They could get practical experience at home, interning at local hospitals, clinics or pharmacies.
But it wouldn't be the same.
So some nurses-in-training, and a few pharmacists-to-be, are opting to go global to get their community health care experience.
A relatively new class in Washington State University's Intercollegiate College of Nursing offers nursing and pharmacy students a hands-on opportunity to examine the cultural, social, environmental and economic factors that influence health care while testing their assessment and evaluation skills and providing basic health care education.
In the Amazon.
"Health Care in Peru" is a 400-level, three-credit nursing class or five-credit pharmacy elective taught, in part, by Yakima's Laura Hahn, a WSU clinical nursing professor and pre-nursing adviser.
She's part of a contingent of 28 students, instructors and others from around the state -- including the Yakima Valley -- and as far away as California and Utah, who left last Wednesday for the international, public health experience. It's the biggest contingent so far for the intensive, immersion program that's in its third year.
Their destination: Iquitos, the largest city in the Peruvian rain forest with a population of about 400,000. Located on the Amazon River, it's generally considered the most populous city in the world that cannot be reached by road.
Established as a Jesuit mission in the 1750s, Iquitos can be reached only by airplane or boat, with the exception of a road to one small town roughly 100 kilometers away. Transportation to nearby towns typically requires a river trip on a small, public motorized boat.
The remote city and its outlying areas -- some 4,500 miles away from Yakima -- will serve as the students' training ground for nearly three weeks.
"They will see cases rarely seen in the U.S.," says 55-year-old Hahn, who has taught at WSU since 1989 and has been on both of the "Health Care in Peru" experiences as well as a fact-finding trip in 2005.
In all, this is her fourth time to Iquitos.
Her hopes for students: "That they get a heightened awareness of universal health care."
"I believe health care is an entitlement everyone should receive," she says. "It shouldn't be an economic issue."
"We have the capabilities in every country," Hahn says. "It doesn't matter if you live in Yakima, Washington, or Iquitos, Peru, health care concerns are health care concerns, and they need to be addressed."
In Peru, these concerns include malnutrition, tooth decay, parasites, premature death, and eye, ear and skin infections, such as impetigo. Major infectious diseases are hepatitis A, typhoid fever, dengue fever, malaria and yellow fever.
And nearly 45 percent of the country's 29.2 million people live below the poverty line.
"The whole experience was very overwhelming for me, but I'm very glad I went," says Ellensburg's Minda Rose, who participated in last year's Peru trip and is now one semester away from earning her bachelor's of science in nursing at WSU's Yakima campus.
"I went to get practical nursing experience and see how people live in other countries, what their health care resources are like and if I could help in any way," the 36-year-old says. "I feel like a much better person, and I feel like I'll make a much better nurse, because of that experience. I saw things I wasn't expecting to see, things that were very hard for me to see. It was hard on me emotionally, but it was also very rewarding."
This year's group is made up of four faculty members -- three in nursing, one in pharmacy -- four pharmacy students, one nutrition science student, 17 nursing students, and two support staff.
More than 2,000 patients -- mostly women and children -- are typically seen each trip. Students perform health screenings, including height, weight, vision and dental checks. They also provide public education workshops on basic health care and hygiene in forums such as community centers, schools, churches and clinics. And they have the chance to tour orphanages and a public hospital, as well as a private hospital.
But the experience doesn't come cheap. Program fees range from $2,010 to $3,285, depending on enrollment, and include in-country transportation, accommodations and meals. Plus, airfare costs about $1,000 and tuition for nursing students is another $945.
Rose recommends the study abroad program, held in conjunction with the Idaho-based, nonprofit People of Peru Project, to other nursing students who can afford it and hopes to participate in similar programs in the future.
"It pulled on my heartstrings for sure," she says.
"They don't have health care or they have very minimal health care," she says. "They die from things we would never die from here."
To prepare for the experience, students take part in pre-departure seminars and do some recommended reading, including "Where There is No Doctor" by David Werner.
"For me, this is a mainly a cultural experience and the chance to learn about health care in a different environment," says 25-year-old Rachel Smith of Toppenish.
A day before departure, Smith, a December 2007 WSU graduate, was working one last shift in the emergency room at Yakima Valley Memorial Hospital.
"I'm going because I want to learn about a culture other than my own," she says.
"And I'm really excited about going down the Amazon River into the jungle to the villages and see how that's different from the city environment."
After more than two weeks of field work, the group will spend a few days sightseeing in Cuzco, near the Sacred Valley of the Andes mountain range in southern Peru, and explore the famous Machu Picchu ruins.
They're slated to return June 3.
About Peru
Location: South America, bordering the Pacific Ocean and Bolivia, Brazil, Chile, Colombia and Ecuador
Ethnic groups: Amerindian, 45 percent; mestizo (mixed Amerindian and white), 37 percent; white, 15 percent; other, 3 percent.
Religions: Roman Catholic, 81 percent; Seventh-day Adventist, 1.4 percent; unspecified or none, 16.3 percent.
Languages: Spanish (official), Quechua (official), and a large number of Amazonian languages
Independence: July 28, 1821, from Spain
-- The World Factbook, Central Intelligence Agency
* For more information about the People of Peru Project -- including photos and blogs from the 2005, 2006 and 2007 WSU "Health Care in Peru" programs -- visit www.peopleofperu.org.
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