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Medicine and public health come together in Ecuador internship

Pre-med student squeezes global health, clinical practice out of one career-affirming internship

An internship could be located just 10 minutes from campus, but Emily Burney would rather travel to the equator, some 4,000 miles away.

As a wide-eyed high school senior, Emily learned about international internships while on a tour of Oregon State’s campus. She was intrigued, and four years later she made her international dream a reality with an internship in Ecuador.

Emily is an Honors College student studying public health, with an option in health management and policy. She’s also thrown two minors into the mix — one in business and entrepreneurship, and one in chemistry.

To say she’s up for a challenge is an understatement.

Why did you want to do your required internship abroad?

“I chose to complete my internship abroad because I’m passionate about global health, and I wanted to challenge myself to learn about and work in a culture and health system that’s different from the U.S.

“I’m also on the pre-medical path, so having the opportunity to combine public health work with clinical exposure through my particular internship program really interested me.

“I lived in South America previously, and I wanted to return to the region as well as improve my Spanish skills through my internship. I had actually learned about a very similar program when I was a senior in high school, visiting Oregon State as a prospective student. I thought it sounded interesting at the time, and when I had the opportunity to pursue it as a current student — almost four years after first hearing about it — I jumped at the chance.”

Where did your internship take you?

“I was in Ecuador for 10 weeks, spending five weeks in two different cities. I was in Guayaquil, which is the largest city in Ecuador, and Puyo, a small rural town in the Amazon jungle. These two cities are incredibly different from each other, and each offered a unique view of public health and medicine in Ecuador.”

Was your international internship affiliated with a specific program?

“My internship was with Child Family Health International, which runs programs around the world for students and professionals of all levels who are interested in health. In order to apply to the program, I worked with the internship advisor for public health and the IE3 office in OSU’s Office of Global Opportunities.”

What were you doing in Ecuador?

“I worked in several urban and rural community clinics, where I learned about public health and the Ecuadorian health care system from doctors and other clinic personnel. In these clinics, I was able to help run community vaccination programs, work with the elderly and improve health literacy among low-income families. I also worked with a vector control program with the Ministry of Public Health and assisted with a long-term epidemiological survey focused on preventing mosquito-borne diseases in the community, especially among low-income pregnant women.

Pre-med student completes internship in Ecuador

Emily worked alongside staff members at a clinic she interned at in Guayaquil, Ecuador.

“I also worked in the Puyo General Hospital on a variety of health management and education projects. While working in the hospital, I was part of a multidisciplinary integrated HIV/AIDS team, working with hospital records and national databases to identify characteristics of patients who had left treatment for HIV/AIDS in order to improve treatment processes and disease management protocols. I also observed multiple surgeries, learned about the hospital’s clinical practices and collaborated with nurses to develop patient education procedures and materials for diseases such as diabetes and tuberculosis.”

What was it like interning at Puyo General Hospital?

“The structure of my internship meant I was working side-by-side with local physicians every day. This meant I was learning about the realities of the Ecuadorian health care system as they provided care within a public health sphere.

“I was able to assist the physicians as I worked in the local community clinics, and I was also able to observe their interactions with patients and their steps toward diagnosis and treatment. When I was in rural clinics this process was especially interesting, as physicians and clinical staff had to work with challenges common to rural areas.

“Puyo is a small town in a rural area, so medicine there, especially as performed by the primary care physicians I worked with, actually involved a lot of preventive public health work. For example, some families wouldn’t bring their children in to get vaccinated, so clinic staff visited families who lived in very rural areas in the jungle, educating parents on the importance of vaccinating their children and then providing vaccinations on the spot.

“I also went with physicians and clinic staff as they visited pregnant women in the area. I then participated in the health data tracking — essentially field epidemiology — they performed for the entire area on the health outcomes for mothers and babies.”

What was the most interesting experience you had at the hospital?

“The most interesting experience I had was a very eye-opening one, in which I worked with one of the head nurses at the Puyo General Hospital to organize housing and a treatment plan for a patient. This patient was a 17-year-old mother who had arrived at the hospital with an active tuberculosis infection, AIDS and a young child who had been born with HIV.

“Her family had shunned her because of stigma associated with her AIDS diagnosis, leaving her in Puyo with no money and no support. We prepared housing for this patient and her daughter, arranged support and developed a long-term treatment plan.

“This young woman and her daughter had many obstacles, but seeing the dedication and support of the nurse is something I’ll never forget. Her selflessness and service to her patients is something I aim to live up to as a doctor.”

Did you learn anything unexpected?

“I spent about a week learning about indigenous culture and traditions from members of the Quechua San Virgilio community, which is about a two-hour drive into the jungle outside of Puyo. I learned about medicinal plants and healing practices, as well as how the San Virgilio community works with the Ecuadorian government to maintain their culture and way of life in Ecuador’s plurinational society.

“Learning from the San Virgilio community reinforced my understanding of how public health permeates every part of life, and how it can empower everyone to live healthy and happy lives as they wish to, through respecting and celebrating differences among people.”

Was your internship aligned with what you want to do in the future?

“I plan to apply to medical school after I graduate in December, and I aim to become a primary care doctor. I hope to work in global health to improve others’ health and well-being through public health initiatives that remove systemic barriers to care.

“My internship experience was definitely aligned with my future goals, since it combined public health work and clinical medicine. I was able to work with a range of populations and cultures, and learned from many diverse viewpoints about health and medicine.

“Through my internship, I decided how I plan to serve patients, and I learned much more about the opportunities for public health and medicine to change lives in the future.”

What advice do you have for other students considering an international internship?

“I highly recommend an international internship! I thoroughly enjoyed it, and I think having a global perspective is immensely important. It takes a little bit of planning and preparation, but by starting early and working with the advising teams it’s definitely achievable.”

Let’s back up. What led you to major in public health?

“I originally didn’t know what I wanted to study, as I was interested in everything when I first started at Oregon State in 2014. At this point in time the Affordable Care Act was going into effect, and I was intrigued.

“I was interested in health and medicine, so I took a class called Social and Individual Health Determinants. I had never heard of public health before, but learning about the myriad of ways in which public health work impacts our lives made me want to learn more, so I could work to make others’ lives better in the future.

“I believe public health gives me a great way to approach medicine, as I am able to understand health and health determinants at a macro and a micro level.”

We hear you’re an Honors student as well. Has this enhanced your college experience?

“Through the Honors College, I’ve been able to dive into subjects and explore fields that aren’t included in my program of study, but still add to my understanding of the world and enable me to develop new interests.

“After my freshman year, I went to Ethiopia through the Honors College thanks to a class about international service. I became further motivated to work in global health after seeing what I had learned about in my classes firsthand, and it challenged me to further develop my understanding of international service, as well as my place in it.

“I have also grown academically because of the Honors College through my work on my thesis in the CPHHS Translational Metabolism Research Laboratory, which enabled me to work with extremely smart and talented individuals. Thanks to that experience, I learned laboratory techniques and scientific practices, and I gained an understanding of high-level scientific work. Because of my experiences in the lab, I know I am better prepared to move into the next stages of my academic career.”

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