Medical Certificate

I had meant to address this as part of the Tortola, Ho! series, as it was definitely one of our big surprises in trying to get HB's paperwork together for his work permit. However, since I am working on my own work permit right now, it is very much on my mind.

At the very end of the process for immigrating to the BVIs, the employer is sent a letter granting the work permit. I will address the actual letter and its requirements at another time. For now, I want to focus on the medical certificate that is attached to the letter.

The immigrant must complete the medical certificate, along with all supporting documentation, before arriving in the BVIs.  The medical certificate is two pages of instructions, accompanied by three pages of the actual certificate. Let's take a look at what is required:

The final page, which I was unable to get the scanner to reproduce contains the following:

IMMUNIZATION:

VACCINE:
1st DPT & TDPV
2nd DPT & TDPV
3rd DPT & TDPV
1st Booster
2nd Booster
BCG

It then gives space for the doctor to provide a Conclusion, and then has the certificate for the doctor to sign and seal or stamp.

Examining the elements of the medical certificate individually, the most important things to note are the required lab tests and the immunizations, as these seem to cause the most difficulty and take the most time.

The required labs are: 1) VDRL; 2) Stool O & P; 3) Mantoux.

The Mantoux is a skin test for Tuberculosis. It is a common test, administered by pricking the skin. The site must then be examined by a medical professional 48-72 hours later to see if any reaction occurred. The medical professional will prepare a certificate giving the date and time of administration, the date and time of reading, and their observations of reaction, including measurement of swelling in millimeters. If you test positive for Tuberculosis, you are also required to bring your most recent CBC, ESR, and Chest X-Ray. Neither HB nor I tested positive, so I cannot speak to what these items entail.

The Stool O & P (Ova & Parasites) is also fairly simple. The lab will give you the required equipment and instructions. At home, you will take samples of your stool and place them into the appropriate containers before returning them to the lab. My understanding is that results can take as long as two weeks. HB never had a stool sample, and I am still waiting on my results, so I cannot verify turn-around time on this yet.

Finally, VDRL is intended to test for syphilis. It is a serum-based blood test, so you will have to have blood drawn. Additionally, VDRL results take a minimum of two weeks. In HB's case, it was actually three weeks before his results came back. The extended length of time for VDRL results is especially frustrating in light of the fact that another, newer test for syphilis exists. Called an RPR, results are returned in two to three days. Unfortunately, since VDRL is on the certificate, VDRL is what we have to do.

The required immunizations are the three DPT & TDPV shots, plus two boosters and BCG. DPT is the Tetanus, Diphtheria, and Pertussis shot. In the US, the DPT series is required for all schoolchildren, so if you received your school vaccines, you should be fine on this. My last DPT booster was in 2001, so I went ahead and got another one while I was at the doctor. BCG is the bacille Calmet-Guerin vaccine, which is used to vaccinate against tuberculosis. BCG is no longer common in the US, as tuberculosis is very rare here. Neither HB nor I have had the BCG vaccination, but this was not a problem for HB in receiving his work permit. My doctor advised against getting the BCG vaccination, as it can often result in a false positive for the Mantoux skin test (see above).

In all, if you are immigrating to another country, be prepared that a medical certificate may be part of your process. Do your best to find a version of the medical certificate before you submit your visa application, so that you are not stuck, as HB was, waiting for three weeks for lab results while everything else pertaining to the work permit was ready.

If you are immigrating to the BVI, please feel free to print these copies of the medical certificate to use in making your own preparations, but be advised that your doctor must fill out and sign the original that BVI Immigration will provide to you.