Reproductive & Sexual Health as a Human Right
Ecuador is one of the few Latin American countries to explicitly guarantee sexual and reproductive health rights and to provide free emergency contraception. In 1998, it passed the Free Maternity Law providing free healthcare for pregnant women and newborns. Despite its progressive laws, tensions persist given the predominantly Catholic and largely socially conservative nature of the country.
Learn about reproductive healthcare in Ecuador, where limited discussion and openness regarding sexual health issues and lack of funding predominate. Witness how cultural attitudes toward gender equality affect a woman’s willingness and ability to seek treatment or obtain information about reproductive and sexual health. Learn from healthcare professionals through rotations at a public maternity hospital where high-risk pregnancies are managed. Services provided include prenatal and postnatal care, labor and delivery, and emergency care. Other rotations include an adolescent clinic, where pregnant patients and new mothers between the ages of 12 and 18 are treated, as well as a primary healthcare center providing women’s health services such as pap smears, IUDs, etc.
Become immersed in Ecuadorian culture and language through conversational and medical Spanish classes while living with a local family in Quito. CFHI participants may also organize weekend trips to destinations such as Tena in the Amazon region, known for its waterfalls and adventure sports like kayaking and zip lining, the town of Mindo and its subtropical forest, and Otovalo, an indigenous community with a bustling weekly market.
Clinical Rotations & Public Health Placements
Public Maternity Hospital- Located in the center of Quito, this public hospital of over 400 beds serves pregnant women of all ages from some of the poorest areas in the city. It is also a referral center for high-risk pregnancies and deliveries, and all services provided are free of charge. It is a teaching hospital for medical students and residents, with labor and delivery, emergency, outpatient, and inpatient ward for more complicated cases and post-partum care. Join healthcare teams for morning rounds, followed by rotations at one of the wards mentioned above. While rotating at the outpatient ward, witness how the staff conducts pre- and post-natal check-ups. This hospital is one of the busiest in the country, thus opportunities to ethically observe labor and delivery and related procedures are frequent.
Outpatient Obstetrics Rotation- This rotation features a community clinic in northern Quito offering primary healthcare services, pediatric and obstetrics and gynecological services. This rotation focuses solely on obstetric services. Learn from a local obstetrician who provides free services to low and middle class patients. Witness activities alongside the on-site preceptor in the clinic such as prenatal check ups, general obstetrics consult, which can include focused physical exams, differential diagnosis and discussing treatment options with patients. In addition, accompany your preceptor as he/she performs home visits providing care to women on bed rest due to complications such as placenta previa.
Public Hospital- Located in the northern part of Quito, this hospital offers outpatient care to pregnant women. Students may shadow healthcare professionals as they engage in pre- and post-natal check-ups, witness deliveries and C-sections and join preventive health education initiatives such as sexual and reproductive health campaigns.
Quito is the capital of Ecuador, one of the most bio-diverse countries in the world. Founded in the 16th century atop the ruins of an Incan city, today this modern metropolis boasts a diverse population of about two million people. As the capital and economic hub of the country it attracts migrants from rural areas - mostly indigenous groups, as well as immigrants from neighboring countries.
Quito is nestled in a valley within the Andes Mountain Range, surrounded by volcanoes and impressive peaks. At an elevation of 9,000 feet above sea level, it is considered one of the highest capital cities in the world. Due to its close proximity to the equator, the climate is spring-like all year long, with warm days and cool nights. Quito’s historic center is one of the largest and least altered in the Americas and one of the first world cultural heritage sites declared by UNESCO in the 1970’s. As the nation’s capital, it is a lively urban center with dancing, dining, historical sites, shopping and museums.
Things to Do
CFHI participants have free time during most evenings and weekends and may choose to organize weekend trips to nearby destinations and take part in cultural activities offered within Quito itself. Popular activities include visiting the “middle of the world” or the equatorial line, the famous Guayasamin art museum and home, and the historic city center. Served by various bus lines, Quito is an ideal jumping-off point to see the rest of the country. Travel to the Amazon to hike, nature watch, and visit jungle communities. Closer to Quito and ideal for a day or weekend trip is Otavalo, a primarily indigenous town that has maintained its traditional way of life and is known for its weekly market.
Accommodations & Homestays
Participants stay with homestay families, chosen and screened by CFHI’s Local Coordinator. Homestays are located in a middle class residential neighborhood in the northern part of Quito. 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, thought each student on this program will 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 orientation session upon arrival, participants will be informed about 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 with a focus on women’s health. Non-students are also eligible. The program offers an overview of women’s reproductive and sexual health in the context 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. 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 Quito, Ecuador on the program start date (a Saturday) and will be met and picked up from the airport by a CFHI representative and taken to their homestay. The orientation for the Medical program will take place on Sunday at 1 pm; the orientation for the language school will take place Monday at 8:30 am. If you arrive at an alternate date, please check with the local coordinator for your orientation schedule.
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.
- Guidance from CFHI staff in San Francisco before departure
- Pre-Departure Training materials including program-specific materials with information on making travel arrangements, visa requirements, recommended immunizations, historical, geopolitical, cultural, ethical and other need-to-know preparatory info.
- Airport pick-up upon arrival and transportation to homestay in Quito with local CFHI representative
- Welcome orientation with other participants covering safety, transportation, and other logistics
- Welcome dinner, city tour and cultural activities through language school
- Spanish Classes: 20 hours of Spanish classes, including medical Spanish and cultural activities (students may purchase additional hours)
- Weekly meetings and lectures on local healthcare system and socio-economic determinants of health
- Accommodation, two meals a day, and laundry services once a week
- CFHI Local Team: providing instruction, logistical support, and 24/7 emergency response
- Placement and coordination of clinical rotations/public health activities
- Local cell phone
- International emergency medical and evacuation insurance
- CFHI Alumni status- including ongoing global health educational offerings, news about global health educational/leadership opportunities and fellowships
- Post-Return program evaluation
- Access to CFHI alumni-only LinkedIn group featuring news and career opportunities related to Global Health
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.
Meet the Local Team
Dr. Susana Alvear - CFHI Medical Director in Quito. 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. Alvear is the expert on socioeconomic determinants of health in the region and healthcare delivery strategies in low-resource settings.
Dr. Alvear has served CFHI since 1996. She is an accomplished family physician who obtained her MD and specialty certificates in Ecuador. She then completed clinical education courses at the University of New Mexico and workshops at McGill University in Montreal, Canada. Dr. Alvear teaches at Pontificia Universidad Catolica del Peru, where she manages their residency program. Dr. Alvear has participated in several international trips providing healthcare services to countries after natural disasters stricken areas such as Pakistan and Ghana.
Elvira Hinojosa: Assistant to the Medical Director. Elvira schedules your medical rotations, introduces you to your preceptors and is always happy to help you with any questions or challenges you may face in your medical program.
Patty Ribadaneira & Sandra de Maldonado - CFHI Local Coordinators in Quito. The Local Coordinators in Quito are members of the Academia Latinoamericana de Español, Quito. Their names are Patty Ribadaneira and Sandra de Maldonado. Patty and Sandra are sisters and have been servicing students since 1989. They both studied in the U.S. and are aware of the specific needs that students have. Patty is a collaborative, motivational and inspirational leader; she instills confidence in others. Sandra is a consensus builder, and acts with integrity and fairness when dealing with students.
What Alumni Say
“Initially the biggest difference between this hospital and those in the US was that there were so many patients in one room, all of them laboring together. One morning I counted 13 patients packed into the main room! The patients would stay in this room until just before they were ready to deliver, and then…” read more on Megan’s blog.
-- Megan Bright (CFHI Reproductive Health Program Participant, October 2011)