Tuesday, November 29, 2011

Reflecting on my trip

In October, 2011, I had the unforgettable opportunity to participate in Child Family Health International's Reproductive Health program in Quito, Ecuador.  As a fourth-year medical student, this was a great time for me to to an elective abroad.  I learned about CFHI at the AAFP National Conference for Residents and Students where they gave me a free t-shirt.  It wasn't until two years later, when I began to seriously consider an international rotation, that I learned about the variety of well-developed programs that they offer.  I chose this program because I am interested in family and community medicine, and particularly enjoy Women's Health and Pediatrics.  Reproductive Health in Quito combined my medical 
interests with the opportunity to improve my Spanish skills, which will be very valuable as I move forward with my career.  I applied for the scholarship through CFHI, hoping that it would make funding my trip more feasible, and I am very thankful for the financial assistance. Also, if it hadn't been for the scholarship, I might not have kept as detailed journal/blog entries or taken as many photos, and I am happy to have these to share with my family and friends, and future participants.  



One whole month seemed like a long time to be away when I was preparing for my trip, but the time actually flew by.  We spent every morning during the week working in the clinic or hospital, and rotated to a different site each week.  For the first two weeks, we attended Spanish classes at the Amazing Andes Language School all afternoon.  I had only had a brief Medical Spanish course before my trip, but I studies a lot on my own and was able to place into the "intermediate" Spanish class.  These classes provided lessons on grammar as well as Medical Spanish, and often focused on medical terms that were relevant to our particular clinic sites (maternity hospital, pedicatric clinic).  Following class, we would have some free time to run errands, or just return home to relax.  We had dinner
at our home-stay every night at 7.  Following dinner, we were often busy with homework or studying Spanish, but we also had time to go out or stay in and talk with family and friends back home.  After working all week, we had all of our weekends free to travel and take in all that Ecuador has to offer (there's plenty on that in previous blog posts).

As I stated above, I have always been interested in Family Medicine and Community Health, so it seemed natural to get involved in activities that provide services for people who are medically under-served.  Throughout medical school, I worked at our Free Clinic for the Uninsured and learned about how we can utilize resources to help provide medical care for people in need.  In Ecuador, all people have access to free healthcare, but there is a great disparity between the quality of facilities available to the wealthy and to the poor.  In all of the public sites that I worked, doctors repeatedly told me that certain things weren't available, because there was no money.  This was most evident in the maternity hospital, where laboring patients didn't even have sheets or pillows on their beds.  Still, with limited resources, all of the doctors I worked with provided invaluable services to their patients by focusing on small ways to improve health, such as making sure vaccinations were up to date, providing education about nutrition and contraception, and promoting breast-feeding.  




Looking back, I feel that this program added a vital dimension to my medical education.  My school places a lot of emphasis on cultural awareness in the curriculum, but learning about different cultures in a lecture hall cannot compare with being immersed in a culture for several weeks.  I feel that after this experience, I will have a better understanding of the experiences and values of my hispanic patients and hopefully will be able to make them feel comfortable.  Finally, after having to navigate a foreign country, I have a newfound respect for all people who have emigrated to the US or speak English as a second language.  As I move forward in my career, I would like to continue to learn and practice Spanish, so that I can communicate clearly with more patients. I would also like to incorporate international rotations to South and/or Central America into my residency training and future career so that I can continue to explore different cultures while providing much needed services.