Text: Lucy van Dieijen, master student Biology
 
Hospitable Eduadorians
“In Ecuador our shifts theoretically started at 8am. But since everyone is so laid back there, arriving at 8:30am never was a problem,” Madieke jokes. In the afternoons she was part of the emergency department until around 4pm. “The people are so friendly there, they are genuinely interested in knowing how you are. Doctors took their time explaining what was going on and patients seemed ever so grateful for that. Ecuadorians are so incredibly happy when you help them and their children. They truly thank you wholeheartedly and that is quite a difference to what we are used to here”.
 

Since people in Ecuador are so hospitable, we were fortunate enough to truly get to know the culture



When something unexpected happens, not all the necessary medications or instruments are always at hand. That definitely teaches you to be creative.



At first Madieke had trouble with the language barrier in Ecuador. “In the beginning I didn’t know a lot of Spanish yet, so I was bound to following doctors and only assisting with consultations. But by the end of the residency, I was able to converse in Spanish with the patients.”
 
Madieke got acquainted with some Ecuadorians in the hospital and hung onto that opportunity to really immerse herself in the culture of the country. “On the weekends we would make day trips and we discovered the country that way. Since people in Ecuador are so hospitable, we were fortunate enough to truly get to know the culture.”
 
Getting creative in India
In Mumbai Elfi and Madieke would hold consultations, perform ultrasounds and assist with operations. “Sometimes we would even deliver babies,” Madieke elaborates.
 
Elfi: “Most schools in India teach English, so it was no problem interacting with the majority of patients. All the Indian doctors spoke English, so when a patient wouldn’t speak it, they would act as interpreters.
 


India has public and private hospitals. “In the former the government pays the brunt of the treatments, yet still a lot of Indians have limited access to health care,” Madieke finds. “Since patients in India have to purchase the necessary materials prior for treatment they are used very sparingly. Every little piece of thread is used to the max. And when something unexpected happens, not all the necessary medications or instruments are always at hand. That definitely teaches you to be creative.”
 
Elfi: “Mumbai has very modern city areas around the Indian Gate, but the hospital was a bit less advanced than I had anticipated. India is very diverse as a country, in terms of religion, culture, languages, smells
 Especially the crowds and chaos were different, with a total lack of traffic rules. Even the cows don’t seem to let the busy traffic get to them!”
 


Best to start a small year in advance to set everything up



Role reversal
Their internships were not only valuable to Madieke and Elfi. The roles were sometimes also reversed. The Indian and Ecuadorian doctors would often ask for feedback from the Flemish residents. “In Ecuador and India women often give birth in rooms with up to 20 other patients that can hear and see every detail of the delivery. Some patients are attended to by a professor and ten students at the same time. Even in the waiting room there is no need to get bored: the curtain to the treatment room is open, so everyone can ‘enjoy’ the gynecological exam of the patient before them. We proposed to close the curtains between the different patients.” Aside from privacy and sterility doctors tend to deal with children very differently. Madieke: “Where physicians in Belgium try to make a connection with the child itself, doctors in Ecuador tend to interact mostly with the parents. We told them they could change that as well.”
 
Network of friends, senior students and professors
Finding an internship in an unknown and faraway country - sometimes you need a little luck finding the right place. Professors and older students can help you make the right contacts.
 
Elfi: “I always wanted to go to India. I’ve been fascinated by the country since I was a child. Friends of my parents, Indian gynecologists, came to Belgium one time to follow extra courses and my parents in turn traveled to India.” The physicians’ couple helped the friends make the necessary contacts for their residencies.
 
Madieke’s internship in Ecuador also came to be through her network. One of her friends works with an Ecuadorian in a laboratory at Campus Jette. His mother works in a hospital in Ecuador and got her in touch with people over there.
 
They found housing through the Fundacion Eslabon Social, helping support a good cause at the same time. Madieke: “You have to take care of all this stuff yourself, but that is part of the adventure.” In many countries arrangements are made more instantaneously than in Belgium and it really differs from country to country how quick you get a response to your requests. “Best to start a small year in advance to set everything up,” Madieke advices. 
 



You learn to deal with patients in new ways, get more respect for everyone and it changes your view on medicine



For Elfi things went smoother: “Half a year would have been enough.” Her advice is to write to lots of people, seek advice from professors and students in higher years. “They often have great contacts for internships abroad.”
 
Scholarship
The pair applied to a grant from VLIR-UOS, a foundation that support among others inter-universitary collaboration and awards scholarships to students wanting to attend school in the developing countries, well ahead of time. Madieke: “The application process is extensive and requires a lot of work. A full description of what you plan to do there is needed.” Since their goals were well received and it concerned unpaid internships, they were awarded a grant.
 
Last year 21 medical students submitted a proposal for a VLIR-UOS scholarship, twenty of them actually received the grant.
Life lessons
By doing an internship in a developing country you not only help the local population. It also broadens your own horizons. It is practically not comparable to doing an Erasmus program ‘with the neighbours’. The cultural differences tend to be smaller within Europe and it is relatively easy to come home if that need arises. 
 



Your student years are the best possible time to go abroad. It is easier to do so for shorter periods now



Elfi and Madieke find that every medical student should be compelled to attend a foreign internship. “It broadens your worldview and enriches you thoroughly. You learn to deal with patients in new ways, get more respect for everyone and it changes your view on medicine, both at home and abroad. It also make you realise how fortunate we are with all our freedoms. In India the majority of marriages is still arranged. And even though things are not perfect here, it makes you happy to be in Europe now.”
 
Madieke: “We don’t have it bad here at all. I also learned not to take everything for granted and that there are a lot of changes to be made in the world. You experience things that will stay with you throughout your whole life.”
 


Elfi: “And it also happens to just be a lot of fun!” Asked whether she never felt homesick Elfi immediately answers: “No! I love being abroad. The longer the better.” Madieke: “Your student years are the best possible time to go abroad. It is easier to do so for shorter periods now. And try to travel to the country before the actual internship, that way you can get to know country first.”


More information on how to study, go on training or volunteering abroad? Check my.vub.ac.be/goingabroad or call in at the International Relations and Mobility Office (IRMO), Pleinlaan 5.  E: international.relations@vub.ac.be  and T: (+32)(0)26148101.
 
In december Elfi went back to Goa to attend the wedding of the son of the Indian gyneacologist couple. Madieke is still in contact with some of the doctors in Ecuador. 

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