a Community Medicine from Rainforest to Coast | IE3 Global
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Community Medicine from Rainforest to Coast | Guayaquil and Puyo, Ecuador

More pictures from this internship can be found here.

Experience Ecuador’s diverse cultures and geography–from Ecuador’s most populated and modern tropical coastal city of Guayaquil, to Puyo, a small city of 28,000 on the edge of the Amazon basin.

Interns in this program have the opportunity to explore and compare community-based medicine in a wide variety of settings, from in a large city and a small town, and from large public hospitals to home visits.  They will learn how communities in Guayaquil and Puyo are addressing their most pressing health challenges including chronic, infectious, and vector-borne diseases. At the same time, interns will be improving their Spanish and gaining insights into public health realities, indigenous cultures, community medicine, and the main tenets and structure of the healthcare system in Ecuador.

As a frontier town on the edge of the vast Amazon, the world’s largest tropical rainforest, Puyo provides medical care not only to its local community but also to indigenous populations that travel up to four to six hours to seek care.  Here, geography, resources, and culture affect healthcare access, as the area is home to seven of Ecuador’s 13 indigenous groups.

Unique to this program is the opportunity to live with an indigenous tribe for several days, providing an anthropological insight into indigenous communities.

This program includes 20 hours of Spanish classes in Guayaquil.

Duration of Internship:

  • 10 weeks


Interns are provided with opportunities to learn about global health while imbedded in the existing health systems and social services sectors alongside local community members and champions. This internship seeks to develop students’ broad-based understanding of the interplays between disease processes, social circumstances, poverty, resiliency, geopolitical realities, historical contexts, culture, and the complexities of health and wellness. Our partner company’s expertise is in “preserving the authenticity of the community’s expertise and presenting ‘real-life’ global health, while nesting programs in gold-standard educational pedagogies and safety standards”.

Thousands of students and medical professionals have taken part in their unique programs, which foster reciprocal partnerships and empowerment in local communities. Internships are open to all students with an interest in health in an international context and is especially ideal for pre-med, pre-nursing, public health, and global health students.

Our partner company in Ecuador is a global health ethics leader; as such, their programs uphold strict standards and comply with all local laws.  This program is not an episodic volunteer experience, and is not designed to provide service to those who would otherwise not have healthcare.  Therefore, the internship experience will be predominantly observational and interns should be aware that they are not to be providing direct healthcare to patients. The learning objectives for this internship, as outlined by our partner company, are:

  • 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

This program provides the opportunity for interns to compare and contrast healthcare realities for local populations in an urban coastal city and a rural town in the Amazon basin, while also participating in classes to further develop interns’ Spanish language skills.  Interns begin and conclude their internships in Guayaquil, spending a total of approximately five to six weeks in Guayaquil and four to five weeks in Puyo.

In Guayaquil, interns participate in clinical rotations in government primary healthcare clinics as well as medical brigades working to eradicate and prevent vector-borne diseases like malaria, dengue, and Chagas.  Primary clinics may be public or private, and generally offer free or low-cost services to patients without health insurance.  Services include detection and treatment may also observe treatment of infectious and tropical diseases, as well as the detection and treatment of chronic and acute disease, like hypertension, diabetes, asthma, arthritis.  Basic maternal and child health services are also provided as well as family planning services.  Interns may accompany local healthcare providers on home visits.

In Puyo, interns learn about health issues facing rural and indigenous communities through rotations in clinics, hospitals, primary healthcare centers, and local non-profits.  Interns may also accompany local healthcare providers on community and/or home visits.  Interns may have the opportunity to rotate at a small primary healthcare clinic located at the mouth of the Amazon jungle, serving a largely indigenous population that travels 4-6 hours from deep within the rainforest to seek care for primary care, obstetrics, immunizations, and to treat emergencies such as snakebites and machete wounds.  It is worth noting that while rural, Puyo does offer modern conveniences such as internet, cell phone services, banks and many other tourist attractions.

A highlight of the portion of the program based in Puyo is a visit to an indigenous community.  Interns hike into the Amazon jungle to visit an indigenous community and learn about the Shuar tribe.  Unlike tribes that regularly receive tourists, this community works exclusively with participants of this program and thus provides an authentic perspective of Shuar culture and daily family life. Interns learn about the unique worldview of the Shuar, their uses for traditional medicinal plants and important spiritual practices.  They also spend time with village children, sharing personal skills or knowledge such as art, music, or sports, and experience a traditional welcoming ceremony for guests and hike to a sacred waterfall.

Activities and Tasks: This is an observation-based experience (see “About the Organization”).  Much of interns’ time will be spent shadowing physicians and healthcare providers as they work with patients during routine exams, taking medical histories, and performing procedures and surgeries.  Interns will observe patient-physician interactions, and may assist with note-taking as their language skills allow.  They may also be asked to assist with fetching and preparing supplies, and may participate in community outreach initiatives.  As time and circumstances permit, interns may have the opportunity to ask questions of medical providers and patients.

NOTE: All rotations are subject to change depending on availability and local conditions.

Spanish classes:  75 hours of Spanish language classes are built into this program, and are provided by a local language school in Guayaquil.  Depending on the number of participants and their language proficiency levels, students may be placed into small groups or one-on-one with a language instructor.

Academic Background

  • Pre-Med, Pre-Nursing, Pre-Pharmacy, Public Health, and other Pre-health majors


  • Prior experience in healthcare settings preferred

Language Requirements

  • Minimum of intermediate Spanish is required, and more advanced Spanish skills are encouraged.
  • While some program staff and doctors may speak English, most interactions with patients and other staff will take place in local languages. Students are encouraged to build their health and medical terminology.

Other Requirements

  • Interns should be at least 20 years old to participate

Estimated One-Time Expenses

  • IE3 Program Fee: $3,450
  • Host Site Fees: $6,095
  • International Travel: $1,300
  • Visa Fees: $0*
  • Recommended Immunizations: $500-700**

Estimated Monthly Expenses

  • Housing: Homestay included in host site fees
  • Food: $100 ($25/wk) for some meals
  • Local Transportation:  $200 ($50/wk)
  • Recreation: $150 ($37.50/wk)
  • Personal Expenses: $100 ($25/wk)

Budgeting Note:   Estimated costs are based on typical internship-related costs and a modest standard of living.  Each intern’s costs will vary based on lifestyle choices (eating out vs. cooking or eating provided meals, taking taxis vs. walking or taking the bus) and recreational spending (travelling on days off, expensive hobbies, etc.).

Additional Expense Information

The Host Site Fees include:

  • Homestay arrangement
  • Two meals a day with host family
  • Language courses
  • Airport pick-up & drop-off
  • In-country orientation
  • Use of a mobile phone
  • Weekly meetings with medical director & local coordinator
  • Placement in clinical rotations & coordination of internship activities
  • Administrative costs
  • 24/7 Emergency Support

* No visa required for U.S. citizens

** Fees vary based on medical history and insurance coverage

In both Guayaquil and Puyo, interns will stay with homestay families.  In Guayaquil, homestays are located in a middle class residential neighborhood. In Puyo, homestays are generally located near the main square with easy bus access to clinical rotations. Interns may be placed in a homestay with other participants and may share a room. Two meals per day are included, as are laundry services (once a week).

Participants will be instructed on recommended transportation from homestays to clinical rotations and getting around the city at the welcome orientation.

Check out pictures from this internship.


Fall | Winter | Spring | Summer

Application Deadline

Summer: January 25
Fall: April 15
Winter: September 1
Spring: November 15

Basic Requirements

- See Qualifications/Requirements section