Gruel’s original training was for five years at the North German Naturopathic College in Hamburg. Later he emigrated to the U.S. and studied four more years at the New England School of Acupuncture in Boston, which he claimed is “the best school of Chinese medicine outside of China”. Although he had originally planned to return to Europe, he decided to remain in the U.S., and eventually opened the first acupuncture practice in Vermont. He has also been on radio and television and visited schools and colleges in New England as a speaker on Oriental medicine. He has now sold his business and he and his wife have moved to Uruguay.

His presentation explained that acupuncture is just one part of Chinese medicine. It is based around “chi” or life energy, which manipulated with needles through certain points in the body. These points are chosen by function and location. The purpose of acupuncture is to reduce pain and provide cures. Gruel explained that the body can resolve problems but that it sometimes needs outside help. Western medicine has always been skeptical of acupuncture and herbal medicines, but both have gained more acceptance over the years.

The most interesting part of Gruel’s presentation was when he began discussing laser acupuncture. Light therapy is ancient he told us. In 1903, a Nobel prize was awarded for the use of light in the treatment of tuberculosis. Now light has become part of acupuncture. Modern, “cold” lasers produce incredible reactions in the body. Hemoglobin can absorb laser light of the right frequency and will effectively charge up with energy, Axel told his audience. When he explained that there are now devices that can be inserted directly into a vein so that lasers can be emitted directly into the blood, he really had the group’s attention. He explained that laser acupuncture techniques have long been appreciated and developed in Europe, while being ignored in the U.S. Surprising to most, China is not the leader in this field; Russia and Germany are. He said that opposition in the U.S. comes from pharmaceutical concerns that do not see a profit in this type of technology.

A number of questions were posed about the uses of acupuncture, Chinese herbal medicines, and lasers. Cosmetic surgery, allergies, sleep problems, and memory problems were some of the topics. When questioned about the receptiveness of the Uruguayan government, Gruel admitted that at the moment it seems cosmetic applications are acceptable; more work will be needed for approval of other treatments.

The Gruels have been in Uruguay less than a month. They are seeking a home and a location for a business in the Punta del Este area. They have even brought laser equipment with them from the U.S. Still, there are many obstacles to be dealt with. Axel said the opening of a clinic of any kind is a minimum of six months away. He promised to keep the phyle group updated on his efforts to establish a business in Uruguay.

What are the most important considerations when planning your retirement abroad? For most, the cost of moving from your current location, and ongoing living cost after the move, is a big concern. How easy it is to gain residency in your new homeland is also important. The quality of health care is a major factor. Then of course you’ll want to move somewhere that gives you lots of culture and leisure options in your new locale—once you become settled, and have dealt with the nuts and bolts of the move, this becomes one of the most important requirements for an enjoyable retirement.

Money talk

First, you will need to assess how much money you’ll need to retire to Uruguay. A normal rule of thumb is that you will need 70% of your annual pre-retirement income to live comfortably. However, that’s a rule normally geared for domestic retirement. You might need less than that in Uruguay, but maybe not, depending on your planned lifestyle. Take a look at last week’s Quick Guide (http://www.olauruguay.com/2010/06/27/cost-of-retiring-to-uruguay-an-ou-quick-guide) article for more on the cost of retiring in Uruguay. From my research a pensioner’s budget is somewhere around US$900, without a mortgage.

Residency for retirees

Specific to living in Uruguay, you don’t need a visa to enter the country. You will be granted a 90-day tourist visa. In this time, you can apply for residency. As we often state, Uruguayan residency is easy to obtain. You will need your birth certificate (stamped by the Uruguayan consulate in the country of birth), a clean police record from the country of origin and from those countries where you resided in the past five years, and proof that you can support yourself throughout the residency process (the “income requirement,” which is US$6,000 a year). You can demonstrate this through a pension, a mutual fund, lease income from an asset inside or outside Uruguay, dividends of any nature, or a wage. Whatever your income, you will need to be sure it can be proven as permanent. After five years of having filed for residency (three in the case of families) you can apply for citizenship.

A special law that applies to retirees with a government pension of over US$18,000 per year guarantees a Uruguayan passport more rapidly (from a year to eighteen months). However, the income requirement is higher. Your income must be from an official pension, and at least US$18,000 per year, but you also must also own a property in Uruguay valued at US$100,000 or more. You can bring a car into the country tax-free, but since bureaucratic delays can make the process very expensive, it is not recommended.

Health care

Health insurance can be got for as low as $76 each per month. This is a big draw for expats to come to Uruguay. Doctors are well trained, and many have studied in the U.S.

As an alternative to traditional medical insurance, private hospitals each offer a medical coverage scheme which, depending on the hospital and level or coverage offered, typically covers treatment and medication within that hospital, and often visits to pre-appointed GPs outside of the hospital. All private hospitals have an age-limit for their scheme, which is usually 65 to 70 years, and require a medical examination. Occasionally a hospital will take an older person who has passed the exam. Hospital Britanico is one of the more prestigious hospitals in Uruguay.

• Hospital Britanico, Av. Italia 2420, Montevideo, Uruguay; tel. (598-2)487-1020; fax (598-2)487-4080; e-mail: info@hospitalbritanico.org.uy; website: www.hospitalbritanico.org.uy/english/index.htm. (From their website, click on the “The British Hospital Scheme” link for more on their medical coverage scheme.)

Do your research

Now, you might be thinking, “Um, I need more information before I up and move to Uruguay.” Lucky for you, the internet is a wealth of information on the topic of retirement. Need reasons why to choose Uruguay? Expat David Hammond has you covered. You can check out his 10 Reasons to Retire in Uruguay on the site Boomers Abroad. His reasoning is very similar to what we mention here on Ola each week: Uruguay is safe, stable, there are no taxes on foreign source income, etc. In addition, Uruguay has a comfortable climate, and offers a variety of lifestyle choices ranging from the city to the beach, to the campo, to a high rise. People are friendly and residency is easy to obtain. If David doesn’t have you convinced, you can read Ola’s Top Ten Reasons Why Uruguay is a Great Retirement Destination.

For more tips about retiring in general, check out CNN’s Planning for Retirement. For ideas about how to live the retired life well in Uruguay, check out Ola’s Retirement Section.

How two couples planned their retirement to Uruguay

I spoke with two expat couples living in Uruguay about their planning process. Interestingly, both couples thought they would not be good candidates for the article because their planning was fairly organic. However, it seems that each person and each couple does things as they see best, which could either result in a studious investigation of the chosen destination, or a whirlwind adventure of packing up and seeing how it goes. Though both couples were a bit more spontaneous than methodical in their retirement planning, the most important part is that both are very happy with their life in Uruguay.

Syd and Gundy do not do things in typical fashion. They are a couple that chooses their own path, even if it is unconventional. According to Syd, they did not plan thoroughly before they came here. They came for a two-week look at Uruguay in November 2006 and started the process to buy a house before the end of the first week. That house had appeared on an internet listing less than two weeks before their departure. They had been looking at several sites at that time featuring houses in coastal Uruguay. They also had some interest in Colonia del Sacramento but had no desire to live in Montevideo. The strongest targeted community for them was Atlantida as it was close to Montevideo, coastal, and affordable. Syd added, “the universe took care of us by showing us a house at exactly the right time.” They flew home from Uruguay suddenly realizing they had businesses to sell and that their lives were about to change. While far more impulsive than most people are willing to be in life, it worked for them. They have chosen to live in Uruguay for the rest of their lives.

Similarly, Denise and Wally didn’t exactly plan for retiring in Uruguay. They told me that perhaps they should have been more pro-active, but that it has never been their style. After just six months of considering the move, they sold their home in the States and bought a house here in Uruguay with cash. They found the practice to be normal in Uruguay, as they believe that people here generally value living debt-free. Another reason to buy their home using cash was to keep their monthly expenses down. They considered a condo, but felt that the monthly association fees, doorman tips, and assessment fees would be out of their control, and would be a constant unknown cash liability.

Along with purchasing their house outright (so no mortgage payments), their additional (non-traditional) retirement planning has involved:

1. Buying a “Solar” Hot Water heater, thus reducing their electricity usage a little. (Read more about how to Save Money with Solar.
2. Buying an efficient Wood Burning Stove. It has a motor and they installed vents to heat the various rooms in their homes. They only heat their house by wood (though Wally has an electric heater under his desk for really cold mornings).
3. Buying affordable Health insurance here. As you age, you need more care, so they said they definitely included health costs into their retirement budget.

The Glass’ stressed that Uruguay is not as inexpensive of a place to live as other places in the Latin American world. Two years ago Uruguay added local income taxes; there is also a rental investment tax now. That said, permanent residency was easy for them to obtain in Uruguay. The water is drinkable, the streets are safe to walk around, and the people are kind and helpful to foreigners. Denise and Wally feel at home. They find that Uruguay is not an overly materialistic nation. I would agree. People are more interested in family and friendship, reusing and simple living (clearly sometimes out of necessity, sometimes as a lifestyle choice). Denise and Wally moved here because they can live as they please and because they feel well off here. They don’t think they could be able to say the same if they would have stayed in the states.

You can read more about how these couples fill their retirement days in this week’s article “Retiring in Style in Uruguay”.

Three years ago, our youngest child was born here, and even though my pregnancy was too strictly controlled for my rebelious nature, and I never thought to persist in finding an obstetician who spoke fluent English, nor an english speaking doula to help me through all the new vocabulary and medical tests, it was a very positive experience. Throughout the labor, the staff was friendly and even gathered around my bed to chat with us about soccer, forestry, and mate. Where else in the world could this happen?

For the most part, Uruguay is a traditional and conservative country in terms of its birthing practices. There are few services, and doulas are almost unheard of. Although a few women I know have had their babies at home, most people here think that this is a very risky option. There is no water birth or other similar alternative practices, as far as I have heard. You may bring only one person in to the room to accompany you during your labor. In addtion, unless you pay extra or are a member of the Biritish Hospital Society, the doctor at your birth may not be the doctor who attended you throughout your pregnancy.

In the hospital, birthing beds are equipped with the traditional stirrups, and preparation for a birth includes a complete shave and an enema, (unless you think to do a Briazilian wax just before.) Indeed, except for the British Hospital, the laboring area is separated from the birthing area.

Still, according to vital statistics, Uruguay has a very high success rate in terms of live births. Doctors are very careful and take precautionary measures. For example, when my water broke, I wanted to lounge at home and take my time but was requested to come to the hospital immediately where, upon entry, we were requested to change into the world’s ugliest sea green smocks and my husband had to tie some kind of cloth slipper over his shoes. We looked and felt ridiculous. I was fitted with an IV, an oxytocin and antibiotic drip, a monitoring machine for our baby’s heart, and then, they taped all the plastic tubing of the epidural on me, which by the way is an extra $400 or so. I felt almost gift wrapped in a strange way.

Although my phsycian had told me that I could walk during the labor process, when I asked about it in the hospital, the nurse pointed from one corner of the room to the other. “Yes,” she said, “from that corner to this one.” My visions of strolling on the beach during the first stages of the labor were shattered. They offered me a rather deflated exercise ball instead.

At a certain point, our doctor told me that I had only seven more hours to produce our baby. The rule seems to be that once your water has broken, you have only 24 hours to give birth, or you have to have a C-section. The threat of a C-section caused me much stress. According to what I have heard, all obstetricians, except for those practicing in the British Hospital, are paid extra for the C-section surgeries that they perform. From the circle of five children that we know who were born around the same time as our daughter, ours was the only natural birth. For me, the reason was not that the mothers were “too posh to push,” although you can request a C-section from the beginning, I think that doctors may be too anxious to act.

When our daughter emerged into the world, I saw that we were outnumbered by three to one by medical personnel, even with the new arrival. The obstetrician on call, our obstetrician, her assistant, two nurses, the neonatologist, his nurse, the anetheologist, and his assistant were all present.

It turns out I had to get used to the crowds, because, as soon as we were moved into a room, family and friends started to appear. Baby showers are not customary here and everybody brings a gift to the hospital to welcome the baby. I was glad that I had brought a nice nightgown to wear. My husband slept on a very hard sofa in the room with us. Luckily, this meant that he did not sleep deeply and could attend to our newborn while I recuperated from all the guests.

Still, our girl was born into this culture, and even though I want more privacy sometimes and don’t like so many eyes on me watching what I do, I do appreciate the willingness to help, and I can learn to feel the safety of this time-honored, medically tested system that works.

For more about how the U.S. and Uruguay are fighting cancer together, read a recently published article here.

You’ll find the best prices with local dentists. However if you do decide to take this route, make sure you ask around and choose a dentist with a good reputation. We have heard lots of horror stories from expats who went with some of the cheaper dentists without asking for recommendations. And if you are struggling with the Spanish language, before you make your appointment, remember to ask if the dentist speaks English.

Don’t be surprised if a visit to a local practice finds you in the dentist’s home—their sitting room doubling up as their surgery. For most Uruguayans, this is perfectly acceptable, and often some of the really good dentists operate in this way. However, if you, like many expats, prefer to keep your authentic-Uruguayan experiences away from the realm of health care, you’ll prefer to pay a bit more for a more familiar experience with one of the high-end clinics.

One dentist based in Montevideo that some of the staff of OU have used is Josefina Hughes.

• Josefina Hughes, tel. 5982-600-8446; Calle Lieja 7027, Carrasco, Montevideo. We have found Josefina to be very kind, and a great dentist.

The following two dental clinics based in Montevideo are recommended by the British Hospital, widely regarded as the number one hospital in Uruguay:

• Clinica Odontologia 2000, tel. 5982-401-6527; 18 de Julio #2172. Under the British Hospital Scheme you are entitled to free emergency care and 40% discount on treatments from this clinic.

• Clinica del Golf, tel. 5982-711-8768; Bulevar Artigas #4.

Uruguayans have a very traditional view of pregnancy. Saying that, the facilities here are top notch, and the support I’ve received during my pregnancy has been outstanding.

When I first went to our doctor, she assured me that they have all procedures taken care of. That includes an episiotomy and epidural (I can get a shot before even feeling anything)…I can even watch my contractions in a TV monitor.

I am part of a private health society that is known for its high standards. Luckily, I don’t have to change rooms just before I give birth which is usual in other hospitals. In addition, I get to choose my birthing position (no stirrups). I get a private room. My husband can accompany me (in public hospitals, this is not allowed). And my doctor will be the attending physician. Usually, you pay an extra US$300 to get your own doctor and another US$400 for an epidural if you want it. My doctor is a gynecologist who attends about 100 deliveries per year. An obstetrician and a neonatal specialist will also be involved.

I have had five ultra sounds to date with a sixth pending. If we wanted to, we could opt to pay $180 for a special 3D ultrasound that shows the baby’s facial features. We opted instead for the video of the 20-week ultrasound ($3). Our little girl moved almost the whole of our 20 minutes, and our whole family was entertained by her cord-chewing antics.

Here, everyone knows the sex of their baby and chooses a name before birth. This is very important—we haven’t chosen a name yet and are often told how negligent we are. Although regulations exist to control C-sections, women with influence can choose the time and date of their extractions to fit family scheduling and to make up birth announcements ahead of time. Girl babies have their ears pierced and their heads are shaved when they are three days old. Circumcision is routine.

I have been sitting for two hours now in the glucose haze of my diabetes test, which my doctor ordered when I had gained more than 2kg in a month. Anyway, my neighbor told me last night to bring lemon juice to add to the disgusting glucose solution. What a godsend! So even though I have endured more blood tests that a professional athlete—blood coagulation queries, cord blood samples among them, I appreciate help like this and in fact, I feel even privileged. Here, pregnant women are given a seat on the bus. We, don’t have to wait in deli line-ups or bank line-ups or the supermarket line-up… We have “preferencia”.

There is a caring and consideration of my growing “panza” displayed by so many strangers—the woman at the bakery who gave me ricotta biscochos, the man at the deli who served me first and told me about the “preferencia” system, the stranger at the bus-stop, my doctor neighbor who chastised me for carrying groceries—and even those who have yelled at me out of the car window while I was on my daily run…something about how I should take better care of my baby.

There seems to be a public celebration of another baby coming in to the world. In my dance class, my friends even “saludo” my belly with hugs and hellos.

All this makes for a family-friendly country. Plus…

It’s safe
Most importantly, it’s widely known as one of the safest countries in Latin America… According to the Overseas Security Advisory Council, while there are often incidents of petty crimes such as pick pocketing and home burglaries (in the wealthy suburban areas, and usually when there is no one in the house), violent crime levels are very low. In fact, after Cuba, Uruguay has the lowest level of violent crime. Uruguay was also rated as the 21st most peaceful country in the world by visionofhumanity.org in the Global peace index 2008.
            
Uruguay has a good education system with many bilingual schools
There are lots of schools in Uruguay that offer a bilingual education. However, you have to be careful, as there are widely varying levels of English emersion amongst them. In many cases graduates will be fully fluent in English, but some schools will claim to be bilingual merely because English classes are taught there.

If your want your child to have the best chance of getting into a good University, either in Uruguay or elsewhere, many schools here offer the International Baccalaureate. The International Baccalaureate (IB) is an international academic qualification, which is highly regarded by Universities worldwide.

The following schools offer one or more of the three IB programmes—Primary Years Programme, Middle Years Programme, and Diploma Programme:

• British Schools (Mr Timothy Deyes), Maximo Tajes 6400, Montevideo; tel. (598) 2-600-8958, e-mail: inquiries@british.edu.uy.Regarded as the best bilingual school in the country and offers the Diploma Programme.
• Colegio Stella Maris (Sr. Rubén Comotto Basanta), Máximo Tajes 7357/7359, C.P. 11500 Montevideo; tel. (598)2-600-0702. Offers Diploma Programme.
• Escuela Integral Hebreo Uruguaya (Prof. Rosana Erosa), Jose Benito Lamas 2835, Montevideo; tel. (598)2-708-1712. Offers Diploma Programme.
• St Brendan’s School, Av. Rivera 2314, Montevideo; tel. (598)2-409-4939. Offers Primary Years Programme (contact Ms Jimena Taboada), Middle Years Programme (contact Prof Jorge Nández Britos), and Diploma Programme (contact Prof Rosario Rodríguez).
• St Patrick’s College (Ms Mary Evans), Camino Gigantes 2735, Montevideo; tel. (59)82-601-3474. Offers Middle Years Programme.
• St. Clare’s College (Prof. Dilamar Larrosa), California y los Médanos, Punta del Este; tel. (598)42-490-200. Offers Diploma Programme.
• Woodlands School (Prof Alfonso Perendones Paseyro), San Carlos de Bolivar s/n, Montevideo; tel. (598)2-604-2714. Offers Middle Years Programme.

For more about the International Baccalaureate, visit: www.ibo.org.

The Uruguayan – American School in the Carrasco neighborhood of Montevideo offers a U.S.-style curriculum in English and Spanish.

• Uruguayan – American School, Av. Saldún de Rodriguez, Montevideo; tel. (598)2-600-7681 email: contact@uas.edu.uy.

Many of these schools also have kindergartens onsite.

Good healthcare
Uruguay has a good public healthcare system and reasonably priced private medical schemes. You can read more here: http://www.olauruguay.com/Issue4a.html.

Natural, healthy food
While the traditional food in Uruguay maybe unusual to your kids at first, there are a lot of culinary options available. Fresh fruit abounds, cheap but healthy restaurants are on every corner, freshly caught seafood is commonplace, and you’ll find lots of American-style groceries stores. (And if all else fails, you’ll come across those all-too-familiar U.S. fast food chains here too.)

Lots of outdoor activities
With such a great climate, you’ll find most of your family activities will take place outdoors. A day at the beach, with soccer, surfing, wind surfing, or kite surfing; a trip to a national park; or a day at one of the many family-friendly festivals including the children’s movie festival (for more read here:www.olauruguay.com/Issue6b.html).

Uruguay has miles and miles of unspoiled coastline, vast stretches of rolling grasslands, colonial cities with pristinely-preserved architecture, and stunning beaches that go on for miles.

2. It’s safe

Uruguay is one of the safest countries in the world and certainly the safest in South America. Violent crime levels are very low. And natural disasters simple do not happen here.

3. It’s easy to get here

You can fly direct from the U.S. to Carrasco Airport in Montevideo with American Airlines from Miami, which takes about nine hours. Alternatively, you can fly directly (from most major U.S. cities including
New York, Chicago, San Francisco, LA, Houston, and Dallas) to Buenos Aires, then take the 30-minute flight to Montevideo, the 40-minute flight to the international airport at Punta del Este, or the one-hour ferry to Colonia del Sacramento.

If you’re coming from Europe, Iberia Airlines offers direct return flights from Madrid, Spain to Montevideo six days a week, with no stopover.

4. It’s easy to get residency and citizenship as a retiree here…

Residency can be obtained by proving that you have a yearly income of at least US$6,000. As for citizenship, a special law applies to retirees with a government pension of over US$18,000 per year, who own a property in Uruguay valued at US$100,000 or more, guaranteeing them a Uruguayan passport. For those who apply for residency under this law, a passport is granted after a year to eighteen months (the time the process usually takes). 

5. A great climate where the summers fall during the U.S. winters

Uruguay has a warm temperate climate with summers from December to February, so lots of retirees choose to spend part of the time here and part of the time back home, and enjoy summertime all year round.

6. Cheap real estate, emerging market

You’ll find first class properties here in great locations for just a fraction of the cost of comparable properties back home. Plus, this is an exciting emerging market…Brazilian and Argentinean investors have had their eye on good value real estate here for a few years now, but North American and European’s have more recently started coming here with their dollar and euros to invest. And property prices have already begun to rise.

7. Favorable tax laws.

No tax is charged on income sourced outside of Uruguay, so if you’re factoring a hobby business back home into your retirement years, this will be welcome news for you.

8. Endearing people and a great lifestyle

Uruguay has a ruch culture and warm friendly people. Honor is alive and well and anti-american sentiment is minimal.

9. Great cuisine

Grade A restaurants are everywhere in Uruguay, and they are reasonable. Fresh fruit and seafood are plentiful and cheap, and supermarkets are up to par with the quality of those back home. Uruguay also produces good quality wines. Plus, there’s the mouth-watering traditional parrilla, http://www.olauruguay.com/Issue8b.html.

10. Good health care system

Uruguay has good quality health care facilities, both public and private, throughout the country. The public health care system is said to operate to a good standard, however many expats opt to pay for one of the reasonable medical coverage schemes at one of the many high-standard private hospitals. For more see: http://www.olauruguay.com/Issue4a.html.