Study Abroad in Multiple Countries

I wouldn't say I'm fluent in English but I do use it every day so I have a very good level. The course was easy to understand and with good information that was of a nice design. I learned many interesting things about teaching children.

My time in Cusco was amazing, and I really appreciated everything and all the staff who took care of us. Juda, Manuela, and Surabhi were all very helpful when it came to asking them questions about the program, and they were equally helpful when we asked questions about Cusco, such as restaurant or shop recommendations and how to navigate around the city. I have no complaints with any of the doctors; all of them were super nice and answered any of our questions. Particularly, Dr. Silva and Dra. Yadhira stood out to me, and I really liked their approach to medicine. Lastly, I participated in the Machu Picchu trek, and I want to shout out Hans and Raul, who were our guides. They were amazing and very accommodating. I am a slow hiker, so Raul stayed back with me and my friend so that we wouldn't get lost or be unsafe. They were also very fun and did karaoke with a few of us after the trek, which is forever going to be memorable for me. Overall, I have no complaints with any staff. I also want to shout out Victor for being the best driver, and all of the staff in the hotel for all their hard work. My experience being a pre-Physician Assistant intern through International Medical Aid (IMA) in Cusco, Peru is an experience I will be eternally grateful for—not only because it was a determining factor in why I want to pursue medicine, but also because I learned so much from the social and medical culture in Peru. A reason I applied specifically to the Peru location is because I never hear much about South America as a whole in U.S. media, and if I do hear about it, they only mention the “dangers.” However, the three weeks I have spent here gave me so much growth and knowledge about Peru. I was able to connect deeply with the mentors and other locals in the city of Cusco, and getting to talk to the doctors about their experience in the medical field was eye-opening. Coming to Peru was like finally understanding the expression, “Don’t knock it till you try it,” because all my preconceptions were erased and replaced with true knowledge of the culture and the socioeconomic structure. Ever since I was younger, I was always interested in the medical field, and as I grew up, I started to become more and more aware of how medicine is run in the U.S. I am lucky to have grown up in a household where we are able to afford sufficient insurance, so personally, I have never dealt with the hardship of large medical bills, but through personal research, I have learned how difficult it is for people of low socioeconomic status to get proper insurance and medical care. In the United States, healthcare is not free, but as I learned in Peru through our cultural presentation sessions, all Peruvians have the right to universal healthcare. Though I did not know this before coming to Peru, I was not shocked. It is rarer to see countries that do not provide free healthcare, such as the United States. One of the largest ongoing debates is whether the U.S. should pivot to a universal healthcare plan; some of the disadvantages include “significant upfront costs and logistical challenges,” while the advantages could create “a healthier populace and thus, in the long-term, help to mitigate the economic costs of an unhealthy nation” (Zieff et al., 2020). Due to the U.S. having an extremely advanced healthcare system that can offer some of the best care and procedures for extremely unique cases, many people disagree with the idea of offering a universal plan because it will create more complications in how healthcare should be divided. However, the latter perspective suggests that having an option of universal healthcare will create a healthier America and illness in our population will decrease. Furthermore, in Peru, the way healthcare works is that everyone has access to universal healthcare, but if they are employed, they can opt in to affordable insurance that gives them access to more advanced hospitals such as EsSalud, which is a division 3-1 center. The level of care there is not entirely comparable to the advanced care in the U.S.; however, these hospitals provide general and some specialized care, which is considered high level. The highest level of care in Peru is division 3-2. These centers contain sub-specialized fields and are only found in the capital, Lima, because it is the most populated city (International Medical Aid, 2025). This is unfortunate because if someone were to have a unique medical emergency, they would have to be rushed to Lima to get quality care, while in the U.S., it is common to live closer to hospitals with specialized care. During our time with IMA in Cusco, we also made a short trip to a nearby rural city called Casacunca, where we held a community clinic to help and provide medical attention to the citizens of the city. As we learned in our clinical debriefing sessions, most of Peru’s population is in the large cities such as Lima and Cusco, but there are a vast number of rural cities that, unfortunately, rarely get medical attention, so it was amazing that we were able to assist those who deal with this misfortune. Through my American perspective, I initially thought it was so unfair that people who live far from major cities hardly ever seek medical attention from doctors, and I believed it was almost diabolical that the government hasn’t expanded and created more large hospitals in these regions. However, as I learned by being in the rural cities in Peru, a lot of the citizens do not go to physicians and/or do not believe in Western science and instead prefer herbal medicines and advice from shamans/healers. This is because they strongly believe in the powers of traditional medicine, and access to it is more proximal (van Soeren & Aragon, 2016). In contrast, in Cusco, more people tend to turn to Western medicine because they have access to it, and the EsSalud hospital and many clinics we shadowed at are examples. In an even larger contrast, in the United States, we are the pinnacle of Western medicine—so much so that we try to cure anything and everything with medicine or medical treatment. The U.S. also spends the most out of all wealthy countries on healthcare, which allows us to have many advanced hospitals and medical technology throughout the country. However, we still see a lot of problems with the health of our citizens (PFPG, 2022). Even with this level of spending, we see high infant mortality rates, unmanaged diabetes, and more (PFPG, 2022). This shows that maybe Western medicine is not always the cure for medical problems, and instead there should be a balance between traditional and Western medicine. In one of my classes in college, I learned how if someone is pre-diabetic, instead of instantly starting insulin doses, they should invest in caring for their diet by cutting out artificial sugars and eating more protein. Ultimately, from my knowledge of Western and traditional medicine, I believe that they are both valuable and people should research both when they are looking for a “cure” to what they have. Additionally, through the IMA program, we had weekly presentation sessions, and in one session we specifically discussed the disease burden in Peru. One large takeaway I had from this presentation was that many people die from disease annually in Peru, and some of the main diseases that are killers in Peru are completely managed here in the United States. From the lecture, we learned about the most common communicable and non-communicable diseases found in Peru. Communicable diseases are transmitted between people or other organisms, and the common ones in Peru are malaria, dengue, tuberculosis, and acute respiratory infections (International Medical Aid, 2025). Non-communicable diseases are not spread from person to person, yet they arise due to the individual’s behavior, and the most widespread ones in Peru are hypertension, diabetes, and COPD in adults and anemia and malnutrition in infants/children (International Medical Aid, 2025). Two diseases that stood out to me from being in the lecture and staying in Peru for three weeks were tuberculosis and anemia. According to the lecture, there are about 27,000 cases of tuberculosis (TB) annually in Peru. In the U.S., we have less than half that rate annually, at around 10,347 cases reported by the CDC in 2024 (CDC, 2025). One possible reason that could explain why the U.S. does not experience as many TB cases compared to other countries like Peru is because of our widespread healthcare system. Again, as I have mentioned earlier, U.S. healthcare is considered to be one of the most technologically advanced and is well known for having extremely specialized care. This is most likely the reason why we do not see as many cases of TB, and if we do see them, there is less chance of it leading to mortality. In Peru, healthcare is not as widespread, and what I mean by this is that large hospitals with specialized or sub-specialized care are only seen in the most populated cities. If people are diagnosed with TB in a rural city, they will have to travel long distances to get specialized care in a hospital, and if they can’t afford the travel or do not have access to travel, they have to treat themselves the best they can. This is why TB is extremely prevalent in Peru specifically, and the reason why TB is one of the most deadly diseases in Peru, causing an estimated couple thousand deaths annually (International Medical Aid, 2025). This is why Peruvian healthcare should be more accessible, and this can start with the government allocating more funds to build more division 3 hospitals throughout the country, not just in major cities. Anemia was another disease that I became more familiar with through this internship. Working alongside the doctors and nurses in the EsSalud hospital, I learned that anemia has a different detection threshold in Cusco, Peru in comparison to the U.S. and even other cities in Peru, such as Lima, due to the high altitude. In Cusco, Peru, a detection of 11 mg/dL or below in the hemoglobin is considered anemic, but in the U.S. it is 13.5 mg/dL for men and 12 mg/dL for women (International Medical Aid, 2025; American Society of Hematology, 2025). The high altitude causes there to naturally be less oxygen in your blood because there is less oxygen in the atmosphere, and that is why anemia has a lower threshold in Cusco than in other cities/countries—because Cusco stands at about 12,000 ft, being one of the tallest cities in the world. Anemia is also highly prevalent in infants and children in Cusco, and this is due to malnutrition. Children in Cusco do not eat enough red meat and, in general, have poor nutrition, and I was able to actually see this while shadowing in the pediatric and nutrition departments. Fortunately, most of the doctors I worked with explained that anemia usually goes away after about 3–4 years of age, so it is able to be managed, but they did explain that malnutrition is something that is very common in infants throughout all of Peru, and this is the larger problem. Malnutrition comes with a lot more problems than anemia such as irregular bowel movements, thermal issues, dehydration, and even mortality. Chronic malnutrition in infants in Peru is at levels of 11.5%, and in the U.S. it is about 1%, which shows that our government has more control over infant malnutrition. However, according to the USDA, 1 out of 5 children in the U.S. lack food security, so the statistics on chronic malnutrition could be fluctuating regularly depending on the state of the economy (International Medical Aid, 2025; USDA, 2025). Ultimately, infant malnutrition should not be something prevalent in any country, and it should always be a priority that children have access to sufficient nutrition and meals. To conclude, my pre-Physician Assistant internship with International Medical Aid was life changing and taught me more about medicine and myself. I learned exactly how passionate I am about medicine, and I am grateful that I was able to learn in a new environment where I experienced medicine in ways that I have never seen or heard of before. Now, as I pursue my future career, my perspective on medicine and patient care has broadened, and this is for the better because I can approach medicine with the structured U.S. mindset and also the more interactive Peruvian mindset. I will always remember my time in Cusco, and I cherish it. Thank you for giving me this outstanding opportunity.