Study Abroad Programs in Ecuador

I had an excellent experience with IMA. The staff all went above and beyond to ensure my comfort and safety. The experience was so incredibly meaningful, and IMA’s accommodations helped me feel less overwhelmed and more prepared to take in the experience. Hilda in particular went above and beyond, especially on the Malindi adventure. She was very approachable, fun, and organized. I remember sitting in my high school biology class, flipping through a textbook when I stumbled upon a section on diseases prevalent in the developing world. It described, in vivid and unsettling detail, the symptoms of illnesses like Ebola and malaria—two diseases I had never heard of at the time. The page depicted Ebola’s internal hemorrhaging and malaria’s destruction of red blood cells as they burst and release parasites into the bloodstream. The section ended with a sobering note: Ebola and malaria might be curable, but little progress was being made due to a severe lack of research funding. The textbook also estimated the total cost to eradicate malaria. According to the Gates Foundation, the estimated cost to eliminate malaria by 2040 is between $90 and $120 billion—a sum less than the net worth of many of the world’s wealthiest individuals (Renwick). That statistic stuck in my mind and has remained with me ever since: global health inequality is a solvable problem—so why aren’t we doing more to solve it? Over the following years, my interest in global health deepened, particularly as the COVID-19 pandemic exposed glaring inequities in vaccine access. I found myself inspired by frontline healthcare workers—many of whom were my own neighbors—and by the efforts to democratize vaccine availability worldwide. I trained to become an EMT, responding to medical emergencies on my college campus, and became involved in vaccine delivery research focused on developing pulsatile-release vaccines aimed at improving vaccination rates in low-resource settings. I joined a global health club on campus and worked to raise awareness of global health issues among my peers. Still, something felt missing. I didn’t fully understand who I was helping. Who were these vaccines for? Who truly bore the brunt of these inequities? Why was it urgent to act now? I wanted to understand who was behind the numbers—the lives, the faces, the families. Landing in Mombasa marked my first time outside the developed world. I remember the drive from the airport vividly. It felt chaotic, alive, and strained all at once—tuk-tuks, motorcycles, cars, and pedestrians weaving through the streets with no apparent regard for traffic rules. At every stop, people approached our windows offering fruit, nuts, or handcrafted goods, desperate to make a sale. The struggle for daily survival was tangible. I watched silently from the backseat, feeling a complex mix of awe, guilt, and anticipation for what lay ahead in the hospital. During my first week, I was placed in the internal medicine ward, where we were introduced to Dr. Suhail, who guided us through patient rounds. One of the first patients we met was Margaret, a woman who had clearly suffered a stroke. I had been trained to recognize strokes as an EMT, but this was the first time I saw the reality firsthand: facial drooping, right-sided weakness, and expressive aphasia. Dr. Suhail explained that Margaret had been in the ward for about a week and was showing slow signs of improvement. Margaret could understand us but couldn’t speak. She lay motionless on a rusty bed, covered by a colorful blanket, with flies buzzing across her face. Her daughter, strong and vigilant, stayed at her bedside, advocating fiercely for her care—swatting flies, changing Margaret’s clothes, and reading aloud to her. When I asked Dr. Suhail how long it had taken for Margaret to reach the hospital after her stroke, he explained that many patients arrive well past the “golden hour,” when intervention might still reverse the damage. In neighboring Somalia, the average time to arrival for stroke patients is 16 hours (Sheikh Hassan). Many delay care due to lack of healthcare literacy or a belief that divine intervention will heal them (Kimani). As we continued our rounds, I began to notice the silence that filled the ward. Patients sat quietly, not using phones or engaging in conversation. It wasn’t peaceful—it was haunting. It felt like a collective understanding that not much could be done for them. Limited resources meant that Dr. Suhail had to prioritize only the most urgent conditions. Retroviral diseases, for instance, were often left untreated. Despite taking thorough histories and analyzing labs and imaging, there was often little he could offer by way of treatment. One moment that struck me deeply was meeting a 20-year-old woman with stage 4 cervical cancer. She was my age. No treatment was scheduled; she was only receiving palliative care and was expected to spend her final days on a deteriorating hospital bed under the beating sun. That image stayed with me—how unjust it felt that someone my age, with a potentially preventable and treatable disease, was forced to endure such a fate. Had the cancer been caught earlier, this woman might have a better prognosis. However, like many of the other patients we saw that day, she presented with an advanced-stage illness, and the opportunity for curative treatment had already passed. The internal medicine ward revealed a grim reality, yet within it, I also witnessed resilience and community. The patients, though suffering, created a comforting environment within the ward. They wore vibrant fabrics and their beds were covered in intricately patterned blankets. Family members looked after not only their loved ones but checked in on others in the ward as well. In the midst of helplessness, the community thrived. My second week was spent in the surgical department. I observed an array of procedures—from the placement of a ventriculoperitoneal (VP) shunt to a coronary artery bypass graft. On my first day, I watched a double valve replacement. Dr. Iqbal, a visiting surgeon, generously spent two hours walking us through the procedure. He explained that such surgeries are often the result of untreated rheumatic fever—something nearly eradicated in the U.S. due to access to antibiotics like penicillin (Cleveland Clinic). It was jarring to see complex, high-risk surgeries being performed for diseases that could have been prevented with basic, affordable interventions. This theme of treating symptoms instead of root causes recurred throughout the week. VP shunts, for example, are used to treat hydrocephalus, which can arise from neonatal infections like Streptococcus pneumoniae (Sakurai et al.). In many African countries, these infections go untreated due to limited access to antibiotics (World Health Organization). Similarly, I observed a spina bifida surgery—another condition preventable through folic acid supplementation, a standard and inexpensive part of prenatal care in high-income countries (Mayo Foundation). The reality is stark: in Africa, families face costly, high-risk surgeries for conditions that are preventable with the right public health measures. In a country where the health expenditure per capita is just $88.39 compared to over $10,000 in the U.S., bearing the cost of expensive, preventable procedures is unconscionable (International Medical Aid). It was a painful reminder that without robust public health infrastructure, expensive hospital interventions become the last resort for preventable tragedies. Even the operating rooms reflected the resource gap. During one open-heart surgery, a fly buzzed around the room. The presence of a fly during open-heart surgery wasn’t just a nuisance—it was a symbol of how drastically under-resourced the system had become. At one point, Dr. Iqbal requested an alpha blocker only to be met with silence—it wasn’t available. Instead, he instructed the anesthesiologist to improvise using a mix of saline and nitroglycerin. I later learned that Dr. Iqbal was a visiting cardiothoracic surgeon and had only been at Coast General Hospital for three days. Many doctors at the hospital split their time between public and private hospitals to make ends meet. Coast General, the largest public hospital in the region, has only one full-time cardiothoracic surgeon. As my time in Mombasa came to an end, I was left with a deepened sense of purpose, humility, and urgency. I witnessed physicians delivering care under unimaginable constraints, doing everything they could with the limited resources they had. I was struck by their willingness to teach and share knowledge despite the demands of their work. I returned home with renewed gratitude for the healthcare systems I had always taken for granted. Yet, I also returned with frustration. Why are essential resources being cut from USAID-supported programs in this region? I heard stories of emergency rooms without working defibrillators, CT machines being down, patients undergoing procedures without anesthesia, and common medications being out of stock. These are all solvable problems. Programs like PEPFAR (President’s Emergency Plan for AIDS Relief) are being significantly disrupted. PEPFAR has saved over 26 million lives since its inception and cuts to the program could put millions of additional lives at risk (UNAIDS). Additionally, PEPFAR alone employs 41,500 healthcare workers in Kenya, many of whom are now facing layoffs (Kenya News Agency). When international aid programs are cut abruptly, the burden falls on local communities who are ill-equipped to fill the gap, exacerbating health inequities and endangering the lives of many additional people. The future of healthcare in Kenya is unstable and it has me worried. The world has the tools, resources, and knowledge to fix this, but the will to help is eroding. This experience affirmed my commitment to global health—not just in theory, but in action. I now understand that to be a good healthcare professional is to care deeply about people and systems alike. It means advocating for equity, addressing root causes, and seeing the patient within their full human, social, and economic context. My hope is to one day contribute to the transformation of healthcare systems like Kenya’s—through better infrastructure, expanded access to care, and increased healthcare literacy. I am more determined than ever to be part of the solution.

My internship in Cusco, Peru, through International Medical Aid was an incredibly rewarding and transformative experience. From the moment I arrived at one in the morning, the in-country team went out of their way to ensure that we felt comfortable, safe, and welcomed. They checked in regularly, offered tips such as where we should get food or exchange money, and made sure we always had someone to turn to if we needed help. Safety was clearly a priority. Whether we were in the clinic, traveling to our placements, or exploring the city, I felt well-supported and informed about precautions. Accommodations were comfortable and clean, with a friendly and welcoming atmosphere that made it easy to connect with fellow interns. The food provided was both delicious and varied—meals reflected the local culture, which was a wonderful part of the immersion experience. Professionally, I learned so much through shadowing and observation in the local hospital and clinics. I gained a deeper understanding of how healthcare is delivered in resource-limited settings and saw firsthand the adaptability and creativity of medical professionals working with fewer resources. I especially appreciated the chance to engage with patients, practice my Spanish, and observe procedures that broadened my clinical perspective. On a personal level, this experience deepened my cultural awareness and reaffirmed my passion for medicine. I left Peru with a stronger appreciation for community-based care, a greater respect for global health work, and lasting friendships with fellow interns. The combination of meaningful clinical exposure, cultural immersion, and outstanding in-country support made this one of the most impactful experiences of my life. I am truly grateful for everyone who made it possible and would highly recommend this program to anyone considering a healthcare career. As an aspiring future healthcare worker, I believe that the opportunity to travel and experience other cultures and healthcare systems is extremely integral to a comprehensive education in medicine. Global health experiences provide valuable insight into how socioeconomic, cultural, and systemic factors can shape patient health and, as a result, their experience with healthcare. In July 2025, I participated in a three-week internship in Cusco, Peru, through International Medical Aid (IMA). The program placed me in local hospitals and clinics, where I observed patient care in a variety of specialties such as general medicine, obstetrics, pediatrics, among others. My goal was to gain a deeper understanding of how healthcare is delivered in a country different from the United States, particularly in rural and underserved communities, and to compare these observations to my experiences volunteering in rural Pennsylvania. Peru presents a unique healthcare landscape. While the Ministry of Health (Ministerio de Salud, MINSA) provides public services for citizens, geographic and economic disparities persist. Rural communities, particularly those in the highlands, face limited access to physicians, inadequate infrastructure, and significant travel times to reach care. Language and cultural differences, such as the use of Quechua rather than Spanish in some regions, can further complicate patient–provider communication. According to the Pan American Health Organization, these barriers contribute to higher rates of preventable disease and delayed treatment in rural populations (PAHO, 2024). During my internship, I witnessed the consequences of these barriers firsthand: patients who had waited weeks for care, difficulty explaining treatment plans across language divides, and the creative problem-solving of healthcare workers operating with limited resources. These experiences not only enhanced my understanding of global health disparities but also reinforced the importance of culturally competent, patient-centered care—principles I plan to integrate into my future career as a physician. As part of our education and lecture series with International Medical Aid, I learned that Peru’s geography creates significant challenges for healthcare delivery and patient care. The Andean highlands and Amazon basin contain remote communities where the nearest health facility may be several hours or even days away by road. Public healthcare is available through the Ministry of Health (MINSA), but resources are concentrated in urban centers such as Lima and Cusco—especially with the highest-level clinics only being found in the capital city of Lima. According to the World Health Organization, rural areas in Peru have significantly fewer physicians per capita than urban regions, and residents face longer wait times for both primary and specialty care (World Health Organization, 2017). One of my first encounters illustrating this issue occurred in an emergency clinic in Cusco, where two Quechua-speaking sisters arrived to visit their critically ill mother. Their distress was compounded by the language barrier—Quechua is Peru’s most widely spoken Indigenous language—and luckily, the nurse I was shadowing knew enough to help quell the sisters’ frustration and uncertainty. In another instance, while shadowing in general medicine, I met an older man suffering from a severe case of bronchitis. He had been ill for over a month before reaching the clinic, unable to access a physician sooner due to the distance from his rural home and limited transportation options. These experiences reflect a broader pattern in rural Peruvian healthcare: geographic isolation, limited infrastructure, and language barriers not only delay treatment but also erode trust in the medical system. Studies have shown that such barriers contribute to poorer health outcomes, particularly for preventable or manageable conditions (Houghton et al., 2020). Addressing these challenges requires a multifaceted approach, including expanding rural healthcare infrastructure, improving transportation networks, and increasing the availability of trained medical interpreters. Rural communities worldwide often face significant barriers to accessing timely and quality healthcare due to geographic isolation, limited infrastructure, and workforce shortages (Strasser et al., 2016). My experience in the rural area of Casacunca in the Anta province of Peru exemplifies these challenges. Located several hours from the regional hospital in Cusco, Casacunca is a community where many residents must navigate difficult terrain and scarce transportation options just to reach basic medical services. During my internship with International Medical Aid, I participated in a rural outreach clinic in Casacunca, which provided critical primary care services at a primary school directly within the community. This model addresses some of the obstacles residents face by bringing healthcare closer to patients, reducing travel time and associated costs. At the clinic, I observed patients presenting with a range of conditions, from chronic diseases such as hypertension and diabetes to acute respiratory infections—many of which had worsened due to delays in care. During one memorable case, I could only watch as a doctor diagnosed an eleven-year-old child with malnourishment after finding him 10 kilograms underweight and very small for his age. It was hard to watch, knowing I could not even offer verbal comfort as I was unable to speak the mother’s language as she walked away with her son looking utterly defeated. This experience in a remote rural community highlighted the importance of preventive care and consistent management in rural settings, which are often under-resourced. During this time, I also learned about Peru’s SERUMS program, where medical students are required to complete a mandatory one year of service in a rural or low-resource urban area. This year of service is a prerequisite for medical graduates who want to work in the Peruvian public health system or pursue a specialization. As someone interested in rural medicine, I found this program very compelling and found myself wondering why we do not have similar programs in the United States. My experience in Casacunca deepened my understanding of how rural outreach programs can mitigate healthcare disparities by improving accessibility and fostering trust within communities. It also echoed themes I had seen earlier in my volunteering with patients in rural Pennsylvania, where similar barriers (geographic, economic, and cultural) affect health outcomes. These parallels reinforced my commitment to practicing medicine that not only treats disease but also proactively addresses social determinants of health. My clinical experiences in both Peru and rural Pennsylvania have profoundly shaped my understanding of the multifaceted challenges that affect health outcomes in underserved populations. Witnessing firsthand the geographic, cultural, and systemic barriers in Casacunca, Anta, alongside my work at a rural hospital in Pennsylvania (Evangelical Hospital) and local outreach programs, emphasized the critical need for adaptable, patient-centered care that considers the whole person. These experiences have reinforced the importance of cultural humility and effective communication in building trust with patients. In Peru, I observed how language differences and cultural beliefs could complicate healthcare delivery, highlighting the necessity for physicians to engage respectfully with diverse worldviews. Similarly, in rural Pennsylvania, I see how religious and cultural norms influence patients’ healthcare decisions, reminding me that medical knowledge must be paired with empathy and contextual awareness. As an aspiring future physician, I am especially drawn to the holistic approach central to osteopathic medicine, which emphasizes the interconnectedness of body, mind, and community. This philosophy aligns with the lessons I learned abroad and at home—treating patients not merely as clinical cases but as individuals shaped by their environments and experiences. By integrating osteopathic manipulative treatment with culturally competent communication and community engagement, I aim to address both the physical and social determinants of health. Furthermore, my time with International Medical Aid has inspired a commitment to serving underserved and rural populations. I recognize that improving healthcare access requires not only clinical expertise but also advocacy for systemic change, including expanding rural healthcare infrastructure, enhancing interpreter services, and supporting community-based health initiatives. These goals will guide my future medical practice, ensuring that I contribute to reducing disparities and promoting equitable care. My internship with International Medical Aid in Peru offered far more than a glimpse into another healthcare system; it fundamentally reshaped how I view the practice of medicine. From the bustling clinics in Cusco to the rural outreach program in Casacunca, Anta, I witnessed the resilience of patients and providers working within the constraints and stress of limited resources. These experiences highlighted both the universality of health disparities and the shared human need for trust, respect, and access to care. When compared with my work in rural Pennsylvania, the parallels became strikingly clear: geography, culture, and systemic inequities create barriers to care regardless of national borders. Yet in both settings, I also saw the profound impact of providers who listened, explained, and treated patients with dignity. This reinforced my belief that the most meaningful medicine is practiced at the intersection of clinical skill and human connection. As I move forward in my medical career, I will carry with me the lessons of cultural humility, the importance of preventive and community-based care, and the value of addressing the broader determinants of health. I aim to practice medicine within a framework that aligns seamlessly with these insights, emphasizing the treatment of the whole person rather than just the disease. My goal is to apply this perspective in rural, underserved, and global contexts—wherever the need is greatest—helping to narrow the gaps in healthcare access and equity. The internship not only deepened my passion for medicine but also clarified my purpose within it: to serve as a physician who advocates for patients, bridges divides, and delivers care that is both clinically effective and profoundly human.