Research

Child Family Health International, Cordoba, Argentina

Summer Entrepreneurial Internship Program
Year of Funding
2017

This summer, I had the unique opportunity to pursue a clinical medical internship with Child Family Health International in Cordoba, Argentina. I studied hospital medicine in Latin America through various shadowing opportunities while discussing healthcare policy in Argentina with fellow residents and physicians, and taking medical Spanish courses and Argentine culture classes, as offered through my program. I rotated primarily through the infectious disease hospital and pediatric hospital in the city, which allowed me to compare and contrast health systems in Cordoba and apply my knowledge to my experiences abroad in Denmark, Nicaragua and within the United States. My medical Spanish classes have allowed me to expand my linguistic and cultural fluency, which will enable me to effectively communicate with a variety of patients in my future profession.

During my first month in Argentina, I worked at Hospital Rawson, a public infectious disease hospital in the southeast part of the city. Argentine healthcare is set up so that any person, regardless of citizenship, can visit a public hospital, free-of-charge. People go to public hospitals to receive chemotherapy treatment, pick up their medication, and receive immediate medical treatment. The idea is that healthcare is a basic human right, and people suffering from chronic illnesses should not be denied their medication because they lack the money or coverage to pay for it. This system, while theoretically sound, has a few drawbacks. The guardia in which I worked (basically an emergency room) is always teeming with people, and waiting to see a doctor for something nonurgent can take hours and hours. The hospitals also lack a lot of basic resources; I remember a day when a doctor used my phone flashlight to inspect a patient’s throat and ears.

The hardest thing to get used to in Argentina was the pace of life. For example, on nationally observed holidays, all of the shops are closed and I did not have work. This is very typical for Latin America; nearly all businesses close on Sundays and holidays. The first entire week of my time in Argentina, there was a transportation strike. The ‘colectivos,’ or buses, were not operating because the drivers were demanding higher wages. The bus drivers have a very powerful union in Argentina; most people depend on public transportation as their means of getting to work, and Cordoba is a rather large city. When bus drivers strike, the government usually gives in and negotiates with them within a day or two. This strike, however, lasted eight days. At first, I was really frustrated and angry; I was not able to work in the hospital, it was impossible to find an empty cab car, many businesses shut down because of lack of customers, and hospitals had few patients. After talking about this issue with my host, Stefi, she explained to be that Argentina has a longstanding history with inflation, and that this year inflation was particularly high.
Usually, the government match union workers’ salaries with the inflation rate, but this year they did not quite do that for the bus drivers. Unfortunately other labor unions are not nearly as powerful; some jobs are just too important to strike.

After the strike lifted, I resumed my activities in the hospital with increased vigor, and was thankful to see grocery stores open during normal business hours. Cordoba maintains the long-standing tradition of the ‘siesta’ between 12:30-2:30 pm. This has a large effect on the culture here; most people relax for those two hours, return home for lunch and a nap, and then return to work. Given this time off in the middle of the day, people often work until later hours, getting off of work around 8 or 9 pm. As you can imagine, dinner is therefore eaten much later than in America. The meals go as follows: a light breakfast before work consisting of medialunas (croissants) or galletas (cookies) with dulce de leche (which is a food staple here) and coffee. Then, during the siesta most people eat a larger lunch. Between 5 and 7 pm there is traditionally a “merienda” or midday snack, which resembles breakfast: medialunas, bread with meat or cheese, coffee, tea, and other sweet things. Dinner is served at the earliest around 8:30 PM. My host and I typically did not eat dinner until 10:30 or 11. On weekends, her friend Dani usually would cook dinner for a group of us before we went out, during which we did not sit down to eat until midnight.

My favorite part of the weekends was Sunday evenings, when my host and I usually go for a walk around the city. There is a plaza near her home, which has organized Tango/Bachata/Salsa dancing every Sunday night around 8 PM. I could get lost watching couples dancing and laughing along with the music, enjoying them despite the cold. This simple activity speaks volumes about life here; Argentine culture places a huge value on leisure time, on enjoying the simple things in life. While it may be frustrating at times that doctors spend the first hour of their shift drinking mate (an herbal tea passed around and shared with friends or coworkers), eating and catching up, or that stores close at the most inconvenient times, it is a reminder to take a step back… stop, and smell the roses.

After the initial excitement of my new adventure wore off, I began feeling sad. I was frustrated with myself for my English accent, something that immediately notified everyone of my identity as an ‘extranjera.’ I grew tired of the countless “Dale, Rubia!” and “De donde sos?” I would hear… all I wanted was to fit in. I found myself feeling as though I did not deserve to be in Argentina, and I felt guilty for not feeling more grateful for this opportunity and not making the absolute best of it.
But I am human. That is what I had to keep reminding myself. No one said this experience was going to be easy! Growth does not happen unless you are challenged, and I have definitely had my challenges in Argentina. After a week of moping, I finally resolved to reach out to friends and family for support. Bobby (a fellow Kellogg intern in Cordoba) was a great friend and supporter, and I enjoyed showing him around the city and introducing him to my Argentine friends.

After finishing my final rotation in Hospital Rawson, learning about Argentine healthcare and infectious diseases, I was eager for a change of scenery and to work in a hospital that had more resources and better organization. Alas, once I started my rotation in Hospital Pediatrico in July, I immediately knew this was the place for me. I spent most of my time there in the Sala de Terapia, which is the section of the hospital where long-term patients stay, and also houses the ICU. I had never really been interested in pediatrics, but after a few early mornings of rounds, I found myself visualizing a possible future working with children in this sector of medicine. One morning, I asked Martin, the doctor I was working with that day, what brought him into pediatric medicine. He smiled and told me that for him, it was incredible to see how resilient children are; one day, they can be lying on their beds, unable to move, and the next day they are running around giggling and tripping over their own feet. Some things are difficult to watch, but I am humbled to have had the opportunity to learn about pediatric healthcare and procedures in Argentina.

My rotations continued and I found myself embracing Cordoba and the Argentine way of life more and more. After discussing living situations with other CFHI interns, I realized that I got really lucky with my host situation. I lived with a 27-year-old woman, Stefi, who is a student at Universidad Nacional de Córdoba. I have had the opportunity to meet an incredible amount of people through her. Her friends have welcomed me with open arms, as did her family. We often visited her brother Manuel in Carlos Paz, a little pueblo in the sierras surrounding Cordoba. It never ceased to amaze me how welcoming and warm people were in Argentina, and how eager they are to learn more about myself and America.

I have also learned a lot about the education system in Argentina. The country offers free public college education to anyone; people from all over South America immigrate to Cordoba for its reputable universities. I have met students from Colombia, Chile, and Bolivia and all over Argentina. Moreover, the public universities are more reputable than the private ones, which may come as a surprise to many Americans. This is because the professors are paid better and have more resources at their disposal, so usually the best professors and professionals prefer to work at public institutions. To enter into the university, you must ‘rendir’ or ‘take’ an exam and pass. That is the only qualification. There are no formal applications, no letters of recommendation, no essays nor standardized exams. You take an exam in the topic you wish to study, and if you do not pass, you must wait a whole year before you can try to take it again. Cordoba is the student city of Argentina; there are a few universities in Buenos Aires, but arguably the most well-known and largest ones reside in Cordoba.

Being in Argentina also made me realize how fortunate I am to have had the opportunity to travel the world. When you attend Notre Dame, traveling to other countries or hearing about people’s experiences abroad is normal, and so it sometimes loses its uniqueness. I was surprised to learn that many people have not even been out of Argentina let alone off of the continent. Traveling for Argentine people is very expensive, especially since their pesos are so devalued. Apart from that, it can be extremely difficult to receive a visa to travel, especially to places like the United States. My host once told me that if she wanted to visit the United States, she would first have to fly to Buenos Aires to apply for a visa, which costs a lot of money. Then, the application process would include grueling interviews and analyses of her life, her income and a ‘risk assessment’ of sorts regarding her inclinations to stay illegally in the United States if Argentina granted her a visa. Especially with this new presidency, it is becoming increasingly difficult for Argentines to travel to the United States. I am even more grateful for my opportunities to travel and experience the world, because I now recognize that most people cannot even dream about doing the same.

My weekdays were extremely busy, what with medical school application season in full swing and responsibilities both within the hospital and outside of the hospital (my medical Spanish classes). After the hospital, I would come home to eat a quick lunch and begin filling out endless secondary applications. The process itself was stressful and draining, and was very difficult without my mom or family in Argentina, but I believe that it made me stronger and more independent. In the evenings, I would often cook dinner for my host and I, and we would stay up talking in Spanish about our days, our dreams, and our passions. Whenever I found time, I attended Zumba classes at the local gym. I loved dancing with Latino women, listening to Reggaeton music and singing along. I fell in love with the vibrancy of the culture in Argentina; the slower, more relaxed way of life, and the focus society puts on spending time with friends and family.

Overall, my two months in Argentina have been the most incredible experience of my entire life. I am so grateful to have had the opportunity to study hospital medicine in this country, and to learn as much as I did about the culture. As with any experience, there have been ups and downs. Traveling to a different country and immersing yourself in a completely different culture is difficult, but so rewarding. I have returned to the United States with a linguistic and cultural fluency that a classroom simply cannot teach; I have attained openness to the world and a desire to continue understanding people’s thoughts, values and decisions as a function of their culture. This is the most important skill I have acquired as a future physician. I believe that as a future medical professional, it is imperative to understand your patients holistically, not just as a set of symptoms. I believe that treating your patient effectively can only be done if you understand your patients and foster a trust that stems from compassionate care. My experiences in Argentina have definitely prepared me for this aspect of my work, and have ignited a fire in my heart that strives to continue incorporating global health and contributing to sustainable global initiatives as my career unfolds. I will forever cherish the memories I made during my time in Cordoba, and am thankful to Kellogg for allowing me to have this experience.

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