Group Discounts for groups of 4 or more may be available for CFHI programs. If you have a group of 4 or more people that are interested in applying contact students@cfhi.org for more details.

• Application Fee: $95
• Program Fee 2010: $2195
• Program Fee 2011: $2395

 ANNOUNCING 2011 PROGRAM DISCOUNT- Submit your CFHI 2011 program application before August 16th 2010 and pay 2010 fees for any January-May 2011 program. This is an average savings of US$200 for most programs.

* Please note that this discount will be applied to your final program payment fee after September 1st, 2010.

Payment Schedule: The application fee is charged upon application to the program. Within 2-3 weeks, applicants will be accepted or rejected for participation in the program. Upon acceptance, a transferable, but non-refundable deposit of $350 is due within 30 days. The final balance of the program fees is due 6 weeks prior to your program date.


* For equivalent costs in other currencies please click here for currency converter.
Please note that all bank check or money order payments must be made in U.S dollars only. Credit card payments are converted to U.S dollars automatically.

Fundraising

Scholarships may be available depending on budget allocation each year. Please visit the scholarships page for the latest information/availability for CFHI scholarships.

Once accepted, students may also do their own fundraising through Firstgiving.org.  Please click here to view a sample fundraising page. Please note that some important restrictions apply to funds raised through Firstgiving.  To review the terms of use, click here.


What’s included?

• Pre-departure and on-site orientation materials and guidance
  
• Two meals and a private room with a homestay family for the program’s duration (Saturday – Saturday). The local coordinators will charge you for additional nights outside the program dates.
  
• International Emergency Medical and Medical Evacuation Insurance
  
• Airport pick up on arrival
  
• Twenty hours of Spanish classes. Additional language training beyond 20 hours: $6/hour
  
• All preceptor, hospital and coordinator fees
  
• Weekly meetings with coordinator and Medical Director
  
• A limited number of extra activities such as salsa classes, cooking classes organized at the language school etc.
  

What’s not included?

• Airfare to Quito, Ecuador
  
• Airport Drop-off
  
• Passport or visa fees
  
• Inter-city transportation between Quito and Puyo
  
• Local transportation to and from clinic sites
  
• Other expenses of a personal nature like weekend and after-hour activities. This includes but is not limited to local transportation, tourist trips in and around Quito or Puyo, and any personal expenses incurred.
  

During the first week of the program, students will be in Quito, the capital city of Ecuador. It is a lively city of nearly 1 million inhabitants from all walks of life. For the remaining three weeks of the program, students will be based in Puyo located in Pastaza Province. Puyo is a small city with 28,000 inhabitants in the jungle about 6 hours by bus from Quito. Although it is a rural town, Puyo does offer modern conveniences such as internet, cell phone services, banks and many other touristic attractions. In Puyo there is a large indigenous population (Kichwas, Shuar, Achuar, Shiwiar, Huaoranni and Zapara). The Community Medicine program also will take students into rural villages and communities in the Pastaza area.

• Photos
• Practical Information
• Recommended Vaccinations
  

• Wikipedia
• Official Quito Site
• Wikipedia Puyo
• Ecuador: A country study
• Recommended Books on Ecuador
  
  

• For information about Ecuador's health indicators provided by the World Health Organization, please click on the following link: WHO-Ecuador
  

Language Ability
This program is open to those who possess:

• Conversant Spanish
  
• Fluent Spanish
  
• For those who are not completely confident with their language skills before participation in the program, we strongly recommend that you arrive at your program site early and pay extra for additional Spanish instruction before you begin the CFHI program. If you have Minimal Spanish skills and still wish to participate in the program, please call our office before applying.
  

This program is open to participants who are 21 or over at the time of participation.We accept students of all nationalities with interest in international health and relevant educational background. Participants may be any of the following:

• Medical Residents, MD & DO
  
• Medical Students, MD & DO 1-2
  
• Medical Students, MD & DO 3-4
  
• Senior level Pre-Medical Students
  
• Post-bacc pre-medical students
  
• Gap year pre-medical students
  
• Graduate nursing students
  
• Nursing Students
  
• MPH Students
  
• Physicians Assistants Students
  
• Naturopathic students
  

The following hospitals and clinics are a sample of possible rotations during this program. Restrictions may apply for pre-clinical, pre-med, and those students with minimal Spanish skills.

CFHI's rotations are designed to offer you clinical and observational experiences relevant to your level of medical education. CFHI programs can be predominately observational depending on your previous clinical training, your level of Spanish, local laws that prevent foreigners from directly providing healthcare services and whether the preceptors who will be supervising you trust your clinical skills. Rotation availability depends on local conditions.

This program focuses on a holistic approach to community medicine in rural areas including indigenous health. Participants will gain exposure to common diseases such as: scabies, fungal infections, parasites, malaria, diarrhea, pulmonary infections, pneumonia and TB, as well as public health issues facing the community. Please note that in Ecuador the doctors only receive pay for 4 hours per day and usually only in the mornings or early afternoon.

QUITO

Hospital Carlos Andrade Marin del IESS
During the first week in Quito, participants will get a chance to rotate at Hospital Carlos Andrade Marin del IESS (Instituto Ecuatoriano de Seguridad Social). To visit their website, click here. This semi-public tertiary hospital includes all specialties (Área Materno Infantil, Servicio de Estomatología, Servicio de Oncología y Radioterápia, Servicio de Neurología, Servicio de Nefrología, Servicio de Urología, Servicio de Gastroenterología, Servicio de Oftalmología, Servicio de Obstetricia, Servicio de Cardiología, Servicio de Rehabilitación, Cirugía General, Centro de Alto Riesgo Obstétrico, Comité de Infectología).

PUYO

Hospital Voz Andes de Shell
Hospital Voz Andes de Shell is located in the village of Shell, about a 10 minute bus ride from Puyo. It serves the city of Puyo and its surrounding villages. The facility is a non-profit and non-governmental organization run by American missionaries and primarily serves a low-income population from Puyo and surrounding villages in the jungle. Most patients receive free or low cost healthcare at this facility. The hospital has 35 beds and offers the following services: medicine, surgery, internal medicine, OB/GYN, E.R, and hospitalization. They also preform surgeries and endoscopies. Students will rotate with local physicians at this facility.


Servicio Nacional de Erradicacion de Malaria (SNEM)
This is a small, under-funded center charged with combating malaria in three provinces, including Pastaza, covering a vast area of the Ecuadorian Amazon. At this site, students will help in compiling malaria statistics and research outbreaks in the Amazon. Students studying for a Masters in Public Health are welcome to participate in research projects if they are interested.

Indigenous Community visits
Students are invited to visit and experience a local indigneous community first-hand. Participants will learn about the health of the Shuar culture. Students will learn about the importance of plants for the Shuar: to flavor food, heal wounds, cure headaches, to fish, to sow and harvest fruits and vegetables, to hunt; in general, to survive in the jungle and continue their way of life. Participants will also have the opportunity to learn about Shuar culture and family life. For instance, that Shuar men may have as many as four wives and ten children with each wife.

Click here to view video footage taken by a CFHI student during a site visit to an indigenous community.

Disepensario del Vicariato
Disepensario del Vicariato is located in the center of town. It is an ambulatory service outpatient clinic with two general medicine doctors, one odontologist and one OB/Gyn. It is run by Catholic charities and receives no government funding. Healthcare services are provided to the general public, for this reason students may be able to observe many different types of pathologies, especially tropical and rural ones. The daily numbers of patients ranges from 8 to 20. Students will rotate with local physicians. The hours of operation are from 9:30 AM to Noon and from 2:30PM to 6 PM.

Seguro Social Campesino
Seguro Social Campesino is a non-profit organization that provides healthcare services in rural areas. It is comprised of several clinics located at various communities that are 1 to 2 hours away from Puyo. Among these are Madre Tierra, San Jose, Capricho and Vencedores, which offer primary healthcare services, odontology, as well as house and community outreach visits within the designated area of each clinic. About 8 to 16 patients are seen at each of these clinics daily.

Centro de Saludo El Dorado
Is a government-run rural primary healthcare clinic, located in the city of Puyo, which offers all Public Health Ministry services and programs. Each doctor at the clinic see between 8 to 20 patients daily. Services offered include primary healthcare services, odontology, as well as house and community outreach visits. Participants are generally encouraged to participate and provide healthcare education presentations for patients at the clinic and communities they may visit with local preceptors.

Fundacion Casa de Fe
Is a non-profit orphanage located near Puyo. Participants are encouraged to help provide care for the children and promote early stimulation. Around 40 children can be found at this orphanage. Participants are able to help by providing an extra set of hands which are usually sorely needed.

All rotations are subject to change depending on local availability and general Ecuadorian holidays. Local coordinators will try and make alternate arrangements if a particular activity or facility is not available during the program month.

CFHI is a nonprofit organization committed to providing students a unique opportunity to experience another culture and healthcare system in a responsible way. Though we work closely with our global partners to provide you the best possible trip, the nature of international travel means that we cannot anticipate all challenges that may occur. It is important that participants realize they must remain flexible in the face of situations that may be difficult to understand. Participating in a CFHI program means that you are an informal ambassador to the community you visit and your professional behavior is of the utmost importance.

Child Family Health International (CFHI) offers service-learning programs around the world. CFHI would like to stress to prospective applicants and institutional partners, that service-learning is not an episodic volunteer experience, and our student programs are not designed to provide service to those who would otherwise not have healthcare. The main objectives are to broaden your public health knowledge, experience a different culture, and develop creativity in problem-solving. CFHI has assembled a global family of outstanding local healthcare professionals who are at the forefront of healthcare delivery in their countries. You will have the rare opportunity to shadow these unique women and men observing and learning to work in a clinical and public health environment with limited diagnostic and therapeutic resources.

1. What problem do we address?

2. How do we address the problem?

3. How does the community benefit?

4. How do participants help in the clinic?

5. What kind of educational experience is the CFHI global health elective?

6. What are the objectives of the program?

7. Where do CFHI students come from (past participants' universities/colleges)?

8. What role can domestic Institutional Partners (universities, collaboratives, et. al.) play?

9. What is Service-Learning?

1. What problem do we address?

In today’s world we often see the uneven distribution of healthcare that leaves many impoverished communities underserved. Economic, political, and social factors all contribute to people’s access to healthcare, both internationally and at home. Increasingly, we need culturally and linguistically competent healthcare providers around the world to address these inequities.

2. How do we address the problem?

Child Family Health International’s (CFHI) Global Health Service-Learning Programs combine instruction, experience, service, and reflection to create a model that supports physicians and clinical sites abroad, addresses the healthcare needs of the underserved, and adds an unforgettable experiential element to each program participant’s education.

CFHI programs bring service-learning to hospitals and clinics around the world, allowing participants to gain insight on the contextual constructs of illness and healing in foreign settings. Program Alumni return from the host country with new perspectives on healthcare systems and delivery in places where resources and supplies are extremely limited. To read further on the potential benefits of international experiences for health students, we recommend the paper “The Effect of a Global Multiculturalism Track on Cultural Competence of Preclinical Medical Students” by Godkin and Savageau (2001).

Since 1992, CFHI has arranged for nearly 4,000 pre-medical, medical and other students of the health professions, from over 400 top universities in the and the world, to work and study in Bolivia, Ecuador, India, Mexico, and South Africa

3. How does the community benefit?

While a student’s ability to practice medicine may be limited by clinical knowledge or language skills, the participant’s contribution to the community is not an illusion. For example, we provide each participant with a box of donated medical supplies to carry with them for distribution among partner facilities. In addition, our partner physicians at each program site are compensated for their willingness to mentor CFHI students. This supplementary income promotes job retention in countries where physicians are paid small salaries, often by financially strapped governments. Furthermore, the exchange of information between students and their preceptors provides an invaluable experience for participants, the patients, and the physicians.

4. How do participants help in the clinic?

Each of our program sites has many locally qualified and experienced healthcare providers, so the participant’s primary motivation for participation should not focus on a concept of humanitarian aid, in which one expects to provide medical care to people that would otherwise not receive it. The participant’s main objective should be to actively observe, according to current language abilities, level of training, and local laws, in order to develop a high level of community health awareness. While abroad, this happens in the social and cultural context of the program site.  Child Family Health International (CFHI) would like to stress to prospective applicants and institutional partners, that service-learning is not an episodic volunteer experience, and our student programs are not designed to provide service to those who would otherwise not have healthcare.

5. What kind of educational experience is the CFHI global health elective?

CFHI's rotations are designed to offer you hands-on  or observational clinical experience (depending on your clinical and language skills as well as local laws), much like what you would experience during a rotation in the . The program includes the following educational aspects:

• Pre-trip orientation materials & web conference opportunities
• Orientation upon arrival, including cultural adjustment exercises
• Weekly meetings with Medical Director and Local Coordinator
• Clinical rotations Monday-Friday, excepting holidays or work stoppages, working with a local physician who has opted to participate in CFHI as a teaching preceptor.
• Information sessions that highlight the health care system in that country, common cases you will encounter and other site-specific information.
• Post-trip debrief materials & other on-going alumni activities/services

If you are attending a program in a Spanish-speaking country, we recommend you study as much Spanish as possible before you go, as it will greatly decrease your personal frustration during the CFHI experience. Most activities listed above will be conducted in Spanish, except for the orientations and alumni services.

MD Consult and FIRST Consult bring the leading medical resources together into one integrated online service to help physicians efficiently find answers to clinical questions, make better treatment decisions, and stay abreast of recent developments. MD Consult has been adopted by over 90% of North American medical schools and by over 1,700 health care organizations in 46 countries worldwide. FIRST Consult offers an evidence-based resource for the Point of Care, peer-reviewed content and a differential diagnosis tool.

(Please view the FAQs on the right had panel for more information)

6. What are the objectives of the CFHI Service-Learning program?

CFHI’s International Health Service-Learning Programs help participants:

• Develop a larger sense of cultural competency
• Observe and develop existing clinical skills
• Broaden public health knowledge
• Develop creativity in problem-solving
• Deepen their commitment to service
• Promote medical supply conservation

Prospective participants may apply online. Our participants are 21 years of age and over, come from around the globe, and are dedicated to a diverse array of professions in health.

7. Where do your students come from (past participants' colleges/universities)?

CFHI has provided global health education programs to nearly 4,000 health science students since 1992.  Our participants come from over 35 countries and 400+ of the most prestigious universities in the world, and represent a huge variety of the medical profession’s student population.

8. What role do domestic institutional partners (i.e. universities, collaboratives) play?

In addition to providing quality programs for individual students, CFHI is dedicated to building relationships with institutions of higher learning for relevant international programs. Creating and sustaining international programs is a long-term and labor-intensive process. Our international partnerships with physicians and clinic sites are established and reliable, and CFHI can offer the expertise needed to administer an international program to match institutional needs. Some of our current partnerships include:

• Princeton University—Health Professions Advising Office and the Pace Center for Service-Learning: CFHI developed a domestic and international health service-learning program that combined 5 weeks of international work in Quito, Ecuador with 40 hours of service in Spanish-speaking health centers in urban New Jersey.

• Oregon University System—IE3 Global Internship program: CFHI designed 11-week clinical internships in and that focus on cultural competency and valuable clinical experience within the structure of an internship. The internship promotes planning and goal-setting for students in the clinic setting.

• College Corps—CFHI currently working with College Corps, a project started several years ago by Harvard University undergraduate students, to offer 8-week programs in Bolivia, Ecuador, India, Mexico or South Africa, for pre-med students.

• University of California Davis—has teamed up with CFHI to offer a quarter-long study abroad program in Oaxaca, that highlights Latino/a Health Internship Program for undergraduate students. This course is certified by the university as a 20-unit course entitled "Bi-National Health".

If you are an administrator and would like to discuss partnership possibilities we would be excited to hear from you! Please contact Program Staff at CFHI at students@cfhi.org or by phone at (415) 957-9000 and ask for Nick or Amanda.

9. What is service-learning?

Child Family Health International (CFHI) would like to stress to prospective applicants and institutional partners, that service-learning is not an episodic volunteer experience, and our student programs are not designed to provide service to those who would otherwise not have healthcare.

The following is an excerpt from the Campus Community Partnerships in Health (CCPH) website (http://depts.washington.edu/ccph/):

Service-learning is a structured learning experience that combines community service with preparation and reflection. Students engaged in service-learning provide community service in response to community-identified concerns and learn about the context in which service is provided, the connection between their service and their academic coursework, and their roles as citizens.

Service-learning differs from traditional clinical education in the health professions in that:

• Service-learning strives to achieve a balance between service and learning objectives - in service-learning, partners must negotiate the differences in their needs and expectations.

• Service-learning places an emphasis on addressing community concerns and broad determinants of health .

• In service-learning, there is the integral involvement of community partners - service-learning involves a principle-centered partnership between communities and health professions schools.

• Service-learning emphasizes reciprocal learning - In service-learning, traditional definitions of "faculty," "teacher" and "learner" are intentionally blurred. We all learn from each other.

• Service-learning emphasizes reflective practice - In service-learning, reflection facilitates the connection between practice and theory and fosters critical thinking.

• Service-learning places an emphasis on developing citizenship skills and achieving social change- many factors influence health and quality of life. The provision of health services is not often the most important factor. In service-learning, students place their roles as health professionals and citizens in a larger societal context.
  
  

Citation: Seifer SD. (1998). Service-learning: Community-campus partnerships for health professions education. Academic Medicine, 73(3):273-277.  

Medical Director
Dr. Wilfrido Torres has worked with CFHI for several years in various capacities in the Amazon region of Ecuador. He will be your Medical Director in the Community Medicine program. Currently he is the Program Coordinator of the Chagas Control Program of the SNEM in area II (Pastaza and Napo Provinces). He is also a Continuing Assitance and Medical Educacion Coordinator of the Diabetic Association of the Province of Pastaza.
Dr. Torres has extensive experience with the local population. In the past he has served as the primary care provider in the village of Pitirishca and ran a CFHI training program for health promoters in the surrounding villages. He has performed hundreds of village visits requiring hours of trekking through the treacherous Amazon jungle.

Local Coordinators
Amazing Andes Language School is where your Spanish classes and weekly meetings are held. Ms. Rosa Tamayo and Ms. Francia Ducos run the school together. The women were interested in creating a responsible small business that would support the local economy and generate employment. Rosa Tamayo has been hosting visiting students from the U.S. and Europe in her home for several years. She is the homestay coordinator for the Quito program. Lorena Bermeo Rivera recruits and trains Spanish teachers, and develops the Spanish language curriculum for CFHI students, and those students with special needs.

In Puyo, Viviana Torres, Dr. Torres's wife, will act as the local coordinator, providing homestays, guidance such as assistance with transportation and any other information students may need.