_Admin|2018-12-15T20:28:24+00:00June 15th, 2017|To begin again|Comments Off on Advice to an industry, from the loss side of study abroad’s ledger
In March of 2016, The Forum on Education Abroad, which is the standards setting body for the study abroad industry, issued the following paper, Insurance Claims Data and Mortality Rate for College Students Studying Abroad.
When Ros and I read The Forum Report, to say we were disappointed does not begin to capture our feelings. For several years, we’d been asking both the study abroad industry and state and federal legislators for transparent and comprehensive safety data. This was not the product we’d ever imagined. For one thing, there were so many issues with the paper’s research methods*. But even more, The Forum Report began with its conclusion, and Ros and I had a bad feeling about what purpose this conclusion might serve.
Key Finding:College students studying abroad are less likely to die than college students studying on campuses in the U.S.
The Forum Report’s “key finding” is based on three data sources, all of them flawed, though in different ways:
The Critical Incident Database (CID):
CID is The Forum’s own tool
CID was launched in 2012, with 2014 as its first reporting year
CID asks broad categories of questions (this is a good thing)
CID participation is voluntary (this results in something called self selection bias, which is problematic)
The Forum guarantees confidentiality to CID participants (this makes independent review of claims impossible, which is problematic)
During 2014, with Forum membership around 650 schools, 38 responded to CID (~6% participation)
In 2014, CID reported no deaths
The Turner Study:
The Turner Study is a pilot study looking at student deaths on campus
A pilot study’s purpose is to test feasibility for a larger study (to date, no further study)
Turner’s objective was to look at leading causes and rates of mortality for students at a sample of US institutions of higher education
Surveys were sent to 1154 American College Health Association member institutions; 166 schools returned the survey (~14%)
Data arrived in widely varying formats
Turner found an all-cause mortality rate** of 22.4
Insurance Claims Data:
Two large insurers of higher education, Cultural Insurance International (CISI) and HTH Worldwide (HTH), volunteered their data to the Forum
2014 claims data reflected 146,898 study abroad students
In general, using insurance data for research intended to inform public policy is problematic for several reasons:
Actuarial data is geared to answer one question: How many policies must be sold to offset claims?
Not everyone who can make a claim does—a claim may be made through another insurer, or not at all
Actuarial data cannot represent populations outside the insurance pool
During 2014, four student deaths generated claims
These four insurance company deaths formed the basis for The Forum Report’s key finding. Using Open Doors*** data to estimate that same year’s number of students studying abroad, they calculated an all-cause mortality rate for study abroad of 13.5. The Forum then compared this number with Turner’s home campus death rate of 22.4. Thus, their claim of study abroad as safer.
Aside from fundamental pitfalls born of comparing data that is “apples and oranges” (as CID, Turner, and the insurance data are), The Forum Report fails as a scientific study for the following reasons:
No named author(s)
No review of the literature
No definition of terms
For example, how is “death” defined? Who is included? Who is excluded?
The definition of death can explain what we believe to be an undercount
A poorly written methods section****
No expert reader we consulted can precisely say what was done
For this reason, experts told us no scientist could replicate this study, which means no possibility of peer review*****
As listed above, there are problems with all three data sources
Voluntary, with low participation rates
Confidentiality for all
Data represents a limited scope of time
Was 2014 a representative year?
The authors did not question 13.5 as a reasonable all-cause mortality rate
Experts familiar with youth mortality research suggest this number is “implausibly low”
Neutrality is foundational to scientific research, yet bias permeates the entire Forum Report
“Key Finding” appears first
A scientific research paper places findings and opinions in the conclusion section
Potential legislation is cited by The Forum as the reason for this paper, as well as “reassurances” to the industry and future study abroad families
The Forum Report is published in a Forum publication, which again means no peer review
For these reasons, ProtectStudentsAbroad has concluded, though The Forum Report looks sort of like a research study, it is not. It is an “industry report”, written by the industry for the industry.
Industry reports are common to for-profit corporations, where business success depends upon budgets, quotas, and organizational control derived by powering through narratives. Industry reports are not intended to protect human safety. They are meant to drive business.
Indeed, four months after The Forum released its report, a University of Wisconsin student died. Beau Solomon was murdered while studying abroad with third party program John Cabot University in Rome.
In the aftermath of Solomon’s death, news headlines read, Despite Beau Solomon Death, Few Students Die on Study Abroad (Newsweek) and Despite Rome murder, study finds students are less likely to die abroad (Christian Science Monitor). Articles quoted study abroad senior leadership, including Forum president, Brian Whalen, and The Forum’s key finding was repeated like a tagline.
Aside from the flagrant insensitivity of such statements, The Forum Report’s underlying question of campus safety versus study abroad safety isn’t a line of inquiry bereaved families have ever pursued. Risks faced by students on campus versus students during study abroad are different; we get that. It is disappointing to us that The Forum Report did nothing to identify specific risks to study abroad students.
And so, in the aftermath of The Forum Report, using student deaths and injuries available via Internet, we are reviewing this information in an increasingly systematic way. While we do not claim PSA’s data as quantitative, or even scientific, we believe it is qualitative and notable—an ad hoc dataset compiled using available resources, including the web, volunteer experts, and the labor and knowledge of bereaved families. From our review, we would like to share a few observations.
While The Forum Report based their key finding off four student deaths, during that same calendar year we’ve identified fourteen. The following are categories of students we suspect were not included in The Forum Report:
High school students
Students who are foreign-born, but studying in the US, including US study abroad
Students studying abroad and not receiving credit, including internships, mission trips, religious trips, and performance trips
Students whose death occurred during “free-time”, including pre-, intra-, and post-program travel
Students whose programs were not insured by the two companies who participated in The Forum Report
Students attending non-Forum schools
Among our dead, injury appears to lead causes of death, specifically motor vehicle accidents, drowning and falls. Furthermore, heightened risk appears to be linked to specific demographics. For example, gender appears to be linked with manner of death. Also, certain countries of study appear to be linked with manner of death. In light of these observations, ProtectStudentsAbroad issues two recommendations.
To the study abroad industry: If fatality prevention is your profession’s premier goal, then embrace principles of transparency. To do less goes against American higher education’s historic ideals and operates as a betrayal of trust for students and their families.
To students and parents: The American publics’ lack of scientific literacy has allowed all sorts of industries, including the study abroad industry, to market sloppy science as “truth”. Until such time that the study abroad industry steps up and into the 21st century of evidence-based education******, we implore you to vigorously interrogate all claims made by programs. Ask difficult questions. Expect real answers.
The stakes are high. This work is hard. The cause is good.
*Research methods refers to the means by which data is gathered, and then statistically treated and analyzed.
**All-cause mortality is a measure used in research as an indicator of the safety or hazard of an intervention. For deaths, it is customary to use rates per 100,000, over a one-year period. In Turner’s study, he was measuring all deaths that occurred in his specified population, regardless the cause.
***Open Doors is a “comprehensive information resource on international students and scholars studying or teaching at higher education institutions in the U.S., and U.S. students studying abroad for academic credit at their home colleges or universities”. Under the umbrella of the Institute of International Education (IIE) and supported by a grant from the U.S. State Department, institutions of higher education voluntarily complete yearly surveys, from which an annual Open Doors publication is produced. Open Doors express purpose is to promote and grow international education; it does not collect safety data.
****The methods section of a research paper follows an exhaustive review of existing research on the topic. The methods section describes procedures used to collect data, and also details statistical treatment of that data. Methods are the nuts and bolts of a research project. When scientific methods are sound, the findings can illuminate, without bias, otherwise indecipherable connections between outcomes and a whole host of variables.
*****The peer review process begins with a research paper being submitted to editors of scholarly journals. If interested, editors refer the paper to experts in the field. Using discreet criteria, experts read and comment. Peer reviewers pay particular attention to the methods and results section, since these are most complicated and technically difficult. Methods sections should be written clearly enough that another researcher could pick up the paper and replicate the project. When well done, the peer review process serves to screen out poor research, screen in good, and in this way promote “best practices” for the entire field.
******Evidence-based education considers all aspects of education, from policy-making to classroom implementation, and applies evidence obtained from scientific research. Such research is not meant as a substitution for professional experience. Rather, it is a critical adjunct, meant to deepen and broaden fact-based knowledge.
By PSA_Admin|2018-12-15T20:28:24+00:00March 13th, 2017|To begin again|Comments Off on Scientific research versus The Forum Report
At the end of World War I, four men—a former Secretary of State, a college president, a political science professor, and a Nobel Peace Prize winner—joined forces. Because of this first-ever global conflict, they’d concluded that lasting peace could only be achieved when peoples from every nation know one another, and thus, the essential value of educators and students.
So with support and funding from the Department of State, the Institute of International Education (IIE) was founded. IIE located its headquarters across the street from the United Nations. They began by organizing student and teacher exchanges with European governments. In 1921, IIE’s president persuaded the U.S. federal government to create a new visa class, “non-immigrant student visa”, thus bypassing immigration quotas. By the ‘30’s, IIE had expanded their activities into the Soviet Union and Latin America.
After World War II, America’s allies, though victorious, found their economies near collapse. With infrastructures destroyed and millions of people homeless, old powers of Europe were sidestepped, territories carved, colonies turned loose, and geopolitical maps redrawn. It was in this context that the United States and the Soviet Union began what seemed a terminal wrestling match, global dominance the prize.
In this climate, IIE was instrumental in spinning off an alphabet soup of study abroad-related organizations. CIES. CIEE. NAFSA. The latter, pronounced Naf-sa, but also known as the National Association of Foreign Student Advisors, began with the goal to train academic counselors for the many foreign-born students who arrived in America after World War II. In 1976, the State Department reinterpreted its funding for NAFSA, which allowed the organization to support not only foreign students in the U.S., but also U.S. students studying abroad. With over 10,000 members, NAFSA is now the largest professional membership organization, their main goal the advancement of international education.
In the 1950’s, IIE began publishing an annual accounting of study abroad. Called Open Doors, IIE dubs its publication “a comprehensive information resource” on study abroad. In order to do this work, Open Doors sends surveys to programs and collates responses. Questions include how many U.S. students go, to where, for how long, and with what program types—though Open Doors never counts students who die or are injured.
To you, the reader, I hope you are coming to understand just how complex study abroad is. When Ros Thackurdeen and I were dropped into this arena, we were newly bereaved mothers with hardly an idea of what we were seeing. Thomas and Ravi’s study abroad program, home university, and the U.S. embassy in the country where they died had contacted us, and these were the entities we knew.
What we’ve gradually come to understand is that over the past century numerous organizations have woven together with the singular goal of moving young learners around the world. In a sense, the study abroad industry started with the good intentions of a few and quickly intertwined the fabric of higher education with the federal government and professional membership organizations. Aided by lobbyists, international businesses, global tourism, insurers, and accreditors, it is not an overstatement to refer to study abroad as an industry.
The three 1996 study abroad safety incidents that resulted in student deaths, rapes, and robberies, also resulted in the year 2000 Congressional hearing on study abroad safety (see “To Begin, Again”, Part 1 and 2). Moreover, it led to a level of press scrutiny this industry was unaccustomed to.
In May of 2000, when the annual NAFSA convention met in San Diego, within the industry an ideological skirmish was brewing. Some study abroad professionals had concluded that industry standards were imperative, while others disagreed, arguing that standards would impede program flexibility. Ros Thackurdeen and I have been told that this debate was heated and some professional relationships never recovered.
In 2001, a handful of study abroad professionals reconvened to found the Forum on Education Abroad. Known as “The Forum”, this newest membership-driven coalition based itself at Dickinson College in Carlisle, Pennsylvania. They stuck to their goal and devised written standards for the entire industry, including Standard 8, which applies general guidelines to student “health, safety, security and risk management.”
Then, history arrived; this time, 9/11.
“What nations don’t know can hurt them.”
So begins the final report from the Abraham Lincoln Commission on Study Abroad. As a consequence of 9/11, Senator Paul Simon, a beloved Illinois legislator and bow-tie wearing former professor, worked with national legislators and the education community to create the Abraham Lincoln Study Abroad Fellowship program, with the goal to grow study abroad.
In 2003, as a complication of heart surgery, Simon unexpectedly died. In the aftermath, Senator Dick Durbin took the helm. The assembled committee included a Who’s Who of higher education professionals, plus another Illinois legislator and a former governor. Much like the founding fathers of IIE, Commission members had already concluded that understanding others is essential to global security, and study abroad is essential to the next generation’s understanding.
Titled Global Competence & National Needs, the Lincoln Commission’s 2005 final report opens and continues, “What nation’s don’t know can hurt them. The stakes involved in study abroad are that simple, that straightforward, and that important. For their own future and that of the nation, college graduates today must be internationally competent.”
The Lincoln Commission’s solution? By 2017, annually send one million U.S. undergraduate students to study abroad, with student demographics reflective of the general U.S. undergraduate population, and “non-traditional destinations” emphasized.
To read the Lincoln Commission’s 40-page final report is to understand that good intentions require funding. How much and who will pay informs most of the report. There is no interrogation of the resolution’s underlying logic, and never a mention of student safety.
It is for lack of funds that the Abraham Lincoln Study Abroad Act died in committee. In 2005 (the same year that the Lincoln Commission’s final report was issued), the Forum received recognition from the U.S. Department of Justice and the Federal Trade Commission. This official approval came to the Forum in spite of the fact that there were still no federal, state, or industry requirements to count and report study abroad safety incidents.
In the decade since The Lincoln Commission, the federal government, in concert with higher education and professional membership organizations, and with the financial support of American businesses and endowments, has inaugurated a number of study abroad growth initiatives, including 100,000 Strong in China, 100,000 Strong in the Americas, Young Africa Leaders Initiative, Young Southeast Asia Leaders Initiative, and Generation Study Abroad.
Introduced in 2014, IIE’s Generation Study Abroad is particularly interesting in that it recruits teachers to pitch study abroad to students, including high school and middle school students. “Join the commitment” and “Pledge your action,” IIE’s marketing reads, their goal to double study abroad enrollment by the end of the decade. In return, “Commitment Partners” are promised access to “resources…including a Generation Study Abroad badge, press materials, invitation to annual conferences and much more.”
During that same year, the State Department opened a study abroad office, with the goal to grow study abroad, though quotas were not set. At the end of 2014, the White House hosted a study abroad summit, inviting 130 of the “most influential travel bloggers and digital media outlets…to discuss U.S. government initiatives and strategies for encouraging American students to study, volunteer, and work abroad.” No student safety advocates were invited.
Ros Thackurdeen and I remember how much our sons believed—how we believed, too. It is devastating to imagine Thomas and Ravi’s last moments, the shattering of trust, so much potential disappeared.
We want you to know, even after Thomas and Ravi’s deaths, we believe in the principles that underlie international education. It is the execution that remains flawed, and devastatingly so. The absence of data means an absence of fact. The absence of fact means there is no possibility for science to impact risk assessments.
Instead, this is an industry built on political need, economic aspiration, and yes, good intentions, with so many players, multiplied agendas, and a complex of maze of interests. It is no wonder, when Ros and I meet with national leaders and their staff, Democrats and Republicans alike are visibly moved by our stories from the dark side of student travel. They often acknowledge that transparency is a “reasonable” request. But by the end of our meetings, there is an all-too-common deer-in-headlights moment, and then this question, “What do you want us to do?”
Huh? We’re a couple of bereaved moms. We didn’t imagine having to figure out the how-to of transparency.
The study abroad industry imagines their role as shepherds of America’s youth, preparing them for life and work in a globalized world. And surely, we can agree that, in an emerging political climate that may favor protectionism, even nationalism, there is value in an internationalized education.
But the industry has institutionalized a peculiar logic: Study abroad is assessed to be worth the risk—though precisely how much risk and what type, no one can say. On the front end of student travel, marketers rule. To understand this, all you have to do is peruse the impressively photographed brochures at campus-based study abroad forums. Pre-travel information is geared to sell a product. Wrap this product in a pro-America message, navigate the funding, and voila, America’s next generation of leaders.
On the back end, Open Doors provides a tally of how many students go, but not a tally of those who never return. Facile accounting comes with a narrative—promote the system as built, aimed toward growth, and that is all.
To bereaved families, this logic comes across in a way that the industry seems not to have anticipated: Sure, some programs have had a death, but not mine. Or, sure, my program has had some deaths, but look at how many students we’ve turned into leaders.
And if you need validation of our view, all you have to do is track newspaper quotes from industry heads in the aftermath of a study abroad student death: More students die going to the airport than studying abroad. Or, more students die on home campuses than studying abroad. Then come the numbers these leaders can prove, how many students they’ve educated—as if the students who come home somehow compensate for the one who didn’t.
A scientific mind will see through this logic, informed as it is by need, belief, incomplete data, and a shocking lack of knowledge regarding scientific methods. A scientific mind will understand the distinction between what is unforeseeable, as in truly random, and what is rare, but potentially predictable. Scientific methods enhance the foreseeability of rare events, which allows for strategies of prevention.
In the aftermath of a child’s death during study abroad, bereaved families go through a crash course into a new world. It is a chaotic scramble for details about what went wrong, and why, all the while navigating profound shock and grief. Gradually, we come to understand two things. One is that we will learn some facts, but not all. In other words, in the wake of a student’s death, the lack of institutional transparency, itself, becomes transparent.
The second thing we learn is more a general impression: Study abroad deaths do not represent some unknowable error within a landscape; they are not “accidents” in a scientific sense, as in random. Rather, these deaths represent error at the hands of shepherds who consistently refuse to use science to understand the landscape they place students in.
This is not an scientist’s mentality. It isn’t even an academic’s mentality. Study abroad as an industry manifests a gambler’s mentality. A gambler says: If a death happens, it will probably (hopefully) be someone else’s program, someone else’s student, someone else’s child. A gambler says: If a death happens in our program, protocols are in place, and those procedures will dictate our response. A gambler says: If death happens, it’s probably not our fault…Or, if we had some responsibility, it was only partial, and we’ll learn, but quietly, behind the scenes.
Reaction is not pro-action. Response protocols are prudent, but they’re not science. And they’re never a substitute for prevention.
We the bereaved ask individuals who make up the study abroad industry to begin again. Become the institutions you claim to be—academic. This will necessarily require you to become transparent. Educational programs and professional membership organizations that support transparency will be pioneers. To the extent that you work with other programs to aggregate data, you will be courageous. And when you safeguard someone else’s child with knowledge made from the best evidence available, you will have opened yourself to your own humanity. After all, our children—all of our children—are this world’s future.
Failing that, we ask federal officials to become the institutions you claim to uphold. Be legislators and leaders, safeguards for the people.