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Cacha Medical Spanish Institute – Afton Chavez, MD

Written by Afton Chavez, MD, PGY-1 at Kaiser Permanente Oakland Internal Medicine Program while on Global Health rotation at Cacha Medical Spanish Institute in Riobamba, Ecuador in March 2017.

I highly recommend this global health elective.  In just a two-week period (8 days of Spanish classes), my medical Spanish improved significantly.  The teachers at the institute are very professional and are excellent at teaching Spanish.  My professor had a degree in Linguistics and was incredibly

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Cacha Medical Spanish Institute – Eric Bautista, MD

Written by Eric Bautista, MD, PGY-3 at Kaiser Permanente San Francisco Internal Medicine Program while on Global Health rotation at Cachamsi in Riobamba, Ecuador in March 2017.

Global Health Background and Departing for Ecuador

I took off for Ecuador after my last night shift in residency. I left one of the most resource-rich and connected systems in the world and was off to experience medicine with much more limited resources. Being in a “developing country” is not new to me; my parents emigrated from the Philippines a year before I was born and I had spent some time back in the Philippines. I had also spent a summer visiting HIV organizations in India during college to investigate the impact of discriminatory laws against sexual minorities on the HIV epidemic there. Just this past year, I took a trip to visit my relatives in the northern tip of the Philippines. About a full day drive from Manila, it is a poor region of the Philippines that is not on the typical tropical tourist circuit. Having been to the Philippines multiple times in the past, I never recalled obesity as something I commonly encountered in trips in the past. This time was different. My family had asked many medical questions knowing that I was doctor: not about exotic tropical diseases, but about hypertension, hyperlipidemia, and arthritis. To me, “global health” for my family in the Philippines looked a lot like my practice in Kaiser. I was heading to Ecuador reflecting on this.

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Cacha Medical Spanish Institute – Brittany Kausen, MD

Written by Brittany Kausen, MD, PGY2 at Kaiser Permanente San Francisco OB/GYN Residency Program while on Global Health rotation with Cacha Medical Spanish Institute (CACHAMSI) in Riobamba, Ecuador from April-May 2016.

My first two days were spent in the Ob unit that carries all postpartum (12 cs beds, 12 vag delivery beds), antepartum (alto riesgo 6 beds), and early laboring patients. There are also separate rooms for pre-eclamptic patients that have big black curtains to make them dark with little stimulation – so as not to piss off the pre-eclampsia. Days start with table rounds at 7am followed by walking around seeing patients with the whole team which is a small army. There are approximately 6 interns, 2 resident doctors, one junior attending and Dr. Lino who is the chief. Dr. Lino quizzes everyone — on everything. From pre-eclampsia to doses of antibiotics to units on lab values. The level of training is very different here; interns are more like medical students on their first year of clinical rotations and the residents are more like interns. As a second year resident from the US, my depth of knowledge is probably greater than theirs especially on topics like pre-eclampsia, but having to answer questions in Spanish is a whole new challenge. My first day he quizzed me all about pre-eclampsia – questions I actually knew – but translating it into Spanish was difficult. I somehow got through

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