• Application Fee: $95
• Program Fee 2010: $2195*
• Program Fee 2011 (except June and July): $2395
• Program Fee 2011 June and July: $2545
  

Puerto Escondido is a small, traditional town in the state of Oaxaca in southern Mexico. It is located about 300 km from Oaxaca City, which is a little over 500 km south of Mexico City. The town has a rich indigenous population and caters to international and Mexican tourists who come for the beautiful beaches, which are renowned for great surfing. Despite the number of tourists, the local community remains largely separate from the tourism culture. Students will be able to critically observe tourism in that area, its impact on community life and the relationships that have formed between the different communities of people in Puerto Escondido. In addition, participants in the program are encouraged to recognize their own identity and role within this unique cultural context.

Photos  
To view photos of CFHI participants at this location and other CFHI sites check out our CFHI Picasa Web Albums as well as Flickr photos online. You can also click on our “Photo Gallery” bullet on the right side menu.

Practical Information

• Wikipedia Mexico
• Wikipedia Puerto Escondido
• Puerto Escondido information
• Mexico: A country study
• Recommended Books on Mexico
  

Language Ability
This program is open to those who possess:

• Conversant Spanish
• Fluent Spanish

For those who are not completely confident with their language skills before participation in the program, we strongly recommend that you arrive at your program site early to stay with a homestay family and pay extra for additional Spanish instruction before you begin the CFHI program. Minimal Spanish skills are NOT sufficient to participate in this program.

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
  
• Naturopathic students
  

The following hospitals and clinics are a sample of possible rotations during this program. 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. Each site will be able to take 2 students. Rotation availability depends on local conditions.

Ministerio de Salud Publica de la Costa, Salud Reproductiva
This office manages all aspects of women's health programs along the coast of Oaxaca. Activities include family planning education, training and certification of midwives, maternal health data collection, and managing the stocks of women's health medications and clinical supplies for all of the 95 clinics and 3 hospitals along the coast. This office also gathers all maternal deaths statistics and creates working plans each year based on those statistics. Students will work directly with the entire staff, including the Medical Director, Dr. Isabel Saucedo; another female physician who manages domestic violence training programs for women and physicians, as well as prenatal and postnatal follow up; and a nurse who manages the parteras training and certification programs for the region.

ISSTE
This secondary level hospital is a government facility offering care to federal government workers and their families. About 14 physicians work in pediatrics, ob/gyn, internal medicine, surgery, and preventative medicine. The facility is equipped with radiology and lab facilities. There is also an emergency department that is open to the public. Students will work with the Obstetrics and Gynecology team at this hospital and may be able to observe births, c-sections (when available) and other more routine procedures.

Centro de Salud Puerto Escondido
Centros are government run primary care clinics that serve everyone in Puerto Escondido and surrounding villages. Students will work with nurses and physicians to address reproductive and women's health needs throughout the day. All of the centros de salud facilitate educational programs such as Oportunidades and other community health programs for the wider community on a regular basis.Most of these Centros de Salud are located in and around Puerto Escondido. These include San Pedro Mixtepec, Bajos de Chila, San Jose Manialtepec, Rio Grande, Barra de Colotepec, Santa Maria Colotepec, Colonia Aeropuerto and Colonia Lazaro Cardenas.

As part of the provision of comprehensive primary care services, these clinics offer the following reproductive health services:

• Prenatal care and delivery
• Health education on prenatal care, domestic violence, STD’s breast/cervical cancer
• Pap-smears and routine gynecological exams

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

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

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
  
• Weakly 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
  

Academic Credit Assistance

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 the personal frustration you may experience during the CFHI experience. All the 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 Puerto Escondido (outside of the language school) do NOT speak English and will not be able to translate for you in the clinical sites.

CFHI Students will take Spanish classes at the Oasis Language School, located in downtown Puerto Escondido. The Language School is responsible for your airport pickup, and offering 30 hours of language classes during the program. Depending on the number of students in the group, some may be taught in small groups, and others individually. Click here for a general overview of Spanish-language course learning objectives. 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, and film screenings. They are available to give suggestions and guidance for things to do and see in your free time.

Accommodations
This program includes homestay accommodation with 2 meals per day. Homestay families are chosen and screened by the CFHI Local Coordinator at the language school. Most host families live in town, allowing for participants to walk to and from their language classes, clinics and meetings with ease. In some cases, students may stay with one other student in the homestay, and sometimes may be required to share a room (same gender). If this is the case, you will hear from your local coordinator in advance.

If you decide to arrive early or stay after your program has ended, you will need to pay ~$17 USD per night for the time spent outside of the CFHI program. This fee 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 at the end of the program. 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.

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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.