Carleton College dispatched three administrators to its study-abroad program in India, after a student reported a local doctor molested her and a rash of illnesses tested the program’s health-care plan.

The University of Minnesota settled a lawsuit by a student who said she was raped while studying in Cuba. And the College of St. Scholastica drew a federal inquiry after a student complained about its handling of her sexual assault during a semester in Ireland.

While such serious problems are rare, Minnesota study-abroad programs have faced growing pressure in recent years to be more vigilant on issues of student health and safety. The state is on the forefront of a national push for study-abroad accountability: In 2014, it passed a first-of-its kind law to require reporting hospitalizations and deaths. Minnesota parents and lawmakers have also pressed for federal oversight of a multibillion-dollar industry that largely polices itself.

“People are starting to focus on student safety in a way they didn’t five years ago,” said Elizabeth Brenner, a Minnetonka advocate whose son died on a study abroad trip in India in 2011.

Studying abroad has become an integral part of the college experience. Each year, Minnesota campuses send more than 8,500 students to study abroad, according to the Institute of International Education — with the U in the Top 10 of study abroad institutions nationally.

A loss of trust

Carleton, a private college in Northfield, took over the 40-year-old Buddhist Studies program at the famed Bodh Gaya pilgrimage site in 2016. It draws students from top schools — and some rave reviews.

Given that long track record, Carleton student Ross Matican expected the program would be better prepared to handle health issues. When faculty took him and other students with severe a gastrointestinal illness to an emergency room last fall, one staffer scrambled to translate. Matican shouted to ward off a nurse trying to inject unknown medicine he feared might interact with medication he takes.

Students were discouraged from bringing phones and computers to the monastery that hosts the program. So as illness and an intense class schedule ratcheted up anxiety, Matican struggled to contact his U.S. physician.

“The message I got was that if you were overwhelmed and had a hard time adjusting, you were condescending to the local culture,” he said.

Meanwhile, a student who was not from Carleton reported that a local doctor with whom the program had long partnered touched her inappropriately during an exam. Then, students found out about a similar complaint made several years earlier. At that point, Rachel Zvara, a Cleveland State University student, recalled her faculty health adviser had suggested she take another student with her to the doctor. “It’s just an India thing,” the instructor had said when Zvara asked why.

“We felt we couldn’t trust the people who were there to help us,” she said.

Zvara, who struggled with persistent vomiting and a cough, was among about a half dozen students who left India early.

Carleton officials said they did not know about the previous complaint and immediately cut ties with the doctor. After the earlier incident, officials at Antioch Global Education, which ran the program at the time, kept the physician on because “health-care sources are limited in this area,” said Carleton spokeswoman Helen Clarke Ebert. They directed students not to visit that doctor alone — and let them know other doctors were available.

The program’s current director, Arthur McKeown, knew about the previous incident, but he had been a faculty member uninvolved in setting health policies when it happened, Ebert said.

Institutions such as Brown University and Hamilton College removed the program from their approved study abroad lists — though Hamilton says it plans to reinstate it after Carleton made “impressive adjustments.”

A push for oversight

In Minnesota, study abroad officials say the data collected under the law requiring campuses to report deaths and hospitalizations underscore these programs’ safety: There have been no deaths, and only 116 of nearly 39,000 students who attended over four years were hospitalized. A 2018 update for legislators said the most common causes were gastrointestinal illnesses and infections.

But for Sheryl Hill of Minnetrista, who lobbied for the law, the outcome has been a letdown. Hill’s 16-year old son, Tyler, died of altitude sickness during a high school exchange program in Japan.

Hill, who runs the nonprofit Depart Smart, believes the data should come from an objective source such as insurance company claims and include more information about causes. Institutions don’t have to report sexual assault, despite studies suggesting study abroad participants face a greater risk.

“Sexual assault is the Number 1 issue I hear about in my advocacy,” Hill said. “Most of the time the woman is blamed and shamed and admonished.”

Duluth-based College of St. Scholastica overhauled its response to sexual assaults following a federal investigation into a student complaint that the school failed to assist her after she was raped while studying in Ireland.

Last year, the U paid $137,500 to settle a suit by a former undergraduate who said she was raped during a study abroad program in Cuba by an interpreter affiliated with the program. Her complaint says a U lecturer supervising students blamed her for the assault and mishandled its aftermath.

In recent years, the university, which sends about 4,700 students a year abroad, reported between six and 10 incidents of sexual misconduct annually during trips overseas to its Equal Opportunity and Affirmative Action office. Additionally, since 2012, the U has reported two incidents during study abroad programs under the Clery Act, which requires reporting crimes only on property the university owns or rents: a rape and a fondling, both in Ecuador.

Brenner, co-founder of Protect Students Abroad, has advocated for federal oversight bills, which will be reintroduced during this session. Two years ago, U.S. Rep. Betty McCollum, then-U.S. Sen. Al Franken and other lawmakers called on the federal Department of Education to require study abroad safety data reporting.

After Brenner’s son, Thomas Plotkin, fell from a cliff and died during a study abroad program in India, she found out he was the program’s 12th fatality.

Renewed focus on risks

Carleton has enlisted a new physician to visit the Buddhist Studies monastery twice a week. The program is adding a full-time wellness coordinator and beefing up employee training. It will set up a private space in the monastery where students can get phone counseling around the clock.

Some local officials say they have redoubled prevention efforts. The University of Minnesota — one of the first campuses nationally to hire a full-time study-abroad safety staffer — has expanded health and safety orientations for students, said Kevin Dostal Dauer, the U’s director of international health, safety and compliance.

Two years ago, the University of St. Thomas tapped a staff member to oversee study abroad safety and beefed up safety training for faculty advisers.

“People have this mind-set of, ‘Oh, I’ll be in Paris, this wonderful French paradise,’ ” said Timothy Lewis, senior international officer at St. Thomas. “It’s easy to go to a place year after year and lose sight of the risks.”

At St. Cloud State University, Associate Vice President Shahzad Ahmad says the Minnesota State Colleges and Universities system now requires travel insurance from a vetted provider, which has a network of English-speaking doctors. The university also provides sexual assault prevention and LGBT student safety resources.

Campuses say they have stepped up efforts to address mental health needs while studying abroad. The U has expanded access to counseling, said Dauer. St. Thomas trains faculty to spot warning signs of mental illness and encourage students to seek help.

At Carleton, students such as Matican say they were distraught to learn the Buddhist Studies program will continue with McKeown at the helm. Another Carleton student, Liz Moore, said the changes the college is making are on the right track: “I think this past fall was a wake-up call.”