Inés DeRomaña, the principal analyst in charge of health, safety and emergency response for the University of California's systemwide Education Abroad Program, would be hard-pressed to describe a “typical” problem she confronts in her job. A student visiting a coral reef in Australia needs to be airlifted out after suffering multiple bone fractures. A student gets arrested for drug possession in a foreign country. A student travels abroad without his HIV medication, believing, incorrectly, that he would be able to obtain it for free overseas. That last case involved three weeks of intensive work, DeRomaña said.
There’s also the work on the front end: ensuring that mental health services are adequately covered by the university's travel health insurance plan or working intensively with an individual student with a preexisting health condition prior to departure to help him or her have a smooth study abroad experience. “I could spend four months on one student case, trying to arrange accommodations, trying to account for what-if scenarios,” she said.
The evacuations of study abroad programs from Egypt  earlier this month drew renewed attention to health and safety issues in study abroad but, said DeRomaña, responding to civil unrest and natural disasters is just a small fraction of her job. “That is very palatable and, yes, you have to be prepared for that, but my mantra is you have to be as prepared for that as you have to be for responding to student incidents.”
“We send 5,000 students abroad a year. We will always have student incidents,” she said.
DeRomaña is one of the leading voices in a growing sub-profession within study abroad and international programs: the health and safety analyst or international risk manager. Although such a position is still a relative rarity, the number of full-time staff members dedicated to health and safety in international university travel has swelled from three in 2007 (including DeRomaña) to 27 today, according to those in the field who maintain something of an informal association. Gary Langsdale, president of the University Risk Management and Insurance Association and the university risk officer for Pennsylvania State University – which is among those institutions that has created an international risk analyst position – argued that the number of such positions is in practice closer to 100, “although you may not see it as a job title. There are a growing number of institutions where this is the primary responsibility of somebody.”
“There is not a crystallizing event that I can point to, to say here is the event which caused everyone to say we need an international risk analyst,” Langsdale said. “I think it’s been death by a thousand paper cuts, as there have been more and more incidents – not only the large publicized incidents like the tsunami in Japan or the evacuations in Cairo, but also individual problems with students who got into trouble or got sick.”
Those in the field also point to the simple issue of scale. The number of students studying abroad has more than tripled  over the past two decades, and students are traveling to a broader range of locations beyond the traditional domain of Western Europe. There are also more students studying abroad who have preexisting health issues or disabilities . Indeed, increasing access to study abroad for students with disabilities is a priority in the field.
“One of the things I’ve observed is that the area of health, safety, and security and risk management has become more complex in education abroad,” said Brian Whalen, president and CEO of the Forum on Education Abroad. “There are a lot of issues that relate to student health and safety that are more pronounced now than perhaps they were years ago. How do we account for that? Well, we have a greater number of students studying abroad, so some of that is because of the numbers, but I think we also mirror what is happening domestically in terms of [growing] counseling center loads  and challenges about drinking and behavior that stems from student drinking.”
While some of the newly created positions focus on study abroad specifically, others encompass international programs more broadly. Joseph Finkhouse, the associate director for health, safety and security for the Boston University Global Programs office, said his position was created in 2011 as part of an effort to centralize international programs at BU: “BU’s like a lot of universities. There’s all kinds of activity going on all over the world,” he said, noting that his portfolio includes not just traditional study abroad but things like overseas internships and international trips sponsored by student organizations. Finkhouse said that much of his job entails meeting with people to offer individual assistance and arranging large-scale training opportunities to help build competency on health- and safety-related issues throughout the university. “It’s not like these things were neglected over the years because competent faculty members were taking these things into account and there were lots of resources available, but we really feel that by more centrally approaching these things, we can add value to their activities,” he said.
Stacey Tsantir, director of international health, safety, and compliance for the University of Minnesota, said similarly that much of her role entails creating policies and procedures for the five-campus system and educating faculty and staff members in order to increase compliance. There’s no mandate that people come through her office in planning a study abroad program, she said, but there are policies requiring students participating in education abroad opportunities to sign a release and waiver, to purchase the university’s international health insurance and to attend an online health and safety orientation; the unit that is sponsoring the travel also would be required to have an emergency plan on file.
Pascal Schuback, the global emergency manager at the University of Washington, has a background in emergency management for King County, Washington (where Seattle is located). He emphasized the need to view risks associated with student travel as encompassing four areas: preparedness, response, recovery, and mitigation. The university evacuated one student out of Egypt this summer, for example – that’s the response – “but now the recovery process starts.” Will that student receive academic credit? Is that student eligible for reimbursement? Would that student benefit from undergoing counseling? And then there’s the issue of mitigation of risk moving forward: “What are you going to do about it?” For example, after a fire in an apartment rented by students, will you create a new policy regarding smoke alarms in university housing overseas?
The institutions that have created risk management positions are large universities or study abroad provider organizations; at a smaller institution, the responsibility for health and safety in study abroad might typically be assumed by a director or assistant director in the study abroad office or be shared among several study abroad personnel. But it does seem likely that more institutions will consider creating these specialized international health, safety and security-related positions as they grow or centralize their global programs.
Julie Anne Friend, the associate director of safety and study abroad at Northwestern University, has talked with representatives from other institutions interested in creating such a slot. Though she welcomes the interest and the development of the subfield, she also worries about universities that have faced a tragedy abroad hiring such a person in order "to check a box" without giving adequate consideration to his or her duties and role within the university and investing in the resources that the person needs to do the job well: a smartphone, subscriptions to security information services, a television for monitoring the news, a budget for conference and international travel. Friend noted that some of her colleagues don’t have funds to travel overseas: “I don’t know how you can do this work without being able to visit some of the higher-risk locations to see the environment in which students are living," she said.
What those in the subfield want to avoid, the University of Minnesota’s Tsantir said, is this trend becoming “for lack of a better term, a fad,” in which institutions create these positions but don’t set up their hires to succeed.