Capital Commentary is the weekly current-affairs publication of CPJ, written to encourage the pursuit of public justice.
Study Abroad and Health Professions Education
Study Abroad and Health Professions Education
By Jessica Ventura
October 27, 2010
Four years ago, I created a course for pre-health profession students at Gordon College. Most of these students have grown up in the US health care system and will go on to be educated in that mindset. My goal was for them to spend time abroad getting a taste of what health care means to the 80 percent of the world’s population living in developing countries . Study abroad is largely absent from physical and life sciences programs. Whereas 19 percent of social science students participated in overseas programs in 2012, only 8.4 percent of science and 3.8 percent of health professions students did the same. And only eight of the top twenty-five destinations where US students study abroad are developing countries. So we traveled to Copan, Honduras the first year with only four students: one pre-nursing, two pre-physical therapy, and one in physical education. I wanted them to see.
To see? Not to go give aid? People in the United States thought we were going on a mission trip. But this was not the case; this was a college course for credit. The students were required to purchase textbooks, I had prepared lectures and homework, and every day we either visited a site or had a guest speaker. The Honduran contacts I cold-called were puzzled: American students want a tour of our private hospital? Want to visit the chamber of commerce? That is all? Directors were perplexed but very receptive and set aside time to meet with us. We were not there to give aid. We were there to learn.
What did we learn in Honduras? We learned that there is no privacy in the public hospital where beds are often shared in large wards divided by gender and age. We learned that simple surgeries often cannot be performed because the hospital is not consistently stocked with sufficient oxygen or anesthesia, and that the further a clinic is from the big city, the less likely it is to be stocked with medicine. During a visit to a family clinic, we saw that money was not spent on sanitary paper items but rather patients shared hand towels in the restroom and pillowcases on the exam table. We also saw that general health education was lacking: a patient was told by the doctor to care for a sprained ankle by soaking it in warm water, a woman raising her child with Down's syndrome was doing it alone with no support system, and a teenage girl caring for her sister with severe cerebral palsy had learned outdated range-of-motion exercises that often do more harm than good.
We visited a school with classrooms that had thirty to forty grade school students each and saw how impossible it would be for the teacher to give individualized attention to students with special needs. As one teacher served the kids a midmorning meal of beans and rice, she told us that it was the only solid meal many of the children had each day, and that due to hunger, many could not retain what they learned in school. We learned that laws require businesses to employ a certain percentage of disabled workers, but that in Copan only an estimated 15 percent of businesses are registered and thus regulated. We walked narrow sidewalks that changed height in front of almost every business and imagined the difficulties people with movement impairments would have navigating their hometown.
We also experienced excellent hospitality and saw the Hondurans’ love for their countrymen. We attended a fundraiser that local students organized to raise money to aid neighboring villages. We met families with limited means caring for disabled loved ones at home. We looked, we listened, and we learned. We came to love the Honduran people and while we left without doing any service, we left with them in our hearts. Swiss physician Paul Tournier once wrote, “One who feels understood feels loved, and one who feels loved feels sure of being understood” . The Honduran people we met felt loved because we were there to listen to their stories and understand their struggles.
I have been encouraged to see an increase in programs that give future US health workers the opportunity to learn who their global neighbors are and the struggles they face. Many liberal arts colleges and nursing programs require all students to learn about diverse cultures, and the new Medical College Admission Test (MCAT2015) “recognizes the importance of socio-cultural… determinants of health.” As institutions of higher learning begin to recognize the value of understanding diverse cultures in our global society, the hope would be that participation in learning experiences like my seminar would increase and through it a better understanding of the diverse peoples around the world.
With increased multicultural understanding, US health workers can move past the “us and them” way of viewing doctors and patients from different communities and realize that their perception of the world is only one of many viewpoints. By gaining exposure to different health care systems, like my students did, they will better understand the difficulties immigrants may have navigating US health care and how clinics in the US can help support clinics abroad through partner programs, and thereby be better able to serve those constituencies.
- Jessica Ventura is an Assistant Professor of Kinesiology at Gordon College in Wenham, Massachusetts and co-inventor of a low-cost prosthetic ankle joint designed for fabrication and use in developing countries.
- United Nations, Department of Economic and Social Affairs, Population Division (2013). World Population Prospects: The 2012 Revision, Highlights and Advance Tables. ESA/P/WP.228
- Tournier, Paul (2000). To Understand Each Other. Westminster John Knox Press.
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Capital Commentary is a weekly current-affairs publication of the Center for Public Justice. Published since 1996, it is written to encourage the pursuit of justice. Commentaries do not necessarily represent an official position of the Center for Public Justice but are intended to help advance discussion. Articles, with attribution, may be republished according to our publishing guidelines.”