The words study abroad bring to mind traveling to new places, meeting different people, eating all kinds of delicious foods, and having new experiences. I had the pleasure of leading a dozen Fordham pre-health students to Cali, Colombia, on a weeklong study abroad course. Since this is the third time I am leading this course, I can say that study abroad not only opens students’ eyes to new cultures and new possibilities but also gives them the opportunity to learn about themselves.

Almost half of all Fordham undergraduates study abroad, but it is not very common for students in the pre-health professions track. A one-credit service course, called Community Health in Cali, Colombia, held each year during spring break, is probably the only study abroad program available for pre-health students. As the faculty leader, I have always enjoyed the trip as it feels like an extension of my Human Physiology course here on campus. Not only do we talk about human health and disease, but I can also extend the discussions on health care systems in the U.S. and abroad.

As part of the service course, these students get to visit the city of Cali and learn about the health care system there. Colombia has the fourth largest economy in Latin America and Cali is the third largest city in Colombia, located southwest of Bogotá and situated in the Valle de Cauca. It is a thriving metropolis of about 2.4 million people. Cali has many private and public universities and Fordham has a special relationship with Javeriana University, a private Jesuit university that hosts us while we’re there. Javeriana is a nonresidential university with undergraduate and graduate programs; it also has a medical school. Colombian students start medical school directly from high school and graduate in five years, followed by a one-year internship and residency.

Fordham students are inquisitive and eager to learn about other cultures and different health care systems. The study abroad course is ideally suited for pre-health students interested in pursuing medicine as well as public health. What we discover is that Colombia’s healthcare system is based on the income level of the people and organizes the population into six strata, or levels. The bottom-most layer is made up of people that have very low or no income; their basic medical care is covered by the government. At higher income levels, people receive better medical coverage from their employers. People at the highest strata are often able to pay out of pocket and access the best medical care available.

As the week progressed, we interacted with many Javeriana medical students, who are very open and friendly, and attended lectures and labs with Javeriana medical school faculty. The students dissected pig hearts, studied the electrophysiology of the cardiovascular system, and learned how to get a medical history of patients in Spanish. They also listened to a lecture on the various facets of being a physician—the hard work, the physical and emotional toll, as well as the financial remuneration. One of the medical school professors also highlighted the most important reason to choose medicine as a profession: the capacity to serve others and derive happiness from it.

We visited several hospitals and clinics to get a better idea of the healthcare system in Colombia. One of the best and most touching experiences for students was visiting the Institute for Deaf and Blind children, where the disabled children get necessary surgeries and treatments for their conditions. The institute also has a school that teaches them skills to make them independent and help them transition to high school and college so that they can become productive members of society.

We also got to be a part of an outreach program run by Javeriana public health faculty and Javeriana medical students. The students visit areas in and around Cali, especially on the hillsides, where it might be harder for people to access the medical centers. They talk to people about good nutrition, maternal and children’s health, vaccinations, how to maintain healthy lifestyles, and exercise, among other things. This is a great opportunity for Fordham students to actually meet the local people and interact with them.

One of the most important aspects of education, and certainly Jesuit education, is to reflect on the learning and incorporate the learning into practice. As part of the program, I asked the students to submit a daily reflection. At the end of the trip, I asked them to write a reflective paper examining how the program influenced their thinking in terms of their commitment to health professions, and how they might incorporate the lessons they learned in Cali moving forward. All the students felt that the program helped them to visualize themselves in medical school and a hospital setting and to be able to communicate with people from different backgrounds. They felt a new sense of confidence.

In all, it was a fun and educational experience and that leaves the students reenergized and refocused on their future plans to be part of a profession that improves lives. The most important thing we learned about was our ability to connect at a very human level—and that it’s our connections that define us, not our differences. That, I hope, is the lasting message that resonates with all my students, regardless of the professions they enter.

Photos courtesy of Usha Sankar.

Top photo, standing, left to right: Sydney Souness, Antonia Flores, Maribel Molina, Samantha Hamilton, Fatima Khan, Usha Sankar Ph.D., John Soriano, Brittany Zaita, LiYing Wei, Stephanie Pepdjonovic. Sitting, left to right: local guide Veronica Paris, Issy Asianah, Kevin Quiah, Daniel Garcia

Montoya, a psychotherapist who earned a master’s degree in social work at Fordham in 2005, had been organizing a closet in her New York City apartment while a Colombian TV station played in the background. She had grown up in Bogotá with an aunt and uncle who are fraternal twins and cousins who are identical triplets, so the topic of twins has always piqued her interest. But this report—about twins discovering at age 25 that one in each pair had been accidentally switched as babies—seemed too improbable to be true.

It was no soap opera. The Bernal Castro brothers, Jorge and Carlos, had been raised as fraternal twins in cosmopolitan Bogotá, while the Cañas Velasco brothers, Wilber and William, had been raised as fraternal twins on an isolated farm near La Paz. Neither set turned out to be biologically related. Through the detective work of mutual friends, it came to light that William and Carlos had been separated from their identical brothers, most likely in the hospital nursery. “I couldn’t stop thinking about it,” said Montoya, a licensed clinical social worker and the associate director of advising at Columbia University’s School of Social Work. “I couldn’t stop thinking this has to be a study.”

Because identical twins share 100 percent of their genes, they provide valuable information about genetic and environmental influences for medical and psychological research. The Colombian twins were even more ideal as research subjects since the two sets had been raised in starkly different settings, which opened a fascinating window into how identities are shaped by nature and nurture.

A Rare Research Opportunity

Though they’d never met, Montoya decided to contact Nancy Segal, Ph.D., a psychologist and behavioral geneticist known for her groundbreaking research on twins. Over the course of six rapid-fire emails, they decided to join forces on an extraordinary research project that resulted in the new book Accidental Brothers: The Story of Twins Exchanged at Birth and the Power of Nature and Nurture. Until the Colombia case, there had been only seven recorded instances of switched-at-birth twins. This was the first known case of two sets of identical twins being split up, reared apart, and then reunited as adults.

A practicing psychologist in Bogotá, Montoya came to the U.S. in 2001 to study at the English Language Institute at Wheeling Jesuit University in West Virginia. Missing big-city life, she moved to New York to attend Fordham. After graduation, she worked in varied settings as a clinical social worker, including with immigrant families and with September 11 rescue, recovery, and cleanup workers.

It took all of Montoya’s clinical skills, compassion, and resourcefulness to conduct the twin study. Segal laid out what she would need to do, which included personality questionnaires, health histories, IQ tests, more DNA tests, individual interviews, and small group discussions. In December 2014, she flew to Bogotá to meet the twins and ask them to participate in a study. They said yes.

A Tale of Two Upbringings

Jorge and Carlos were raised by a single mother and her close-knit family in a working-class neighborhood in Bogotá. Both attended good public schools and went on to college, where Jorge studied mechanical engineering and Carlos studied finance. Wilber and William grew up 150 miles from Bogotá on a farm with no running water or electricity. They attended school until they were 11, walking an hour each way over rough terrain. Then they worked full time on the farm. After compulsory military service, they worked at a butcher shop in Bogotá. That’s where a woman spotted William and mistook him for his identical twin, Jorge, her friend and co-worker. That encounter led the four to discover the truth, that the twins who grew up together weren’t twins at all—they weren’t even related.

The revelation upended their lives. Jorge and Wilber, who grew up with their biological families, worried about losing the close ties with the twins they’d grown up with. William pondered the hardships of his rural upbringing and the more difficult path he took to get an education. He eventually passed the high school equivalency exam and enrolled in law school in 2016.

Carlos grappled with the unanswerable question of what he’d be doing today if he’d grown up on the farm. And both William and Carlos dealt with the profound emotions that accompanied meeting new biological relatives as well as the fears that relationships with non-biological family members would change. In short, they were overwhelmed.

Brothers from Another Mother

In the spring of 2015, Montoya and Segal spent 10 days with the twins in Colombia. The most eye-opening part of the trip was a visit to the farm—not only for the research team but also for city slickers Jorge and Carlos. To reach the farm required a grueling hourlong trek through knee-deep mud. This was the key to understanding how much Wilber and William overcame to achieve what they had, Montoya said.

“When they experienced that, it was admiration for these children who had to do that walk twice a day in order to get a fifth-grade education,” she said.

After working with the twins, which way did Montoya lean—toward nature or nurture? Do genetics or environment matter more when it comes to upbringing and personality development? “I don’t think I’m into one versus the other,” she said, pointing to the book’s subtitle. “That’s why we use the ‘and’—nature and nurture.”

Montoya has been impressed by the resilience of the twins. All four refer to each other as brothers, even Wilber and Jorge, who have no familial or biological ties. Instead of focusing on the trauma of the situation, they’ve chosen to concentrate on what they’ve gained.

“They are really amazing muchachos,” she said.

—Mariko Thompson Beck is a Brooklyn-based freelance writer and a frequent contributor to this magazine.

With the extremely close vote (about a 1 percent difference) coming on the heels of the Brexit vote and amidst a heated American election, comparisons to other polarized nations were made in the media.

But while the Colombian vote shared similarities, it was unique to that country, said several experts attending a large public event on Nov. 1 at Fordham that was entirely in Spanish, by design, to reach out to the Colombian community. The talk was sponsored by Fordham’s Institute of International Humanitarian Affairs (IIHA) in cooperation with Latin American and Latino Studies department and the Fordham College at Rose Hill assistant dean’s office.

“There are three specific characteristics that make the Colombian conflict a very different place than other parts of the world,” said Luis Fernando Álvarez Londoño, S.J. vice rector of Pontificia Universidad Javeriana, the Jesuit university in Bogotá, Colombia. “First is drug trafficking, second is social inequality, and third is corruption. Even though these three things take place in different parts of the world, in Colombia they’re combined.”

Brendan Cahill, IIHA’s executive director, concurred.

“When you lack the rule of law, it allows for illegal crops. And that becomes a vicious cycle,” said Cahill. “To replace the income for someone growing illegal crops is not just apples to apples. And that social inequality has to be addressed.”

Father Álvarez Londoño and other panelists noted that while the vote may not have been in favor of the peace accord, the cease-fire has held as negotiations continue. He added that he supports the process, but is more concerned about how peace will be maintained should an accord be reached. For that he sees a direct role for the Jesuits, specifically through education.

Gonzalo Hernández, director of the economics department at Javeriana, said that the vote was not split along class lines. He said the vote was influenced more by geography, with those near the conflict voting “Yes” and those away from the dangerous areas voting “No.”

Among elites, he said that there is a rural-versus-urban divide.

“I know that this is reductionist, but those against the agreement in the rural areas are landlords,” he said. “They would eventually be more affected, because the most important economic component of the agreement says that some of that land is going to be redistribute—and that’s a big deal.”

Through Colombia’s Office of the High Commission for Peace, Mario A. Puerta, negotiated the accord that was voted on. He did not view the “No” vote as a complete setback, but rather a part of a process that could have been skipped entirely by President Juan Manuel Santos. Santos was awarded the Nobel Peace Prize last month for his efforts.

“Constitutionally he was entitled to have implemented the agreement on his own, but he felt that the importance of the decision was something that had to be consulted to the people,” he said.

Puerta said that it was important to bear in mind that 62 percent of those eligible to vote did not vote—one of the highest abstention rates in more than 20 years.

“We have to assume this as an opportunity for improving what has already been achieved and finding the means for incorporating criticisms,” he said. “The supporters of the agreement are so strong that, even though they got a negative result, their strength is stable. The most important thing is that the bilateral cease fire has been maintained.”