David is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on his recent experience.

"Seven months earlier, I had been looking at similar holes in the ground. The work of my parents in Pakistan included sanitation among its central aims, so when I went back to discover some of my roots in rural Mansehra, I found myself looking at a latrine. It was built in the same year that I was born, founded in the same Pakistani soil. And so, to visit the model latrines by Swami Vivekananda Youth Movement in India was for me a form of homecoming, of rediscovering my community health heritage.

Water-borne diseases still account for a large portion of the burden of disease in rural India. According to UNICEF, 1.7 million children worldwide under 5 years of age die from diarrheal diseases, accounting for 16% of all child deaths.

Diarrheal deaths are both easy and difficult to prevent. Easy, because prevention is low tech: all that's needed is basic sanitation and access to life-saving oral re-hydration salts for when children do get sick. Difficult, because these are infrastructural solutions, and the problem persists in areas in which infrastructure is most lacking: remote, rural communities. Since these areas tend to be politically disenfranchised, and because sanitation projects aren't very glamorous, mobilizing the resources to confront the issue can pose additional challenges.

After taking this photograph, I stood staring at the holes in the ground for a time, even as the others started down the road toward the school. This model latrine seemed to be the intersection of my past experiences. From my childhood confrontations with poverty in Pakistan and my corresponding lifelong interest in community health, to the maturation of this interest in rural Ecuador, to my return to Pakistan, and finally this visit to rural India, the concrete between the bricks of the latrine seemed like it was holding together the disparate pieces of my personal history. I felt that if I could put my figure on the unifying theme between these experiences, I might have some indication as to how I should approach the future.

Standing there, I found one possible answer, one unifying thread to join each of these experiences together: leadership. In Pakistan, it was my parents; in Ecuador, it was the Ministry of Public Health; in India, it was Swami Vivekananda Youth Movement. In each place people dedicated themselves to the problem of infant mortality, and set about finding the best way to bring about change. As I stood gazing at the latrine's narrow profile, so familiar I swear I could have found myself in Alto Ongota or Mansehra, the wall's seemed to tell me a silent message: It doesn't matter where you are. Just be a change agent."

- David, U of M Pre-Med Student

Abhayjit is a University of Minnesota student, who shared his reflections from his learning abroad experience in India.

"In the big picture, today was no different than yesterday and will probably be the same as tomorrow. However, sometimes it's the little things that happen everyday that are memorable. I'd like to share one that occurred today.

I was doing routine surveying and was about halfway through the village when I knocked on Mrs. Rai's door. She was an elderly woman who lived alone, and so normally I would have politely declined her invitation to come in for chai and moved to the next house (I am supposed to survey parents with children between the ages of 1 and 3), but for some reason I decided to stay for a few minutes.

We briefly discussed where I was from, what I was doing, etc., before I started to ask her about her life. Before I knew it, a few minutes had turned into an hour. As we were chatting, I found out that her husband had been killed several years ago while at work in a factory and her only daughter had fallen victim to malaria as a child.

I could not muster any words past 'I'm sorry.' What other words were there?

When it was finally time for me to go, Mrs. Rai suddenly burst out, 'Thank you so much for listening. I haven't had anyone to talk to in years. God bless you.'

In Indian culture, blessings from an elder are worth more than all the material successes in the world and are thought of as a blessing from God. Nursing homes do not exist in India, elders are cherished as the wisest people and no child would lose the honor of caring for their parents. I had been given the blessing of my elders, the greatest gift I could receive, from a woman I had met just over an hour ago and would probably never see again.

And yet, never have I felt less deserving of such blessings. What had I done for her? Sure, I had talked with her, offered a fleeting hour of relief, but it pained me that I was powerless to do anything else. We are always told that actions speak louder than words, and perhaps that is why I feel so helpless in situations like this. I wonder how many other people and their stories go unheard.

Today I learned that a listening ear is such a small thing to give, but can be huge to receive. Thank you, Mrs. Rai, for sharing your story with me and honoring me with your blessings."

Students often run a blog to document and share experiences and photos of their learning abroad adventures.

Here is a blog featuring a former Health Careers Center student, who is now completing a learning abroad experience in Tanzania. Read about her exciting adventures here:

Olivia in Tanzania

Alanna is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on her recent experience.

"On my recent trip to Mysore, India I had the amazing opportunity to visit a rural elementary school set up by Swami Vivekananda Youth Movement in Hosahalli. We arrived at the school during several of the classes outside time and so we watched the girls help each other carry dirt to an area where the boys were building a new stage.

The children were all cooperating amazingly well and although it seemed like fun to us, they were all actually learning a lot from the exercise. They were building many skills including teamwork, leadership, and cooperation, as well as practical skills such as balancing heavy objects on their heads and engineering. I found the addition of practical skills that they will need for their daily lives in their villages into the normal school curriculum extremely practical and very intelligent.

After a few minutes of us watching in awe as the young girls carried very heavy plastic containers on their heads about 100 yards to the new stage, they became very interested in us and stopped their activities to come over and talk.

Right after I took this picture all of the girls started singing one of their traditional folk songs for us and it was absolutely beautiful. When they finished they all giggled and then asked us to sing for them.

We all looked at each other in confusion as we tried to think of what to sing.

It was then that I realized how close they were to their community and to each other and how comfortable they were with singing impromptu songs together. I feel that we have lost that as a culture and as we are so far spread apart and separate in our daily lives, we have lost our sense of community.

These girls although very close were also very different in their reaction to us. Some of them were very shy and although they came over to see us, they did not directly interact with us. Others were a little more confident but not comfortable with direct questions, and then there were the few who were very confident and curious and enjoying engaging us directly.

The picture that I chose really shows all of these girls feelings very well and just sums up my experience at the school perfectly. From this photograph I can feel the excitement of our visit and the confidence and shyness of the girls.

I also think that this picture tells the universal story of girls around the world. There will always be a variety of personalities in any group of children and even though we were in India, I think that this picture shows what would be seen in any country and just shows how similar and connected we all are. I really enjoyed my experience at this school and will always look back at the memories made there very fondly."

- Alanna, Global Physician student

Christina is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on her recent experience.

"This is a picture of the market that our group often traveled to in order to pick up food, clothes or gifts for people back at home.

This market was such a central part of this trip--not only because we needed to purchase items but because it was here that our entire group got a taste of real Indian culture; we had our first visit to the market on the first day of our trip (jet-lagged and all).

We experienced all of its' smells and colors and tastes. We experienced the feeling of trying to stay calm as dozens of aggressive people selling from their market stands paraded us, and in even larger quantity the beggars whom physically blocked our way to sell their products. We experienced the curiosity of everyone we met to who we were and where we had come from. Saying that this experience on the first day of the trip was a culture shock would be an understatement.

Of course, after the first visit, the visits got easier and more comfortable. We got used to the colors, smells, tastes and people. And let me tell you, the people were the best part.

We started making friends with locals who wanted to hear our stories. Every once and a while we got lucky and they shared theirs.

One story that sticks out in my mind is man who was selling a bizarre mix of souvenirs, personal hygiene products and candy. One of my friends was buying a razor from him when the vendor asked if I had any coins.

At first I didn't understand what he was saying (language barriers can be rough sometimes), but when it hit me I started looking for American coins. When I pulled out a quarter and some other small change, his face lit up. He said he loved collecting coins from the foreigners that he came across.

I gave him the coins that I had and he sent me off with more candy than I could eat in a week. The friendliness of everyone there at the market (minus a few of the most aggressive beggars) was astonishing. A few of the most genuine moments I had happened in this marketplace."

- Christina, Global Physician student

Elaina is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on her recent experience.

"This photo was taken at a local volleyball court just a few minute walk from our hostel. This photo is relevant because it brings back so many memories of why I enjoyed our trip. I loved the people I got to meet in India. The locals are incredibly nice and always willing to help. I loved the fact that we could walk for a bit, and suddenly there would be the hustle and bustle of India.

There was always something going on for us to enjoy. As you can see, our trip to India was far more than a class or lecture on public health of a different country. It was a full submersion into a different world, causing us to think in different ways and contemplate how our belief systems affect our health. Therefore, it was important for us to go out and see how daily lives of the people.

Most memorable moment:
My most memorable moment from the trip was the visit to the market on the first day. We were set on our own in Mysore's largest market. As a jet-lagged, slightly ill, and probably a little homesick blonde American girl, this was enough to send me into culture-shock. I was amazed by the amount of smells, colors, vegetables, fruit, and people.

We were being bombarded by beggars and people trying to sell us bangles, bracelets, head-scratchers, and something called "pecking chickens". I was frankly too amazed to even try and buy anything. We tried to escape the business of the market and ducked down a different street, where we were approached by a mother and her baby. It was incredibly hard to turn them away, but we all learned life lessons from the experience. I know I will never forget the feeling of being in the city on that day.

What have I learned about myself on this trip:
The thing I learned most about myself on this trip is that I barely know anything at all. After this trip, I see that there is a wealth of knowledge in this world that I need to pursue, starting with a little soul-searching.

I was inspired by the Indian belief systems that emphasized knowing one's self. Knowing yourself is important, especially in health care, because how are you supposed to make the right decision or bounce back from trauma if you don't know what you think or how you feel. Similar to what we talked about in India, you have to start with the circles closest to yourself. You fix you, then your family, and then move outwards until you're healing the world.

Advice for future students:
Go in there with your eyes wide open but ready. Read articles and stories from India beforehand. Study their religions, medical practices, and epics. However, be ready to change your opinions once you get there.

Also, practice cold showers before you get there."

- Elaina, Global Physician student

Katelynn is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on her recent experience.

"Most schools in India are not like this school. Most schools simply focus on memorizing the facts. As we toured the school, we saw many different vision statements and important quotes on the walls:

Two of my personal favorites were 'your greatest challenge might be to learn to love yourself' and 'If you are born poor, it is not your mistake. If you die poor, that is your mistake'.

I felt a real emphasis on development of a person as a whole rather than rote memorization. The teachers wanted to create a low-pressure environment for the kids. In order to do this, they preferred that the kids called them sister or brother instead of using Mrs. or Mr.

Tests were presented in the form of a worksheet as well to keep anxiety levels low. In the school, there was a biology lab, a physical sciences lab, a computer lab, and much more. These students were learning things that I don't think we learned that young.

Specifically, the preschool children pictured above were learning multiplication and division, already having mastered addition and subtraction! The point is--these children, born in rural areas, are given all the resources to develop into quite the intellectuals--they are extremely bright. They are placed into an environment that makes them excited to learn. Regardless of their financial status, they are given the opportunity to become something, and it seems as though they are fully accepting this opportunity, so watch out world!

One thing that I may not have realized before traveling to India was the variety of subjects we would actually be encountering. For instance, we learned about philosophy during the first lecture. We learned about Indian culture, education systems, economics, and dabbled in some politics in following lectures. Then we went on to learn about the infrastructure of the healthcare systems, public health, and diseases heavily affecting India among other things.

From day one, we talked about why we were sitting in a classroom in India instead of sitting in a classroom in the United States learning about Indian healthcare. It simply could not be done without immersing ourselves as best we could into the culture. We got to learn and experience all of these topics firsthand and education, in particular, has an impact on healthcare. Getting to visit the Viveka School of Excellence showed me how.

In America, I don't think we would ever even consider going to the bathroom outside or in a hole when we have the comforts of indoor plumbing. For some people in India, a hole in the ground is all they have ever had and all they have ever known. And for example, what they don't know is that this hole for human waste lies close to a water line, supplying a small town of their water (which could be infused with bacteria from fecal matter). So when a child goes into the doctor with a stomach ache and the doctor finds a parasite, they give them antibiotics which are only a temporary fix. The doctor needs to go to the root of the problem, and that is where education comes in. If children can be educated from a young age, they can avoid or learn to solve problems like these. So when I am asked which is more important: medicine or public health? I stand on the line. One cannot survive without the other. Education is imperative to the success of medical practices.

This trip has been the most influential experience on my life this far. I would say the biggest way this trip has affected me is that I now feel empowered. I think this trip has given me the motivation and the courage to incorporate what I have learned into my daily life. Like our instructor, Balu, said, I will first need to start with myself. I can change the ways I live to use my resources more wisely, for example. Then, I can start with my community and expand from there. I think the best thing to do is to carry the message of what I learned and people who want to make a difference will care. On the road to becoming a future physician, I've learned that being a doctor will be so much more than treating a symptom. I think this is the beginning for me to start making a difference, and public health and medicine will always be something that I am passionate about.

Advice for future students--embrace the culture shock! I think you can choose to reject the culture or you can jump outside your comfort zone and just immerse yourself into the culture. The comforts of home aren't going to be there, and that is the point. Pay attention to how you feel after all your experiences, and reflect on this feeling. Lastly, challenge yourself, and try something new. When else will you be given an opportunity like this?"

- Katelynn, Global Physician student

Jamie is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on her recent experience.

"The picture here was taken at the Mysore market, one of the first days we arrived in India. The market largely consists of fresh fruit and vegetables, and way too many people! The market was insane because of the amount of people and trash, along with the exaggerated smells and sounds. It was a lot to take in and observe for our first day, but the sooner we were exposed to the scene, the better. By the end of the trip I felt completely comfortable going to the market.

I chose this picture to do the assignment on because the market was a good indication about the lack of public health in India. The main observations I made were about the trash all over, the flies, people not wearing shoes and the unhygienic environments the food was kept in. It was not uncommon for people to throw their trash on the ground. I did not see many garbage cans in general throughout my stay. The fruits and vegetables generally looked dirty, and were kept in wooden boxes on the street, and flies on the food were not uncommon to see. I mentioned that some people did not wear shoes. While this unhygienic practice is not related to the food, it is a public health risk that is not addressed. Certain kinds of worms can enter in through your feet and make a home in your stomach and intestines.

Seeing such practices show how far behind India is in educated the public about hygiene. The main thing I learned from this specific experience and others related to it is the importance of both medicine and public health. Medicine cannot be effective without treating the source of the problems. Our group discussed this a lot in our debriefing and even had a short debate about the importance of medicine versus public health. It only makes sense that if a disease or infection caused by an environmental issue is treated with medicine, once the patient goes back to their home they immediately become at risk again. Public health and medicine should go hand-in-hand and my trip to India helped me to realize this."

- Jamie, Global Physician Student

Tyler is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on his recent experience.

"The Mysore Palace is lit up for one hour every night and we had the pleasure of witnessing this first hand.

Personally, this was one of my favorite activities that we did as a group. Besides serving as a tourist zone and attraction, I believe that the palace has much more to offer, especially to the citizens of India. As aiming to be a Global Future Physician, it is important to understand others' backgrounds, what they believe in, and the lifestyle that they lead.

The Palace is especially relevant since it represents one belief cohort and/or religion that may be practiced in India. Although we have many different religions in the U.S., the Indian religions are much more sacred, whole-hearted and implemented into daily life.

Despite these various religions country-wide, people would come to this palace to worship the Gods and temples. It didn't always matter that they were of different religions or had different beliefs. What mattered was that everyone could agree on something, everyone could find common ground.

Seeing this had a huge impact on my outlook of being a Future Physician. As a physician, diversity and cultural differences will be vast, but, is it truly possible to find a common ground among everybody? To serve everyone as equals? I believe that this is true. Every single person deserves a right to equal and above-adequate health care and through a round-about way, the visit to Mysore Palace showed me that.

Most Memorable Moment
My most memorable moment of the trip was being able to work together as a team of students, 9,000 miles away in a foreign country, and to help each other deal with problems that arose.

Mainly, culture shock was the biggest thing to hit everyone. But, through talking with peers, team leaders and the trip advisers, we were all able to help each other out. Yes, the excursions, field trips and lectures were all very memorable, but, the interpersonal skills shown by the entire group is something that will stick with me forever.

Reflection
Reflecting back on the trip, I have learned that the U.S. is not the best at everything. It sounds quite naive to admit that, but I feel that the trip helped me to overcome this issue. Just because the U.S. is more technologically advanced and has a higher GDP does not necessarily make citizens better-off. One lecturer told us how happy most Indian citizens were, although they may have sub-par living conditions and lack of adequate health care. This taught me that there is an inner-happiness to be had, regardless of annual income, profession or how many "things" one person may have.

Advice for Students Traveling Abroad
Keep an open-mind. I have traveled abroad before, but the culture shock I experienced in India took me by surprise. I thought I would be fine and wasn't worried at all, but it hit me by about the third or fourth day. Staying responsive, talking about what's bothering you, and being accepting of the culture is the biggest piece of advice I can give."

- Tyler, Global Physician student

Abhayjit is a University of Minnesota student, who shared his reflections from his learning abroad experience in India.

"This week Dr. Ashish was going to Utter Pradesh, a nearby state, for some work and asked me to accompany him. There were various forest tribes living near the Nepal border whose land had been illegally seized by the government. To make matters worse, the government was also refusing to open a desperately needed health centre nearby, which is why my boss had volunteered to teach some basics of disease prevention and treatment.

After nearly 24 hours of straight traveling, we arrived around dawn at a small hut deep inside the forest. I was shocked that people actually inhabited areas so cut off from the rest of the world, and even more surprised that their ancestors had been here hundreds of years.

Shortly after, we were all sitting cross-legged in a circle and having a discussion about polio, malaria, and other diseases that these communities were suffering from. A lot of the conversation was spent explaining things I had always assumed as common knowledge, such as how mosquitoes (not magic curses) cause malaria, but was very important for these people.

What impressed me most was Dr. Ashish's patience with the villagers, who were obviously less educated than him.

As someone who has always fervently denied mysticism or non-scientific causes of disease, I wonder how I would have reacted to some of the villagers' insistence in their beliefs. Would I understand that it wasn't their fault no one had bothered to teach them to read, much less human biology? I tried my best from there on out to relate to the villagers and see things from their point of view.

And then I heard them.

Around sunset, the women of the village had gathered in an open area with several homemade instruments and started to sing. The song put into words the hardships they faced in day-to-day life. Their husbands slaving away for meager pay. Their land being stolen. Their children dying of illness. And all the while the rest of the world went on without them.

However, I cannot describe it is sad. It was both sobering and uplifting, resentful and empowering. I cannot fully put into words what I felt right then.

We have all experienced moments where we feel like an outsider looking in. I was the boy who understood too little, stood out too much, and would be gone as soon as I arrived. I have come to look at these fleeting moments as opportunities for self-change.

As I sat there, listening to the song but unable to relate to the message, I thought about what the lyrics of my own song would be. The death of a distant relative? A broken bone? A poor grade?

It was then that I truly realized just how fortunate my upbringing had been. I have never had to wonder whether I will have dinner, never had to sacrifice my education, never experienced a shortage of love.

People say that visiting poor regions such as this gives you perspective on life, but I think there is more to it than that. It is easy to witness poverty and hardship and say that it changed your life, but to truly gain perspective, I feel that one must open yourself up and try to genuinely connect with the people around you.

I have been here over a month, and to be honest, this is the first time I have felt like this. I don't feel happy or sad or upset or grateful. I simply feel humbled."

- Abhayjit, U of M Pre-Med Student

Tom is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on his recent experience.

"During our trip to India, I was very surprised and excited to meet local people who were just as interested to learn about our culture, as we were to learn about theirs. Nearly everywhere that we went as a group, we had children and adults alike coming up to us to ask us our names, where we were from, what it was like there, and to share stories. Many would even ask to have pictures taken with us to remember the moments.

This group of boys pictured here was very inquisitive. They were fascinated by American money and history, and wanted to know what each and every symbol on the one-dollar bill stood for. They even knew that our first president, George Washington, was that big face smack dab in the middle.

The children followed those questions by telling us about their school, and their studies, and what they liked to do outside of classes. They were so interested in that bill actually, that they were willing to trade it for Indian Rupees from one of our members. I believe they ended up getting it as a gift.

By far, my favorite part of this experience was getting the chance to step outside of my comfort zone, and to be able to talk and share cultures with the welcoming people of India. My biggest advice to any future student on this trip is to jump right out there, be uncomfortable, and be willing to absorb and digest a culture that is worlds apart from what they are used to. The best way to learn is to experience firsthand, to not waste any chances, and to make the most out of it."

- Tom, U of M Pre-Med Student

Abhayjit is a University of Minnesota student, who shared his reflections from his learning abroad experience in India.

"Today my boss thought it might be interesting to try something different. Knowing that I eventually planned on a career in medicine, he thought it might be nice to see the difference between a hospital here and the US and asked whether I wanted to shadow an overnight shift in the Emergency Room in a government run hospital. An important thing to keep in mind is that healthcare in India is divided into public and private sectors, and you can guess which one is better funded and equipped. And it's not the one with more than double the patients...

The first four hours of the shift had gone by relatively quickly, due to the enormous rush and huge number of patients yet waiting. I was shocked by the doctor's ability to keep the names, symptoms, or medications straight, as she was talking to 3 or 4 simultaneously. I could drone on and on about how there were too many patients, too little staff, no organization, and so forth, but I would rather share a story about a patient encounter I found interesting.

Around midnight, an unconscious patient was brought in by his family. The doctor quickly checked his vitals with a slightly annoyed look on his face. After a 30 second or so appraisal, the doctor announced that the patient was faking and delivered two quick slaps to the patient, after which it looked like the patient winced.

Both and patients family and I were flabbergasted at the scene unfolding in the ER, and some began to protest, but the rest of the staff didn't even give the scene a second look. Not paying any attention to the family, the doctor started tickling the patient on the foot. Immediately and to the shock of the family, the patient burst out in laughter with a mixture of anger and guilt on his face.

The physician who just moments ago had seemed cold and rash was now intelligent and experienced.

Thankfully, I didn't get a chance to see the events unfold between the patient and his family, but the doctor I was with tried to make some sense out of the event for me. Apparently, the scene we saw is not uncommon, with make patients coming in without symptoms and simply faking, or putting on a "nattuck". I found out that these patients are sometimes unemployed, depressed about something, or feeling unappreciated (the last one is more common in young women) and so they come to the ER under any guise. Since there are not counseling centers or mental health professionals available at the clinic, the physicians just send the patients home.

I understood that there are too many patients already and the hospital cannot possibly treat all of them, but as someone who tries not to love or hate, rather falling somewhere in-between, I wondered how I would have handled the case. The main reason I have for sharing this story is that today I was shown firsthand how big a part culture and society can play, even (or perhaps especially) in the confines of the Emergency Room. I hope that I can grow to be a physician who is knowledgeable about different people and cultures, and try to provide appropriate care if I have the resources to do so."

- Abhayjit, U of M Pre-Med Student

Taylor is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on her recent experience.

"LakSchmithathachar was lecturing this morning about Indian philosophy and the basic ways that Indians find greater meaning or explanation in this world. I love thinking myself in circles and trying to riddle out the motivations for certain ways of thinking.

He asked the question, 'Is an apple one or many?'

Both.

He went on to say that science divides while philosophy unites. In my opinion, science is a method to understand not only more about a subject, but also the how behind its purpose, which is the ultimate goal of philosophy. I would say that science actually brings us closer to knowing everything. Philosophy is big picture while science is more detail orientated but they both compliment when integrated.

Indians are passionate and very intelligent people. Their childhood ingrains excellent memories through their memorization of the Vedas. Furthermore, lessons learned from the ancient texts themselves can be applied to everyday challenges. For example, mortality and death were some central themes in Indian beliefs. Interestingly, it is not feared so much here because dying is viewed as a release from human/secular suffering. This is an interesting concept when thinking about some drugs that encourage suffering to prolong life. I am still against euthanasia, but I would like to not fear death so much and greet it as a welcoming cycle where I can continue onto the next adventure. It opened my mind to new ways people think and use logic to explain the grey area outside of science.

Indian philosophies can also relate to health. Doctors must have systemic view of the human similar to Visistadvaita followers. The consciousness and body work together in order to sustain life. Integral parts are present that mutually depend on each other. Many physicians today see the body and healthcare as mechanistic. Replace what is broken. Remove the bad. However, these practices aren't enough. The human body and mind are beautiful and compose a work of art that requires cohesion. They are both inseparable and complimentary. Therefore, a holistic approach to treatment is the best option. Similarly, doctors themselves cannot be independent. They are an integral part of healing but not the only part. They must be able to work on a team in order to accomplish what is best for the patient's health."

- Taylor, U of M Pre-Med student

Yusuf is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on his recent experience.

"The photo [here] displays the immense concentration of people within India. India's population vastly overwhelms its resources and is a major factor hindering India's rate of development. The over-crowding in India has perpetuated the neglecting of 'personal space'. The uncomfortable and/or awkward feeling a typical American would get in a packed to capacity elevator is a feeling one has to become accustom with while being in India.

The first day in India we were submerged into India's dense population via the 'sink or swim' method in the market area. This method of acquainting us with a typical day-to-day interaction in an Indian community tested our ability to adapt outside of our comfort zone. Our encounters in India ranged from friendly smiles and greetings to nomad salesmen badgering us to buy their product, and then to mothers (some with babies) and children begging for money.

The encounters with the begging mothers and children really hardened me in the sense that I would not give in to their begging and would instead ignore them and their actions. By not giving in to the begging, I did not further perpetuate this way of living and instead indirectly pushed the beggars to seek alternate routes of providing for themselves and their families. This experience in India really highlighted the concept of finding a solution that will better serve people in the long run instead of a quick-fix solution that will not be sustainable. This concept is crucial when it comes to healthcare, especially at the global level, in order to truly better everyone's health.

My experience in India has showed me that an individual can spark an idea that can change many lives, but the idea needs to be carried out and implemented by a team in order for the idea to take affect. This idea of teamwork reflects back to public health and medicine collaborating with one another in order to develop and improve health starting from the local level and expanding to the global level.

My advice to future students who go on this study abroad is to expand your boundaries and welcome all the aspects a different culture can offer you from the food to the philosophy and beliefs. Being able to understand and assimilate to a different culture can broaden the way you think and perceive the world around you."

- Yusuf, U of M Pre-Med Student

Allison is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on her recent experience.

"On our jungle retreat weekend some of us woke up early for a morning hike up a nearby hill. We were told there was a temple there, and when we arrived at the top we were not disappointed.

The fog was still heavy while we explored the temple and listened to the sounds of India waking up. A man came to bless the temple and music echoed across the fields from a nearby festival.

Soon the fog began to burn off, and our hill was made to look like an ant hill as mountains appeared to erupt from the clouds. Slowly the morning fog receded and the giants surrounding us were a reminder of how limited our perspective of India, and the world, truly was from a top that small hill.

One of the major lessons I have come away with from my experience in India is the importance of reflection. Before the mountains around us were exposed, I felt my position on top of the hill was the highest I could climb. When the fog lifted and I realized what was truly surrounding us it was a reminder to reflect on my experiences and the perspective I have.

There were many times on the trip when I felt a less literal sense of the fog lifting and new ideas or inspirations coming into view. Without reflection these experiences would have been far less meaningful. I will never forget how mystical the mountains looked as they appeared to float in the clouds, but more over I will use this memory as a reminder to reflect."

- Allison, U of M Pre-Med Student

Melissa is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on her recent experience.

"I was not ready to come home. The thick smells, vibrant colors, intense noise, passionate culture-it all hit me as soon as I took a step off of the plane. Everything about India captured some part of my heart and a large majority of it was consumed by the people, mainly the children.

This picture was taken at the Viveka School of Excellence, a community based educational project which is targeted at providing a new type of learning system for the children in Sargur, a rural town located in the Mysore District of Karnataka. This school incorporates an interactive and open thinking approach which differs from the accepted standard of the memorization learning method. While this modification challenges traditional Indian education, it can be argued that it stimulates better thinking processes and ultimately creates better advantages later in life. However, parents are still fixated on their child passing the required exams that are based off of the traditional memorization methods, making this transition less readily acceptable. This is just one example of multiple movements throughout the country where traditional beliefs and customs are being adjusted to promote a better life. This also shows a general theme that was seen throughout the trip of how issues must be addressed from the source to promote a sustainable change.

The three little girls in this picture saw my camera and immediately took a pose for a picture. The sole reason for this, as I soon figured out, was so that they could promptly look at it after to point each other out while laughing hysterically. Soon we had a mini photo shoot taking place, with the youngest consistently taking center stage in front of the older girls. She would grab my camera after, point herself out, throw out a high-pitched squeal of excitement and run back to the others for yet another picture. When it was time for me to leave, she waved with a big smile on her face and say "bye akka!", which I was told soon after by Dr. Prasad was the word for older sister. I cannot explain how the children affected me and the feelings I experienced at this school or even being to think of how to explain the influence this entire trip had on me. All of the children throughout the trip were exceedingly warm-hearted and just genuinely happy, even when it was noticeable that their lives were not economically stable. This is probably one of the most important aspect that I learned on this trip; wealth and happiness does not come in the form of money. It is a simple statement which is brought up throughout life, but I did not really grasp this concept until I came to India.

My advice to future students would be to not let something keep you from the numerous experiences available during the trip. There may be something that you may not enjoy very much or a bad experience may happen, but do not let this take away the rest of the trip for you and always keep a positive attitude. This opportunity will go by so fast and you never know when you will get another one, so take advantage of it."

- Melissa, U of M pre-med student

Abhayjit is a University of Minnesota student, who shared his reflections from his learning abroad experience in India.

"My initial success was apparently short-lived. The very next day, I went to a different region- alone. Unknown to me, but this region was not very accustomed to speaking Punjabi, and even less accustomed to foreign dialects. Further, it seemed they had their own dialect that I had to navigate. My first victim must have thought I failed grade school. It took a good ten minutes to explain why I was there, and that too with slow, sloppy, and at times incomprehensible Hindi.

Despite the language barrier, I was able to get my point across (charades are universal, it seems) and to get some answers. The rest of the interviews in the region proceeded in much the same way, except for a few near the end. Unlike yesterday, not everyone here was so welcoming. Maybe the presence of my boss had helped to reaffirm people yesterday, but today they wanted more information. Who was I? Why was I there? What are my qualifications? (This one made me scratch my head as I tried to think of an answer)

Overall, aside from a couple of people who really couldn't understand me, and one who had refused to let me in, the day as a success. Moreover, I was noticing a trend after just two days. It seems the two most common answers to why people missed vaccinations were lack of communication and transportation. Before I got too caught up in my deductive powers, I reminded myself that the villages I had visited were both in very remote locations. Suddenly my discovery wasn't so groundbreaking."

Abhayjit is a University of Minnesota student, who shared his reflections from his learning abroad experience in India.

"To my relief, my boss has decided to accompany me on my first day, although he has taken a vow of silence unless I really crash and burn. As we approach the village and head toward the first house, I silently run over the survey we spent the last couple days making. I'm still not exactly sure what I am so nervous about, but I nevertheless prepare myself for an awkward and uncomfortable meeting.

It seems I'm way off the mark, however. The woman who answers the door greets us very warmly by clasping our hands and touching her heart. She invites us into her modest home, which is one big room containing the kitchen, dining table, and two makeshift beds. As we make small talk, she prepares chai, brings us water, and force-feeds us biscuits, despite our many objections.

This is one thing I love about India that still exists in rural regions -- Mehman Bhagwan hota hai, which is roughly translated to guests should be treated like God. This woman has no idea why we're here, and yet she invited us to share her home. Her entire family may live on one meal a day, but she'll make sure we don't leave without having something to eat. It's a rare thing to see in today's world, and one can't help but smile at her generosity.

Back to our interview, it's going very smoothly. The woman is being very helpful, and even seems to understand my strange foreign dialect of blended Hindi and Punjabi. She lets us know that the reason her son didn't receive his vaccination was because he was delivered at home (which is often the norm), and didn't know where or when to go for the immunizations. It seems that although India has planned for immunization visits to each village at least once a month, the chain of communication is lacking somewhere. I was very happy with how the rest of first day turned out as well, and had high hopes from there on out."

- Abhayjit

Shailey Prasad, MD, MPH and Tricia Todd, MPH led a group of 25 undergraduate students to Mysore, India for three weeks to help them understand the challenges and opportunities they will have as global future physicians.

Five teams of students will present what they learned during their global seminar:

A Day in the Life of...How Environmental and Social Surroundings Impact the Health of Indian Citizens

The Road to Care:
Global Rural Health Disparities

DETAILS
Monday, Feb 27
5:30 - 8:30pm
1-450 Moos Tower
No registration needed.
Refreshments will be served.
All are welcome!

This trip was sponsored by the U of M Health Careers Center and supported in part by the U of M Department of Family Medicine and Community Health.

Colin is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on his recent experience.

I approached a young Indian boy wandering the grounds of the Viveka School of Excellence who had been eying our group of pure-bred mid-westerners inquisitively from a distance. The top of his head barely grazed the height of my waistline, yet his beaming smile exuded confidence that could hardly be contained by his miniature stature. After bumbling through a the few phrases in Kannada I had picked up from Dr. Prasad, I asked him if he was going to grow up big and tall like me some day.

"It depends on my genes," he replied.

Taken aback by the complexity of his response, I asked what grade he was in.

"4th standard."

I stood there completely stunned.

After a twenty-hour plane ride followed by a several hour-long bus commute through the countryside of India, I had just received a lecture on developmental biology in my native language from a ten year old. Yet, the best part about the entire situation was how right this little boy was. Everything, apart from our Y chromosome, could not have been more completely different. With a sudden burst of energy, the little boy ran off to rejoin the game of tag my presence had interrupted.

Later on that day we visited another school founded by the Swami Vivekananda Youth Movement located in a tribal community well north of Mysore. After touring the campus with a few of the teachers, I broke off from the group with a few other students and began exploring the grounds. Off in the distance, we heard the shriek of giggling girls resonating from the forest. We crossed the cricket pitch and ran into a truly extraordinary sight. One by one, a line of girls were passing buckets of mud from the tops of each other's heads, dumping the contents in a uniform square pile in a clearing.

"They are building a stage," one of the teachers explained, "for the choir to practice."

Suddenly, one of our group members emerged from behind a hill with a group of girls in his wake. Tom, the six-foot-four Goliath, had hoisted a bucket over his head ran for the clearing as the screaming girls chased after their precious tool now located far too high off the ground. The entire student population was now aware of our presence, and all of the girls had stopped their current duties to form a circle around us.

"Would you like to hear a song?" the teacher asked.

Before we could respond, the teacher had ordered the girls to bunch together, glancing at each other nervously as they formed a group. From the moment they opened their mouths to sing, it was clear why they needed a stage; their rendition of a local tune was a combination of cute and beautiful that I cannot quite do justice. When they were done, all of their eyes darted towards us, eager to hear us sing next.

After much deliberation, we forced our way through a pitchy version 'Happy Birthday' and continued to help the construction of the stage they rightfully deserved.

Honestly, there were a dozen other stories I could have told about the Indian children that flocked to our group every time we left the hostel. With a population of over 1.2 billion people, it was not hard to find a group of kids playing cricket or covering the streets with sidewalk chalk that were eager to practice their English, smiling ear-to-ear as we talked about frigid Minnesota winters or our pets back home.

I thought I left for India prepared for what I was going to find. Everyone from my parents to the physicians at Boynton Travel clinic had warned me about the poverty, disease, and suffering I would encounter during my stay in this rapidly developing country. Yet, amidst all of the bad things India is often portrayed as, no one told me the people would be so welcoming, the children would be so happy, the history would be so rich, or countryside would be so gorgeous. I had no idea I would learn so much about myself from simple things like running water and fresh air. Most importantly, I would have never expected to fall in love with a culture so different from my own.

Before I go, quick words of advice for any students wanting to go on the trip in the future. Be prepared for anything and everything, you never know when a learning opportunity will arise. Who knows, you may even be lectured by a 4th grader.

- Colin, U of M pre-med student

Lauren is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on her recent experience.

"I learned that there are still millions of women in India who aren't as "valued" as the men in their society, especially in rural villages. Daughters are considered a burden. ¼ of Indian women cannot leave their home unescorted by a male. Girls are being wed to older males before the legal age. Many are not well educated about contraceptives and women's health. Often women have too many children too close together because they don't know of the risks and how to prevent it. Overall many Indian women just don't get the respect and rights they deserve has human beings. However there is change happening. And with that change comes hope for a brighter future for India.

I learned that the empowerment of women leads to a more developed society. Empowering women includes giving them a formal classroom education along with social and environmental education. It has been shown that once women feel more empowered, they strive to make a difference in the community. Women tend to be the ones spending more time raising the children. If a women is empowered, she can teach her children good morals and to be strong, hardworking people. These children in turn will be able to help build India.

I chose this picture because I firmly believe that the women of India truly have a big part in the country's progress. Once women find the strength and confidence, they can move mountains. I really like how it shows the traditionally dressed older women alongside the girls in school uniform. I think it truly shows that in the rural parts of India change is happening.Girls are getting an education and improvement is bound to follow. "

- Lauren, Pre-Med Student

Abhayjit is a University of Minnesota student, who shared his reflections from his learning abroad experience in India.

"Bright and early Monday morning and I'm finally beginning to get over my jetlag caused by the 11 ½ hour time change (I'm clueless about the ½). I've had a few days to get adjusted to the setting and I'm feeling pretty comfortable about my theoretical knowledge of the Indian Health System. The organization I'm working with is the National Rural Health Mission (NRHM), which was created in 2005 in an effort to improve the health condition in rural India.

My boss (Dr. Ashish) is working in the child health division of NRHM, and the first project we are working on is immunization. Six years ago, India had implemented a universal immunization policy, but there are still a large number of children left unvaccinated. I was to take sample size surveys in an attempt to figure out the reasons children missed vaccinations.

I had wanted a project that involved community interaction, and I was very excited to be working on an issue I felt was relevant to Indian and global health. Still, I couldn't help but feel a little apprehensive about the whole thing. It's one thing to extract RNA from cell colonies, but asking people why their children aren't immunized? Would they think me rude or disrespectful? Even worse, what if their child was suffering from polio or measles or something else on the vaccination list? Would they feel I am blaming them? All questions which, for some reason, I am too afraid to ask. I guess I'll find out soon enough."

Abhayjit is a University of Minnesota student, who shared his reflections from his learning abroad experience in India.

"Surprisingly, I felt pretty good as we were seeing my dad off back to the States. Maybe it was because I felt comfortable with my uncle and my mentor, or maybe I was distracted by the chaos of getting settled in a new place. Either way, I have no doubt I will get homesick at some point, but that's to be expected.

My mentor thought it best that I take the first week to settle in and become familiar with the area, as well as to learn as much as I could about the health system in India. To help with the latter, he give me several large booklets to read over by weeks end...

I have a cousin who lives in a neighboring city (it's a tri-city area), and so I'm excited about exploring with him. We see relatives and visit the highlights of the city during the day, and then I get back to learning all I can at night. In a couple days, my boss will let me know what exactly my first task will be, so here's looking forward to getting started."

Sam is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on his recent experience.

"This picture was taken in Kenchanahalli, India on the campus of a Swami Vivekananda Youth Movement healthcare facility. This particular building was, as the sign indicates, an Ayurveda Treatment and Research Center. This picture has paramount implications in regard to the Indian healthcare system."

Traditional and "Western" Medicine
"Ayurveda is system of traditional medicine in India that translates in Sanskrit 'ayus' meaning longevity and 'veda' meaning knowledge or science. This form of medicine uses both preventative and palliative forms of treatment to fight against ailments of the body. Most traditional systems of medicine are rejected or considered alternative forms of medicine by an allopathic centered healthcare system.

In India, this is quite the opposite. The building, which this picture focuses on, is situated across the way from a 10 bedroom allopathic clinic. These two clinics work in a complimentary manner to assist their patients using both of the systems most beneficial attributes. I really was impressed with the integration in both forms of treatment, setting aside each system of medicine's differences for the good of the patient."

Most Memorable Moment
"Without at doubt, the most memorable moment I had while in India was pushing our bus off of a Mysore road. It broke down while on our way to a palace after we passed a speed bump. We sat for a while hoping the bus driver would fix the bus, but after about 20 minutes of stressful waiting and traffic piling up behind us, we finally had the O.K. to push the bus off of the road."

My Advice to Students
"Advice that I would give to students that are going on the trip on the future is to go into the trip ready for anything! Keep an open mind!

Try things you're scared of. I played a game cricket with the locals with absolutely no knowledge of the game and almost no means of communicating with them. But you know what? I had a blast, regardless of the fool I made of myself, this was undoubtedly one of the fondest memories that I have from the trip.

I remember Dr. Prasad told us right when we got there and I took it to heart, he said, 'Totally immerse yourself while you're here.' I feel like I immersed myself just about to the best of my ability and walk away from the trip with almost no regrets about what could have been."

Rachel is a U of M pre-med student in the Global Future Physician course, who recently traveled to India as part of a 3-week experience. Below is a reflection on her recent experience.

"On our last day in India, somewhere at a stop along the road between where we had been staying in Mysore and the city of Bangalore, the question came up of what we would miss the most once we returned to Minnesota. It was not an easy question for anyone to answer, but now that I have been home for almost two weeks, the answer I gave that day is much more real to me.

I would miss the colors and the liveliness of the city we stayed in; everyone was so carefree, and rather than in the U.S. where it is easy to find yourself rushing from place to place all the time, while in India, whether it was a result of the daily tea breaks during the day or just a slightly different way of life, time seemed to slow down...in a good way.

This picture is one of my favorites from the trip, showcasing some of the colorful tikka powders at the Mysore market. We went to the market our very first day in India, and it was definitely a bit of a culture shock experience as I found myself so suddenly and completely immersed in the crowds of people and aisles upon aisles of different fruits, vegetables, and colors such as these.

Although I did not realize it at the time, as we learned more and more about India during our stay, I realized how many of those things could be brought back to this one excursion. For example, the area around the market showcased some of the disparities that are so prevalent throughout the country - small children came up to us begging for money, along with elderly women slumped on the ground gesturing to their mouths for food.

However, as we learned, a lack of food or wealth is not the problem in India. In fact, many tons of food rot every day, and the richest man in India - the third richest man in the world -owns forty percent of the country's wealth; the problem lies in the distribution (or lack thereof) of these goods. The market was also merely across the street from the Mysore Medical College and Krishnara Jendra Hospital, the government hospital in Mysore, both which were places we later got to tour and compare to their private counterparts. Therefore, although not only was the market a wonderful cultural experience, it was also extremely important in being a central place to so much of the rest of our trip that helped me to learn about so many things including the people, culture, health, sanitation, and disparities.

Prior to going to India, I had no idea what to expect. However, despite going into this program with so many unknowns, I have come away from it with a much greater understanding of not only the culture and healthcare system of India, but also a greater understanding of myself and what it means to be a global future physician, as well as a global citizen. My advice to students going on this trip in the future is to keep an open mind, ask questions, and remember that you are not only there to learn about health, but also to learn about yourself and others, and it is so important to take time to reflect on everything that you learn."

- Rachel, U of M Pre-Med Student