Sarah Chen is a third-year student from Bettendorf, Iowa majoring in public health and minoring in political science. She spent the summer abroad interning through the Council on International Educational Exchange (CIEE) Taiwan Summer Internship program, working alongside social workers, nurses, and families at Harmony Home Foundation where her experience offered a unique window into Taiwan’s health care and social service systems while reinforcing the critical role of advocacy and human rights in advancing public health.

Tell us about your internship experience in Taiwan. What did you do there? What were the goals?

For my internship, I worked as an intern at Harmony Home Foundation in Taipei, Taiwan. Harmony Home is divided into two primary areas; HIV and migrant workers/undocumented individuals in Taiwan. I worked with the children of migrant workers, primarily interning under the social worker division and public health nurse. My main duties were developing and teaching English curriculum to elementary age students, assisting with new client meetings, helping develop ideas for maternal health programming, and attending medical clinics for children in the shelters. Every day looked different for me, and my day-to-day tasks depended on what was needed that specific day.

Going into my internship, my main goal was to gain a better understanding of Taiwan’s National Health Insurance (NHI) system, health infrastructure differences between the U.S. and Taiwan, and how the migrant worker population experiences/receives health services.

What were your key takeaways? What did you learn?

My main takeaways were from observing the healthcare and social service systems of Taiwan. Taiwan operates under a National Health Insurance (NHI) structure which differs in many ways to the structure of the U.S. healthcare system. We often discuss Taiwan’s universal healthcare system in public health classes, so I learned a lot from speaking with citizens and attending healthcare appointments at a variety of medical facilities in Taipei. I observed many of the strengths of the single-payer system but also many downsides of how the system is currently operating. Taiwan is currently experiencing strain on the healthcare system from the growing elderly population and resistance of citizens to increase healthcare premiums.

My internship at Harmony Home also provided me with an insider’s perspective because I was able to see how different demographic groups receive health and social benefits. Healthcare is extremely unique for the migrant workers at Harmony Home. Many of them start working in Taiwan and eventually break their work contracts and experience additional barriers to receiving care. Harmony Home acts as a community network, filling in the gaps of both Taiwan’s healthcare and social support systems. Harmony Home’s role in the immigration and health system of Taiwan ultimately showed me that social service organizations function similarly across different countries.

Another key takeaway was understanding the role of parental status, citizenship, and external circumstances on the provision of social and legal rights. Through my internship, I talked to many individuals with different circumstances that left them with little to no access to obtaining citizenship or social benefits in Taiwan. This aspect of the internship prompted me to look at the provision of health through other lenses that we don’t often focus on in public health like economics, sociology, and political science.

Did anything about the experience surprise you?

Something that surprised me was how extensively Harmony Home approached the promotion of human rights. It was apparent from the start that Harmony Home didn’t function exactly like other non-profits or social work organizations I had experienced in the past. The structure of the organization was unique in that many of the staff were also clients or previous clients of Harmony Home. There is a deeply ingrained community and family like nature to the organization which creates a strong social network. With the staff being so intertwined with the clientele, there is a deeper understanding of cultural nuances with being a migrant worker and children of migrant workers.

Beyond providing services like housing, food, and healthcare, Harmony Home also works on preserving the culture of the children’s home countries. Many of the children and mothers are from Indonesia which creates a strong cultural identity within the organization. Harmony Home leadership and social workers constantly prioritize the Indonesian language along with Indonesian food, dance, and Islamic studies. The dedication and effort put into cultural rights is something I hadn’t seen before which reminded me that health as a right also extends to mental health. Cultural identity and preservation are about mental health that will directly impact the well-being of the children once they grow older.

Seeing the integration of these practices within the daily function of an organization was truly special, and I learned so much not only about Taiwan but numerous cultures across Southeast Asia.

How did this experience impact your interest in public health and health policy overall?

My internship at Harmony Home strengthened my passion for global health and stressed the importance of advocacy in health policy. The founder of Harmony Home, Nicole Yang, constantly stressed the importance of storytelling, advocacy, and policy reform when it came to advancing human rights in Taiwan.

As someone that wants to work in global health in the future and is also pursuing human rights, my experiences throughout the summer reminded me how intertwined public health and human rights are. My time spent with people from all different countries reminded me that health requires an interdisciplinary approach and a multitude of stakeholders across all levels. I was able to see how the different sectors of the government, community, and health system directly impacted everyone’s overall health.

I also gained critical cross cultural communication skills, as I solely communicated in Mandarin Chinese for the duration of my internship. Even with those that spoke Indonesian, I was able to learn how to communicate across language barriers and make meaningful connections. I will carry the skills and tools for communication I learned at Harmony Home into my everyday life, graduate school, and future job in global health.

What advice would you give to other students considering a study abroad opportunity?

I think that study abroad is an extremely valuable experience for anyone pursuing a future in public health, especially those with global health interests. There are so many study abroad resources available at the University of Iowa which makes it extremely realistic and feasible to do a summer, winter, or semester abroad.

I would also say don’t let the language and cultural differences prevent you from going to a country that is not primarily English speaking. Going to a country outside of your comfort zone provides you with a great chance to practice and understand cross cultural communication. Also, with public health, applying classroom learning in the real world provides you with an invaluable experience and perspective on health in general. My experience in Taiwan has prompted me to reflect on my next steps post-graduation and how I want to pursue public health.