Realities of Health Access & Inequities
Mexico, the most populated Spanish-speaking country in the world, retains influences from Mayan and Aztec culture, as well as European colonialism. It is famous worldwide for its ancient ruins, tropical beaches, and colorful traditions. The city of Oaxaca, the capital of the southern state of Oaxaca, is medium sized colonial city of over 260,000. This region is distinct from the rest of Mexico, with over 16 different ethnic groups each with their own unique language and culture. The city of Oaxaca is well known for its cuisine, skilled artisans and traditional handicrafts. Yet, with all the richness in culture, the state of Oaxaca trails behind the rest of Mexico in its health and economic indicators. It is one the poorest regions in all of Mexico, with the average daily income less than half of the national average. Oaxaca faces challenges in literacy, sanitation, unemployment, and access to healthcare services.
Join local healthcare professionals and learn about primary care and preventative medicine, as well as community health education programs. Rotate at community level clinics and hospitals serving low-income populations. See Mexico’s three-tiered insurance system, and understand how quality of care, wait times and access to medications varies between each. In 1940, Mexico’s life expectancy was 40 years of age. Today, with increased industrialization and longer life spans, Mexico is struggling with “first world diseases.” Witness chronic conditions like diabetes and hypertension that are increasingly common as a result of poor nutrition, unhealthy lifestyle and lack of education. This program will provide participants with unique insight and cultural competency when serving the growing Mexican immigrant population in the US and abroad.
Become immersed in Mexican culture and language through Spanish classes and living with a local family in Oaxaca. In the city of Oaxaca, go shopping, explore museums and art galleries, or hang out with locals in the vibrant Zócalo or main plaza. CFHI participants may also organize weekend trips to nearby destinations such the Zapotec ruins of Monte Albán.
Clinical Rotations & Public Health Placements
Primary Healthcare Centers- Located in every neighborhood, these clinics provide services including health education and promotion, diagnosis and treatment of disease, prenatal care and family planning, and primary care services including vaccinations and well-child checkups. Join physicians and nurses educating the local population about chronic conditions like hypertension and diabetes, and infectious diseases including dengue, malaria and tuberculosis. These facilities also offer vaccinations, pap smears, and cancer screenings.
General Government Hospital- This teaching hospital, located in the northern part of the city, receives funding from the government and civil organizations in Oaxaca. It provides primary, secondary and tertiary care at low cost. Rotate alongside Mexican medical students and residents in ob/gyn, pediatrics, surgery, and emergency wards. Participate in morning rounds, general consults, and follow-up treatment.
Government Social Security Hospital - This government funded facility provides secondary and tertiary care for state workers, including school teachers, and their family members. Take part in rounds in surgery, OB/GYN and emergency units. The facility has a strong surgical department and staff here are eager to mentor students.
Traditional Medicine Clinic- This small clinic focuses on traditional medicine from Eastern and Western cultures. The main preceptor is a doctor trained in holistic medicine and nutrition. In this spa-like atmosphere, learn how acupuncture, yoga, aromatherapy and herbal remedies are used to treat common ailments like asthma, chronic pain and gastrointestinal issues.
Red Cross Clinic - This clinic has been in operation for over 60 years, with 2 emergency rooms and 6 beds. It handles urgent care cases like broken bones, lacerations, and accidents. More serious cases are stabilized and transferred to a nearby hospital. Join physicians and residents at this busy facility, located in the historic center of Oaxaca. During down time, learn emergency room techniques and procedures from local residents.
Nonprofit Rehabilitation Center- This state-of-the-art facility receives most of its funding from a national telethon campaign televised annually. It provides genetic counseling for families, as well as physical and speech therapy. It also provides services and equipment for handicapped children from across the state of Oaxaca. Rotate alongside orthopedic specialists, general practitioners and rehabilitation experts, and participate in patient consultations and rounds. Since its opening in 1997, this facility has provided care for over 4,000 children.
CFHI is considered a global health ethics leader therefore CFHI programs uphold strict standards and comply with all local laws regarding student involvement in health settings. Your experience on the program depends on your previous clinical training (if applicable), Spanish level, and the relationship you build with your supervising preceptor. Above all, YOU are the most important factor in making the CFHI experience as fulfilling as possible by being respectful, inquisitive, and open to the wide variety of learning experiences which you will encounter.
The state of Oaxaca is best known for its indigenous peoples and cultures. There are sixteen officially recognized indigenous groups in Oaxaca, the most populous being the Zapotec or Mixtec. These groups have survived better than most others in Mexico due to the state's rugged and isolating terrain. It is estimated that at least a third of the population speaks indigenous languages, and 50% do not speak Spanish.
The capital city, Oaxaca de Juarez or Oaxaca City, is located in a beautiful valley surrounded by the Sierra Mountains, approximately 500 km south of Mexico City. At the center of the city is Santo Domingo Plaza with a magnificent church and convent dating back to the 16th century. The city’s cobblestone streets and architecture date to Spanish colonial times and are bustling with creative artisans and street vendors.
Things to Do
CFHI participants have free time during most evenings and weekends and may choose to organize trips to nearby destinations and take part in cultural activities offered within Oaxaca itself. In the city, enjoy colorful street markets and a lively nightlife. Sample local foods unique to the region like Oaxacan cheese, mole, a sauce made with chocolate and chiles, chapulines or fried crickets and mezcal, a smoky, distilled alcohol similar to tequila. Approximately 6 miles outside of the city is Monte Albán, a pre-Columbian World Heritage Site dating back to 500 BC. Take a tour of local villages each specializing in a traditional folk art including weaving, black clay ceramics, and alabrijes, or brightly colored wooden sculptures.
In Oaxaca, the celebrations are said to be some of the most vibrant in all of Mexico. It is home to the month-long cultural festival Guelaguetza taking place in July featuring indigenous music, food, art and costumes. Another important event is Día de Muertos or Day of the Dead at the end of October where locals organize parades and decorate altars in honor of their ancestors.
Accommodations & Homestays
Participants stay with homestay families, chosen and screened by the CFHI Local Coordinator and language school. Homestays are located in a middle class residential neighborhood in the historic center of Oaxaca City. They are located in close proximity to one another and the language school, allowing participants to walk to language classes and meetings with ease. In some cases CFHI participants may be housed with others in the same homestay, but will always have their own room.
Homestays provide a unique opportunity to learn about local culture and practice Spanish skills on a daily basis in an informal setting. At the welcome orientation, participants are 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 who have a foundation in Spanish and have an interest in health and medicine in small town and rural settings. Non-students are also eligible. The program offers an overview of primary and secondary level care through visits within a hospital and primary care clinics, as well as Spanish language classes with an emphasis on medical Spanish. To confirm whether you're eligible to apply, please read CFHI's general eligibility requirements.
Minimum Language Required: Beginner 1 Spanish or Above
Beginner 1 Spanish: “I can speak a little and understand at times if people speak slowly and clearly.”
- I can understand and use familiar everyday expressions and simple phrases to get across basic needs.
- I can introduce others and myself. I can ask and answer questions for example where I live, people I know and things I have.
Leading this program on-site are our on-site partners (see Local Team tab), all of whom share Spanish as their native language, but may speak 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. This information will then be shared with the on-site partners. A placement test will also be given at the start of the program to ensure you're learning at the correct level. Most important is your general ability to communicate verbally with those around you and to be proactive in speaking Spanish, 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.
Participants should arrive in Oaxaca City, Mexico 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 Mexico. More information on travel and logistics will be provided by CFHI after acceptance into the program.
- Guidance from CFHI staff in San Francisco before departure
- Program-specific materials with information on making travel arrangements, visa requirements, recommended immunizations, etc.
- Airport pick-up upon arrival and transportation to homestay in Oaxaca City with local CFHI representative
- Welcome orientation and welcome dinner with other participants covering safety, transportation, and other logistics
- Spanish Classes: 30 hours/month of Spanish classes, including medical Spanish instruction
- 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
- Accommodation and two meals a day
- Local cell phone
- International emergency medical and evacuation insurance
- 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, 50% 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.
Dr. Magaly Chavez- CFHI Oaxaca Medical Director: The role of the Medical Director is to arrange clinical and public health placements, supervise the participant experience at these sites, and provide instruction on healthcare topics during weekly meetings. Dr. Chavez is the expert on socioeconomic determinants of health in the region and healthcare delivery strategies in low-resource settings.
Dr. Chavez is a general practitioner and works in the Emergency Room of a local hospital. She has worked with CFHI since 2011 and enjoys teaching students about the healthcare system in Oaxaca. She has grown personally and professionally from her interactions with CFHI participants, and likes being a part of their training as future healthcare workers. In her free time she enjoys reading, dancing and listening to music and has completed several triathlons.
Marta Canseco and Sandra Rivera- CFHI Oaxaca Local Coordinators: The role of the local coordinator is to organize housing, transportation, orientation and weekly meetings. Sandra and Marta are great resources for any questions related to navigating the program locale, cultural norms and tips on planning weekend travel.
Marta and Sandra have been working with CFHI since 2004 and are co-directors of a language school in Oaxaca. They have extensive experience running cultural immersion programs for foreign students. Sandra has a diploma in Teaching Spanish as a second language from the Autonomous University of Mexico. In her free time she enjoys cooking desserts, going to the movies, and spending time with her family. Marta is a Dental Surgeon with her own clinic and a certified Spanish instructor. She completed her training at Benito Juárez University in Oaxaca and the Autonomous University of Mexico. She loves all music; especially dance music from the 80s.
What Alumni Say
"This experience opened my eyes to the universality of health disparities and grew my compassion and interest in global inequality. I learned so much, my heart was opened and Oaxaca is beautiful. I hope I get to return soon!"
--Ellen Line, Masters of Social Work Student, University of Texas at Austin, June 2016
"This trip to Oaxaca was one of the most amazing experiences I have ever had in my life. I was able to absorb a culture closely linked to its past almost each day by hearing indigenous languages at the market, eating food that is native to the state, and exploring the ancient ruins of the Zapotecos. The day times were filled with our internship in various hospitals or clinics that truly helped us compare the differences in health care, which positively...” Read More on Beatriz's blog.
-- Beatriz Haro (Alumna, January 2014)