Trip to Quito Provides Recent Nursing Grad with a Renewed Perspective on Global Health

How can a trip to Quito, Ecuador, benefit a recent nursing graduate who will soon work at a hospital in Duluth?

Alexa Akre, MSN, said the experience provided a better understanding of the multitude of factors that affect health and wellbeing, something she’ll take with her as she embarks on her new career. 

Akre traveled to Quito in May of 2024 to learn more about the social determinants of health. The trip opened her eyes to the numerous factors — economic, industrial, social and political – that have shaped today’s Ecuadorian healthcare system.

“Before going into this course, I thought about social determinants on an individual level — one person's socioeconomic status or ability to get to appointments. But, really, every single aspect of life is connected to health care and how a person or people can receive health care and benefit from it,” she said.

Akre was in Quito as part of the Center for Global Health and Social Responsibility’s course, Ecuador: Social, Environmental, and Cultural Determinants of Health. Applications for the 2025 course, which will take place May 17–30, 2025, will open on Jan. 15.

Akre called out lectures on Ecuador’s economic history and its role in the country’s current healthcare system as particularly eye-opening.

“It was just fascinating realizing that everything is interconnected,” said Akre. “I didn’t realize the economic history of a country could have such an intense impact on how each individual today is receiving health care.”

Akre and her classmates went on numerous excursions in Quito, visiting a local Indigenous community leader to learn about Indigenous medicine, touring a flower plantation to explore pesticide use and agricultural health, and taking trips to local healthcare facilities. 

She lived with a host family that would make her breakfast every morning before she left for class. Akre said learning from Ecuadorians themselves made the trip particularly impactful.

The course is run in partnership with Fundación Cimas del Ecuador, a nonprofit organization that provides academic programs for students around the world.

“The best way to travel is to talk to the locals and get suggestions from the locals. It was really important for us to not just have someone from the University of Minnesota researching what hospitals to go and see — we needed a guide who was experiencing the health care system as an insider and as a participant,” she said. “That was really helpful.”

The course is offered to UMN graduate and professional students, faculty, staff, alumni, and community learners. Akre said traveling with students from a variety of backgrounds made the experience more rewarding. Last year’s course included students from the School of Nursing, School of Public Health, Humphrey School of Public Affairs, College of Food, Agricultural and Natural Resource Sciences and the College of Pharmacy.  

“It was cool to be having discussions about all of the things we were learning and be able to get the perspective of people who have a different knowledge base and different interests,” said Akre.

“I wasn’t just learning about the nursing side of things. I was also getting feedback from people with other pools of knowledge.”

Akre said young health care professionals should experience how medicine is practiced in other parts of the world to have a more holistic view of the care systems in the U.S. The experience has the potential to produce innovative ideas related to creating a more equitable medical system in the U.S., she said.

“If you’re staying here in the United States and not opening yourself up to other forms of health care systems, you’re going to look at our system and say this is normal, when it’s really important to realize this system is not working for everyone, and to get perspective on how it could work better,” said Akre.

“This was a very valuable course for me, and it could be valuable for a lot of people.”

Applications for CGHSR’s course in Ecuador are open Jan. 15 – Mar. 1. Learn more about the course and how to apply