From Rainforest to Coast: Community Medicine (2-week Intensive)


This program offers a unique opportunity to explore community-based medicine in a variety of settings, from the delivery of healthcare in a big urban environment,  to a small public primary healthcare clinic at the edge of the rainforest. Learn how communities in Guayaquil, Ecuador’s most vibrant and populated city, and Puyo, a small city on the Amazon rainforest in the province of Pastaza, are addressing their most pressing health challenges including chronic, infectious, and vector-borne diseases, all while improving your Spanish and gaining insights into public health realities in Ecuador. Be immersed in local communities and collaborate in existing initiatives that prevent and promote their wellbeing.

CFHI offers options for students and faculty to fit your interests and schedule. Choose your program duration, or for a comparative experience, choose to participate in multiple programs. CFHI can also often accommodate alternate program dates upon request. For more information see our How to Apply page.


2 Weeks $1,875
Arrival Dates: 
Dec 04, 2021 Dec 18, 2021 Jan 01, 2022 Jan 15, 2022 Dec 03, 2022 Dec 17, 2022 

Primary Healthcare Clinics- Located downtown Guayaquil, these clinics offer free or low cost services to patients without health insurance. Services include detection and treatment of chronic and acute diseases like hypertension, diabetes, asthma and arthritis. Shadow local physicians, community health workers, and/or nurses they engage in physical exams, patient histories, and community interventions, including oral health campaigns.  

Vector Control Center- This under-funded public center is responsible for combating malaria and other vector-borne diseases in Guayaquil, covering a vast area of the coastal province of Guayas. The Center compiles malaria, dengue and chagas statistics, researches outbreaks, performs laboratory activities, and educates the community on various vector-borne diseases. Engage with the Center’s staff as they conduct home visits to contribute to the prevention and promotion of health.   

Indigenous Community Visits- Visit a Kichwa/Shuar indigenous community in the Amazon jungle and learn about their unique world-view and ancestral healthcare system. Unlike tribes that regularly receive tourists, this community works with CFHI participants and thus provides an authentic perspective of their culture and daily family life. Explore the ancestral beliefs and practices that inform every aspect of the community’s life, including the use of traditional medicinal plants and spiritual practices of the Amazon region.  Spend time with the community members, sharing personal skills or knowledge such as art, music, or sports. Experience a traditional welcoming ceremony for guests and hike to a sacred waterfall. Click here to view video footage taken by a CFHI student during a visit to one of these communities.

In Guayauquil, participants stay with homestay families, chosen and screened by the CFHI Local Coordinator. Homestays are located in a middle class residential neighborhood. In Puyo homestays are generally located near the main square with easy bus access to clinical rotations. In some cases CFHI participants may be housed with others in the same homestay but participants will never share a bed. 

Homestays provide a unique opportunity to learn about local culture and practice Spanish skills on a daily basis in an informal setting. Accommodation includes two meals a day and laundry once a week. At the welcome orientation participants will be instructed on recommended transportation from homestays to clinical rotations and getting around the city.

Eligibility: Who Can Apply?

This CFHI program is ideal for students of all levels with an interest in fields of community medicine and care, as well as understanding ancestral indigenous healthcare systems and practices. Non-students are also eligible.

To confirm your eligibility, please read CFHI’s general eligibility requirements.

Minimum Language Required
: Beginner 2 Spanish or Above

Beginner 2 Spanish: “I can communicate simply when I am in familiar, everyday situations.” 

  • I can understand sentences and frequently used expressions related to areas of immediate relevance (e.g. very basic personal and family information, shopping, local geography, employment).
  • I can communicate simple and routine tasks requiring a basic and direct exchange of information. Examples include discussing weekend plans, asking for directions, planning social outings or going grocery shopping.

Leading this program on-site are our on-site partners (see Local Team tab), all natives of Ecuador who speak Spanish as their primarily language, but do know English as well. To provide authentic learning experiences translators are not provided. Daily interactions will be in Spanish, but CFHI’s local team is able to support and help you through your experience.

All CFHI participants applying to programs in Latin America will evaluate their Spanish language skills as part of their application. Most important is your general ability to communicate verbally with those around you, versus accuracy with grammatical tenses. All CFHI Latin America programs include Spanish language instruction on-site. 

Not sure about your Spanish level? View a full list of CFHI’s language levels for all Latin America programs on our Spanish Level Guidelines page. 

CFHI partners with Canopy to offer high-quality online Medical Spanish courses. Apply using this link for a 20% discount and start improving your medical Spanish today!

Arrival Information

Participants should arrive in Guayaquil, Ecuador on the program start date and will be picked up from the airport by a CFHI representative and taken to their homestay. A welcome orientation will take place the Sunday or Monday after arrival. 

Visas are not required for U.S. citizens staying less than 3 months in Ecuador. More information on travel and logistics will be provided by CFHI after acceptance into the program.

What's Included 

CFHI Program fees include the majority of your on the ground costs. As a nonprofit, CFHI strives to keep fees low and offers fundraising opportunities, scholarships and discounts. 

Pre-Departure Support

  • Guidance from CFHI staff in San Francisco before departure
  • Program-specific materials with information on making travel arrangements, visa requirements, recommended immunizations, etc. 

On-Site Services

  • Airport pick-up upon arrival and transportation to homestay in Guayaquil with local CFHI representative
  • Welcome orientation with other participants covering safety, transportation, and other logistics
  • Spanish Classes: 10 hours of Spanish classes (in Guayaquil only), including basic medical Spanish instruction 
  • Welcome dinner, city tour and cultural activities
  • CFHI Local Team: providing instruction, logistical support, and 24/7 emergency response
  • Weekly meetings and lectures on local healthcare system and socio-economic determinants of health
  • Placement and coordination of clinical/public health activities in Guayaquil and Puyo
  • Accommodation, two meals a day, and laundry services once a week in Guayaquil and Puyo
  • Ground transportation to/from Guayaquil and Puyo
  • Indigenous community visit: local guide and activities
  • Local cell phone
  • International emergency medical and evacuation insurance

Post-Return Resources

  • Access to CFHI alumni-only LinkedIn group featuring news and career opportunities related to Global Health
  • CFHI alumni newsletter highlighting events, resources, and ways to stay involved

Uniquely CFHI, 60% or more of student program fees go directly to the communities they will be visiting, benefiting the local economy at large and specifically underserved health systems. Read more.

Meet the Local Team

Dr. Wilfrido Torres – CFHI Medical Director: The role of the Medical Director is to arrange clinical rotations and public health placements, supervise the participant experience, and provide instruction on healthcare topics during weekly meetings. Dr. Torres serves in this role during both the Quito and Puyo portion of the program. He has extensive clinical and public health experience with local populations.

Dr. Torres has worked with CFHI since 1999 in the Amazon region of Ecuador. He completed his degree in Medicine and General Surgery at the State University of Guayaquil, where he also completed his Master’s in Clinical Investigation and Epidemiology. Currently he is the Program Coordinator of the Vector Control Program with the Ministry of Public Health. He previously served as a primary care provider and ran a CFHI training program for health promoters in Indigenous villages outside of Puyo. He enjoys guiding CFHI students as they learn about global health and take part in experiences that shape their future careers. His hobbies include listening to music (especially songs his kids play on the keyboard), as well as traveling to nearby mountains and beaches.

Viviana Torres – CFHI Local Coordinator:  Viviana has served CFHI since 2004. She is the wife of Dr. Torres and is the main student contact for cultural and travel matters while in Puyo. Viviana is originally from Guayaquil, Ecuador and is currently finishing her degree in Psychology and Human Resources from the University of San Francisco. She enjoys spending time with her family, listening to music, cooking, and since moving to Puyo she has gained a big appreciation for nature and spending time outdoors. She has a positive energy and is very approachable.

Ruby Centeno – CFHI Local Coordinator: 

Ruby Centeno serves as one of the primary contacts for students. She helps with orientation and provides support throughout the program. Ruby is also the point of contact for students with limited Spanish while they are in Puyo. Ruby is originally from Manta, Ecuador. She obtained her BA degree in communication and language at Laica Vicente Rocafuerte University in Guayaquil Ecuador. Since 2010 she runs Time for English and Spanish School, in Guayaquil. She enjoys spending time with her family, being a nature photographer, cycling, and cooking. She is a proactive and communicative person.


 What Alumni Say

“I just returned from our wonderful trip deep into the jungle of the Amazon and let me just say, it. was. not. real. I can’t even begin to tell you how incredible this journey was. Words definitely will not do it any justice..” read more on Jessica’s blog.

-- Jessica Valdez (Amazon Community and Indigenous Health Participant, October 2013)

The Sustainable Development Goals are a global roadmap set forth by the United Nations General Assembly to end poverty, protect the planet, and ensure the well-being of all individuals by the year 2030. This program highlights the following SDGs: