Study Abroad Programs in Ecuador

Participating in International Medical Aid’s program in Kenya was a truly transformative experience, both professionally and personally. I had the opportunity to shadow physicians and healthcare professionals at Coast General Hospital in Mombasa, gaining firsthand exposure to global healthcare challenges and delivery in a resource-limited setting. From the moment I arrived, the in-country support team made me feel safe, welcomed, and well-oriented. IMA’s staff were consistently responsive and approachable. They ensured that all volunteers understood local customs, safety protocols, and expectations in clinical settings. We had weekly check-ins, and the team was always available to address any concerns. Despite being in a new country, I felt incredibly safe throughout my stay, thanks to the reliable transportation, secure housing, and clear communication from the local coordinators. IMA did a great job preparing us with pre-departure materials and continued that level of support on the ground. The accommodations exceeded my expectations. The volunteer housing was clean, secure, and comfortable, with amenities like running water, Wi-Fi, and mosquito nets. Meals were delicious and diverse, offering a great introduction to Kenyan cuisine. The kitchen staff also accommodated dietary preferences and restrictions without hesitation. The clinical shadowing was eye-opening. I rotated through various departments such as maternity and pediatrics. I observed cases I would likely never encounter in my home country and learned to appreciate how medical professionals innovate and adapt under constrained conditions. One particularly memorable moment was observing a C-section where the team maintained high standards of care despite limited resources. I also appreciated the cultural immersion opportunities provided, including excursions to historical sites, safaris, and time spent in local communities. These moments added depth to my understanding of healthcare in Kenya by allowing me to witness the social and economic factors influencing health outcomes. The program strengthened my desire to pursue a career in global health and gave me a more nuanced perspective on the importance of healthcare equity. I became more adaptable, empathetic, and aware of the cultural dimensions of medicine. I also believe that, through volunteer outreach initiatives like health education days, we made a small but meaningful impact on the community. From a young age, I felt an unshakable pull toward the medical field. My white coat was never far from my shoulders, and the plastic stethoscope that draped around my neck felt like a symbol of something bigger, something I couldn’t yet fully explain. I would transform my dolls and stuffed animals into patients, performing makeshift surgeries on them as if I were already a seasoned doctor. Even my dog, who was far too old to escape my ministrations, became my loyal patient. My family played along, offering their arms for bandages, pretending they had broken bones or caught the flu, while I took it all in with a fierce sense of responsibility. It was in seventh grade when my sister asked the question that everyone asks: “What do you want to be when you grow up?” Without hesitation, I said, “I want to be a doctor so kids like me can feel safe and healthy.” I know many kids make fleeting promises to become doctors, only to let those dreams fade. But for me, even then, it was never just a passing thought. It was a passion that felt destined, something I’ve carried with me ever since. When I first considered a career in medicine, I never imagined that a Physician Assistant (PA) was an option or even that the profession existed. It wasn’t until I found myself in the hospital one day, expecting to see a doctor, that I was instead greeted by a PA. At first, I didn’t realize the extent of responsibility and autonomy this role carried. But the more I learned, the more I discovered how much PAs actually do, from assisting in surgeries to diagnosing patients, ordering tests, prescribing medications, and performing physical exams. This role offers the perfect balance: the opportunity to be deeply involved in patient care, but still working collaboratively with doctors. The ability to specialize in different fields, combined with the flexibility to work in diverse settings such as hospitals, clinics, private practices, and urgent care centers, made me realize that this is exactly what I’ve been searching for. Suddenly, my path became clear. I knew this was the profession I wanted to pursue, one that would allow me to contribute meaningfully, grow continuously, and make a real difference in healthcare. I knew I was destined for healthcare the moment I didn’t hesitate to save a life. It was Halloween weekend in 2022. My friends and I were standing outside the bar, waiting for a ride home, when suddenly, the sharp crack of a crash split the air. I turned around and froze. A man lay unconscious in the street, blood spilling from his body, while a motorcycle lay in pieces just a few feet away. Without thinking, I ran straight to him. Later, I learned he’d been hit by a motorcyclist, but in that moment, it was clear only one thing mattered: getting to him. I dropped to my knees beside him. He wasn’t breathing. Blood was pooling around him. I grabbed his wrist, searching for a pulse. Nothing. A rush of adrenaline surged through me, and without hesitation, I started chest compressions. Another person appeared beside me, panic in their eyes. “What do I do?” they asked. “Two breaths every thirty compressions,” I instructed, barely looking up. I could hear the sickening sound of his ribs cracking under the pressure, but I didn’t stop. I couldn’t. We kept switching, exhaustion creeping in, but we pushed through, each compression a desperate plea for life. Time seemed to stretch and warp as we kept going, our breaths shallow, our hands working in sync. Finally, we heard the distant wail of sirens. The ambulance screeched to a halt, and the paramedics rushed in to take over. I stood up, my hands slick with blood, and looked down at them, bright red and trembling. A police officer approached me, his gaze steady as he placed a hand on my shoulder. “You did great,” he said, his voice firm but filled with something more. “You may have just saved that kid’s life.” In that moment, everything shifted. I felt a sense of certainty wash over me; this was no longer just an instinct. It was my purpose. From that moment on, I knew this was meant to be. There was a moment, not long ago, when I truly questioned whether I was cut out for this profession. About six months ago, I was helping a nurse with a blood transfusion. She casually asked, “Do you get squeamish around blood?” Without hesitation, I said, “No.” I figured, having donated blood countless times and seen my fair share of bloody injuries, I’d be fine. But then, as the nurse started the procedure, she pulled out this long, 12-inch needle. With a swift, almost aggressive motion, she drove it into the patient’s arm. The pain was immediate and intense. The patient screamed in agony, but because he was on a ventilator, no sound came out. In that moment, I froze. My body went ice cold, and I knew exactly what was happening. I’d fainted before, and I could feel all the signs: my limbs tingled, my legs started to give way, and my vision blurred, fading into stars. Desperately, I turned my head away, trying to block it out, taking deep breaths to keep myself steady. I knew I had to leave before I collapsed, so I whispered to the nurse, “I need to get out of here or I’m going to pass out.” But she quickly responded, “You can’t, or he’ll bleed out.” I fought with everything I had to stay focused. But suddenly, the room went black. My legs buckled, and I crashed to the floor, hitting my head hard. When I came to, I was surrounded by a crowd of nurses, all staring at me. Embarrassed and shaken, I made my way to the break room and broke down, overwhelmed with doubt. “How can I be a PA if I can’t even handle a simple procedure like this?” I thought. Then, a nurse walked in and asked what had happened. I explained, feeling humiliated. She smiled and told me a story. “When my brother broke his nose,” she said, “there was so much blood pouring out that I passed out. My mom told me, ‘How can you be a nurse if you can’t handle blood?’ But here I am, 10 years in.” Something about what she said stayed with me. “Don’t let one moment define your future,” she told me. “Keep going.” From that day on, I’ve carried her advice with me. Every time doubt creeps in, I remember her story. It became my motivation, proof that even the toughest moments can become stepping stones toward achieving something greater. I never imagined that choosing the path of becoming a Physician Assistant would lead me to this internship, an experience that completely reshaped the way I see medicine, privilege, and the reality of global healthcare. Before this, my understanding of healthcare was largely rooted in what I saw in the U.S., a system full of flaws, yes, but still one with access, options, and a certain level of expectation. But nothing prepared me for what I would witness during my time abroad. One of the first things that hit me was the line outside the hospital—dozens of people, some waiting for hours just to see a doctor for a single minute. That kind of patience, that desperation, shook me. And it wasn’t just the wait times. It was the staggering lack of resources and staff that made me stop in my tracks. When I learned that there was only one neurosurgeon and one cardiologist in the entire country, I was stunned. Then came the numbers: a nurse-to-patient ratio of 1 to 70, and a doctor-to-patient ratio of 1 to 13,000. For comparison, in the U.S., it’s about 1 to 5 for nurses and 1 to 400 for doctors. I was speechless. In the maternity ward, a nurse explained to me how their scope of work stretched far beyond what we’d expect in the States. They did everything: suturing, delivering babies, examining placentas, because there simply weren’t enough midwives or doctors to do it. The only thing they couldn’t legally do was diagnose or prescribe a treatment plan. They had no choice but to stretch themselves thin. In some cases, heartbreakingly thin. One nurse told me how, during critical shifts, they’d sometimes have to make impossible decisions, choosing who had the better chance of surviving, because they didn’t have the time or resources to save everyone. They had to let go of patients who were fading, simply because they didn’t have the luxury to sit beside them in their final moments. I remember watching a woman undergo a labial laceration repair after giving birth. Lidocaine was scarce, so it was diluted to conserve every drop. I’ll never forget the sounds: sharp inhalations, low groans turning into cries, the way her fingers gripped the edge of the bed as her body trembled. The pain was visible in every part of her. It was like the anesthetic barely worked, and yet it was all they had. Back home, I work in a hospital where nurses often talk about being overwhelmed with five patients instead of three or four. I’ve heard the frustration, the burnout, and the complaints about skipped breaks and long hours, and I don’t dismiss any of that. But after seeing what I saw, I can’t help but think: some of us need a reality check. We forget how much we do have. We forget that access to clean instruments, consistent medication, and specialized staff is a privilege, not a given. We take so much for granted. This experience didn’t just show me the cracks in the global healthcare system. It lit a fire in me. It made me realize that being a PA isn’t just about diagnosing or prescribing. It’s about being adaptable, compassionate, and resourceful even in the most limited of settings. It’s about seeing the patient in front of you, not the chart. And sometimes, it’s about bearing witness to pain—real pain—with the humility to learn from it. This was more than an internship. It was a wake-up call. And I’ll carry that with me into every patient room, every diagnosis, every decision I make in the future. I spent my first week in the maternity ward, a deliberate choice driven by a deep curiosity about the female body and the intricate process of childbirth. On my very first day, we were led upstairs to the operating room. The moment I stepped in, a wave of cold air hit me, sterile, sharp, and unforgiving. The room was tense, thick with anticipation. A woman lay on the table, visibly trembling, not from the temperature alone, but from the shock and fear coursing through her. Then the surgeon walked in. She carried herself with unshakable confidence, as though she had done this a thousand times, and maybe she had. The sudden blast of upbeat music filled the room, lifting the heavy silence. It was unexpected but oddly comforting, a tactic, I realized, to keep the energy high, the mood steady. The procedure began. What felt like 15 minutes stretched into an hour; time warps in places like this. The surgeon moved with precision, almost like she was dancing through the motions, each action flowing from muscle memory. But nothing about the procedure was gentle. I watched as she made the first incision, then began pulling and tugging with force to open the abdomen. It was raw, intense, and real. That’s when the nausea crept in. The room started to spin ever so slightly. My arms and legs tingled. Lightheaded, I fought to stay upright. I didn’t want to miss this. I didn’t want to be that person who had to step out. But my body gave me no choice. I slipped out quietly. By some miracle, I returned just in time. The room was still. And then a sharp, powerful cry filled the air. A newborn. Her lungs were strong, her presence undeniable. It was one of the most profound moments I’ve ever witnessed. From cold steel and silence to life and sound, all within a single breath. It was nothing short of extraordinary. After experiencing that, the next two C-sections were amazing to watch from start to finish. I felt like I could handle seeing anything. My second week was spent in the Pediatrics ward, a world entirely different from Maternity. In Maternity, we celebrated new life, the joy of arrival. But here, we faced the fragile thread between hope and heartbreak. It wasn’t about welcoming a child into the world anymore; it was about fighting to keep them in it. The first thing you notice when you walk in is the sound—not soft coos or lullabies, but the piercing screams and cries of children in pain. Then you see the mothers, weary, worried, clutching their sick little ones with tired eyes that have known too many sleepless nights. It was hard to approach the children without fear reflecting on me. To them, we weren’t helpers; we were strangers in white coats who brought needles, pain, and confusion. I could feel their distrust, and it made me feel helpless. I wanted to reach out and let them know I was there to help, not hurt. I wanted them to feel safe, even in the scariest place. That feeling, that longing to be a comfort in the chaos, is exactly why I chose this department. Because in pediatrics, medicine isn’t just about charts and treatments; it’s about connection. It’s about kindness, magic, and making space for laughter even in the midst of fear. Someone once said, “Children may forget what you say, but they’ll never forget how you made them feel.” That’s the truth of pediatrics. Sometimes, the most powerful medicine is simply making them smile. A silly face, a warm hand, a few minutes of pretending the hospital bed is a rocket ship—it changes everything. Children fight hard. They recover fast. They believe in magic. And in pediatrics, you start to believe, too, that maybe, just maybe, anything is possible. It was 8:40 AM when we stepped through the doors of the pediatric emergency room. Almost immediately, I sensed something was wrong. A commotion behind a curtain in the corner of my eye pulled me in. I moved quickly toward the noise. Behind the curtain was a little boy, or so I thought. He looked no older than six or seven. I later learned he was thirteen. His body told a different story. He had pneumonia and was dangerously susceptible to secondary illnesses like meningitis and anemia. His frame was skeletal, every rib visible beneath pale, stretched skin. His abdomen was distended, a stark contrast to the rest of his frail body. Malnutrition had taken a cruel toll. Two nurses were performing CPR—fast, hard compressions—and I could hear the crack of ribs with each push. They were tiring. Without hesitation, I stepped in. Thirty compressions, pause, glance at the monitor. Flatline. Silence. A breath held. Then nothing. Again. And again. Twenty minutes passed, but it felt like an eternity. I pressed a stethoscope to his chest, hoping the monitor had missed something. Still nothing. No heartbeat. No murmur. Just silence. We checked his pupils. Black, fully dilated. No response. No reflex. His brain was gone. There was no life left in that fragile body. We called the time of death: 8:59 AM. That number is etched into my memory. I will never forget it. And then came the part no one can prepare you for: the mother. She entered through the curtain, her face shifting instantly from anxious hope to unspeakable grief. Her knees buckled. She collapsed to the floor, sobbing uncontrollably. Her cries filled the room and pierced through every layer of calm we tried to keep. We stepped out, giving her space. But the sound stayed with me. He had so much life ahead of him. And yet it was taken not by something rare or untreatable, but by something entirely preventable. If he had been in the United States, his outcome would likely have been very different. Routine vaccinations could have protected him from the infections that weakened his immune system. Early medical care could have treated his pneumonia before it became severe. Nutritional programs, regular checkups, and access to antibiotics, oxygen, and intensive care could have given him a fighting chance. Even his severe malnutrition, so apparent in his fragile body, would likely have been addressed long before reaching this point. In the U.S., a child like him wouldn’t just be seen; he’d be saved. This experience gave me more hands-on exposure than I ever expected. But more than that, it exposed me to the brutal reality of healthcare inequity and the devastating cost when basic needs go unmet. Medicine is more than procedures and protocols. Sometimes, it’s about witnessing a loss that never should have happened and carrying it with you so it never happens again. After my week in the Pediatrics ward, something clicked. For the first time, I felt a real sense of direction, a clear understanding of not only what I wanted to do, but why becoming a Physician Assistant is the right path for me. That week, I rotated through three different pediatric settings: two days in outpatient, two in inpatient, and one unforgettable day in the pediatric ER. Each offered its own lessons, but it was those first two days in outpatient that lit something up in me. It wasn’t just interesting; it was fun. Surprisingly fun. I’ve always had a thing for puzzles. I find myself doing mini puzzle games all the time—during car rides, in waiting rooms, even while half-watching TV. There’s something so satisfying about taking scattered pieces and fitting them together to reveal the bigger picture. Outpatient care felt exactly like that. A child walks in with a list of symptoms, sometimes vague, sometimes oddly specific. You ask the right questions, listen closely, and examine carefully. You take all those disconnected pieces—the fatigue, the rash, the cough that won’t go away—and slowly, you build a picture. You work backward from the clues, solve the case, and figure out how to help them feel better. It’s medicine, yes, but it’s also a puzzle. And I loved it. Working alongside the Physician Assistants during those outpatient days was eye-opening. There was an ease to the way they moved—calm, confident, efficient. They listened to their patients, made swift yet thoughtful decisions, and always stayed one step ahead. Sometimes they’d already guessed the diagnosis before even starting the physical exam. It wasn’t rushed; it was refined, like muscle memory earned through years of practice. Watching them, I could see a glimpse of my own future. I imagined myself in their shoes: solving puzzles, guiding patients, making a real difference. It didn’t feel out of reach; it felt like the right fit. That week didn’t just reaffirm my career path. It gave me something more powerful: clarity. And for the first time, I could truly see the future I’ve been working toward. On my last day, we held a mental health awareness clinic at a local high school. One of the activities we did was simple on the surface: a piece of paper divided into four prompts—“I feel…,” “Because…,” “I wish…,” “I will….” The students filled them out anonymously and handed them in. Most were what you’d expect: stress about exams, pressure from home, friendships, the usual teenage chaos. But then I read one that stopped me cold: “I feel sad and scared because I like boys (I’m gay). I wish my friends and family would accept me. I will try to figure it out.” That was it. Just a few words. But behind them was a storm of fear, isolation, and incredible vulnerability. I sat there, holding the paper, unsure of how to even process what I had just read. This wasn’t a cry for attention; it was a silent scream from someone hiding in plain sight. What hit me hardest was realizing just how dangerous that confession was, even anonymously. I hadn’t fully grasped how severe the consequences of being gay could be in this country. Homosexuality isn’t just stigmatized; it’s criminalized. A person can be expelled from school, fired from their job, refused medical care, violently attacked, evicted from their home, or sentenced to up to 14 years in prison. And that’s not even counting the emotional trauma of being rejected by your own family. That student, whoever he is, is living a life of secrecy, fear, and constant self-monitoring. Just being seen could ruin everything. And he’s only a teenager. I wish I could have helped him. I wish I could have told him that he’s not alone, that his identity isn’t something to fear. It wasn’t long ago that being gay was illegal in the United States, too, and was only decriminalized in 2003. And same-sex marriage didn’t become legal until 2015. It’s easy to forget how recent that progress is. For millions around the world, it still feels impossibly out of reach. In Kenya, public pride parades are rare and dangerous. LGBTQ+ activism is heavily restricted. There are no laws that protect queer individuals from hate crimes or discrimination. The fear is not just cultural; it’s legal, physical, and endless. Reading that note reminded me why mental health advocacy matters. It reminded me that healing isn’t always about medicine; sometimes it’s about being seen, being heard, and being safe. And it reminded me that change takes more than time; it takes courage, protection, and people willing to listen to anonymous cries for help and say, “I hear you.” This journey has deepened my understanding of medicine beyond clinical skills and textbooks. It’s shown me that being a Physician Assistant is about more than just treating illness; it’s about listening when someone is afraid to speak, acting when others hesitate, and showing up fully, even in the hardest moments. I’ve witnessed the power of empathy in a crowded ER, the strength of resilience in underserved communities, and the urgent need for equity in global healthcare. I’ve seen how a single act, whether it’s saving a life on the street, holding a child’s hand, or reading a note from a student too afraid to be themselves, can ripple out and change lives. I am no longer the little girl with a plastic stethoscope and big dreams. I am someone who has seen the beauty and the brutality of medicine and who is ready to step into this role not just with knowledge, but with compassion, purpose, and unwavering commitment. Becoming a PA is no longer just my dream; it’s my calling.

Participating in the International Medical Aid (IMA) internship program in Mombasa, Kenya, was one of the most formative experiences of my academic and professional life. My time interning at Coast General Teaching and Referral Hospital not only solidified my passion for OB/GYN but also deepened my understanding of global health disparities and the importance of compassionate, culturally competent care. In-Country Support and Staff: The in-country support provided by IMA was exceptional. From the moment I arrived in Mombasa, I felt cared for and supported by the entire team. All of the mentors were approachable, knowledgeable, and always willing to answer questions or provide guidance, both in the hospital and outside of it. I especially appreciated their attentiveness when I was feeling under the weather; Mitchel always checked in on me and made sure I was okay, which meant a lot being far from home. I want to give a special shout-out to Hilda, who was absolutely awesome to be around. Her energy and warmth made the experience even more memorable. I especially enjoyed hanging out with her during the safari; she was fun, supportive, and made the trip memorable. Safety: Safety was a major concern of mine before arriving, but IMA did an excellent job maintaining a secure environment. Our housing was guarded 24/7, and we were advised on areas to avoid, appropriate dress codes, and how to navigate the city respectfully and safely. I never felt unsafe, and knowing that IMA was always reachable in case of emergencies gave me peace of mind. Accommodations and Food: The accommodations were clean, comfortable, and conducive to rest after long days at the hospital. Rooms were shared with other interns, which fostered strong friendships and a sense of community. The meals provided were consistent, nutritious, and offered a mix of local and international flavors. Having home-cooked meals prepared daily made a huge difference in helping us stay energized and healthy throughout the program. One of my favorite memories was getting to help the pastry chef bake cinnamon rolls and a cake for the other residents. Even though most of us didn’t have strong baking skills, he was incredibly welcoming and made the experience fun and relaxed. It was a small but memorable moment of connection and hospitality that made our temporary home feel even more like a community. Clinical Experience and Impact: The clinical rotations were diverse and eye-opening. I was exposed to several departments, including pediatrics, internal medicine, surgery, and maternity. I found myself deeply drawn to the labor and delivery ward, where I observed numerous births and even had the chance to assist in some non-invasive ways under supervision. This was where I discovered my true passion for OB/GYN. However, this area also exposed one of the most challenging parts of my experience: witnessing the lack of empathy in some clinical interactions. While technically proficient, many staff lacked bedside manner, rarely acknowledging mothers post-delivery. While this was difficult to witness, it also shaped my own understanding of the kind of provider I want to be: one who prioritizes both clinical excellence and compassionate care. Additionally, the resources in the hospital were lacking. From reusing supplies to patients having to bring their own bedsheets, the lack of basic necessities was an ongoing challenge. These experiences gave me perspective on the privileges of the healthcare system in the U.S. Community Impact and Cultural Insights: The program’s connection to the community was one of its strongest features. We weren’t just observers in a hospital; we were invited to engage with a broader conversation about healthcare access, economic disparity, and public health education. Many of the patients we encountered lived in poverty and were unaware of the healthcare services available to them. This highlighted the need for more than just clinical care; it underscored the importance of community outreach and education. IMA’s local partnerships and involvement in community projects show their commitment to making a sustained impact, not just hosting interns. This part of the program helped me understand that healthcare must be holistic, starting long before a patient enters a hospital and continuing long after they leave. Personal Growth and Long-Term Impact: This experience transformed not only my academic path but my worldview. I entered the program as a Pre-PA student, still exploring specialties. I left with a clear vision of becoming an OB/GYN and pursuing medical school instead of the PA route. The emotional and ethical insights I gained from this experience, especially the importance of empathy and equity, are lessons I carry into every patient interaction as a CNA and will continue to prioritize throughout my career. Since returning, I’ve shadowed OB/GYNs in the U.S. and found the same aspects of the field that inspired me in Kenya; emotional connection, variety, and challenge are just as alive here. That consistency across cultures affirmed my decision to pursue this path. Final Thoughts: I am incredibly grateful to International Medical Aid for facilitating such a meaningful, safe, and eye-opening experience. The combination of clinical exposure, cultural immersion, and ethical reflection has had a lasting impact on me as a future healthcare provider. While there were challenging moments, especially in observing disparities and resource shortages, these were necessary for growth and reflection. To anyone considering this program, I would strongly encourage them to go with an open heart, a respectful attitude, and a willingness to learn, not just about medicine, but about humanity. The impact this experience had on me was profound, and I know it will shape the kind of physician I become.