Interview with Child Family Health International

Q: Could you give us a short background on Child Family Health International:

A: Child Family Health International (CFHI) builds and strengthens sustainable healthcare services in underserved communities worldwide. CFHI does this by:

1. Building health infrastructure at the community level,
2. Increasing access to and efficient use of medical supplies, and
3. Promoting cultural competency and awareness of international health issues.

Dr. Evaleen Jones launched CFHI in 1992, after witnessing babies being born on newspapers during her travels to Ecuador. Since then, CFHI has successfully expanded around the world. We now work with 145 international partners in the medical profession who provide services in Bolivia, Ecuador, India, Mexico and South Africa. Our partnership-based programs have grown from one to eleven:

• India: Tropical Medicine, Rural Rotation, Introduction to Traditional Medicine
• South Africa: Challenges to Healthcare
• Mexico: Clinical Rotation, Tropical Medicine
• Ecuador: Clinical Rotation, Reproductive & Womens Health, Community Medicine, Tropical Medicine
• Bolivia: Pediatric Medicine

Providing a comprehensive curriculum to 600+ students a year - up from 15 in 1998 - CFHI has matured into a nationally recognized organization. With the support of these students, our partners serve hundreds of thousands of patients in rural and urban underserved communities around the world every year. In addition, CFHI salvages - or "recovers" - medical supplies and equipment that are then distributed by our global partners. Our students participate in the collection and distribution of recovered medical supplies, offering them a concrete way to contribute to the areas they visit while abroad. Supplies have been donated to Bolivia, Bosnia, Chile, Ecuador, Guatemala, Haiti, India, Iraq, Mexico, Russia, South Africa, Ukraine, and in our own backyard in California. Most recently, CFHI joined a larger relief effort by the International Medical Corps, sending supplies to victims of the Tsunami in Indonesia.

CFHI at a Glance: Founded: 1992 Full-time employees: 6 Board members: 9 Paid partners abroad: 145 Partner clinics/hospitals: 58 Student volunteers since 1992: 1,700 Patients served directly in 2004: 4,456 Universities of origin for students: 324 Program sites supported: 11 Onsite coordinators at each site: 2-4 2005 Budget: $2.1 million Medical supplies recovered since 1995: $3.1 million

Q: What are some volunteer opportunities you offer? Do you have any volunteer opportunities you are particularly proud of?

A: Child Family Health International seeks participants for international, service-learning immersion programs. Students learn Medical Spanish in an International Setting. They rotate in different clinical settings while immersing themselves in the host culture. While there, they gain an excellent comprehensive view of health care in developing nations. Programs are open to: pre-meds, med students, RN students, RNs, PAs, naturopathic/osteopathic students and/or residents, MPH students or those with MPH.

CFHI is always in need of a couple volunteers to help us with our fall and winter shipments of medical supplies to Bolivia, Ecuador, India, Mexico and South Africa – going out of our San Francisco office. There are both on-going and one-time volunteer opportunities available for both individuals and groups. Volunteers help loading boxes and sorting medical supplies. The supplies go directly to our partners abroad, who use the supplies within a matter of weeks.

Q: What kind of daily life should prospective volunteers expect?

A: CFHI programs offer a comprehensive learning experience, which includes exciting clinical rotations in several clinical sites in and around our sites, and – in Spanish speaking countries - medical and conversational Spanish classes tailored to your needs. Programs are 4 weeks long, and can be extended to 8 weeks. Students will stay in a homestay environment, except where explicitly stated otherwise on our website. Volunteer opportunities are open to students who want to have more of a hands-on service experience while in-country. Travel on the weekends and before/after the program duration is highly encouraged, but not included in the program fee.

Q: What is the most important piece of advice you can offer future volunteers?

A: Be sensitive to the cultural context in which you live while abroad. The range of emotions and conclusions you will come to while traveling and living abroad will surprise and challenge you. It is important to remember that you are a visitor in the culture that is hosting you, and the assumptions you carry with you, based on your own cultural context, do not always apply in new countries, cities or towns. Be patient with yourself and your experience abroad, and most of all, be flexible!

Q: What is the biggest challenge while volunteering abroad?

A: Many Americans and people from the developed world carry with them a sense of entitlement… that things are owed to them (whether because they are highly-educated, paying a fee to be involved with a volunteer program, or whatever). Getting over those feelings allows volunteers to find their experience much more joyful and educational.

Q: On the flip side, what is the biggest reward?

A: The experience of being immersed in another culture – whether for education, work or volunteerism – is life-changing and enlightening. Participants learn more about themselves than they ever imagined, and get a view into the way the majority of people in the world experience healthcare – that is, hardly at all.

Q: Why should they pay to volunteer with Child Family Health International? How is the money used?

A: Child Family Health International is a nonprofit organization based out of San Francisco, California. We have partners in Bolivia, Ecuador, India, Mexico and South Africa, all of whom benefit directly from our program fees and presence in their community. CFHI's mission is to build and strengthen sustainable healthcare services for underserved communities worldwide.

What we do:

• Promote cultural competency and awareness of international health issues
• Increase access to and efficient use of medical supplies
• Build health infrastructure at the community level

How we do it:

• Global Service-Learning - this is the program you are taking part in as a student of medicine. These programs focus on cultural competency in the healthcare setting.
• Partnerships - CFHI offers our partners small grants throughout the year, as well as general support and resources so they can continue their important work in underserved communities.
• Medical Supply Recovery - we encourage the collection and distribution of recovered and recycled medical supplies, for example the boxes that many students carry with them to their program sites.

Like most not-for-profit organizations that run international volunteer programs, CFHI's income is largely generated from your program fees. These fees are an essential way for us to run the programs for you and to support our international partners who host you – all at the same time. This does not necessarily mean that your entire fee goes only to the community where you work. Let us explain…

What Your Program Fee Covers:

• Pre-departure materials (a Country Handbook and Program Guide) in order to assist you with your preparation to join a CFHI program. PLEASE read this essential information.
• Expert Management via an experienced, U.S.-based staff (supported by a volunteer board of directors) who serve as your coordinators, liaisons and advisors with our in-country partners.
• Local Coordinators (whom you can contact at any time during the four weeks of the program) to provide cultural orientation, clinical placements, supervision, evaluations and guidance throughout your stay. Most of the time CFHI maintains both a Medical Director and Program Coordinators for each site.
• Placement – in the program of your choice, based on your skills and interests, including all the coordination, in-person visits and communication necessary with each local medical professional or organization.
• Accommodation and Meals , providing you with a comfortable, safe place to live, the basic amenities, most of your meals, and support by in-country coordinators you can contact at any time.
• In-country materials and meetings (Cultural Orientation Workbook, Program Assessment and, where applicable, language materials), including all in-country informational materials and curriculum, in order to guide you through your experience with our partners.
• Spanish Language Courses that are included in Spanish-speaking sites. Countries where English is regularly spoken do not include this aspect. You have the option to pay for more classes (we recommend before for those of you who speak minimal Spanish, or during your program). Please consult the language school materials you receive at the beginning of the program of the cost of additional courses.
• Health and Medical Evacuation Insurance is included as part of the program fee. By leveraging the number of students we send each year, we have been able to negotiate a reduced cost for these important insurance requirements for traveling abroad.

Other Services that CFHI Provides:

• Grants and Partnerships – Nearly 50% of the program fees go to support the communities that you visit and where you work. (Again, this does not mean that your entire program fee goes only to the community where you personally work.) CFHI reimburses local coordinators, home stay families (where applicable), clinical preceptors and sometimes local healthcare projects for the services that they provide to you and their patients. This unique "share" in the profits allows these communities to offer more and better healthcare services. Our contributions are meant to be an additional source of support for communities that have limited financial resources or access to healthcare. Therefore, your participation in CFHI's program does more than simply provide you with an educational, service-learning experience.
• Recover Medical Supply Donations – A portion of your program fee goes to support Recover, CFHI's medical supply recovery and recycling program. In conjunction with other individuals and organizations CFHI gathers unused donated supplies and ships them to our partners with participants in our programs (the boxes you will likely carry with you) as well as in large shipping containers. CFHI has donated over $2.1 million worth of supplies since 1995 (including over $800,000 in 2003 alone), to our partners throughout the world and occasionally during times of medical emergency. We view this program as a complement to the service-learning and partnership programs.
• Scholarships – In 2003, CFHI launched its first scholarship program, aimed at those people traditionally underrepresented in our programs, financially and otherwise. Through our fundraising efforts, CFHI was able to offer 7 spots in 2003, and expanded to offer 9 in 2004. We realize that these limited opportunities may not be enough to support your financial needs, so we've compiled a list of ideas about how to raise funds and support for your trip with CFHI. You can email students@cfhi.org for this list. Let us know if you are successful in your efforts, or if you discover new or better ways that we can recommend to future students in your situation.

What is not included in the program fee:

• Costs associated with obtaining a visa or immunizations (when needed).
• International airfare and corresponding airport departure taxes.
• Personal internet time and (domestic and international) phone calls, other than for an emergency.
• Laundry service (depending upon program site).
• Inter-city transport (depending upon program site).
• Local transportation to and from clinic assignments (depending upon program site).
• Personal travel expenses in-country.
• Activities (cultural or otherwise) outside what is stated above. Other activities may be offered to you by local coordinators for an additional cost. We recommend you read your Program Guide well and budget accordingly.

What it takes to run an international organization like CFHI:

There is a significant cost involved in answering your emails and calls, maintaining the website, doing the paperwork you require for your university, ensuring the quality of the programs and managing the finances of a $2.1 million organization. In addition, it is important to remember that costs to do basic business functions in the U.S. are several times the cost of doing business in the countries you visit. CFHI has a unique structure that allows our partners autonomy and fiscal stability. At the same time, we manage a complicated series of programs throughout the world, maintaining accountability and transparency required for organizations working in the current global environment.

CFHI maintains an incredibly low overhead cost of 6% (most funding agencies consider an overhead cost of less than 30% to be good, and less than 15% to be excellent). You can read more about nonprofit organization standards at www.guidestar.org. The two diagrams below are an attempt to visually show you how CFHI financially supports itself and how its resources are allocated.

Q: Do you have any advice on funding a volunteer experience abroad?

A: Other individuals can help you cover the cost of your program fee. Many students fundraise among their friends, relatives and colleagues for their program fees... check with us about ways we can help you do that! CFHI has compiled a list of suggested methods by which you can fundraise for your trip. Email us at students@cfhi.org after you’ve applied to receive the list of tips.

Q: How does volunteering abroad fit into the bigger picture of aid and development?

A: CFHI sees our work as changing the future of global health. We have 1,700 alumni – and another 600 by the end of 2005 – who have had a life-changing experience working in international health. We know these individuals will go on to become leaders in their respective fields. Our alumni include Chief Residents, Researchers in Global Health, Local Activists and Educators. Their feedback indicates that their first step into the global health field is crucial and drives them be involved for the long-term in issues crucial to the improvement of healthcare conditions around the world.

Q: Why should someone volunteer with Child Family Health International?

A: Why Child Family Health International:

What problem do we address?

In today’s world we often see the uneven distribution of healthcare that leaves many impoverished communities underserved. Economic, political, and social factors all contribute to people’s access to healthcare, both internationally and at home. Increasingly, we need culturally and linguistically competent health care providers around the world to address these inequities.

How do we address the problem?

Child Family Health International’s (CFHI) International Health Service-Learning Programs combine instruction, experience, service, and reflection to create a model that supports physicians and clinical sites abroad, addresses the healthcare needs of the underserved, and adds an unforgettable experiential element to each program participant’s education.

CFHI programs bring service-learning into hospitals and clinics around the world, allowing participants to gain insight on the contextual constructs of illness and healing in foreign settings. Program Alumni return from the host country with new perspectives on healthcare systems and delivery in places where resources and supplies are extremely limited.

Since 1992, CFHI has arranged for more than 1,180 pre-medical, medical and other students of the health profession from over 200 of the top universities in the U.S. and the world to live and study in Ecuador, India, Mexico and South Africa. After sending over 400 students abroad in 2003, CFHI expects 500 students to participate in 2004. We are proud to announce a new site for 2004 in La Paz, Bolivia.

How does the community benefit?

While a student’s ability to practice medicine may be limited by clinical knowledge or language skills, the participant’s contribution to the community is not an illusion. For example, we provide each participant with a box of donated medical supplies to carry with them for distribution among partner facilities. In addition, our partner physicians at each program site are compensated for their willingness to mentor CFHI students. This supplementary income promotes job retention in countries where physicians are paid small salaries, often by financially strapped governments. Furthermore, the exchange of information between students and their preceptors provides an invaluable experience for participants, the patients, and the physicians.

How do participants help in the clinic?

Each of our program sites has many locally qualified and experienced healthcare providers, so the participant’s primary motivation for participation should not focus on a concept of humanitarian aid, in which one expects to provide medical care to people that would otherwise not receive it. The participant’s main objective should be to actively observe, according to current language abilities and level of training, in order to develop a high level of community health awareness. While abroad, this happens in the social and cultural context of the program site.

What are the objectives of the program?

CFHI’s International Health Service-Learning Programs help participants:

• Develop a larger sense of cultural competency
• Observe and develop existing clinical skills
• Broaden public health knowledge
• Develop creativity in problem-solving
• Deepen their commitment to service
• Promote medical supply conservation

Prospective participants may apply online. Our participants are 21 years of age and over, come from around the globe, and are dedicated to a diverse array of professions in health.

Q: How can someone get in contact with Child Family Health International and learn more about your volunteer abroad opportunities?

A: Our website is the best way to learn about our programs: www.cfhi.org, and you can contact us at toll free at 866-345-4674 or students@cfhi.org at any time.