CARIBBEAN

The Caribbean is close, very influenced by the US in drugs, equipment, the medical literature and has a mealnge of language and culture ranging from the Latin common thread with the "Spanish Main" to Papiamento, a Dutch-Latin hybrid in the Netherlands Antilles. There are sizable chunks of the Caribbean that are English speaking, even some that stand in Commonwealth relation or outright US possession (one set of the Virgins); but there is a good deal of British medicine in the Caribbean as well, and one area that is underused by American students is the British Virgin Islands. I will not address such issues as the plethora of "medical schools" crowding some islands for the production of backdoor US medical market everywhere from Republica Dominicana to Montserrat, but you will not likely run interference on them.

There are several Francophone chunks of the Caribbean, both in the Antilles, and also in the fascinating half of Hispaniola-- Haiti. There is a superb program running in Hopital Schweitzer, which would be among the top of my Caribbean recommendations for those for whom it would be appropriate.

I attach suggestions as to contacts in the Caribbean, which many students have found valuable for short-term assignments following freshman year. I myself began my international experience in Santo Domingo, Dominican Republic, running Rehydration Centers for a pediatric dysentery epidemic that WHO had identified as an urgent need. I had a very exciting time, since while I was trying to start IV's in dehydrated kids and calculate fluid and electrolyte balance, a civil war broke out and all US passport holders were evacuated to an offshore aircraft carrier, the Boxer. But being "Laissez Passe"--a de facto international, I could continue to work in the highly unusual circumstances of the US 82nd airborne invasion and nightly curfews of cannonading, crossing the sandbagged and concertina barbed wire borders between rebel and loyalist parts of the divided city, treating patients on both sides with a universally respected medical "white coat" neutrality. Further, since US landing craft were establishing a beachhead, I saw opportunity--and got delivery of 54 tons of vitamins, fluids and antibiotics distributed by US Army vehicles, joined in by the Organisacion Eastados Americanos (OEA) police force. I relate this story to encourage you to think that a freshman medical student can do something of significance, even (or in this case especially) when things look bleak with unexpected disruptions!