Doing More With Less- Healthcare in Remote Southern Bolivia
"The rotations in Tarija were very well organized and I became enamored with the people, the country, and the culture." -Dolly Do, July 2009 (Pre-Med Senior, Oregon State University)
Introduction
Slideshow above includes photos from all CFHI program sites in Bolivia. Click on the “Photo Gallery” bullet on the right side-menu for program-specific photos.
CFHI’s program in Tarija, Bolivia provides students an opportunity to learn about rural and community health in this region. Students will participate in clinical rotations at primary and secondary level clinics throughout Tarija. The state of Tarija is unique in that it offers universal health insurance for all its inhabitants. This has created an enormous demand which at times cannot be met because of the lack of healthcare personnel and equipment. Students will witness first hand the difficulties in accessing healthcare services (cultural and socio-economic) and learn about the different pathologies that are prevalent in Southern Bolivia, such as Chagas, TB, parasitosis, etc.
While on the program, there will also be a strong focus on Chagas Disease, an infectious disease that is a major cause of death and disability in Latin America, but which is very rarely seen in industrialized countries. According to the CDC, an estimated 8 to 11 million people in Mexico, Central America, and South America are currently infected with Chagas. It is an infection which is often symptom-free and can be life-threatening if left untreated. Students will participate in prevention and epidemiological programs as well as clinical rotations where they will observe the various manifestations and stages of Chagas infection.
Read the Why CFHI bullet on the right side menu to find out more about the goals and objectives of CFHI programs as well as the service-learning concept.For quotes and stories from students who participated in the Chagas in Southern Bolivia program, read the What Alumni Say section (right side menu). If you would like to speak to alumni of this program via email, please contact alumni@cfhi.org for more information.
We look forward to having you join our grassroots work to build a global community in support of better healthcare for underserved communities!
CFHI’s Social Networking Sites: Join our groups below for the latest updates on CFHI and to connect to CFHI participants and alumni.
Program Fee
All CFHI fees are based on a 4 or 8 week program. For longer programs, additional fees are calculated on a weekly basis. While only 4 and 8 week options are available on the application page, CFHI also offers the option for you to participate in any program for 5, 6 or 7 weeks, or to apply to multiple programs at once- see how.
Application Fee: $95
Program Fee 2012 for 4 weeks: $2275
Program Fee 2012 for 8 weeks: $4320 * This price represents a 10% discount on the second month of the program.
2013 dates open for applications. Program fees are subject to change.
Payment Schedule: The application fee is charged upon application to the program. Within 2-3 weeks, applicants will be accepted or rejected for participation in the program. Upon acceptance, a transferable, but non-refundable deposit of $350 is due within 30 days. The final balance of the program fees is due 6 weeks prior to your program date.
* For equivalent costs in other currencies please click here for currency converter.
Please note that all bank check or money order payments must be made in U.S dollars only. Credit card payments are converted to U.S dollars automatically.
Discounts
Longer-Term Participation- All participants who go on CFHI programs for 8 weeks or more are eligible for 10% off program fees starting week 5 and beyond.
Group Discounts for groups of 4 or more may be available for CFHI programs. If you have a group of 4 or more people that are interested in applying contact students@cfhi.org for more details.
Fundraising Scholarships may be available depending on budget allocation each year. Please check the scholarships page for status and dates of future scholarship programs.
Once accepted, students may also do their own fundraising through Firstgiving.org. Please click here to view a sample fundraising page. Please note that some important restrictions apply to funds raised through Firstgiving. To review the terms of use, click here. What’s included:
Pre-departure orientation materials and guidance
Two meals and accommodation with a homestay family (private room) for the duration of the program. The local coordinators will charge you for additional nights outside the program dates.
International Emergency Medical and Medical Evacuation Insurance
Airport pick up on arrival
Orientation to the program
Thirty hours of Spanish classes. Additional language training beyond 30 hours: U.S.$10/hour for individual instruction $8/hour for small group instruction
All preceptor, hospital and coordinator fees
Costs do not include:
Airfare to Tarija, Bolivia
Airport Drop-off
Passport or visa fees
City transportation to and from clinic sites
Other expenses of a personal nature like weekend and after-hour activities. This includes but is not limited to local transportation, tourist trips in and around La Paz, and any personal expenses incurred.
Location
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. The state of Tarija is located in the south of Bolivia, at an altitude of 1957 meters with an average temperature of 18.6 ºC, The department in its entirety has a population of 380,000. The region also contains important gas and oil deposits, which are its main exports. It is also a tourist destination, with artisanal wineries that are world-renowned. Tarija also has many colonial churches, such as the Iglesia de San Francisco, one of the oldest colonial churches in Bolivia, plazas and a national museum.
To view photos of CFHI participants at this location and other CFHI sites check out our CFHI Picasa Web Albums as well as Flickr photosonline. You can also click on our “Photo Gallery” bullet on the right side menu.
For information about Bolivia's health indicators provided by the World Health Organization, please click on the following link: WHO Bolivia
*CFHI does not endorse any services provided by these sites nor does it guarantee the accuracy of their information.
Recommended Vaccinations Please visit your local public health office, or travel clinic and heed the advice of a travel physician. You should have all your routine childhood and adult vaccinations as required, including yellow fever for some countries, at least 4 weeks prior to departure. Be sure to set up a doctor's appointment up 4 to 6 weeks before your trip. Please click here for a detailed explanation from the CDC of routine, required and recommended vaccinations. CFHI does not require verification of recommended vaccinations; however we strongly suggest getting all CDC recommended vaccinations. Please click here for a list of CDC recommended vaccinations for Bolivia.
Visas Please note that the Bolivian Government has instituted new visa requirements for U.S. Citizens traveling to Bolivia as tourists. No matter your nationality, please contact your closest Bolivian Consulate or click herefor more information and details about the requirements. After your acceptance, CFHI will also provide you an "invitation letter" from Bolivia, a document to use as part of your tourist visa application. Most U.S. born CFHI participants get their visas by presenting their paperwork upon arriving at the Bolivian airport, and this is what CFHI recommends. CFHI will send you full details on visas after your acceptance to the program.
Read a first-hand account of alumna Sadia Ghaffar's experience on the Doing More With Less Program (April 2011). Visit Great Nonprofits to read her review of CFHI.
Click here to read passages and view pictures from alumna Megan Simpkin's blog (January 2011).
Click hereto read a first-hand account of alumna Jessica Bechler's experience in Bolivia (October 2010).
Click here to read a first-hand account of alumna Andrea Contreras's experience in Bolivia (July 2010).
Click here to read a first-hand account of alumna Dolly Do's experience in Bolivia (July 2009).
Click here to read a first-hand account of Jesse Maupin's experience in Bolivia (August 2009).
If you would like to speak to alumni of this program via email, please contactalumni@cfhi.org for more information.
Arrival Dates
The CFHI dates below are scheduled arrival dates for 4 and 8 week programs running every month. CFHI has flexibility with dates and participants may arrange alternate dates outside of the dates below if needed. CFHI also offers the option of combining several 4 or 8 week programs for a more in-depth or comparative health experience. For details on any of these options, email students@cfhi.org or call our office at 415-957-9000.
Participants are accepted on a first come, first serve basis, and programs may fill up. CFHI recommends applying in advance for any program but can also accommodate last minute applicants.
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March 3, 2012 (4 Weeks )
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Eligibility
This program is open to participants who are 20 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
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
If you do not fit into one of these categories, please contact us to see if you would be eligible to apply.
Language Ability
Please Note: Please use CFHI's language recommendations below as a guideline to assess your own language skills. Most important overall is your general ability to communicate with those around you, versus accuracy with grammatical tenses.
This program is open to those who speak:
Conversant Spanish- You can interact with a degree of comfort with locals. You can easily describe experiences and events in the present/past tense and have some knowledge of other tenses.
Fluent Spanish- You can understand with ease virtually everything heard. In addition, you can use language flexibly and effectively for social and professional purposes. You can easily use a variety of grammar tenses.
Clinical Sites
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 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 Universitario San Juan de Dios
Located in the central part of the city, the Hospital Universitario San Juan de Dios has many different specialty clinics. It is a teaching hospital that accepts students from different universities around Bolivia as medical interns, nursing students, radiology students, dentistry students, etc., in addition to residents in obstetrics and gynecology, internal medicine, pediatrics, general surgery and anesthesiology.
This hospital has inpatient wards in the basic specialties as well as a neonatal intensive care unit, in which they offer treatment for congenital Chagas infections. It is a tertiary care hospital that serves as the reference hospital for the entire state. It offers services to the entire population of the state, including people with limited resources and indigenous groups.
Students will spend one week each rotating in Pediatrics, Surgery, and Internal Medicine, examining the progression and presentation of Chagas infection in each context.
Servicio Departamental de Salud
Under the Minisitry of Health and Sports, the Servicio Departmental de Salud is the governing agency for health in the state, and is located in the central area of the city, close to the Hospital San Juan de Dios.All of the health programs that are carried out in the country have offices in this agency, including Chagas control, Malaria control, TB control, childhood immunization programs, and epidemiology and entomology labs where all testing and analysis of infected vinchucas is conducted.
Students will rotate for one week in the Servicio Departamental de Salud, observing and participating in the prevention and control efforts of the Chagas, TB, malaria and yellow fever programs.
Hospital de San Lorenzo & Hospital Fanor Romero
These secondary level hospitals provide general outpatient and inpatient services for basic specialties. Hospital staff is also within reach of healthcare education and public health outreach campaigns. These clinics facilitate educational community health programs regarding hypertension, diabetes, dengue, malaria, chagas, tuberculosis, leprosy, malnutrition, prenatal care, domestic violence, STDs, etc.
Centro de Salud Palmarcito, Centro de salud Villa Avaroa, & Centro de Salud San Andrés
These primary healthcare centers have a general physician and some specialties, such as pediatrics and gynecology. These centers focus their energy on promotion and prevention, evaluation and treatment of common diseases in the region (TB, Chagas,etc).
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.
Program Details
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 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, 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
Academic Credit Assistance If you expect that you will needacademic 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 program. 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 Tarija (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 (FAQ- right side menu) for more information.
CFHI students will take Spanish language classes at a local language school, located in the downtown area relatively close to host families, and a short ride or walking distance to the hospital. (Transportation is no problem in Tarija, either by taxi or mini buses and are VERY economical). Click here for a general overview of Spanish-language course learning objectives.
The local coordinator 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 extra Spanish classes.
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 local coordinator. Most host families live in close proximity to the school and clinical sites, 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 ~$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. 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 this site nor does it guarantee the accuracy of it's 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.
Why should I go abroad and study global health issues with CFHI?
To read more about our perspective on the importance of global health and how we are trying to make a difference in your professional development, see "Why CFHI?" above.
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What is the First Step?
Read the website information and decide in which program you are most interested. Using the search option, find a program that fits your goals, your academic skills, and language requirements. Read all the program information in detail. Look at the past participants experiences on the program on that web page. Reading the past participants experiences will give you a very good idea of what to expect while you are on the program.
When you are ready to apply to a program click on "Apply Now" located on any Program Description page. Follow the application procedure detailed on the website.
3)
Who should my references be? What is required?
Choose two professional references that know you and your work style well. They may be professors, supervisors at work or a volunteer position, coaches, etc.
Your references will be emailed directly once you submit your application. PLEASE let them know that you are applying to our program and that they will hear from us VIA EMAIL. This is a very simple format of fielding recommendations, there is no requirement for references to write and mail letters. They will only have to reply to an email that describes what we seek in our participants.
4)
What is the duration of the program?
CFHI programs are 4 or 8 weeks long. All program fees specified are for a 4 week duration. If you choose to stay for a total of 8 weeks, the total fees will represent a 4 week program plus a 10% discount on the second month of the program. You may apply to two separate programs back to back if you would like (Example: Quito and Community Medicine, Ecuador programs for February and March). For details on applying to more than one program email us at students@cfhi.org for instructions on how to bypass subsequent application fees and references.
5)
Are there set starting dates?
All of our programs begin on Saturday and end on a Saturday. Normally, these dates lie around the first of the month and run to the end of the month. Check specific program descriptions for exact dates. We ask that you ARRIVE at your program site on Saturday so that you may settle in and begin orientation on Sunday when possible. If you are a clinical year medical student and your rotation dates with your school do not coincide with the set dates, please contact the office and we will see if we can accommodate your needs.
6)
What is the deadline for application?
There are no application deadlines. We prefer to receive the applications at least 3-4 months in advance; however, some programs fill up nearly 7 months in advance, especially in summer. The advance notice allows us adequate time to make all the preparations according to your needs. Please inquire by email or phone about the space availability of the particular program and month that you would like to attend. Programs will close one month prior to the program start date.
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How does CFHI choose the participants?
We accept a participant if we have a program place free and if they meet our eligibility requirements. Admission runs much on a first-come, first-serve basis. So if you are thinking of applying, try to send in your application as soon as possible. We make a decision based on your application form and two references from your University or professional contacts supplied on the application form.
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Can individuals with little or no Spanish apply to programs in Spanish speaking countries?
Yes, we do accept individuals who speak little or no Spanish. Please be aware that the more Spanish you know before you go, the more medical experience you will get out of the program. At the very least go to your library and get some lessons on tape and study as much as you can. If you have little or no Spanish skills, we strongly suggest that you go at least 2 weeks early and take Spanish at the language school before the program starts. If you plan to do this, please contact students@cfhi.org after you are accepted into the program and we can provide you with the contact information of the language schools we work with.
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Do you accept undergraduates in college as participants in your programs?
We do accept undergraduates who are 20 years of age at the time of participation to most programs.
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Can I participate if I am under 20 years of age?
Due to a Board of Directors mandate regarding liability issues, we are not able to accept individuals into our international programs who are not 20 years old at the time of participation. If you are turning 20 during a program month, you may apply to a program during that month or after.
We would like to accept as many participants as possible, but our programs cannot accommodate everyone. We want to give the opportunity to travel with our programs to the people with the most relevant coursework and experience available. If we were to offer the program to everyone who was interested, there would be no space for 1st year medical students and post-graduate pre-medical students looking to solidify their commitment to the health sciences.
11)
Where does my program fee go?
Like most not-for-profit organizations that run international volunteer programs, CFHI’s income is largely generated from our students' program fees. These fees are an essential way for us to run the programs for you and to support our international partners who host you – all at the same time.
This does not necessarily mean that your entire fee goes only to the community where you work. Let us explain by taking a quick look at what it takes to run an international organization like CFHI.
There is a significant cost involved in answering your emails and calls, maintaining the website, doing the paperwork you require for your university, ensuring the quality of the programs and managing the finances of a multi-million dollar organization. In addition, it is important to remember that costs to do basic business functions in the are several times the cost of doing business in the countries you visit.
CFHI has a unique structure that allows our partners autonomy and fiscal stability. At the same time, we manage a complicated series of programs throughout the world, maintaining accountability and transparency required for organizations working in the current global environment.
CFHI maintains an incredibly low overhead cost of 6.4% (most funding agencies consider an overhead cost of less than 30% to be good, and less than 15% to be excellent). You can read more about nonprofit organization standards at www.guidestar.org. You can also read about how CFHI is ranked by an independent charity watchdog, Charity Navigator by looking at CFHI's "Affiliations" page.
All programs are offered “at cost”, meaning that CFHI does not acquire any profit from student fees. The cost you pay is the cost of the package of services you receive.
If you have concerns about the structure of the program, about pre/post-trip support or about the finances of the program, PLEASE DO NOT ask your local coordinators. It is not their job to address these issues, which should be brought up with the San Francisco CFHI staff only. This is to avoid hassle for our dedicated, hard-working partners and so that we can answer your questions most thoroughly and accurately about the global activities of CFHI. ALL PROGRAM FEES ARE NON-NEGOTIABLE, and we trust you will not take advantage of the graciousness of your hosts by violating this CFHI standard.
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What is the payment schedule once you are accepted into the program?
The application fee to a CFHI program is $95 and is due at the time your online application is submitted. The $350 deposit, which is applied toward the total cost of your program, is due within 30 days after acceptance to the program or 45 days prior to the start of the program, whichever comes first. All application ($95) and deposit fees ($350) are non-refundable. The final balance of the program fee is due 45 days prior to the program start date. If you are accepted into to any program within 45 days before the start date, all program fees are due within 72 hours of acceptance, without exception.
13)
Does CFHI offer any scholarships?
CFHI does offer a limited number of scholarships for specific programs. Normally scholarships are available for selected spring and fall programs.
There is much more information on the "Scholarships" page, which is located here --> "Program --> "Global Health Education" --> "Scholarships".
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What if I find a host family on my own or don’t want to take Spanish classes?
CFHI strongly encourages you to stay with the host family with whom we place you. These families have experience with our students and our programs, so, they adapt easily to your cultural preferences and needs. If you choose to seek housing or have found housing outside of the program please contact us at students@cfhi.org
If you visit a Spanish-speaking country, we strongly encourage you to participate in the language portion of the program. Spanish courses are based on medical Spanish so even if you are a fluent or a native speaker, we believe the opportunity will be beneficial to you. The more Spanish you know the more opportunity you will have to get a hands-on medical experience out of the program. If you have any questions please contact us at students@cfhi.org.
Please note: even if you do choose to find other housing arrangements, or do not take Spanish courses, your program fee will remain the same.
15)
Are the rotations set and mandated, or does one have a say in them?
On your application, you will be asked what types of clinical preferences you have. It is VERY important for you to complete this section of the application. Your clinical rotations will be based on this information. This information is sent to your Medical Director before your arrival so s/he knows what you are interested in. They will try and incorporate those activities with your clinical rotations. For example, if you have a specific interest in pediatrics, they will try to place you in rotations with high interaction with children.
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When do I get my rotation schedule?
The local Medical Directors will give you your rotation schedule during your first meeting with them, upon arrival. Depending upon availability, you can ask for changes or preferences after the first week of the program.
17)
Is the program a hands-on clinical experience or observational?
The purpose of our programs is to provide first-hand (rather than hands-on) exposure to the way healthcare is practiced at our various sites. That said, the amount of clinical exposure you get on the program will depend on the following factors:
(1) Whether you are a clinical or pre-clinical student. If you are a fourth-year medical student or advanced level nursing student with good communication skills you can expect to see patients yourself under the supervision of your local preceptor. If you are pre-clinical you will be more in an observational role till the doctor can develop trust in your abilities. It is essential that you work hard to develop good relationships with the doctors in the program. You will get more hands-on experience if you advocate for yourself, and work to express your skills and comfort in the clinical environment. In that same light, if you do not know how to perform a clinical procedure, you should NOT do it. To read more about the ethical implications of doing medical work abroad, a great read is this article published in the Student British Medical Journal: "Rethinking Your Elective".
(2) Your language ability... while you are still getting to grips with your Spanish or other local language, you may find that the amount of direct work you will be able to do will be limited. As your language skills improve you can look forward to taking histories, conducting patient interviews, and discussing case studies with your clinical physicians.
The experience is different for each and every participant depending on their individual skill set and the trust that they can build with their preceptors. In addition, sometimes local laws prevent you from providing direct clinical services, no matter what your level of education or certification in your home country. The physicians will try and involve you as much as possible so you must show interest, enthusiasm, drive and an ability to ask questions. The more outgoing you are, the more doors will open.
18)
If I am a pre-medical student and I don’t have the items listed in the sample suitcase reference guide, do I need to bring them?
ALL participants in CFHI programs are required to have a white coat with a nametag. You should receive a CFHI nametag in the mail. Alternatively, you can bring your own nametag, which can be pinned on the coat, or even one that sticks to the fabric if you do not have one embroidered. Please also bring one green and one blue set of scrubs if you have access to them. Some clinics REQUIRE scrubs. A pocket Medical Spanish dictionary in Spanish-speaking countries is also helpful. You DO NOT need to bring a stethoscope, or drug reference guide if you do not have them. If you do not have the required supplies check out www.Allheart.com, they offer these supplies at an affordable cost!
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How can I get Academic Credit for this program?
Academic credit can be arranged with the cooperation of your university or school. After you are accepted, you may request an “elective letter” to be sent to you or your advisor with information about how you will be evaluated and basic roles and responsibilities of CFHI participants. Each program site has a Medical Director who will complete any on-site evaluation forms. It is very important that you carry these forms to your program site, and take responsibility for their completion and submission to your school. We also ask that you fax or mail a copy to CFHI to keep in your file. CFHI will not be held responsible for incomplete evaluation or credit.
20)
What is a Clinical Journal?
All participants are expected to keep a Journal for the duration of the program abroad. It is very useful to write down your clinical and cultural experiences you have that relate to the program. You may transcribe this document into a word file and you may be asked to submit the journal upon return from the program. This document is used for program evaluation procedures as well as for academic credit if you need supporting documentation from a US based faculty physician.
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Where can I obtain donated Medical Supplies to carry to the host country?
PLEASE NOTE THAT AS OF OCTOBER 2008, WE NO LONGER SEND A BOX OF DONATED MEDICAL SUPPLIES TO INDIVIDUAL CFHI PROGRAM PARTICIPANTS. However, we would like to urge you to collect basic supplies such as gloves, dressings, gauze & alcohol pads, medical tape, bandaids, masks and syringes on your own to carry with you to your program site, as a way of establishing goodwill with your host community.
Please contact the CFHI office at students@cfhi.org for more information about what types of supplies are useful, and ideas about where to solicit donations. It is important that all items are NOT expired.
In past years, CFHI sent over medical supply boxes to over 500 participants a year to our partner sites. So, to you, your box may look small, but it all adds up, and does make a huge impact.
22)
What about Customs Clearance for Medical Supply donations once I arrive in my host country?
You will not have any problems taking medical supplies out of the country. Please make sure to put all supplies in your checked luggage.
The Inventory Sheet is to be handed over to the local preceptor during first-day orientation. Please show the customs officials the letter only if you are searched or questioned as to why you are carrying the supplies. Due to possible delays and we strongly suggest that you re-pack the medical supplies into your own luggage before departing. If problems arise at customs and officials are asking you for payments or bribes to carry the supplies into the country, we ask that you leave the supplies at the airport so you may pass.
23)
Who do we approach if we have complaints or problems with the program?
If for some reason you have any problems with the program, please contact your local coordinator to try and resolve them. You can also speak to your medical director regarding clinical placements and issues. If for some reason you feel the need to contact us, please do so via e-mail. If you have questions about any financial aspects of the program, please direct them to CFHI in San Francisco. If you have an emergency situation and you need to contact CFHI USA representatives after business hours, you may use the emergency contact phone number you have on your important numbers contact card. Please note that collect calls made to the CFHI office will not be accepted unless in case of medical, legal or other emergency. All formal complaints and withdrawal notices must be made in writing via e-mail or post to the CFHI office.
24)
What types of accommodation are available while in the programs?
Accommodation varies from program to program. Please visit the program pages for details about accommodation. Many of the programs use homestay families to house participants individually or on a shared basis. The homestay feature allows for an unforgettable cultural immersion experience, and for many participants is one highlight of the program. Other types of accommodation include: small hotels, hostels, guesthouses, and dorm style accommodations. It is very important to note that all accommodation is provided for the program dates only. If you would like to stay longer with your host family, you must let the local coordinator know this at the beginning of the program, and you will be required to pay for those additional days to the local coordinator. Remember that there are new participants arriving on the last day of your program and everyone needs a place to stay!
25)
Can I change my host family if I am not happy?
If for some reason you are unhappy with your family please talk to your local coordinator at your site. Please make sure to always discuss problems with your family, and it may be an issue of miscommunication. If things cannot be resolved on your own or with the help of the coordinator, you may switch families within the program.
26)
Shoud I take gifts for my host family?
Yes, participants are encouraged to take small token gifts for the family they will be staying with. These can be chocolates; a book of photographs from your home area; or your local sports teams t-shirts or caps. Even household items that people may not buy for themselves, such as towels, are highly appreciated. Be creative!
27)
Will I have email access while in the program?
In most programs you will be shown where internet cafés are located where you may use email and international phone lines. Email access is very affordable, and the international calls from these places, also are very reasonable. In some programs, you will be able to use computers in your coordinator’s offices. Please ask once you arrive.
28)
When do I get the information about my homestay family?
If you are participating in a program that has homestay family accommodation for the entire 4 weeks, you will receive it from the local coordinators via email approximately 2 weeks prior to your program start date.
29)
Can I use the phone at my homestay family’s house?
CFHI strongly encourages participants to use public phones whenever necessary. In most countries, you may purchase affordable phone cards that provide a limited number of minutes of phone time.
30)
When do I fly in?
Please arrange your international flight to arrive on your program start date. All dates listed on this website are Program Start Dates. The program runs from Saturday through Saturday for 4 weeks. At many program sites, there will be a mandatory Orientation with your program group and medical director on Sunday. For Example, if the program start date is May 1st, please plan to arrive on May 1st. Participants may also arrive early to travel independently before the start of the program. Please let us know if this is the case, so we can arrange for you to meet up with your local coordinators.
31)
When do I fly out?
Each program lasts 4 weeks. The program arrival date is a Saturday, and the finishing date is 4 weeks following on a Saturday. For example, if your program date starts on April 3rd, your ending date is May 1st. You may leave on this Saturday, as you will not be working on that day, but WILL be working on the day before, a Friday. Participants may also stay and travel independently if they wish.
32)
Where do I fly in?
If your program is in Ecuador, please fly into Quito.
If your program is in Bolivia, fly into La Paz.
If you are in the Introduction to Traditional Medicine Program or the Rural Himalayan Rotation Program in India, please fly into New Delhi.
If you are in the Infectious Disease program in Mumbai, please fly into Mumbai (Bombay), India.
If you are in the Clinical Rotation in Oaxaca, fly into Oaxaca City, Mexico.
If you are in the Tropical Medicine on the Coast of Mexico, fly into Puerto Escondido.
If you are in the Healthcare Challenges in South Africa program, please fly into Cape Town.
If you are in the HIV/AIDS & Healthcare in South Africa program, please fly into Durban.
33)
Where can I get cheap flights?
Although we realize you are a student, and in all likelihood on a tight budget, we recommend you make sure you buy flight tickets that give you the flexibility to re-arrange your travel plans at a later date. International travel, especially travel to developing countries, can be affected by many issues out of CFHI's control - sickness, natural disasters, political circumstances, etc. It is much better to pay a little extra to have some flexibility and refund ability with your ticket, than to be stuck at the last minute if the situation abroad or at home leaves you unable to travel with CFHI. While situations like these are rare, we want you to be as protected as possible from financial impacts that could result otherwise.
To get a cheap flight, you must try and call as many travel agents as possible. CFHI has preferred travel agents that we will share with you after you are enrolled. Their contact information is included in your handbook that you will receive after you have paid your program deposit, and available after your acceptance in the online resource area. In our experience, international fares are very high if you call the airline directly or if you search on the web. Call you local travel agents and try and shop around as much as possible. Another good place to look is the travel section of your local newspaper for current deals by consolidators.
34)
What time should I arrive?
Most international flights arrive late at night into Quito, and New Delhi. Someone will come and pick you up at the airport whatever the time of arrival. Since many of our participants arrive after 11:00 at night, our coordinators and homestay families are very used to picking up at late hours.
35)
Will I be picked up at the airport?
Yes, you will be picked up at the airport by the local coordinator and taken to your homestay family or other accommodations (depending on the program). In some programs, your homestay family will pick you up from the airport. Once you are at home and settled, the coordinators will contact you to let you know when and where you will be meeting to receive your orientation and hospital schedules.
36)
Do I need to get a visa?
More detailed information on this is in your country handbook that you will receive after we have received your deposit payment. For non-US passport holders, please check with the consulate of your country of residence for more information regarding travel to the country of destination. However, be aware that US Citizens must have a valid visa for India. Participants need to apply for a Tourist visa for India. A sample visa application form is provided in your country handbook.
37)
What vaccinations do I need?
Detailed information on vaccinations will be available in your country handbook. This handbook is mailed to you after you have paid your deposit. You may also consult the CDC at www.cdc.gov/travel.
38)
What should I pack?
A sample suitcase is included in your program guide that you will receive once we have received your final payment. Refer to this list when you are packing for your trip. You may also want to purchase a Lonely Planet guide or other travel guide for more information about climate and weather during the months that you will be in the host country.
39)
What kind of insurance do I need?
CFHI provides international health and emergency medical evacuation insurance as a part of the program. The coverage is valid for six months from the start of the program. You will receive more information about this in your country handbook after you have paid your deposit, and via email once the policy is enacted.
40)
Are the program locations safe? What precautions are taken to ensure my safety?
CFHI takes safety matters very seriously. All of our program sites are well prepared for any emergency situations and emergency plans are in place for natural disasters and international crises. We do not operate programs in countries where there are active travel warnings by the US State Department or in areas deemed dangerous by the US State Dept.
Personal safety is controlled as much as possible at each program site. Participants are placed in host families that have hosted others in the past, and all have been properly screened by the local coordinating agency (i.e. language school or organization). When in public places, please be aware of your surroundings at all times, and travel in pairs or groups whenever possible. Be vigilant about your surroundings and your awareness at all times. We advise that you do not drink alcohol excessively, and to never go out at night alone. Listen to your local coordinators at all times. They know the safety issues best in their own communities. Other site-specific safety tips are located in your program guide that you will receive after you pay your final payment.
41)
Why don't I set it up myself?
The CFHI programs are designed to give participants the most fulfilling possible experience. It is common that participants cannot afford to take more than 4 weeks as part of an elective, and we make it possible to use that relatively brief time fully. You would not be able to create the same experience in such a short period of time. Equally as important, CFHI provides a mutually beneficial partnership that honors the physicians and clinics with whom you work. We are a non-profit organization that aims to empower our partners and offer unforgettable experience to our participants.
While some people may have personal or professional contacts in another country, most do not. Without some form of preceptor or coordinator it is usually difficult to become involved in the health care areas of these countries in any meaningful way. Through the network of hospitals, clinics and academic institutions with which we work, we provide the participants with a broad and comprehensive view of these international health care settings.
Orientation issues such as language barriers and unfamiliarity with the structure and function of the health care system are dealt with gradually while the participants have already begun working.
In addition, the people who participate in CFHI programs have other participants with whom they can network. For many, being able to share experiences and talk about the differences in medicine abroad vs. at home is one of the most valuable parts of the experience.
42)
What free time will I have on the program?
Evenings and weekends are free. Participants will be free to make travel plans on the weekends. CFHI does not make travel arrangements for you. However, our local coordinators can help you with any information or contacts you may need.
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 x304 and ask for Rea (pronounced Ray).
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.
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.
Local Team
Medical Director Karina Gamarra Hoyos is the CFHI Medical Director for the Chagas program and Program Manager of a project for treatment of Chagas for children under the age of 15 in Tarija. She constructs the objectives and goals for the completion of this project along with organizing and facilitating Chagas educational workshops. She is also a medical surgeon and specializes in Epidemiology.
Local Coordinator Fabricio Uribe Itturicha coordinates the language training and accommodation aspects of the program.
A login and password is not required to navigate the CFHI website. Password
access is reserved for those who have been enrolled in a CFHI global health
education program or for CFHI Global Partners and Preceptors. To apply for
a global health education program, please click here.
