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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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Name, Insurance, and Neighborhood – Tessa Stecker, MD

Written by Tessa Stecker, MD Fellow with Kaiser Permanente Napa-Solano Community Medicine and Global Health while on rotation with Cachamsi in Riobamba, Ecuador in October 2015.

What is your name? Do you have insurance? What is your neighborhood? These three questions begin every clinical encounter in Riobamba.

The Ecuadorean health system has undergone an immense and impressive transformation over the last 15 years. Ecuador has become one of the leading countries in the region (and in the world) regarding healthcare efficiency spending (surpassing the U.S. by at least 30 spots on the world rank list). One of the reasons for this success is the strict adherence to patient centered medical homes. Each Ecuadorean is assigned a doctor/clinic based on his/her address and is expected to visit this clinic first except for in an emergency.

The clinic I’m assigned to this week reminds me of

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