Medical student rotation in Tarija, Bolivia

My name is Jenna Frantz, and I am a fourth-year medical student (just weeks away from graduating as an MD) at Wright State University Boonshoft School of Medicine. As I am preparing for my residency and career in emergency medicine, I am continually inspired by my foundational goal: to serve Hispanic patients facing barriers to healthcare, both domestically and abroad. When I found the rotation to Tarija, Bolivia, through Child Family Health International (CFHI), it was a great fit with my goals to obtain further education and experience in global health. I had previously rotated in Peru, Guatemala, Ethiopia, and Puerto Rico for service-learning opportunities (not affiliated with CFHI), and I could tell my experience with CFHI would be different. I was so excited for the stellar learning experience and cultural immersion provided by CFHI.

While still stateside, CFHI made sure I was well prepared for my trip logistically, culturally, and educationally. To facilitate this, there were multiple required online modules about the program, Bolivian culture, cultural sensitivity, and global health ethics. Additionally, the team remained in close email contact with me, and there was even a virtual orientation session to ensure I was prepared prior to takeoff.

Once I arrived in Tarija, I was immediately received with warm, kind smiles from Fabricio – the local program coordinator – and my host family. I got to live with a lovely host family for 8 weeks. The family had 3 daughters about my age, and they took me under their wing immediately, inviting me to hang out with their friends, to walk around the town, to go to the local cultural festivals, and so much more.

Aside from the amazing experience I had with my host family, I had a very comprehensive medical rotation. I rotated for 2 weeks in internal medicine, and 1 week in each of the following: rural primary care, urban primary care, Chagas’ disease clinic, emergency medicine, general surgery, and OB/GYN. I quickly found that the rotations through CFHI are not the same as my medical rotations in the United States – despite being fluent in Spanish, it is difficult to be fully-integrated into the care team as a foreign student where the documentation and work-flow are entirely different from the system in the United States. Furthermore, the local students had to start pre-rounding on their patients at 4-6am; as my scheduled arrival time to the rotation was at 7-8am each day, it was hard to be as fully-involved in patients’ care, since much of the decision-making took place in pre-rounds prior to my arrival. Despite this, it was not at all a barrier to my learning experience, but rather a shift of focus. My learning on this rotation was much more focused on cultural influences in medical decision-making, the influence of government in healthcare in a universal healthcare system, and navigating barriers such as broken equipment and out-of-stock medications.

Another amazing part of this rotation was the extreme kindness and generosity of the local physicians and medical students. Although they had absolutely no obligation to do so, they frequently invited me out to experience the beautiful nature and the lovely culture and customs in Tarija. While rotating in the rural clinic in San Andrés, the physicians took me to the river in the countryside after clinic to enjoy the gorgeous views and to take a dip in the water. At the urban clinic, the physicians invited me to hang out with them during the Carnaval Chapaco, as they wanted to ensure I could experience this great cultural tradition. While rotating in internal medicine, I became good friends with a local medical student, and she and I learned more about the local cultural importance of wine while we toured the local vineyards together. During my experience in general surgery, the residents invited me to get coffee, dinner, and to take a hike to the Chorros de Marquiri, the most beautiful waterfall I’ve seen in my life. All of these people went above and beyond, helping me to have an amazing time in Tarija, and it was truly one of the best parts of my CFHI experience.

My experience with CFHI was valuable and enjoyable learning experience, and I knew I had the constant support of my caring host family and the local team. I would highly recommend an experience through this organization for any students in the medical field who plan on having a career in international medicine.