LATIN AMERICA

South and Central America are open opportunities, with many of the citizens close by within the US to help you learn what opportunities might be awaiting there. They can also be your language coaches and refer you to their extended families and contacts in their home towns. A very good preparation for this experience would be to volunteer in such an environment as "Clinica del Pueblo" or find the Latin Quarter nearest you such as Adams-Morgan. Do not forget the half of South America that is Portuguese-speaking in the "continent of Brazil."

There are a wide variety of facilities in Latin America with a range of services, typically wider in spectrum than they are seen in the US. For example, you might encounter state-of-the- art high technology hospitals (often private clinics) in Colombia, Venezuela, Chile, Mexico or Argentina that are either the equivalent or ahead of most US counterparts, and there may be nearby pueblos and barrios" with minimal facilities and a large crush of patients requiring services. Try to focus on the broader end of the spectrum in which you can do more and be more valuable.

Remember that the drug names and regulations governing them will be different than in the US. And, do not, repeat, do NOT, get close to any illicit drugs, even in jest, since both host and your home government are highly sensitized and not at all amused. And, I , for one, will not bail you out of any such self- inflicted mess, though we try to be as helpful as possible for most situations outside your control.

At least rudimentary Spanish is required, and works surprisingly well in Portuguese-speakiing areas as well. There are lots of short courses in medical Spanish, audiotapes, and easy access to tutors, and the progress you will make will be quite rapid. But try to put in that time before going, since you do not want to dilute this experience as a field trip for language alone; it is far too valuable for that.

Here as elsewhere a preceptor relationship is essential. There are many physicians oriented to US medicine in whatever adaptation they practice it; some of them have even had US training, which is helpful in bridging the gap to help you understand the Latin world and its different attitudes toward life, the family ties, fate, and what illness and health mean.

ECUADOR:
Dr. Edgar Rodas is a surgeon who is a former colleague of mine whom I had met, in-of all places-Saipan, Commonwealth of the Northern Marianas, and since then have exchanged delegations of students and graduates in a mobile health team that he moves around rural Ecuador in very needy areas. This is particularly useful in mobile surgical clinics. Several students have been there this year and you can review the comments about their experiences there. Dr. Rodas can be reached at

Dr. Nick Morrison is a surgical colleague of mine who has worked annually in volunteer clinics in the needy areas of Peru and Ecuador, carrying down an entire team, with the supplies and equipment that they will need. Dr. Morrison is based in Phoenix, Arizona, and can be reached at 602/981-98305 or morfam@aol.com.

GUATEMALA:

The Caribbean component of Latin America is covered on the Caribbean page.