TITLE:
Everyday Health Challenges of Liberian International Students in Hangzhou, China: A Qualitative Descriptive Study
AUTHORS:
Tarweh P. Surkula, Kamara Sedeke Mohammed, Yunxian Zhou
KEYWORDS:
Liberian Students, International Students, Health Challenges, Healthcare Access, Coping Strategies, Qualitative Research, Hangzhou, China
JOURNAL NAME:
Open Journal of Social Sciences,
Vol.14 No.10,
October
28,
2026
ABSTRACT: Background: Few published empirical studies have examined the intersection of everyday health, healthcare navigation, academic demands, and social support among Liberian international students in Hangzhou. This study explored how students understood and managed health while studying in this setting. Methods: A qualitative descriptive design was used. Twenty Liberian undergraduate, master’s, and doctoral students were recruited purposively by direct approach across five universities in Hangzhou. Data were collected from 2 April to 15 June 2026. Semi-structured interviews were conducted in English and in person by Kamara and Tarweh, two Liberian members of the research team who shared the participants’ national background. Interviews lasted approximately 45 - 60 minutes. Interviews were audio-recorded with oral permission; detailed contemporaneous notes were used when recording was declined. Tarweh transcribed the recorded interviews. Coding was conducted manually using Microsoft Word and Excel for Microsoft 365 and was supported by a working codebook, analytic memos, and a dated audit trail. Ethical approval was obtained from the Ethics Committee of Zhejiang Chinese Medical University (ZCMU), and oral informed consent was obtained from all participants. Results: Within this sample, eight themes were developed: health as the ability to continue studying; adaptation to climate, food, and daily life; academic pressure and emotional well-being; reliance on self-care, pharmacies, and delayed formal treatment; language and communication barriers; cost and uncertainty about student health insurance; trust, respect, and perceived differential treatment; and peer, community, and transnational support. Participants described cold-weather discomfort, unfamiliar food, irregular sleep, fatigue, academic pressure, loneliness, and homesickness. Many described postponing formal care because of language difficulties, cost uncertainty, limited insurance knowledge, time constraints, or unfamiliar hospital procedures. Friends, African student networks, family members in Liberia, religious communities, pharmacies, and online resources were prominent sources of practical and emotional support. Conclusion: The accounts in this one-city sample show how academic continuity, environmental adjustment, social well-being, and healthcare navigation can intersect in students’ everyday health experiences. Participant-informed priorities included clearer multilingual healthcare and insurance guidance, confidential interpretation, accessible counseling, peer navigation, and flexible academic support during illness. These approaches may address identified barriers, but their feasibility, acceptability, and effects require evaluation.