• Application Fee: $95
• Program Fee 2010: $2095*
• Program Fee 2011 (except June and July): $2225
• Program Fee 2011 June and July: $2375 
  

ANNOUNCING 2011 PROGRAM DISCOUNT- Submit your CFHI 2011 program application before August 16th 2010 and pay 2010 fees for any January-May 2011 program. This is an average savings of US$200 for most programs.

* Please note that this discount will be applied to your final program payment fee after September 1st, 2010.

Bolivia is a land-locked country bordering Brazil, Peru, Chile, Paraguay and Uruguay. La Paz is the capital with a population of just over a million people. La Paz lies between two geographical regions, the Altiplano, the high mountain ranges of the west, and Las Yungas, a region of mid-elevation valleys. Bolivia is one of the poorest and underdeveloped countries in Latin America. Seasons in Bolivia are opposite those of the north, and the average temperature in La Paz is 65 degrees Fahrenheit (18C).

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Language Ability
This program is open to those who possess:

• Minimal Spanish
• Conversant Spanish
• Fluent Spanish

This program is open to participants who are 21 or over at the time of participation.We accept students of all nationalities with interest in international health and relevant educational background. Participants may be any of the following:

• Medical Residents, MD & DO
• Medical Students, MD & DO 1-2
• Medical Students, MD & DO 3-4
• Senior level Pre-Medical Students
• Post-bacc pre-medical students
• Gap year pre-medical students
• Graduate nursing students
• Nursing Students
• MPH Students
• Physicians Assistants Students
• Naturpathic students
• Dentistry students*
  

*Limited spaces available for dentistry rotations, please contact our office for further information.

If you do not fit into one of these categories, please contact us to see if you would be eligible to apply.

The following hospitals and clinics are a sample of possible rotations during this program. Restrictions may apply for pre-clinical, pre-med, and those students with minimal Spanish skills. CFHI's rotations are designed to offer you clinical and observational experiences relevant to your level of medical education. CFHI programs can be predominately observational depending on your previous clinical training, your level of Spanish, local laws that prevent foreigners from directly providing healthcare services and whether the preceptors who will be supervising you trust your clinical skills. Rotation availability depends on local conditions.

Hospital del Nino
This state run hospital, one of the largest and oldest hospitals in Bolivia, treats patients from all over the country. The hospital has 160 beds and is the national center for pediatrics. Doctors specialize in a number of areas including: oncology, gastroenterology, infectious diseases, neurosurgery, emergency and outpatient care.

Boliviano Holande's Hospital
This is a municipal hospital run by the city of El Alto, located in a neighborhood called Ciudad Satelite (Satellite City), which is very close and accessible to downtown La Paz. It is a new and modern facility with four basic specialties. There are 120 beds in total, 25 of which are in the Pediatric and Neonatology wards. Daily patient flow in pediatrics is about 200 children, including outpatient, inpatient, and emergencies. A brand new NICU was recently built in the hospital, making Bolivian Holandes a reference hospital for the whole city of El Alto. The hospital is also a teaching hospital that receives medical interns from different universities in Bolivia.

The hospital mostly serves low to middle income patients and families, accepts the universal insurance plan for mothers and children in Bolivia, known as SUMI. Many well-respected physicians and health personnel are employed at Boliviano Holanda's. This hospital also provides services in dentistry and any students interested in dentistry are welcome to work here.

Los Andes Hospital
Los Andes is also a municipal hospital located in El Alto. It is a small hospital specifically for children and mothers with 20 pediatric and neonatology beds. It treats a very poor and marginalized population. This hospital does not have a lot of resources, so the students' support will be very welcome. It is also a teaching hospital and receives medical interns doing rotations in Pediatrics and Obstetrics. It is located in El Alto, in an area also called Los Andes. There is easy access from the highway that connects El Alto with La Paz, and it takes about 40 minutes to get there from La Paz. The professionals are excellent and the work environment is pleasant, emphasizing solidarity and friendship.

Alalay
Alalay is an organization dedicated to getting children off of the streets and providing them with a place to live. The organization currently has four houses in La Paz and one in Santa Cruz de la Sierra, which provide a home for a total of 500 children and adolescents. Alalay employs one medical doctor. Students will rotate with a primary care physician who provides services for the children at Alalay.

Hospital Arco Iris

Located in the Grafico neighborhood (Miraflores), it is a hospital created to provide healthcare services to street children and adolescents but also provides care to private patients in order to be financially sustainable. Physicians at this facility are paid by the state but the infrastructure and building belong to the Catholic Church. All medical specialties can be found here: internal medicine, surgery, pediatrics, ob/gyn, neurology, ICU, trauma. The hospital has more than 100 in-patient beds and also offers outpatient healthcare services. Almost every day, ambulances depart the hospital and drive around the poorest neighborhood, providing free healthcare services to homeless children and adolescents.

Hospital Juan XXIII

This Hospital is locaed on Ave. Naciones Unidos, in an area called Munaypata, a low-income neighborhood. This facility belongs to the Catholic Church and its personnel is paid by the state. Healthcare services are provided to patients of all ages, generally of lower socio-economic background. SUMI (Universal Mother & Child Health Insurance) patients are also able to use the services at this hospital. The following medical specialties can be found at this facility: pediatrics, ob/gyn, surgery, internal medicine, neonataology, traumatology. The hospital has 50 in-patient beds and also offers outpatient services.

Adolescent Health and Primary Care Rotations:

Adolescent Services
An outpatient clinic that provides integral healthcare services to adolescents. Located in the Maternidad de Alto Miraflores, this clinic provides medical, odontological and psychological services. Trainings are also preformed at this facility to empower these adolescents to become healthcare advocates in their own communities. This clinic also provides services in dentistry, as well as oral health outreach and prevention. Any students interested in dentistry are welcome to work here.

All rotations are subject to change depending on local availability and general Bolivian holidays. Local coordinators will try and make alternate arrangements if a particular activity or facility is not available during the program month.

Programs are four (4) weeks long, and can be extended for up to eight (8) weeks. Please see our FAQs section (right side menu) for more details.

We strongly suggest you read the "Rotations" section of the FAQ for more information about "Hands on vs. Observational" experiences during your rotations. Please take the time to download and read the "Rethinking your elective" document in that section, particularly the paragraph "Getting hands-on experience".

• CFHI Arrival and Departure Dates
• Clinical Rotations
• Language Training Component
• Accommodations
• Communication
• Program Months

CFHI Arrival and Departure Dates
CFHI participants should schedule their flight to arrive at any time on the designated "arrival day" (see right side bulleted menu for exact arrival dates). Program activities and arrival orientation generally start the following day, thus arriving on the arrival day ensures all participants are present to take part in these activities. The departure date of each program occurs on the Saturday four (4) weeks following the arrival date. Participants not planning on doing extra traveling outside of the program should be sure to schedule their flight to depart at any time on this day.

Clinical Rotations
CFHI's rotations are designed to offer you clinical and observational experiences relevant to your level of medical education. The program includes the following educational aspects:

• Pre-trip orientation materials
• Web conference opportunities
• Orientation upon arrival, including cultural adjustment exercises
• Weekly meetings with Medical Director and Local Coordinator
• Clinical rotations Monday-Friday, excepting holidays or work stoppages, working with a local physician who has opted to participate in CFHI as a teaching preceptor
• Information sessions that highlight the health care system in that country, common cases you will encounter and other site-specific information
• Post-trip debrief materials & other on-going alumni activities/services

If you expect that you will need academic credit for your CFHI program, you will be responsible for getting your university's approval. CFHI can help you and provide you with the appropriate material (printing out this website information generally is not sufficient), however we are not an accredited institution and cannot award credit ourselves. Please click here to read more about ways in which CFHI can help you obtain academic credit from your university.

Language Training Component
We recommend you study as much Spanish as possible before you go, as it will greatly decrease personal frustration you may experience during the CFHI experience. Most activities listed above will be conducted in Spanish, except for the orientations and alumni services. Please note that the majority of our local partners in La Paz (outside of the language school) do NOT speak English and will not be able to translate for you in the clinical sites. Please visit our Frequently Asked Questions page (right side menu) for more information.

Click here for a general overview of Spanish-language course learning objectives.

CFHI students will take Spanish language classes at the Executive Branch of the Centro Boliviano Americano (CBA), located in the downtown area relatively close to host families, and a short ride to the hospital. Transportation is no problem in La Paz, either by taxi or mini buses and are VERY economical.

The CBA is responsible for arranging all host families and offering 30 hours of language classes within the first three weeks of the program. The program includes basic grammar and conversational Spanish, and Medical Spanish interviewing skills. Some classes may be taught in small groups, and others individually. If you would like to continue with additional language classes beyond the 30 hours that are included in the CFHI program, you are welcome to schedule these by the week so they do not interfere with your scheduled clinical rotations. If you set up extra hours of Spanish class, please note that they are not included in the program fee, so you will have to pay the local coordinator of the program directly for the extra hours of Spanish class.

The language school also provides coordination for other activities such as salsa dancing classes, cooking classes, and tours of the city and important landmarks. Activities of this nature are not included as a part of the program fee. They may be available to arrange weekend trips for the students if there are enough interested, and are always available to give suggestions and guidance for things to do and see.

Accommodations
Homestay families are chosen and screened by The Centro Boliviano Americano. Most host families live in close proximity to the school, allowing for participants to walk to and from their language classes and meetings with ease. In some cases, students may stay with one other student in the homestay, but in all cases students will have their own room.

If you decide to arrive early or stay with the homestay family after your program has ended, you will need to pay around $11.00 USD per night for the time spent outside of the CFHI program. These fees should be paid directly to the local coordinator of the program.

Communication
You will be assigned a mobile phone for the duration of your stay. All-important phone numbers will have been pre-programmed along with a limited amount of airtime for emergencies. To make calls over and above the airtime included, you can purchase pre-paid phone cards at various locations locally.

You will be required to sign a $100 release form in order to receive the cell phone. You will not be charged the $100 fee if the phone is returned in good working order to your program coordinator. To learn more about how to make phone calls to and from your program country, click here. (*CFHI does not endorse any services provided by these sites nor does it guarantee the accuracy of their information).

Program Months
All CFHI groups of participants fluctuate in size through out the year. The summer months tend to be the busiest time of year, so please plan ahead and apply early if you want to secure a space in a specific program during the summer months. During the rest of the year, the group size in a program can be small, especially during the fall months. However, we will NEVER cancel a program due to the size of the group, even if there is only one participant.

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CFHI is a nonprofit organization committed to providing students a unique opportunity to experience another culture and healthcare system in a responsible way. Though we work closely with our global partners to provide you the best possible trip, the nature of international travel means that we cannot anticipate all challenges that may occur. It is important that participants realize they must remain flexible in the face of situations that may be difficult to understand. Participating in a CFHI program means that you are an informal ambassador to the community you visit and your professional behavior is of the utmost importance.

Child Family Health International (CFHI) offers service-learning programs around the world. CFHI would like to stress to prospective applicants and institutional partners, that service-learning is not an episodic volunteer experience, and our student programs are not designed to provide service to those who would otherwise not have healthcare. The main objectives are to broaden your public health knowledge, experience a different culture, and develop creativity in problem-solving. CFHI has assembled a global family of outstanding local healthcare professionals who are at the forefront of healthcare delivery in their countries. You will have the rare opportunity to shadow these unique women and men observing and learning to work in a clinical and public health environment with limited diagnostic and therapeutic resources.

1. What problem do we address?

2. How do we address the problem?

3. How does the community benefit?

4. How do participants help in the clinic?

5. What kind of educational experience is the CFHI global health elective?

6. What are the objectives of the program?

7. Where do CFHI students come from (past participants' universities/colleges)?

8. What role can domestic Institutional Partners (universities, collaboratives, et. al.) play?

9. What is Service-Learning?

1. What problem do we address?

In today’s world we often see the uneven distribution of healthcare that leaves many impoverished communities underserved. Economic, political, and social factors all contribute to people’s access to healthcare, both internationally and at home. Increasingly, we need culturally and linguistically competent healthcare providers around the world to address these inequities.

2. How do we address the problem?

Child Family Health International’s (CFHI) Global Health Service-Learning Programs combine instruction, experience, service, and reflection to create a model that supports physicians and clinical sites abroad, addresses the healthcare needs of the underserved, and adds an unforgettable experiential element to each program participant’s education.

CFHI programs bring service-learning to hospitals and clinics around the world, allowing participants to gain insight on the contextual constructs of illness and healing in foreign settings. Program Alumni return from the host country with new perspectives on healthcare systems and delivery in places where resources and supplies are extremely limited. To read further on the potential benefits of international experiences for health students, we recommend the paper “The Effect of a Global Multiculturalism Track on Cultural Competence of Preclinical Medical Students” by Godkin and Savageau (2001).

Since 1992, CFHI has arranged for nearly 4,000 pre-medical, medical and other students of the health professions, from over 400 top universities in the and the world, to work and study in Bolivia, Ecuador, India, Mexico, and South Africa

3. How does the community benefit?

While a student’s ability to practice medicine may be limited by clinical knowledge or language skills, the participant’s contribution to the community is not an illusion. For example, we provide each participant with a box of donated medical supplies to carry with them for distribution among partner facilities. In addition, our partner physicians at each program site are compensated for their willingness to mentor CFHI students. This supplementary income promotes job retention in countries where physicians are paid small salaries, often by financially strapped governments. Furthermore, the exchange of information between students and their preceptors provides an invaluable experience for participants, the patients, and the physicians.

4. How do participants help in the clinic?

Each of our program sites has many locally qualified and experienced healthcare providers, so the participant’s primary motivation for participation should not focus on a concept of humanitarian aid, in which one expects to provide medical care to people that would otherwise not receive it. The participant’s main objective should be to actively observe, according to current language abilities, level of training, and local laws, in order to develop a high level of community health awareness. While abroad, this happens in the social and cultural context of the program site.  Child Family Health International (CFHI) would like to stress to prospective applicants and institutional partners, that service-learning is not an episodic volunteer experience, and our student programs are not designed to provide service to those who would otherwise not have healthcare.

5. What kind of educational experience is the CFHI global health elective?

CFHI's rotations are designed to offer you hands-on  or observational clinical experience (depending on your clinical and language skills as well as local laws), much like what you would experience during a rotation in the . The program includes the following educational aspects:

• Pre-trip orientation materials & web conference opportunities
• Orientation upon arrival, including cultural adjustment exercises
• Weekly meetings with Medical Director and Local Coordinator
• Clinical rotations Monday-Friday, excepting holidays or work stoppages, working with a local physician who has opted to participate in CFHI as a teaching preceptor.
• Information sessions that highlight the health care system in that country, common cases you will encounter and other site-specific information.
• Post-trip debrief materials & other on-going alumni activities/services

If you are attending a program in a Spanish-speaking country, we recommend you study as much Spanish as possible before you go, as it will greatly decrease your personal frustration during the CFHI experience. Most activities listed above will be conducted in Spanish, except for the orientations and alumni services.

MD Consult and FIRST Consult bring the leading medical resources together into one integrated online service to help physicians efficiently find answers to clinical questions, make better treatment decisions, and stay abreast of recent developments. MD Consult has been adopted by over 90% of North American medical schools and by over 1,700 health care organizations in 46 countries worldwide. FIRST Consult offers an evidence-based resource for the Point of Care, peer-reviewed content and a differential diagnosis tool.

(Please view the FAQs on the right had panel for more information)

6. What are the objectives of the CFHI Service-Learning program?

CFHI’s International Health Service-Learning Programs help participants:

• Develop a larger sense of cultural competency
• Observe and develop existing clinical skills
• Broaden public health knowledge
• Develop creativity in problem-solving
• Deepen their commitment to service
• Promote medical supply conservation

Prospective participants may apply online. Our participants are 21 years of age and over, come from around the globe, and are dedicated to a diverse array of professions in health.

7. Where do your students come from (past participants' colleges/universities)?

CFHI has provided global health education programs to nearly 4,000 health science students since 1992.  Our participants come from over 35 countries and 400+ of the most prestigious universities in the world, and represent a huge variety of the medical profession’s student population.

8. What role do domestic institutional partners (i.e. universities, collaboratives) play?

In addition to providing quality programs for individual students, CFHI is dedicated to building relationships with institutions of higher learning for relevant international programs. Creating and sustaining international programs is a long-term and labor-intensive process. Our international partnerships with physicians and clinic sites are established and reliable, and CFHI can offer the expertise needed to administer an international program to match institutional needs. Some of our current partnerships include:

• Princeton University—Health Professions Advising Office and the Pace Center for Service-Learning: CFHI developed a domestic and international health service-learning program that combined 5 weeks of international work in Quito, Ecuador with 40 hours of service in Spanish-speaking health centers in urban New Jersey.

• Oregon University System—IE3 Global Internship program: CFHI designed 11-week clinical internships in and that focus on cultural competency and valuable clinical experience within the structure of an internship. The internship promotes planning and goal-setting for students in the clinic setting.

• College Corps—CFHI currently working with College Corps, a project started several years ago by Harvard University undergraduate students, to offer 8-week programs in Bolivia, Ecuador, India, Mexico or South Africa, for pre-med students.

• University of California Davis—has teamed up with CFHI to offer a quarter-long study abroad program in Oaxaca, that highlights Latino/a Health Internship Program for undergraduate students. This course is certified by the university as a 20-unit course entitled "Bi-National Health".

If you are an administrator and would like to discuss partnership possibilities we would be excited to hear from you! Please contact Program Staff at CFHI at students@cfhi.org or by phone at (415) 957-9000 and ask for Nick or Amanda.

9. What is service-learning?

Child Family Health International (CFHI) would like to stress to prospective applicants and institutional partners, that service-learning is not an episodic volunteer experience, and our student programs are not designed to provide service to those who would otherwise not have healthcare.

The following is an excerpt from the Campus Community Partnerships in Health (CCPH) website (http://depts.washington.edu/ccph/):

Service-learning is a structured learning experience that combines community service with preparation and reflection. Students engaged in service-learning provide community service in response to community-identified concerns and learn about the context in which service is provided, the connection between their service and their academic coursework, and their roles as citizens.

Service-learning differs from traditional clinical education in the health professions in that:

• Service-learning strives to achieve a balance between service and learning objectives - in service-learning, partners must negotiate the differences in their needs and expectations.

• Service-learning places an emphasis on addressing community concerns and broad determinants of health .

• In service-learning, there is the integral involvement of community partners - service-learning involves a principle-centered partnership between communities and health professions schools.

• Service-learning emphasizes reciprocal learning - In service-learning, traditional definitions of "faculty," "teacher" and "learner" are intentionally blurred. We all learn from each other.

• Service-learning emphasizes reflective practice - In service-learning, reflection facilitates the connection between practice and theory and fosters critical thinking.

• Service-learning places an emphasis on developing citizenship skills and achieving social change- many factors influence health and quality of life. The provision of health services is not often the most important factor. In service-learning, students place their roles as health professionals and citizens in a larger societal context.
  
  

Citation: Seifer SD. (1998). Service-learning: Community-campus partnerships for health professions education. Academic Medicine, 73(3):273-277.  

Medical Director
Dra. Cecilia Uribe de Chavez is the medical director for the Pediatric Health program in La Paz. Dra. Uribe is a Pediatrician, working at Hospital Los Andes. It is a municipal hospital located in El Alto. She is also currently the Secretary General of the Committee of Adolescents for the Bolivian Society of Pediatrics. Dra. Uribe is responsible for coordinating all clinical rotations and lectures (run in Spanish) for program participants.


Local Coordinators
The Executive Branch of the Centro Boliviano Americano is where your Spanish classes and weekly meetings are held. Ms. Lorna Prudencio is the Director of the language school. The person who will be in direct contact with participants is the Supervisor of the Executive Branch, Mr. Gonzalo Claure; he will organize all academic and extra curricular activities that are requested. The 85 Spanish teachers are all very experienced and university qualified. The Centro Boliviano Americano has been in existence for 57 years and was started by the U.S. government, and still has close ties through the U.S. Embassy. The Honorary President of the Board of Directors is always the current U.S. Ambassador in Bolivia and additionally, has two members of the U.S. Embassy on the Board. The Centro teaches English and Spanish and has about 3000 students every two months. The main office of the language school is located two blocks from the American Embassy building.