Finishing up my school year, I needed time to step back from my current lifestyle and gain perspective on my hectic pathway to medical school. Why was I pursuing medicine? Was it really worth all of the time and stress? I was absolutely passionate about medicine, but I wanted to be reminded of why. I went to Costa Rica to learn Spanish and better myself as a future doctor, but it undoubtedly exceeded these expectations. Costa Rica left me with an experience that not only changed my perspective on life, but completely solidified my desire to study medicine.
I went to Puntarenas, Costa Rica for a five week intensive Spanish program. Since Spanish is my second major here at WSU, I knew taking a step away from the lab and upper level sciences to focus on Spanish would be beneficial. I took rigorous classes like Spanish conversation, as well as fun classes like Latin American dance. I arrived in Costa Rica as a beginner Spanish speaker and was pleasantly surprised when I could hold a fluent conversation with a Spanish speaking woman on my flight home. I am a strong believer that if you want to grow, you need to stretch yourself. Putting myself alone in a country where I was not comfortable with the native language absolutely did this for me.
My life in Costa Rica consisted of the perfect amount of work and fun. Like many other pre-health students, I always have to be doing something productive. Studying abroad gave me a nice mix of a healthy course load with plenty of time to enjoy the culture and “Pura Vida” lifestyle that Costa Rica had to offer. My favorite memories had to be with my host family. I was worried when I found out my new parents and two sisters did not speak English, but I would not have changed a thing about my living situation. I came home every day to my six-year-old sister yelling “playa, playa!” and I would throw her on my back as we went across the street to the beach to build sand volcanoes. I even taught her how to swim! My family treated me as their own. They were protective over me, fed me very well (they owned a restaurant), and made it their mission for me to enjoy my time. I’m counting down the days until I get to see them again.
Costa Rica is filled with natural beauty and adventure. My weekends consisted of snorkeling in bioluminescent waters, rappelling off of 13-story waterfalls, and relaxing with volcanic mud baths and hot springs. The sights I saw, adventures I went on, and people I met made my trip unforgettable. However, the amount of begging and sick people on the streets opened my eyes to the poverty that lied behind the beach. This humbling experience gave me a new perspective on the need of medicine outside of the US. This awareness of medical demand in third world countries inspired me to go abroad and help in any way that I can. I left with a heavy heart to serve and realized that medical missions would be a priority of mine in the future.
Taking a step back and gaining perspective on my life was one of the best and most rewarding decisions I have ever made. This experience even further enhanced my drive to become a doctor. I embraced another culture and made it my own. I learned to “tranquila” and not stress about situations that were out of my hands. I started taking one day at a time and feeling blessed to do so. I realized the impact we can have on people by just keeping a positive and uplifting attitude. I will utilize everything I gained from Costa Rica when I’m a doctor, from my Spanish skills, to cultural competency, to keeping a positive and less tense outlook on life. This study abroad experience was exactly what I needed to push me toward my dreams in medicine.
Cultural differences between the U.S. and Sénégal are many and varied, as are the similarities. In Sénégal, dinner is traditionally eaten using one’s right hand from a large communal bowl on the floor—though my host family was kind enough to give me a spoon every night, as eating rice with my fingers is not my forte. Ceebu jen is the national dish, which translates from Wolof as “fish with rice” and is an accurate descriptor of much of the Senegalese diet, though food is more varied in the capital, Dakar. The Senegalese are far less talkative during meals than Americans, preferring to focus on the food; no one in my host family drank anything during dinner, as the Senegalese believe that drinking before you are full will fill you up. Mangoes and juice (in a range of tasty flavors I hadn’t encountered before, including ginger root, hibiscus flower, and baobab-with-milk) are after-dinner treats. Filling me up with food was my host mom Maguette’s perennial goal—I heard the command “Lekkal!” meaning “Eat!” so frequently my two-year-old host sister thought it was my last name, and I always followed it gladly. All this is part of the concept of teranga, a source of national pride that can be roughly translated as “hospitality.”
I planned to spend my summer in Dakar, Sénégal as a study-abroad student, taking classes in Islamic History, Wolof, and Public Health. But when I got there, I was introduced to an opportunity I couldn’t refuse—a bilingual internship at the Global Research and Advocacy Group (GRAG). GRAG’s work focuses on collecting information about women’s and sexual health in Sénégal and other countries in West Africa.
I had the opportunity to work on two projects while interning for GRAG. The first was an interview research project done in partnership with the University of Washington. It used a mixed-methods approach to examine who were the influential and decision-making people involved in deciding whether or not to cut young girls (in a process known as Female Genital Mutilation/Cutting). Basically, we conducted group and individual interviews to try and see who in the village holds the most power over FGM/C-related decisions. As the interviews were conducted in the local language (usually Wolof), I worked as a translator—the interviewer would give me the questions and responses in French, and I would record them in French and English.
The most striking thing I remember from these interviews was women’s assured insistence that cutting their daughters was beneficial. There was a sense of hypocrisy, as women declared that there were absolutely no downsides to the procedure and subsequently praised their increased access to antibiotic medications. For anyone unfamiliar with FGM/C complications, they are extensive, including but not limited to pain during sex, menstrual problems, increased odds of complications during childbirth, and increased rates of newborn death. Though at 26%, FGM/C is not as prevalent in Sénégal as it is in other countries (over 96% of Egyptian women are cut), over one-quarter of the female population being cut in a procedure with no medical benefits is far too high.
The second project I worked on was concocted with Anna Cissoko, a UCSF student originally from Dakar and GRAG’s other summer intern. After reading papers about West African public health and development, we decided to focus on one question: What do Dakar students know about the biological and medical aspects of sexual health, and where did they get this information? We designed a list of interview questions to answer our query, and then Anna and another research team member, Aminata, conducted the interviews with both middle and high school students. We decided that the interviews would be most successful if I (the obvious foreigner) stayed behind—this was a lesson learned from the earlier, FGM/C interviews: women reported being less comfortable (and therefore less open) in their interviews when men or non-Senegalese women were present. When we looked back over the results gathered in the student interviews, the trends that emerged were striking, if not surprising. There was a serious lack of knowledge about almost every topic touched on by the interview questions; many students were unfamiliar with even the term “contraception.”
When I left Dakar at the end of the summer, the report Anna and I had constructed from the results of our interview was being expanded into a larger-scale study, with the hope of presenting further results to the Senegalese Ministry of Health. I was able to be a useful member of a team researching topics I was passionate about, and my experience with GRAG has altered the health career path I plan to take. It opened my eyes to the realities of challenges facing progress in women’s and sexual health in a global context, and made me all the more passionate about fighting these challenges. I came to the realization that if I want to spend my medical career helping women, public health aspects including health education and health advocacy are just as important as clinical care. In the future, I plan to pursue a Master’s in Public Health in addition to a medical degree in order to best take care of my future patients.
By Maranda Clark
This summer I was fortunate enough to be able to travel to Thailand and volunteer at an elephant sanctuary/wildlife refuge called Wildlife Friends Foundation of Thailand (WFFT) for 2 weeks with 2 of my best friends. We worked 6 days per week starting at 6:30 am until dinnertime at 5:00pm. The work was physically and emotionally demanding, the weather was hot and terribly humid, and it was one of the best experiences of my life.
I did a lot of work prior to the trip to make sure I was as prepared as possible for anything. I read every line of every page on WFFT’s website at least 3 times, so I was fairly certain I knew what to expect: hard work, play with elephants, repeat. What I didn’t see coming was how much my short trip would affect me.
Upon arrival, we visited all of the animal enclosures, and the tour guides (long-term volunteers at WFFT) would tell us the animals’ backstories. An astonishing majority of them had started out as someone’s pet and were ultimately relinquished because they became too much for the person to handle. Animal welfare laws in Thailand are not what they are in the United States. Wild animals are captured as infants and sold as objects for profit. For some animals, such as elephants, it doesn’t end there.
For decades, elephants have been stolen from their families as babies to go through a process known as “Phajaan.” The babies are chained up and beaten repeatedly until their spirits are broken, so they will be submissive toward humans for the rest of their lives. Only then can they be trained to give tourists rides and do other tricks that exploit them. Bull hooks are common weapons used by people to control elephants, and because of this, most of the elephants at WFFT have shredded ears where the hook was torn right through.
For the first few days, as I was learning about each elephant’s horrifying story that ultimately led them to WFFT, I began to feel a great deal of remorse. How could be people be so cruel? What kind of a world do we live in? What kind of a country was I in? I felt embarrassed to be a human. After I dealt with those emotions, I started to get a wave of new ones. How could people be so kind? There were some volunteers who had been there for months and still had weeks more to stay, including a veterinarian from the U.S. who took 6 weeks out of every year to travel back to Thailand and volunteer at WFFT. I found this to be so amazing as volunteers have to pay for their room and board and are not compensated. What kind of a world do we live in? There were people from all over the world: Germany, the U.K., France, Luxembourg, Scotland, New Zealand, Ireland, Finland, Canada, the U.S., etc. and we all, in one way or another, found our way to this small village in Thailand where we decided we would donate our time, money, and compassion to these animals who so desperately needed it. Something about that experience we shared together will stick with us, even now that we’ve returned home to our busy lives, thousands of miles apart. What kind of a country was I in? On one of our trips to collect banana tree trunks for the elephants, I sat in the back of the truck with the hot, humid air blowing my hair all around, and I took a good look at my surroundings. There were mountains in the distance, and there was a river running next to the road we were on, but I could say that about anywhere in the northwestern U.S. I can’t explain why, but the moment was so surreal; I felt so small. Most of my family has never really left Idaho, definitely not the U.S., but there I was, halfway around the world and 11 hours ahead of them, and I just couldn’t imagine how I would even begin to explain to them what I had experienced. The culture, the food, the wonderful Thai people and people from countries all around the world I’d been lucky enough to work with, the elephants that I fed, watered, and bathed; I knew that none of it would mean to them what it did to me because it’s one thing to read or hear about or even see different places on TV, and it’s a completely different thing to go there and experience it for yourself. It’s a wonderful thing to feel so small yet so enlightened at the same time. It’s something I look forward to feeling again when I get the chance to make it back to Thailand someday.
By Estifanos Kassa
Hello All! This summer I was fortunate enough to participate in the Summer Medical and Dental Education Program (SMDEP) at the University of Washington School of Dentistry, School of Medicine, and School of Public Health. It was definitely a summer to remember and I don’t think I could have used my time wiser. I believe I grew as a person as a result of the program and I now feel more prepared for my endeavor to become a dentist.
A typical day at SMDEP UW consisted of classes from 8am to 4pm followed by guest lectures or additional enrichment activities such as going to a dental simulation lab. The academic courses offered at SMDEP UW consisted of Microbiology, Biology, Physics, Biostatistics, Public Health and a choice of either General Chemistry or Organic Chemistry. In addition to those academic courses, there were also courses that focused on preparing you to apply to dental or medical school. Also, a new component to SMDEP UW was lab rotations. Every individual was paired up with a health-focused research lab of their choice, and we were able to spend a day in the lab to get an idea about how research is conducted. Another component of the program was shadowing. We were all assigned to shadow providers within the Greater Seattle area and were scheduled to observe them once a week.
There were also additional opportunities that were offered on an individual basis outside of the normal curriculum. Many in the program were able to observe a night shift in the ER at Harbor View Medical center. As for me, I was able to go out to Migrant Camps with the UWSOD in Mt. Vernon where I was able to volunteer with the mobile clinic and teach people how to maintain proper oral hygiene. In regards to fun, the program scheduled days for us to go to Wild Waves, hike Mt. Rainer, and have many formal dinners with local professionals.
The experience overall was very liberating and eye opening in regards to what the pre-health process is about and how to navigate it effectively. I got to meet and collaborate with 77 other unique students that came from all parts of the U.S. with a common goal. The curriculum at SMDEP has changed my outlook on healthcare, specifically in regards to thinking about addressing more systemic health problems in a larger population rather than just single patient-provider interactions. I now realize that by having the privilege to become a highly educated healthcare provider, you are now seen as a leader in a community and that it’s important to use your privileges and knowledge to advocate for the health of the community in which you are serving.