High School Study Abroad in Quito, Ecuador

I spent three weeks in Mombasa, Kenya completing a medical internship that combined hospital rotations with community outreach. I shadowed doctors in surgery, the labor ward, and pediatrics, gaining valuable insight into patient care and healthcare delivery in a new environment. The hands-on learning and exposure to different medical challenges broadened my perspective and strengthened my passion for medicine. Outside the hospital, our community outreach work showed me how education can make a lasting impact in the lives of others. The accommodations were comfortable, and I especially enjoyed the local food—like the chicken dishes and chapati quickly became my favorites. When I was young, the doctor’s office was one of my least favorite places to be. I hated the smell of antiseptic wipes, the crinkle of the exam table paper, and especially the sharp sting of shots. If someone had told my childhood self that eight years later I would spend my summer in an East African hospital, shadowing doctors, observing surgeries, and rushing from ward to ward, I would have laughed and run in the opposite direction. But my fear of healthcare did not last forever. As I grew older, the very things that once scared me began to fascinate me: how the body works, how diseases disrupt it, and how doctors step in to restore balance. That curiosity is what caused me to apply for an internship with International Medical Aid and board a plane alone to a very unfamiliar location: Mombasa, Kenya. After interning in a hospital in San Ramon, California for a year, I thought I knew what to expect from my experience with International Medical Aid. I would be rotating through obstetrics, surgery and pediatrics. Also, because I have traveled in a handful of developing counties, I thought I knew what to expect from the environment around me. However, nothing could have prepared me for the totality of the experience in Mombasa. The city was chaotic, with crowded streets, blaring horns, and a humid air with the lingering smell of cooking fires and burning trash. A constant reminder that life here moved quickly and under challenging conditions. I was initially overwhelmed. Looking back, this experience has profoundly changed me. It enabled me to make a real difference in another human being’s life. Beyond a single patient’s case, the experience ignited my interest in global public health because I witnessed firsthand the disparities in healthcare delivery in such a resource-limited setting. I will never forget the day I observed an emergency C-section. Although Kenya is not among the top 10 African countries with the highest maternal mortality rates, it continues to experience a high maternal mortality (OD AWE 2023). In 2015, Kenya’s maternal mortality rate was 510 maternal deaths per 100,000 live births (Muthee R 2025). This is an exceedingly high number when compared, for instance, to the US maternal mortality rate of 17 per 100,000 live births in 2023 (WHO 2025). That day at Coast General, the mom was in distress, lying on her side in pain because she had been in labor for hours, and everyone in the room was tense. When the doctor finally delivered the baby, I felt such relief when I heard the first cry. But then, everything changed as the baby stopped crying and became limp, not showing any of the normal reflexes babies usually have. I kept waiting for someone to do something fast to address the situation, but the nurse did not seem worried at all. The seconds seem to drag on like minutes. The nurse moved slowly, cleaning the instruments like nothing was wrong. My heart raced. I knew the baby was not breathing, and I could not just stand there, so Dani and I gently but urgently tried to stimulate the baby’s body, which did not open the baby's airway. I spoke up and asked if they could suction the baby’s airway, and the nurse finally grabbed the bulb and cleared the mucus, and after what felt like forever, the baby gasped and started to cry again. I could finally breathe, too. That moment shook me. In a hospital back home, a whole team would have rushed in right away. But here, with fewer resources and a calmer attitude toward emergencies, things moved more slowly. The nurse was operating in an environment that was under-staffed and to her the baby’s status was not an emergency. In that moment, I felt I witnessed a situation that teetered on the edge of life and death. Responding to my perception of an emergency, I also learned that even as a student, I have a voice, and using it can make a difference. I believe it is crucial to act quickly when someone’s life is at risk, regardless of where the emergency takes place. As I reflect back on this moment, however, I can see that “less” does not necessarily mean “worse.” It means using the tools around you to the best of your abilities. In this case, for the busy nurse, that included relying on the two interns to try to revive the newborn. After that moment in the operating room, I started paying closer attention not only to individual cases, but to the entire healthcare system around me. Working at Coast General gave me an unfiltered view of what it means to practice medicine in a public hospital in Kenya. The wards were crowded, sometimes with 70 patients in one large room, and just a couple of nurses caring for everyone. Each morning, before even entering the wards, lines of patients waited in areas overflowing with people, and many of them had been waiting since dawn. It looked very different from hospitals at home, where there is privacy, access to technology, and a sufficient number of staff. Even though the doctors were working with so little, they were incredible. They cared about their patients and took time to explain things to us students. They were patient teachers, despite being clearly exhausted. When the doctor could not do well, it was not because they did not care, but rather because they lacked sufficient resources, staff, or equipment. Or the patient came in too late in the evolution of a disease process. Sometimes doctors had to make hard choices about which patients to treat first because there simply was not enough time or supplies for everyone. My experience in Kenya taught me that healthcare outcomes are not purely just about medicine and physician expertise, but also about systems, access, and resources. I saw how strong clinical skills mattered more without advanced technology to rely on. And I learned how important it is to speak up when something feels wrong, even as a student. My internship with International Medical Aid was more than just a learning experience, it was a life-changing journey. I came to Kenya eager to observe medicine in action and care for people, but I left with so much more: a deeper understanding of health inequities, a stronger sense of compassion and independence, and a clearer vision for my future career. In the developing world, healthcare, I learned, is not just about curing disease; the human being, who has come into the clinic for help, has a particular life story and background that is relevant to their reason for being there. Their treatment is embedded within a complex health care delivery system with its own limitations. In a developing country, what I witnessed is that delivering healthcare means working to create the best outcome possible for that patient. I will continue to carry the lessons of Mombasa with me into every classroom I sit in, every patient I meet, and every decision I will make as a future healthcare professional. Through this experience, I learned that fear can evolve into passion, challenges can lead to growth, and even the smallest acts of care can change or even save another person’s life. Most importantly, this journey showed me that medicine is not just a career, it is a calling to help people who need it most in the worst or hardest moments of their lives. And it has shown me how great the need is in other parts of the world.

My internship with International Medical Aid in Peru was life-changing and gave me deep insight into global health disparities and the cultural complexities of healthcare delivery. As I immersed myself in the tapestry of Peruvian life, I was consistently struck by the resilience of the health providers and the people they served. From learning about Incan history to seeing firsthand how healthcare can look very different between the United States and Peru, the experience was full of meaningful revelations. These moments expanded my worldview and helped cement my desire to pursue a career in healthcare with a focus on underserved populations. One of the most impactful aspects of my time in Peru was seeing how healthcare delivery contrasted with what I was used to in the United States. In many rural areas, the infrastructure for health care is still developing. Some clinics and hospitals lacked basic medical supplies and advanced diagnostic equipment that are often taken for granted in more developed settings. For instance, at Clinic Metropolitano, we frequently took blood pressure by hand because there were few automatic machines. In these circumstances, healthcare professionals demonstrated tremendous resourcefulness and creativity. Specialized care was often limited, especially in rural regions, and many patients had to travel long distances to receive basic healthcare, let alone see a specialist. During mental health clinics in a rural town, I saw how limited access to psychiatric care affected patients. Some women struggled to find support if they experienced sexual or physical violence, and young children did not always have the opportunity to speak openly with a psychologist about issues at home or school. At the same time, I was able to observe a public healthcare system that aimed to provide care to all who worked and contributed. For example, those eligible for EsSalud clinics could receive treatment, but they sometimes faced long waits for appointments, procedures, and medications that were occasionally out of stock. When I visited a hospital to observe an Achilles tendon repair, I learned the patient had waited a year for surgery—an experience that highlighted the realities of limited resources. I also noticed that patient privacy was handled differently in a busy public teaching hospital. Interns were often allowed to observe and sometimes participate in procedures in ways that would be approached more cautiously in the United States. These experiences helped me better understand the trade-offs, pressures, and ethical considerations that come with delivering care in resource-limited, high-demand settings. Navigating cultural differences was part of everyday life in Peru. The country’s rich cultural heritage—rooted in Indigenous, Spanish, and African histories—shapes both healthcare practices and health beliefs. One of the most important lessons I learned was the value of cultural competence in healthcare. When cultural differences are understood and respected, they can significantly improve patient outcomes and satisfaction. Traditional medicine and healers remain highly relevant in many Peruvian communities, especially in rural areas. During my internship, I often saw patients using leaves and other herbal remedies that had been passed down through generations. I observed healthcare providers who respectfully acknowledged these practices while also introducing modern medical interventions when needed, carefully balancing both approaches. I also saw patients who self-medicated with antibiotics and pain medications purchased from street vendors. Although this practice can be risky, physicians approached these conversations with patience and education, encouraging safer behaviors. This experience reinforced for me how essential it is to build trust and collaborate with local communities to provide holistic, culturally sensitive, and effective care. Language barriers were another meaningful part of the learning process. Even though I was conversational in Spanish, many patients spoke only Quechua, an Indigenous language common in the Andean region. This sometimes made verbal communication challenging, but it also underscored the universal nature of empathy in healthcare. One powerful moment occurred when I interacted with a 91-year-old woman who came to the clinic alone. Despite the language gap, we communicated through gestures and with the help of the physician’s limited Quechua. That encounter showed me how deeply kindness, patience, and compassionate presence can impact someone who rarely receives medical attention. I also encountered patients with chronic conditions whose health had been affected by a combination of access issues, lifestyle factors, and healthcare hesitancy. For example, one man in his fifties had uncontrolled diabetes that was leading to neuropathy and vision problems because he did not consistently renew his insulin. Due in part to diet and social norms, many patients lived with chronic hypertension. One patient, who had been taking his medications for three months, still presented with a blood pressure of 176/101. The doctor immediately referred him to the emergency room, knowing that such levels could lead to a stroke or heart attack. These cases were powerful reminders of the importance of preventive care, education, and easily accessible services in managing chronic disease. Another highlight of my internship was learning about Peru’s rich Incan history and how it continues to influence health beliefs and practices today. The Incas were known for their sophisticated knowledge of medicine and their holistic approach to healthcare. They used a wide variety of medicinal plants, many of which remain central to traditional Andean medicine. The Incan emphasis on the mind–body–spirit connection is still reflected in the beliefs of many Indigenous communities. As part of my internship, I visited several archaeological sites where we discussed the Incan approach to health and medicine. I learned about trepanation, the surgical removal of a piece of the skull to treat head injuries—a practice that revealed advanced knowledge of anatomy and surgical technique. These visits gave me a deep appreciation for Peru’s cultural heritage and the ways historical knowledge continues to shape modern health practices. During a tour of the city and surrounding ruins, we also learned about the arrival of the Spanish and the impact of colonization on the Incan people. We heard stories of the encomienda system and the attempted rebellion led by Tupac Amaru, the last Incan leader, whose tragic fate is still remembered. The Plaza de Armas—also called the Plaza de Lágrimas—was the site of many of these events and remains a powerful symbol of resilience and history. Seeing Spanish-built cathedrals constructed with repurposed Incan stone was a vivid reminder of the layers of history present in modern-day Peru. Overall, the tour was an unforgettable experience that deepened my understanding of Incan and Spanish history and its lasting influence on the region. Comparing the healthcare systems of the United States and Peru was eye-opening and thought-provoking. In the United States, healthcare is often characterized by advanced technology, ready access to specialized care, and a strong emphasis on patient autonomy—though these benefits are intertwined with high costs and complex insurance systems. In Peru, particularly in rural areas, healthcare is shaped by limited resources, the continued relevance of traditional medicine, and strong family and community involvement in health decisions. I noticed that patients in the United States are often highly informed about their conditions and actively involved in decision-making. In Peru’s rural communities, there tended to be more deference to healthcare professionals and traditional healers. This difference seemed linked to varying levels of education, cultural beliefs, and access to medical information. I saw many instances where patients trusted and followed the advice of their providers wholeheartedly. Preventive care was another area of contrast. In the United States, routine screenings and vaccinations are widely promoted. In Peru, preventive services can be harder to access, and patients may seek care later in the course of their illness, when conditions are more advanced. This experience sharpened my awareness of the importance of public health initiatives and the need to improve access to preventive care worldwide. Ultimately, this internship was not just an academic experience—it was a journey of personal growth. Living and working within another cultural and healthcare system pushed me beyond my comfort zone and taught me to adapt quickly. I learned to navigate communication barriers, build rapport with patients from diverse backgrounds, and develop a deep respect for cultural practices that differ from my own. These experiences have made me more flexible, empathetic, and culturally sensitive. Some of the most rewarding moments came from bonding with local healthcare providers and community members. Their dedication, perseverance, and compassion were incredibly inspiring. Despite the challenges and resource limitations they faced, they were unwavering in their commitment to providing the best possible care. Their example strengthened my own resolve to pursue a health-related career focused on service and equity. Now, more than ever, I am committed to working in healthcare—particularly in global health and healthcare equity. After completing my undergraduate studies and medical school, I envision myself serving underserved populations in international settings, working to increase access to and improve the quality of care. I am also deeply interested in public health initiatives that address social determinants of health and emphasize preventive care. My time in Peru sparked a fascination with medical anthropology and the ways cultural beliefs and practices influence health behaviors. I believe that understanding these factors on a deeper level will help create more effective interventions and better health outcomes. My internship with International Medical Aid in Peru changed my life and provided invaluable insight into global healthcare disparities and cultural competence. From the ingenuity of healthcare providers working in resource-limited settings to the richness of cultural heritage preserved since the Incan civilization, every day offered something meaningful to learn. The differences between the healthcare systems of the United States and Peru were both surprising and illuminating, reinforcing the need to work toward more equitable global systems. This experience solidified my commitment to a career in medicine, with a focus on global health and healthcare equity. It taught me the importance of empathy, adaptability, and cultural sensitivity in delivering compassionate, effective care. As I continue on my path toward becoming a physician, I am motivated to apply what I learned in Peru to advocate for improved access to quality healthcare for all, regardless of socioeconomic background.