Health Sciences Internships in Ecuador

Whenever I reminisce on my journey with Beyond Travels, my inner being lights up. I feel an overwhelming sense of warmth and gratitude. I spent several weeks in the Amazon as part of the Amazonian Indigenous Plant Medicine & Herbalism internship. From the moment I arrived, I felt safe, secure and genuinely cared for by the Beyond Travels team. Their knowledge, and thoughtful guidance sparked the confidence to fully immerse myself in the experience and embrace everything the Amazon had to offer. It was reassuring to have the team there to help translate and make sense of information along the way, as I would have felt quite lost trying to navigate alone. There was something almost ecstatic about being immersed in the aliveness of the Amazon. All of my senses were heightened. From the sound of thunder rolling through the rainforest with the torrential rain, to the incredible richness of lush green landscape, and the taste of forest foods: sweet cacao and guaba fruit, plantain, yuca, freshly caught wild fish, and much more. I often found myself thinking, Is this really my life right now!? One of the most impactful parts of my experience was staying with my host family — The team absolutely got the pairing right! I feel so honoured to have been welcomed into their home and community. They treated me as though I was a family member, showing me unconditional love and acceptance, despite the language barrier. Sharing in their everyday life deepened my connection to the jungle.. from hiking and working in their chakra (garden), to playing with the children in the river. The simpler rhythm of life, rooted me in presence. Spending time at Amupakin (midwifery health centre) with my host Mama, was incredibly special as I was surrounded by feminine energy, that felt truly nurturing. Taking part in ceremonies, limpias, and learning about their traditional medicine added another beautiful dimension to my experience, and opened my awareness to alternative ways of healing. I was particularly curious about Ayahuasca in which I was able to observe and participate in its preparation. It was mind expanding to learn about these traditions within their cultural context, and I was fascinated by how indigenous knowledge has been passed down through generations, and remains so woven into their everyday life. I was constantly confronted with the striking contrast to the ways we live in the West, and left me reflecting on just how disconnected we can sometimes be from the natural world and the knowledge held within it. I would recommend Beyond Travels over and over again. This was, without a doubt, one of the most meaningful experiences of my life. It has left such a lasting impression on me that I feel called to return. See you soon, Amazon. Thank you Andy and your team for creating such a spectacular opportunity

Staying with Patricio and Sylvia and being in the Amazon jungle truly changed me. It was a very healing experience and I learned so much about plant medicine and more about what I want to do in life. I left feeling connected to the forest, and very in tune with myself. They have a beautiful mirador where you can see rare birds which was amazing. They are very accommodating, and social! It really felt like a nice family. The program is structure itself is really nice just be prepared to walk a lot and stay hydrated. Megan was great and Andy truly made me feel safe and supported every step of the way. I definitely will be coming back!

During my internship, I worked in the clinic and on a shaman project. I loved working in the clinic. I loved Carmen and Cris — they made my experience. What I'm most proud of is having acclimated to a completely different culture. The most impactful part was my host family. Being the only white person in an entire community was difficult at first — from it I learned that integrating yourself in a new situation just takes time. I think I could have spent more time in the community during the weekends. Looking back, I developed my Spanish speaking abilities, and the idea of adaptability will definitely help me in my future endeavors. Beyond that, I became more culturally aware. I am grateful for all of the wonderful relationships I made while in Ecuador and all of the amazing people I met. I think I am more confident in my abilities and just more outgoing now in general.

During my internship, I conducted masters research on female corporality and its relation to environment, talking with family, a variety of shamans, Amupakin mamas and more contacts. I also learned procedural skills and taught dance. My host family was absolutely incredible — I 1000000000% recommend them. Always felt safe, was well taken care of, learnt a lot, and lots of fun. Very responsible, incredible food. Timing is not always on the side of an academic who has a time limit — that can pose problems which usually wouldn't be a problem, and it's something I'd plan ahead for next time. The check-ins had good structure, though they could be timed better. What was most impactful was interacting with locals. What I learned from the challenge of timing in the Amazon is that it's not what they verbally say — plan ahead and keep open timing. Beyond that, I developed artesanias, cooking, plant knowledge, survival skills, natural world knowledge, and spiritual and energy level skills. I will carry this experience for my life, both as an academic enhancement and to show the ability to work in different contexts. I felt very comfortable and was inspired every day — I see myself coming back. There's lots of projects happening. It's a great way to get access, be safe, have information and a security net for personal work. I would recommend for students!

During my internship, I worked in the Red Cross lab, worked as an assistant to the paramedics, and worked with Sumak Kawsay Wasi with the physical therapists going out into communities to help the disabled people who cannot travel to Tena. The 1:1 check-ins were one of my favorite parts of the program — when I was having a hard time with something, the check-ins always made me feel better and gave me a better attitude for moving forward. I was living with the Andy Grefa family in Muyuna. Overall, I wouldn't have traded my host family for another experience because we got really close and they think of me as another daughter and I think of them as a family in Ecuador. I really liked how orientation was intimate and very informative — it made me think deep and I learned a lot before starting the actual internship. What I'm most proud of is using my communication skills to become part of the community and make friends here. I didn't come with a friend — I made all these connections on my own, and I'm proud of myself to think that wherever I go in the world, I can use these skills to integrate into the community. The most impactful part was all of the above. Being the first intern with my host family, I learned that communication is key — after really convincing myself that the only way to feel better was to communicate with them, things started to change for the better and I felt more at ease. During this experience I learned a lot about the importance of needs assessment and first studying a place and the people before trying to get involved — being more educated before diving into a project will only help eliminate obstacles and problems before they happen. My experience with Amazon Learning sparked an interest to work with communities in a healthcare capacity, and although I'm still unsure of how, it made me want to continue to travel and work in the healthcare field. I am grateful for the opportunity I was given to see a part of the world much different than what I have seen before and to have spent four months challenging myself and growing as a result of my efforts and the efforts of others. I learned what is important to me in life — experiences and getting to learn from others is more important to me than material things. I think Amazon Learning facilitates an experience that will change someone's perspective on life and will teach them something about themselves and about other people.

The training days, for me, were essential. It was my very first trip alone, so I really appreciated the orientation days in Tena. During my internship, I visited Viktor from Wayta Chocolate, Patricio Andy and his Casa Ingaru, the Ikiam University, Ali Mamallacta and his Chakra, and Amupakin and Pakarina's chakra. I also learned a lot about the cooperation between the University and Indigenous communities and families. Every project was incredibly interesting and unique in its own way — with everybody I learned something different and got another point of view on the things around us. The main project basically was the life at Clemente's and Elena's, where I learned something new every day. I just loved the place and like Clemente's family so much. They really inspired me and I learned more than a lot from them and their way of life. Hopefully I get the chance to visit them soon again. The check-ins were super exciting and a great opportunity to get to the city — they were the guarantee that everything was in order, and on top of that, they were super interesting. So thank you very much for that. What I'm most proud of is clearing a whole area in the Chakra with Clemente one day and producing a ton of wine to sell at the market in Archidona — it was a great day. In the beginning it was some of the foods they eat there, but I realised that almost everything was really good. You have to accept that the time in your family and community will change you as a person, and be ready for this as a process — this really is important for the best time you can have there. If you haven't changed at all, you should rather consider whether you've done everything right. I could have learned even more Spanish and Kichwa and worked a little harder. Next time I would also reduce the contact to Germany a lot more. Looking back, I developed Spanish, working in the field with a machete, cooking, talking to strangers, and many more small things. This experience is definitely going to be part of my bachelors exam — I am also more open to traditional knowledge and have perfected my methods for writing fieldnotes. The things I learned can be used at my home as well, and I also made the decision to come again, even though this was not my idea before I went to Tena and San Luis. I will certainly never forget this time — and I'm sure it won't be my last visit to the Amazon. So thank you very much for everything, and hopefully see you in the future.

During my internship, the main project was just living daily life, getting to know the culture and general way of practicing medicine! I also created a study abroad course for traditional medicine, put together an orientation for new volunteers at Amupakin, and created a Go Get Funding page for Amupakin. I appreciated the check-ins — I feel like they always came at the right time when I needed them the most to stay on track. What I learned most was to adapt to the culture and go with the flow! The most impactful part was all of the above. Having to wait around for buses all the time was a challenge, but I chose to use that lag time to practice reading out loud in Spanish from my book — this ended up being one of my most valuable Spanish-learning tools. Having more confidence that I could indeed do more than I thought is something I wish I had leaned into earlier. Looking back, I developed knowledge of traditional medicine, an understanding of global midwifery practices, the ability to maintain a conversation in Spanish, and an understanding of the dynamic of indigenous cultures and Westernization. I feel extremely benefited by my enhanced perspective of medical practices worldwide, along with the interplay of traditional forms of medicine and biomedicine. The experience definitely made me realize how much I love more traditional, organic forms of practicing medicine, and I don't think I fit into more stressful, systematic medical environments. The Amupakin mamas showed me how valuable and honorable it is to be a mother and raise a family — it was encouraging to see that role truly respected. I have learned a lot about balancing an activity-based mindset with a socially based mindset, and also understanding that as long as one maintains the proper focus, whatever work that needs to be completed will be completed. Tranquila. I'm just super grateful to Amazon Learning for helping me to fulfill my longstanding dream of immersion in another culture, learning indigenous medicine! Thank you for connecting me with the Kichwa people and giving me the chance to learn from people full of knowledge to share!

This program allowed me to grow as an ethical leader in my community, a leader who leads by example. My experiences at Coast General will forever shape my perspective on health care and scarce resources in healthcare settings. While in Kenya, I received constant support from the IMA staff. One specific example that stands out to me was when I was left in the lab by one of the CCC doctors. I called Hilda for support, and even though she was not working that day, she immediately sent Dr. Shaziim to support me. In the residences, the mentors would always be looking out for me, making sure I was healthy and happy as I completed the program. One specific moment in Internal Medicine that stood out to me was when I did rounds in the women's ward with Dr. Shaziim and the gastroenterologist. Dr. Shaziim incorporated my previous knowledge of HIV from the CCC into explanations to help me learn and build upon my knowledge. Thanks to their efforts to involve me in their diagnosis process, I now want to pursue gastroenterology.

During my internship, I worked in a health clinic assisting staff, mostly nurses, as well as doing medical brigades and vaccination campaigns — really good experience and I would recommend it to anyone else who is pursuing a health career. The communication was very open and I knew I could ask for help whenever I needed it. I was impressed with how nice of a house I was placed in. What I'm most proud of is being able to handle prepping patients by myself on one of the busiest days. The most impactful part was all of the above. Learning Spanish taught me not to be afraid of making mistakes and giving it my all. Looking back, I wish I had spent more time with my family. Beyond that, I gained confidence in all aspects of my life that will help me to pursue my career more head strong. This experience also helped me realize what values I hold and how much they really mean to me — these values will help guide me through my next chapter in my life. This is the first time I've truly felt confident and proud of myself and it has made me less afraid of the future. I'm just so thankful for all the inspiring people I met throughout this experience.

During my internship, I worked with women's health, pre/postnatals, birth attendance, working in the chacra, and community visits. The rhythm, the connection, the care was so loving and welcoming with open arms — I loved it so much. The weekend activities, Amupakin, the culture, the connections — all of it felt so tailored to me and I am so grateful. Megan was awesome — attentive, available, reliable with responses and check-ins. What I'm most proud of is that I gave myself to the people, the land, the experiences. Part of my intention for coming was to give back to those holding and sharing knowledge and be in service — I now see it as the attunement, attention, excitement to learn and fall in love with their visions, gifts and culture, along with creating meaningful connections without words or conversation requiring other ways. Physical discomfort — the heat, the bug bites, not feeling 100% great all the time — was the challenge. I learned to surrender to it and allow it to exist alongside everything instead of becoming a focal point. I learned Spanish before coming — that's what I could have done better! Looking back, I deepened my trust in plant medicine and in my own intuition. Not speaking the language offered a very cool opportunity to learn a different way outside the mind — I found a pathway of observation, intuition, and employing other less-used senses, and allowed answers to find me. These skills may be more important in this type of work. This experience anchored things for me — my love and service to plants and women. It brought to life things I have learned and been taught through theory and has inspired more expression from a place of deeper relationship with birth, plants, the land, and the teachers. It helped me define a clearer sense of my gifts, passions, and what is just creating distractions. Beyond that, I now have an embodied sense and knowing of matriarchal and women-led community — and this experience developed a stronger sense of self-trust and confidence. The relationships that have been developed, nurtured, and cared for — that allow for such an expansive and rich experience — are what I am most grateful for. And sooooo grateful to have been able to go to Momma Adela's home to hug her goodbye. It would have felt incomplete without that. Life changing if one lets it.

During my internship, I worked on a nutrition plan with Nick — we were putting together a packet on information about fruits from the Amazon. Stephanie is the reason I survived. She is strong and kind and empathetic and always willing to listen and help in any way she can. What I'm most proud of is going out of my comfort zone. Communicating was a challenge, and I learned that if you're nice and you try, most people respond well. I wish I had studied more Spanish. Looking back, I developed Spanish and patience. The experience and patience I gained will help me in leadership roles and in the medical field in the future. Beyond that, it showed me a lot of things that I don't want to do with my future, which is helpful. I am grateful for all the other interns who made the experience so amazing. I would recommend it — just make sure people know that things change so rapidly that you don't really know what you're going to get.

During the program, I focused on recording medicinal plant species and their traditional uses at Amupakin. The end result was adding signs to their Chakra to support the ecotourism component in communicating their wisdom across the barriers of language. This project helped me crystallize the next phases of other work I am currently pursuing — it was an incredibly valuable experience for my path. I love Elena and Clemente so deeply, they are amazing hosts and incredible chefs! There were moments of really intense confrontation of alcoholism in the community which were difficult to observe and be exposed to, but ultimately it gave me a more panoramic perspective of the challenges going on in Kichwa culture, and I am grateful to have a very real, unromanticized view of Indigenous peoples of the region. For me the check-ins felt very necessary being alone in the program — they gave me an opportunity to reflect and process my experiences. What I am most proud of is connecting deeply with all who surrounded me regardless of language barriers. It was hard not feeling fully comfortable at Clemente's after some very strange and invasive questions and conversations with other family members, but I am grateful to have had two host families — it actually made the experience better. I would have liked to hold a Conversatorio and share my ideas around herbalism more formally. Looking back, I expanded my view of traditional medicine, the process of recording ancestral knowledge, and also increased my Spanish. I am currently applying for a Fulbright to do something similar in another Indigenous community in Costa Rica, and the on-ground experience I received in this program has helped me frame a solid grant proposal and gives me real experience to draw upon going forward. I better understand the challenges rural Indigenous communities face and will be integrating that into my work in International development and ancestral herbalism. I see myself gathering so much knowledge from around the world to synthesize and gift back to all communities in support of an ancient future — a future that amplifies marginalized voices, centers the Earth, and values the traditions of our ancestry. What I am most grateful for is the love I feel from and for the land of the Amazon. I have a lot of people in my circle who could benefit from this program and will surely pass it on.

This internship was an amazing once-in-a-lifetime experience that I am very grateful for. I have met so many wonderful people, including all of the program staff, interns, and hospital staff. Safety was a major concern for my family and me before my internship, but the program mentors and staff were very informative and cautious, so I felt very safe throughout my stay. The accommodations and food were also beyond what I expected. I have learned so much not only clinically, but culturally as well, and I would love to go back once more in the future. My internship this past winter with International Medical Aid in Mombasa, Kenya has opened my eyes to different perspectives and has given me a glimpse of what life is like in a place that is more than 10,000 miles away from my home. I have learned so much in not only medicine but in culture as well. Through the cultural treks and language classes provided by this program, I was able to learn about the history of the Swahili people, how the Kiswahili language came about, along with the traditions and practices of the culture of the people of Kenya. This opportunity has allowed me to gain meaningful experiences and relationships that I will forever cherish. I spent my internship at Coast General Teaching & Referral Hospital, where I had the opportunity to shadow both medical and clinical officers who play a large role in healthcare in three major departments: Emergency Medicine, Pediatrics, and General Surgery. Alongside these healthcare providers were nurses who play a critical role in patient-centered care and whom I came to befriend. Every day of my three weeks of this internship contained precious moments and learning points that have only furthered my passion for the medical field. Even through a slight language barrier, sincerity shines through, which is something that I will always carry into my practice as a future healthcare provider in the United States. If there is anything that has had a profound impact on my view of life, it is the realization that there is a limit to what I am able to control. From my experiences so far, whether in a medical setting or daily life, there is only so much I am capable of doing for people. This realization crossed my mind countless times as I thought about ways in which I could do more because in my current position, I have no say or control in a life-or-death situation, regardless of how dear someone may be to me. Especially as an intern and student, I was limited to speaking words of encouragement as I watched patients suffer, or simply waiting and hoping for good news. The desire to be able to do more than that has sparked my passion to pursue a career as a medical professional. The healthcare system I experienced in Kenya is notably different from the United States in terms of access to care, disease burden, and health coverage for patients. From the medical officers, clinical officers, nurses, and patients that I spoke to, I found that many patients do not seek care due to long distances and lack of transportation. Although hospitals are scattered throughout the country, they may not be evenly distributed throughout each region or neighborhood. Furthermore, some patients live closer to private hospitals but cannot afford them because they charge much more than public hospitals, which many patients are also unable to afford. This relates to Kenya’s poverty rates, with about one-third of the population living below the national poverty line in 2019 (World Bank, 2023). Additionally, the disease burden in Kenya is very high, with human immunodeficiency virus (HIV), which can develop into acquired immunodeficiency syndrome (AIDS), being one of the major communicable diseases. As for non-communicable diseases, major ones include cardiovascular disease (CVD) and metabolic diseases such as chronic kidney disease, diabetes, and hypertension, all of which contribute to the high disease burden in Kenya. The need for non-communicable disease services to be expanded has been recognized, with guidelines supporting these provisions in patients with HIV, but coverage still remains low (Smit et al., 2019). Additionally, during the Global Health Lecture Series presented by Dr. Shazim during our internship, we learned that the high burden of HIV and AIDS in Kenya accounts for about 29% of annual adult mortality, 20% maternal mortality, and 15% mortality in children under the age of five, which are much higher than mortality rates in the United States. Similarly, non-communicable diseases contribute to more than 50% of inpatient admissions and 40% of hospital mortality, which is also linked to a financial burden for these patients that is further connected to nationwide poverty. With a high disease burden in Kenya also comes a high financial burden, with a major issue being health coverage. Informal sector workers, a population that drives a significant portion of employment in Kenya, have a low rate of national healthcare insurance (NHI) enrollment. This may be due to existing socioeconomic inequalities and barriers they face, including limited access and having to pay NHI premiums out-of-pocket (Wamalwa et al., 2025). This contributes to increased morbidity and mortality due to inequitable access to care, as high out-of-pocket costs prevent patients in this population from seeking care. Studies suggest strategies such as using a tax-based system or expanding subsidies to support NHI enrollment among populations like this, though more research may be needed. Diving deeper into the healthcare system in Kenya showed me the existing gaps that prevent patients from receiving the care they need and ultimately contribute to mortality. My first thought when I learned about the healthcare system in Kenya was that these gaps seemed almost impossible to close. However, it made me think about how these gaps could be reduced, even slightly—whether by addressing health disparities through a health equity lens, focusing on advocacy, or working as a healthcare provider in a hospital setting. This led me to ask further questions, which eventually instilled in me a desire to contribute to making a difference. Although my role as an intern may have seemed insignificant in terms of what I was able to practice, I built many meaningful relationships with various people there and I would like to believe that I made a difference in at least one person’s life. Even though I cannot change the world, brightening one person’s day may feel to them as if something meaningful has changed. This could be the drop that turns into a ripple and has a lasting effect. If one drop can turn into a ripple, I can only imagine what numerous drops can do. I believe International Medical Aid is a wonderful example of how gaps in Kenya’s healthcare system can begin to close. Each intern interacts with numerous patients and healthcare providers and brings back a piece of their journey home to share their stories. Each intern may have also offered words of consolation, encouragement, and hope to the patients they encountered, giving them strength during what may have been the lowest points of their lives. I learned that the smallest acts can accumulate and become something deeply meaningful that touches people’s lives. Each person’s life holds immense value, and I want to be part of something that gives people the opportunity to value their own lives—whether by providing treatment options or simply being there to reassure and brighten their days. I want to be someone who brings joy into people’s lives, a shoulder to cry on when they are hurt, and a source of peace for those in their final moments of life, because that is what I would want if I were in such a position. I want to bring good news to families of patients who have recovered, console them when unexpected things occur, reassure them when they express concerns, and be someone not only patients can trust and rely on, but someone their families can rely on as well. My perspective on life has changed, and for that I am eternally grateful.

During my internship, we were able to talk to so many people and visit very special places. We spoke to infectiologists in Tena Hospital and a third-line hospital in Quito, visited urban and rural health centers where doctors and nurses showed us around and spoke about their experiences with TB care, made home visits to TB patients together with nurses and community health workers where we heard impressive stories and saw distressing situations, visited the prison in Archidona and received information from the medical team about their screening programme, met with the district office for TB control, visited the National TB Programme in Quito, and — since traditional Amazonian medicine is a very important part of health care for many people in the Amazon — it was also great to be able to visit chakras with medicinal plants and speak to shamans about their work and views on TB care. Through all these visits and conversations we were able to get an idea of all the possibilities in Ecuador regarding TB care and control. The weeks in Tena and around were amazing — we got a complete overview of TB care and all stakeholders involved. So much is being done comparably to how we work in Amsterdam, and on the other hand there are so many struggles for doctors, nurses and patients. At times it was heart-breaking. The visit to the Ministry in Quito added so much and placed it in a broader light. And we also had a great time personally — we met wonderful people that made our internship very worthwhile and even became friends. Tena and the surrounding area is stunning; it was a privilege to be there. I am not proud — just very grateful for this opportunity. The major challenge was visiting very poor people who were hit hard by tuberculosis or other diseases and not being able to be of real help for them. My Spanish improved quickly. This experience showed me tuberculosis care and control in a global perspective, and Tena, Ecuador is in my heart. I am grateful for the whole programme, the welcoming people, and the friends we made. A great thank you to Andy Gavilanes for organizing this wonderful trip, for being there for us to adjust the schedule to changing insights, and for helping out with translations. I think for people in a public health related field this area offers so much — there is a lot to see and learn in a friendly, safe, and beautiful area.

During my internship, I was teaching English through songs with the ukulele, working on art and trying to find ways for the girls to sell their jewelry in the states, learning about traditional medicine through the finca and cooking, helping with brigades, wanting to implement some health education, and helping set up soccer Tuesdays — I love soccer. It was a lot. I was sometimes all over the place in my head, but I really enjoyed it all. What I am most proud of is the quality of relationships I made with individual people and families — they are all very genuine and relationships that I feel will last a lifetime. The most impactful part was my host family. Communication in the beginning with the family was a challenge — I need to make sure, when speaking in another language, that what I am saying is understood and that what they say I understand, to avoid confusion and questions. I think I could have given more to others, though I think I gave in other ways — writing notes, doing deeds of kindness. I could have also taken advantage of time a bit more and woken up earlier to take some time for myself. Looking back, I developed language — I consider myself fluent, if not very close — along with confidence, initiation, and communication. With the skills I gained, such as the language, initiation, communication, love, compassion, and perseverance, I feel like I have changed in wonderful ways that will most definitely help me in my future endeavors. Being involved in such a vibrant country and culture made me fall in love with Ecuador and its people, confirming my belief that I need to travel as part of my job and continue meeting and being open to people everywhere. Steph! You helped give me the confidence — many times — that what I was doing was worth it! And it all totally was, but was hard to see at times. You always encouraged me to look for the good in the situations and my time here would have been much more challenging without you! Super likely to recommend — however, an experience like this definitely depends on the person and personality. People have to be willing to take initiative to get out there, meet people, and involve themselves.

My experience with International Medical Aid in Kenya was truly exceptional and profoundly impactful, both personally and professionally. From the moment I arrived, it was clear that the program was thoughtfully designed with intern safety, learning, and well-being at its core. The structure and support provided allowed me to fully immerse myself in the experience while feeling consistently supported and valued. The in-country support team was outstanding. Orientation sessions were thorough and reassuring, covering safety, cultural expectations, and hospital dynamics in a way that made the transition into a new healthcare system feel manageable and exciting rather than overwhelming. Throughout the program, staff members were consistently available, responsive, and genuinely invested in our experience. Whether addressing logistical questions, health concerns, or simply checking in on how we were adjusting, their presence made a meaningful difference and created a strong sense of trust and community. Safety was clearly prioritized at every level. Transportation to and from clinical sites was reliable and well coordinated, housing was secure and comfortable, and clear guidance was provided on navigating the local environment responsibly. This allowed me to focus fully on learning and engagement rather than worry. Accommodations were welcoming and well maintained, offering a restorative space after long hospital days, and the food provided was both nourishing and culturally enriching, giving us the opportunity to experience local cuisine while meeting dietary needs. Clinically, the experience was transformative. Exposure to high-acuity cases and diverse patient populations in a resource-limited setting deepened my understanding of medicine, adaptability, and health equity. Despite demanding clinical environments, clinicians and mentors made time for teaching, discussion, and reflection. Case debriefs and guided conversations helped contextualize what we observed and strengthened my clinical reasoning. I gained invaluable insight into patient-centered care, interdisciplinary teamwork, and ethical decision-making in global health contexts. Importantly, the program emphasized respectful engagement with the community. Interns were encouraged to learn with humility, prioritize patient dignity, and understand the broader systemic challenges facing the healthcare system. The presence of the program supported busy clinical teams while fostering meaningful cross-cultural exchange. Overall, this internship reinforced my commitment to medicine and global health. It strengthened my cultural competence, resilience, and sense of purpose, and it was made exceptional by the dedication, compassion, and professionalism of the International Medical Aid staff and local clinicians. This experience will continue to shape my approach to healthcare, service, and learning moving forward. When I arrived in Mombasa, Kenya, to begin my clinical internship with International Medical Aid (IMA), I expected to gain experience in medicine, but I did not expect to feel so immediately immersed. On my first morning at Coast General Teaching and Referral Hospital, voices in the corridor found me before I found the ward: “Daktari, daktari!” The word—Swahili for “doctor”—warmed and unsettled me in equal measure. I wasn’t wearing a white coat, only IMA-branded scrubs, and I was not yet a doctor. But in that moment, the title wasn’t about qualifications; it was about need. “Daktari” carried a weight of expectation that followed me through every ward, every patient encounter, and every conversation. I rotated through the intensive care unit (ICU), emergency department, cardiology, and surgery, with overnight shifts in maternity when the ward was stretched thin. Over weeks, the hospital’s sounds and textures became my syllabus: the oxygen concentrator’s steady sigh, the antiseptic mingled with ocean air, the clink of enamel mugs as tired clinicians shared tea. I learned to say habari (how are you?), asante sana (thank you very much), pole and pole sana (I’m sorry/so sorry), tafadhali (please), samahani (excuse me), ndiyo (yes), hapana (no), kidogo (a little), and polepole (slowly). People smiled at my first crooked attempts and coached me kindly—“Sawa, daktari, polepole.” It mattered to them that I tried. It mattered to me that they let me. A question became inseparable from my days in the hospital: What have I learned—and how will I use it? My answer lives in stories: of scarce resources and stubborn hope, of ethical lines that felt like cliffs, of laughter shared over tea and cake during a ten-minute truce in an endless day, of a husband in a plastic chair at 3 a.m. asking me if everything would be okay and knowing I could not promise it would. These experiences clarified not only the kind of physician I want to be—clinically excellent and radical in empathy—but also the kind of advocate I must become for equity in global health (Afulani et al., 2021; Kinuthia et al., 2022; WHO, 2023). Being called daktari by patients was an honor, but it was also one of the most sobering experiences of my internship. In Canada, I am “Nia, the student.” In Mombasa, I was “Doctor,” simply because I wore a pair of scrubs and stood beside physicians. Patients would look at me expectantly, asking questions, sometimes holding out prescriptions for me to explain. Their trust was profound, but it also reminded me of the immense responsibility medicine carries. The most challenging moments came when Kenyan doctors asked me to do things far beyond my training. In the emergency department, a physician once handed me a syringe and said: “You give the injection — I will show you this one, and you will do the next patient.” I froze. I had never given an injection in my life. I explained that I wasn’t trained, and he smiled, a little surprised, but then proceeded to demonstrate. When he turned back to me, I shook my head. I had to refuse. He looked puzzled at first, but eventually nodded and moved on. That moment taught me two things. First, the scarcity of staff often pushes students into roles they are not prepared for, out of necessity rather than negligence. Second, I realized the importance of knowing my limits. Patient safety must always come before pride or the desire to fit in. The moment branded a lesson I will carry for a lifetime: in settings where task sharing is a pragmatic response to workforce shortages, clarity about scope and competence is an ethical anchor (Kinuthia et al., 2022; Okoroafor et al., 2023). Even without doing procedures, there was plenty I could do. I learned to read the room quickly, to fetch, translate, listen, soothe, count breaths, find a blood pressure cuff that almost fit, and—most of all—to communicate honestly. Briefly as I remember it, a senior physician offered an unforgettable lesson on empathy versus sympathy: “Sympathy stands beside the cliff and waves,” he said. “Empathy climbs down, sits on the ledge, and helps someone look up.” The next day he put me to the test: a family’s matriarch was failing, and we knew she was unlikely to survive the night. He asked me to speak with them first. I used the SPIKES framework—Setting, Perception, Invitation, Knowledge, Emotions, Strategy—pulling chairs into a circle, asking what they understood, inviting permission to share more, delivering information in short sentences, then letting silence do the rest before outlining next steps (Baile et al., 2000; Buckman, 2005). I did not tell them it would be okay. I told them we would not let her suffer and that we would stay. They wept; I listened. When we stood, the physician squeezed my shoulder and said, “Asante, daktari.” It was especially then that I realized how deeply I want to be a doctor who does not only prescribe but also accompanies (Jeffrey, 2016; Byrne et al., 2024). The ICU taught me the arithmetic of scarcity. Beds were almost always full; positions, too. Kenya has grown critical care capacity since 2020, but the distribution remains uneven, and functionality is a persistent challenge—by one national survey, more than a quarter of ICU beds were nonfunctional on the day of assessment (Barasa et al., 2020; Mwangi et al., 2023). On rounds I juggled vitals and vocabulary: pumua polepole—breathe slowly—repeated to a hypoxic patient as we watched an oxygen cylinder’s needle drift toward red. Families seldom entered the ICU; most waited outside or at home, a difference from many North American units where bedside family presence is standard. This wasn’t indifference; it was infrastructure and policy. And still, even behind glass, love found a way—caregivers pressing palms to doors, whispering their person’s name, and trusting us to be their hands for now. One night, we faced a quiet ethical storm. Four patients needed dialysis by dawn: an elderly man with septic AKI, a young teacher with rapidly rising potassium, a diabetic woman in pulmonary edema, and a middle-aged patient with chronic kidney disease who looked relatively stable. We had one machine available. By clinical urgency, the choice seemed clear. Yet the machine went to the one with the lowest immediate risk. A doctor muttered why: “She’s connected… a politician’s prostitute.” I felt my stomach turn. I had been reading about how procurement, politics, and favoritism can distort resource allocation in Kenyan health systems; now the literature had a face (EACC, 2023; Musiega et al., 2023; Munywoki et al., 2023). We stabilized who we could, improvised where we must, and documented everything. That night hardened my resolve to fight corruption and inequity as fiercely as I fight disease. It also pushed me deeper toward policy: devolution has created possibility and variation across Kenya’s 47 counties, but budget execution, cash flow, and procurement bottlenecks still undercut efficiency (Barasa et al., 2021; Musiega et al., 2023). Scarcity is not an abstraction in nephrology. In Kenya, chronic kidney disease affects millions, dialysis is expanding but remains unreachable for many, and transplant capacity meets only a fraction of need (Maritim, 2022; Japiong et al., 2023; Hathaway et al., 2023; Sawhney et al., 2024). That night, the human cost of those percentages sat at the edge of one bed, wrapped in a paper gown, waiting her turn that didn’t come. I want to be the kind of physician who refuses to accept a world where political proximity sets triage. I also want to be the kind of advocate who helps build systems where such choices never arise. The emergency department compressed hours into heartbeats. One evening a boy arrived listless, skin tented over his knuckles, his mother murmuring tafadhali as we lifted him. The chart said suspected cholera. I had read WHO updates about multi-country cholera surges and Kenya’s intermittent outbreaks; suddenly the textbook was on the gurney (WHO, 2024a; WHO, 2024b). We warmed fluids between our palms, counted capillary refill, measured stool in a basin the color of the sea—only thinner, crueler. When he finally sat up and sipped, his mother clasped my hands and said, “Asante sana.” I shook my head: hapana, pamoja—no, together. It was true. The nurse who found an elusive vein, the clinical officer who triaged quickly, the cleaner who changed the soiled sheets in seconds—medicine is choreography, and everyone had a step. In that same department, the cleavage between can and should appeared again in small ways. Could I interpret an ECG? Yes. Should I be the one to adjust a drip? No. Kenya’s Emergency Medical Care Policy and Strategy envision a coherent, universal emergency system; the WHO Basic Emergency Care curriculum is training first-contact providers to act fast and act right (Republic of Kenya, 2020; Lee et al., 2022; WHO, 2024c; Michaeli et al., 2023). I saw the promise—and the gap between policy and practice when volume surged. Strengthening emergency care is not a luxury; it is a multiplier for survival in trauma, sepsis, obstetrics, and cardiac crises. Cardiology days stitched physiology to story. I will never forget a gentle woman in her forties with poorly controlled hypertension and shortness of breath. She had missed clinic visits—money for transport had gone to school fees. Her ECG muttered strain, her ankles told the rest. I sat beside her and tried my Swahili: Tutapanga pamoja—we’ll plan together. The doctor drew a medicine grid with the colors of her cooking spices: red pill with lunch (chapati day), small white at bedtime (lala salama, sleep well). She laughed, promised to try, and pressed a warm orange into my hand from her bag when we were done. Across Kenya and globally, noncommunicable diseases are rising fast while specialist numbers remain thin; in settings like this, patient education is not a bonus but a therapy (World Heart Federation, 2023; Smit et al., 2020; Oguta et al., 2024). Another morning, I helped a young man with suspected rheumatic heart disease understand why stairs stole his breath. With the team’s okay, I only echoed what the physicians had already explained—nothing more—turning their guidance into quick sketches of valves in my IMA notebook while his friend filmed on a cracked phone. We spoke, strictly within those instructions, about prophylaxis and when to seek help if the chest began to thud like a drum; I made clear I wasn’t adding my own opinions, just passing along accurate information from his clinicians. He shook my hand with both of his and whispered, “Asante sana.” Teaching—faithful to the team’s advice—is a clinical intervention; in low-resource settings, it is sometimes the only one you can leave behind. Surgical days carried a ritual clarity—checklists, cleansing, exactness. After shadowing several operations and taking pages of notes, I followed the team to a break room with practically destroyed leather couches. Someone produced a dented tin and a flask. “You must try our tea and cake,” the doctor insisted, breaking the slice into generous pieces though everything was rationed—time, sutures, sanity. We joked about my Swahili and the way I said ndiyo like a question. We also spoke plainly about weight. One surgeon rubbed his eyes and said, “Sometimes I just want to get out of this place.” He didn’t mean Kenya; he meant the machinery of exhaustion: blocked procurement, too few hands, too many late-stage presentations. He was not cruel, only human. Studies from Kenya echo what I saw—burnout is real among providers, especially in high-acuity, under-resourced settings (Afulani et al., 2021; Lusambili et al., 2022). I could not blame him; I could only admire the way he scrubbed again ten minutes later and went back in. Those same surgeons modeled another kind of abundance. They let me stand a little closer, ask one more question, listen a little longer to a patient’s fear before anesthesia. When I thanked them, they shrugged. “We were also students,” they said. Then they handed me another piece of cake. It tasted like saffron and solidarity. On a night shift that still wakes me, a man found me outside the maternity ward. “Daktari, where is my wife?” His hands trembled. I had observed the birth and learned quickly: his wife had delivered a stillborn baby and was now hemorrhaging. She had lost roughly two litres. The team had rushed her to theatre for uterotonics and transfusion. He asked if she would be okay. I wanted to say yes. I could not. I remembered the lesson: empathy sits on the edge of the cliff. I sat with him in plastic chairs for an hour that felt like a day, using the best therapeutic communication I had—short sentences, honest pauses, simple words, pole sana—and I did not make promises. He told me this wasn’t the first time they had tried, how badly he wanted to become a father, how brave his wife was. He held his head and sobbed. I handed him tissues and spoke to the theatre when I could. When the nurse finally waved us closer and said the bleeding was controlled, he broke again—this time with relief, not joy. We had saved a life; we had also witnessed a loss that would live in the room for a long time. Postpartum hemorrhage is the leading cause of maternal mortality in Kenya, responsible for a staggering share of preventable deaths (Clarke-Deelder et al., 2023; WHO, 2023; Miller et al., 2024). Policy and innovation—from calibrated drapes to E-MOTIVE care bundles—are making a dent, but systems strain at three a.m. (Forbes et al., 2023; WHO, 2023). That night honed my understanding of what “advocacy” must mean for me: not speeches, but the slow, procedural work of ensuring blood is in the fridge, oxytocin is not expired, and referral roads are passable. I learned to see difference not as deficit but as context. Kenya’s health system is decentralized; counties hold power over budgets and hiring, yielding both innovation and inequity (Barasa et al., 2021). Emergency care policy is advancing but remains a patchwork in implementation; critical care capacity has expanded yet is uneven and sometimes nonfunctional; task sharing is both policy and necessity (Republic of Kenya, 2020; Mwangi et al., 2023; Kinuthia et al., 2022). These structural variances mattered in daily decisions—who got a bed; which lab test we could run; whether a consultant could be reached. Politics walked the corridors, too. I saw the best of it—county investments that opened new ICU wings—and the worst of it—procurement shortcuts that warped triage, whispers of favoritism, and morale that bent under both (EACC, 2023; Musiega et al., 2023). Culture threaded everything: family structures, faith, the communal cadence of waiting rooms, the hospitality of tea that no one could afford and everyone insisted you take. I also learned that language is a clinical tool. Saying pole at the right time with the right tone mattered as much as any manual skill I had. People corrected me gently—hapana, not hapoana—and then used my effort as a bridge to trust. Competence before confidence. In resource-limited settings, the temptation to “just do it” is real. I learned to hold the line, graciously and firmly. My future self will keep that boundary for patients’ sake and my own (International Medical Aid, 2025; Kinuthia et al., 2022; Okoroafor et al., 2023). Communication is care. Breaking bad news with the SPIKES framework, listening more than I spoke, and choosing empathy over sympathy are not soft skills; they are lifesaving ones. I will keep training this muscle, because it determines how patients endure what medicine cannot yet cure (Baile et al., 2000; Jeffrey, 2016; Byrne et al., 2024). Systems shape outcomes. Clinical excellence cannot outrun broken procurement, underfunded emergency systems, or nonfunctional ICU beds. My internship turned my interest into commitment: I will pair practice with policy, advocating for anti-corruption safeguards, budget transparency, and county-by-county strengthening (Barasa et al., 2021; EACC, 2023; Musiega et al., 2023). Equity is a clinical competency. Dialysis for the connected instead of the sickest is not only unjust; it is deadly. I want to help build guardrails—triage protocols, ethics support, and public accountability—that make fairness the default, not the miracle (Munywoki et al., 2023; Japiong et al., 2023; Maritim, 2022). Joy sustains the work. Tea and cake in a cramped break room were not trivial; they were resistance. Laughter over my rookie Swahili reminded me that hope is a renewable resource. I will carry that with me—and reciprocate it—for my teams and my patients. These lessons have already recharted my academic path. I am minoring in Global Peace and Social Justice to deepen my understanding of health equity, ethics, and policy. I seek coursework in health systems, anti-corruption in public procurement, emergency care strengthening, and community-centered research. Clinically, I envision a life as a traveling physician-scholar who rotates through hospitals like Coast General, supports county health teams, mentors trainees, and returns regularly—not as a parachute, but as a partner (International Medical Aid, 2025; Kinuthia et al., 2022; WHO, 2024c; Siegel et al., 2024). On my last week, a nurse in surgery pressed my hand and said, “When you come back, will you be a real doctor?” I swallowed. Ndiyo. Nitarudi. Yes. I will come back. I want to be the physician who hears “daktari, daktari” in a crowded corridor and knows both the science and the story behind the plea; who can titrate a drip and also sit in the dark with a husband while the theatre doors stay closed; who insists on ethical triage even when the room grows quiet; who fights for emergency systems that answer in minutes, not hours; who teaches in simple metaphors and shaky Swahili until a patient laughs and understands; who accepts cake and offers it; who returns. One day I hope to wear that word without hesitation—daktari—and to bring it back to the very wards that taught me what it means. Until then, I will study hard, listen harder, and carry Kenya with me into every exam room. Asante sana. All patient stories are de-identified and composite to protect privacy. Details altered or composited for confidentiality include: the exact sequence of the four dialysis candidates; the names, ages, and non-essential demographics of patients in emergency, cardiology, and maternity; and the particular phrasing of clinicians’ quotes (the sentiments are faithful to actual conversations). Specifics about procurement favoritism were reported to me verbally during a night shift and are presented here as a firsthand account consistent with published reports on health-sector corruption in Kenya (EACC, 2023; Munywoki et al., 2023). The scenes of tea and cake with surgeons, the SPIKES conversation with a family, turning down an injection at the bedside, being called “daktari” while in IMA scrubs, learning and using basic Swahili with patient interactions, and sitting with a husband during his wife’s postpartum hemorrhage are drawn directly from my internship experience.

During my internship, I helped with the operations of Los Yapas, and participated in a bit of activities related to traditional medicines such as lemon grass, and talks. The most impactful part was all of the above — and also interacting with locals. What surprised me most was learning to be neutral and take things in, although they might not be my favourite things to take in. The language barrier was a challenge — I'm gonna practice better Spanish before I re-visit the Amazon. It would have been great to have a more precise idea about what I can do in my host family rather than taking more time to figure them out upon arrival. Beyond that, I developed a bit of Spanish, patience, and adaptability — tolerating long-journey buses builds that fast! I was already an advocate for sustainability before I went, and upon completing the program I feel like I am making less waste in my daily life now, which is good. I am grateful that everything turned out smoothly, for the great communications with Steph and Andy, for surviving well in exotic surroundings with no major danger, and for how supportive and welcoming Ecuadorians are. I believe a lot of people from Asia would be eager to explore, and Amazon Learning is definitely the first step that they can take.

During my internship, I worked on creating an encyclopedia of medicinal plants and making salves and other remedies with my host family. I'm happy with what I completed and want to come back to do more. The most impactful part was my host family — I'm grateful that I was such a good fit with them. They were incredible. A shower would've been nice. What I learned most from the challenge of communication was how to rephrase things better, to have patience at trying to understand, and that it's important to keep learning Spanish actively, because it takes a ton of experience to become fluent. Taking advantage of waiting time — such as for the bus — to get things done is something I could have done better. Beyond that, I developed Spanish, social skills, drawing, patience, flexibility, medicine making, and writing. I now have a much broader selection of medicinal plants to choose from, and can work with Clemente to get them to the US when I have my own shop. I want to come back to Ecuador to keep studying medicinal plants, and I feel like my definition of "home" has changed — I do have more confidence now that I've traveled to a foreign country by myself. I think it's a great experience to study and work abroad, especially in the Amazon!

During my internship, I worked at the Centro de Salud in Muyuna. What I'm most proud of is learning to communicate with my family and create a bond. The most impactful part was my host family. Losing my headphones was a challenge — it made me learn to be innovative and also learn how to be strong without my music readily available. I think I could have traveled more and made more effective use of my weekends. Looking back, I developed leadership, self-motivation, linguistics, and more. This experience helped me gain valuable experience in the Global Health sector of Public Health and also helped me better improve my linguistic skills. It will definitely make me challenge myself more and go out of my comfort zone more often. I truly learned how to be alone and how to make myself mentally stronger. I am so grateful to all of the people that made Ecuador feel like my home — I met so many phenomenal people and without them, I truly believe I wouldn't have been nearly as successful in Ecuador as I was, including everyone at Amazon Learning. This experience was so life changing and amazing that I want anyone and everyone capable to experience what I did.

During my internship, I volunteered in 9 de Julio. The 1:1s were great for collecting my thoughts and processing all of the experiences I was going through — it was easy to get caught up in the flow of community living and forget to stop and soak in all of the cultural learnings and experiences. I always came away with a greater understanding of what I was going through and how I can continue to grow and enjoy myself. I loved my family and community. What I'm most proud of is becoming a member of the community on a level I couldn't have imagined at the start. The most impactful part was my host family. Communication was always difficult even up to the day I left — I learned that with patience and support, inter-language communicating can be done effectively, and I also learned not to be afraid or embarrassed to at least try to speak Spanish. Everyone always appreciated my effort. I think I could have prepared a bit better with my Spanish, and I also could have interacted with the adults in my community a little more — I found myself interacting with the kids more because it was easier and more comfortable. Looking back, my language skills strengthened immensely. I learned a lot about community development, how to enter a community and build their trust and support, and how to adapt to a difficult situation and make the best of it. I hope to work with communities, so this was great experience in entering an unfamiliar community and gaining their trust. I now have more ambition to travel to new and unfamiliar places, and I feel more capable and confident in my abilities. I am grateful for the warmth and compassion of my community — it was as unexpected as it was heartwarming and meaningful.