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At some point during the 11-hour flight between Miami and Santiago, a realization finally struck me—I was travelling to the Southern Hemisphere. The half of the world I had never set foot in—a new continent in the throes of late autumn, preparing for winter. This was also to be my first time anywhere in Latin America. Finally the plane touched down, and I found myself in the surprisingly small Arturo Merino Benitez International Airport, which was adorned with banners welcoming tourists for the 2015 Copa América soccer tournament—the world’s oldest international soccer tournament—being held in Chile that year.
I’m the type of tourist who likes to find out as much as I can before traveling somewhere. Thus, when I decided to apply to the David Rockefeller Center for Latin American Studies’ Health and Spanish Immersion program in Santiago, Chile, I endeavored to look up as much as I could about Santiago during the application process, learning about a number of different tourist attractions and historical anecdotes from such scholarly sources as TripAdvisor and Wikipedia.
During the long car ride from the airport to my host family’s apartment, my host parents pointed out many of those same landmarks, which I gazed at in amazement, exhausted after an overnight flight, but still wide-eyed. We passed the Mercado Central, Museo Nacional de Bellas Artes, Cerro Santa Lucía, Cerro San Cristóbal, and Costanera Center, with advertisements featuring huge images of Chilean soccer stars Claudio Bravo, Alexis Sanchez, and Arturo Vidal lining the streets. Eventually, I settled into my new bedroom, and went with my host family to Pueblito Los Dominicos—a popular tourist marketplace in the upscale Las Condes district of Santiago.
The next day, I woke up bright and early to reach the DRCLAS office, located right next to the United Nations regional offices, to begin orientation. Harvard operates two programs in Santiago—the 12-student Health and Spanish Immersion program (which I was participating in, and which is largely geared toward pre-med students) and the 9-student Summer Internship Program (where students work for government ministries and non-profit organizations). Orientation and most program-wide events involve all students from both programs together.
Orientation week proceeded at a brisk pace as we heard presentations in the morning covering a wide range of topics related to Chilean history, culture, and language (Chilean Spanish is very distinct from other varieties of Spanish), as well as Santiago, followed by visits to many of Santiago’s principal landmarks and cultural attractions in the afternoon. By the end of the week, we had checked off many of the top “Things to Do” in Santiago according to TripAdvisor. But while giving me, someone who takes far too many photos, plenty of opportunities to use my camera, this only scratched at the surface of truly experiencing Santiago and Chile.
Chile is, of course, a geographical oddity—an impossibly long, comically narrow country stretching across the southwestern coast of South America. One could forgive it for appearing geographically conflicted. Where the country is truly conflicted, however, is socioeconomically. The question of whether or not Chile is a developed country is an interesting one. It leads Latin American countries in a number of important metrics, such as the Human Development Index, where Chile scores an 0.822 out of 1. This places it in the “Very High” category, about even with countries such as Hungary, Poland, and the Czech Republic. It has experienced unprecedented economic growth over the last 25 years, a phenomenon termed the “Chilean miracle.” Santiago has an emerging skyline that projects an image of wealth and security.
A unique element of the Health and Spanish Immersion program is that it sends us all over Santiago—from the wealthiest comunas (sort of like boroughs) such as Las Condes and Vitacura, which look and feel like Back Bay, the Upper East Side, or any exclusive, affluent urban neighborhood in the United States to comunas like Pedro Aguirre Cerda and La Pintana, where Human Development Indices and living conditions very much resemble those found in developing countries.
Santiago is also an extremely socio-economically segregated city. The wealthiest and most impoverished comunas are quite far apart, practically on opposite sides of the city. The Plaza Baquedano (commonly known as the Plaza Italia, its former name), found at the intersection of the Alameda and Avenida Vicuña Mackenna (the capital’s two main streets), is Santiago’s principal socioeconomic dividing marker in the city’s urban consciousness. It divides the wealthy comuna of Providencia from the center of Santiago, thereby setting off the richest part of the city, the Sector Nororiente (the northeastern sector of the capital, which consists of the comunas of Providencia, Ñuñoa, Vitacura, Las Condes, La Reina, and Lo Barnechea, and is located closer to the Andes Mountains), from the rest of Santiago.
It was in one of those impoverished comunas—Pedro Aguirre Cerda—where I found myself shadowing doctors in a consultorio, a large public health family health clinic. My clinic, the CESFAM Padre Pierre Dubois, served a sizable population of patients, virtually all of whom relied on Chile’s public health insurance program, Fonasa, for health coverage. Fonasa covers approximately 80% of Chile’s population, while 15% of the country’s population (generally members of the wealthy and upper-middle class without pre-existing conditions) is covered by Isapres, the private health insurance providers. This has led to two parallel systems emerging in terms of healthcare delivery: a system of public consultorios and hospitals where the vast majority of patients covered by Fonasa go and a system of private clinicas, where the majority of patients are covered by Isapres.
Given the sheer difference in size between the public and private healthcare systems of Chile, there is, of course, a disconnect between the two. While the two perform similarly in many metrics, wait times are significantly shorter in private clinics than they are in consultorios or public hospitals, and private hospitals are able to provide much more personal attention to each patient.
After shadowing doctors in the consultorios for two weeks, a group of us rotated through a rural consultorio in Melipilla province, about an hour’s drive from Santiago, where we accompanied medical students on house visits. We are now currently rotating through hospitals in Santiago, and are also taking Spanish classes with a medical focus and volunteering in different organizations (in my case, the National Institute of Rehabilitation). This has given us a broad spectrum of experience with many different facets of healthcare in Chile, as well as with the social realities of the country. All in all, it has been a wonderfully enlightening experience.
Vimal S. Konduri '17, a Crimson staff writer, is a molecular and cellular biology concentrator in Winthrop House.
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