My Introduction to CFHI

Hello! My name is Fanny Du, and I graduated from the University of California, Berkeley in 2012 with a B.A. in Integrative Biology. I have been taking time off from school to apply to medical school, work, and travel. I am very excited to start my medical education at the University of Michigan Medical School this August!

During college, I explored a variety of healthcare-related experiences, including interning at RotaCare Free Clinic in San Leandro, California. Working alongside compassionate doctors to help struggling families access healthcare showed me the value of the free clinic as a community safety net. Although I was able to help many low-income and immigrant families access much needed healthcare resources, I realized very early on that fluency in Spanish would allow me to better serve the many Spanish-speaking families that came to us. Having taken only a year of college-level Spanish, what I really needed was a Spanish immersion to help me drastically improve my language skills and do more for the diverse population in the San Francisco Bay Area.

It was during an AMSA conference at the University of California, Davis that I heard about Child Family Health International (CFHI). I was ecstatic to learn about the Intensive Beginner Spanish and Healthcare Program in Oaxaca, Mexico—this was exactly the language program and immersion that I had been looking for. With plenty of language instruction, the home stay with a Mexican host family, and immersion into local nonprofits and clinics, I was confident that the experience would significantly boost my Spanish proficiency while bettering my understanding of Hispanic culture. I feel very fortunate to have been awarded the scholarship and am appreciative of CFHI’s support of my endeavors.

Arriving in Oaxaca, Mexico

The plane descended over Oaxaca, and my nerves settled as the mesmerizing city lights came into view.  I had been a little anxious about the trip because of my minimal Spanish proficiency and unfamiliarity with the region. But the view from above gave me good vibes. We landed, and I stepped out of the plane to the warm tropical climate. The humidity made me nostalgic about past trips to Asia that I had enjoyed so much. I got through customs and was warmly greeted by Margara and her husband, whom I started calling “Leonardo di Caprio” by the end of the car ride. They were so friendly and gladly reciprocated my attempts to converse in broken Spanish. We drove through parts of downtown, and I noticed people out and about in the streets gathered at food carts or dressed up and heading to parties. Margara and Leo explained that Saturday night was for fiestas!

When we arrived at the home stay, a sweet elderly woman, Margara’s mother Seniora Clara Hernandez, greeted me just as warmly. I met the whole family including two very cute little boys, Rafael and Francisco. Sra. Hernandez showed me to my room, and I was pleasantly surprised by the accommodations. I had my own room and room key, bathroom, and even internet, so it really felt like a hotel.

Anyway, things were great so far, and I couldn’t wait to get to know this place and the people better!

Settling In

The second day of my stay in Oaxaca, Sra. Clara’s husband, Jose, walked me to Becari Language School. I met Martha, the local director, as well as the other CFHI participants. There were only two others, Onyeka and Jimmy, in the program and we ended up becoming fast friends. We later also met several other students at Becari from all over the world, and everyone was extremely friendly and interested in exploring the city together.

 My daily schedule typically involved waking up to a nice Oaxacan breakfast prepared by Sra. Clara then making the short walk over to Becari. For the first two weeks, I had 4 hours of Spanish instruction along with Onyeka and Jimmy. The instructors, Arturo and Javier, were both very enthusiastic and excellent teachers. They often took us on field trips to local markets and museums and really made class fun!

After classes, we volunteered at Centro de Esperanza Infantil, an organization that helps poor families keep their children in schools. There, we tutored students of all ages in a variety of subjects, helped students translate their letters to their sponsors, and sometimes just played or chatted with them. Our last day volunteering at Centro de Esperanza infantil was a sad one. Throughout the first two weeks of the program, I had tutored Itand, a bright high schooler, in chemistry and some English. The other students and I had gotten to know her during our time there, so leaving a new friend was tough. Even so, making a local friend had made me feel more at home in Mexico, and we are all still in touch with Itand through Facebook.

Typically, we had plenty of free time after classes and volunteering and especially on weekends. We often relaxed at cafes, enjoyed the festivities at Zocalo–a lively park at the city center, or went on excursions to cultural sites and landmarks. One weekend, we even went on a road trip to Puerto Escondido, a beautiful beach town.

What I miss most about Oaxaca are the people and culture. My host family was so warm to me, as was everyone else I encountered there. The people were always friendly and happy to stop and chat or help me when I needed it. The perpetual festivities were also fun to experience. I could always find performances around Zocalo, and it seemed that everyone loved to dance there! So my friends and I decided to give it a try as well. One night, we went to a salsa club and learned some moves. Later, we all took a lesson together. Oaxaca is such a community-oriented place with an incredibly rich culture. I really love that about it!

Moving Encounters at Centro de Salud Volcanes

At Centro de Salud Volcanes, I was placed with Dra. Lopez and got to observe the patient-doctor interaction in this clinic near the city center. The atmosphere was very busy and public. Privacy did not seem to be a huge issue as the exam room doors were sometimes left open, and at times patients even walked in as doctors were seeing another patient. The clinic was part of the government-run healthcare system, which allowed every Mexican citizen to access healthcare. Despite the more public nature of healthcare, I was very impressed with all the services and medications that even the poorest Mexicans could access at little to no cost.

The first day at the clinic, I could hardly understand any of the Spanish conversation. Somehow, everything became much more comprehensible by the second day. Once I could understand more, I was also able to better engage in the conversations and consultations and ask Dra. Lopez questions I had about her cases. She gradually allowed me to work more directly with patients, from taking their basic measurements to helping wrap a bandage across a post-surgery patient’s abdomen.

While I could not follow every conversation, something that I could clearly grasp was Dra. Lopez’s empathy and warmth towards her patients. She treated her patients with respect and expressed genuine interest in their lives. She comforted them when they were in pain. One particularly moving case involved an elderly woman with advanced ovarian cancer. Dra. Lopez allowed me to feel the patient’s massive tumor, and I could not believe that just between my hand and the patient’s flesh was cancer. Tears rolled down the patient’s face as she explained how her children were all in the U.S. and that she did not have much family in Mexico to go through this difficult time with her. My heart ached for her, and I could see the concern in Dra. Lopez’s face. She consoled the patient and explained the next course of action. I admire the way that Dra. Lopez empathized with the patient yet also maintained her composure and role as the physician. The language in which they spoke may have been unfamiliar to me, but the emotions I saw and felt were universal.

Public Health at Centro de Sauld Lomas de San Jacinto

The following week, I observed Dr. Ramirez at Centro de Salud Lomas de San Jacinto, a smaller clinic in a mountainous rural town. Dr. Ramirez spoke so rapidly most of the week that I had an even harder time understanding him. Even so, it was obvious that he was very interested in his students and always made time to check in with us.

He explained aspects of the public health system and introduced us to the public health worker. The public health worker welcomed us in joining him to survey the community. During one of the days, we went with him to a local school and inspected areas that served as mosquito breeding sites. Anything that collected water was a threat. I saw some larvae swimming in little pools of water collected on an old tire, wheelbarrow, and seats holding rain water. As mosquitos are vectors for infectious diseases, we emptied out these pools of water, and the public health worker informed the school director of all the public health concerns at the school.

As I train towards becoming a physician, my experience in the Oaxacan clinics will continue to serve as a reminder that there is more to being a healthcare provider than possessing the expertise. It is about recognizing inequities in the local and international community and applying one’s training and unique skill set to alleviate suffering for the vulnerable. Through my clinical experiences involving inequities, barriers, and resource shortages both in the U.S. and abroad, I have gained a more realistic view of the healthcare field. Such experiences have strengthened my desire to work with the underserved and medically neglected, inspiring me to meet the challenges that come with being a physician. By keeping an open mind and thinking critically about healthcare, I hope that I can find solutions wherever my career takes me.

Lessons Learned

Every now and then, I experienced difficulties in Oaxaca because I couldn’t speak or understand Spanish too well. Whether it was figuring out the right bus to take,  having to ask my preceptor to repeat the prescription too many times in order to write it down correctly, or being unable to connect with my host family on a deeper level than over food, I definitely felt the impact of the language barrier more so than I ever have in my life.

I was aware of some of the challenges that language barriers create since my parents are both immigrants to the United States and have encountered difficulties because they couldn’t speak English well. I thought I understood how hard it was for them until my month-long trip to Oaxaca made it even clearer to me. I experienced firsthand just how easy it is to make mistakes or act inefficiently because you don’t understand exactly what is going on. People also tend to see you differently or overlook you when you can’t explain your thoughts coherently, and there’s not much you can do about it in that moment but feel a little trapped by the language barrier.

While I was open to learning Spanish and experiencing Mexican culture, I could also see how nice it could be in a foreign environment to gather with those of a similar background and freely chat in your native language, seek out the food, music and culture you are accustomed to, and enjoy that bit of refuge from the unfamiliar. I had an idea of all of this before because of my parents’ backgrounds, but going through it myself made it all the more salient.  Especially for those who end up in a foreign country for reasons out of their control such as war, poverty, or persecution, this sentiment must apply even more. In the U.S. and other developed countries, it is easy for people to judge immigrants for failing to assimilate, yet many of the people doing the judging have never been in those shoes.

Overall, my experience in the CFHI program has helped me become more open-minded. I am more aware of challenges that people of different backgrounds might face in healthcare but also in other aspects of their lives. While I may not be able to relate to each individual’s struggles and experiences, I have realized even more the importance of listening and making the effort to understand different perspectives. My month-long experience in Oaxaca, although short in duration, was incredibly enriching, thought-provoking, and has made a huge impact on my mindset. More so than ever, I strive for open-mindedness and tolerance. As a prospective physician, I hope that these qualities will help me better serve my community.