Health Care in Bolivia

BoliviaHighlights this week include the small cafe Fricase Paceño where I sat alone, pretending I live in Cochabamba while eating steak, eggs, rice, salad, and a pitcher of mango juice for less than $5 U.S. dollars. Spanish lessons, daily with a local professor and native, Alejandro; Touring Cristo de la Cacordia, a 132 foot tall Christ of Peace, and German Urquidi, Cochabamba’s trauma center; arts and crafts and dodge ball with local children; and daily work at the clinic. It has been a busy week.

Whether it is a lecture on Bolivian culture or an exciting trip into the city the underlying theme of our visit is health care. Health care in Bolivia is unattainable for most, just as it is for many in the U.S. For this reason, Parker and Brisa, our hosts and presidents of A Breeze of Hope foundation, operate a clinic where I’ve spent much of my time shadowing a doctor, lab tech, and nurse. (Note: Parker Palmer and Brisa DeAngulo are graduates of the Rutgers School of Law-Camden).

Diagnosing Yellow Fever and identifying parasites in the feces of children with Chagas disease is just another day for staff here. If you were here with me, quickly you would identify the need for more. While locals might see the clinic as high tech operations, you and I would start compiling a shopping list of needs including latex gloves and prepackaged gauze pads of varying sizes. Here, once nurses are done for the day they pull out a few hundred yards of gauze and begin cutting and folding them to size; 2×2, 4×4 and even alcohol swabs are all cut and folded by hand. A far cry from the easy to get, prepackaged gauze pads were used to in America.

There are many challenges to practicing medicine in South America including lack of finances, materials, tools and poor infrastructure. My research has begun and my focus is bolstering scientific capacity in the nonprofit Chilimarca clinic. My research starts with best practices in third world countries like Africa, where many of the medical tools they use are made by recycling local materials. I’m excited to have a focus, a way to help, but connectivity in Bolivia is intermittent at best so much of my research will be done once home with reliable access to the internet. If you’re reading this, likely you have a number of other windows open on your computer screen, one for school, one for email, posting on Facebook, or perusing Reddit. I hit the send button and an hour later my blog was sent for publication. The immediate gratification America has to offer has been wiped clean from my expectations since landing here two weeks ago.

In downtown Cochabamba sits, German Urquidi hospital, a level three trauma center. With outdated technology, equipment, and poor sanitation it is still the Jefferson, UPenn, or CHOP of Cochabamba and for the over one million locals it is their last resort for medical attention before flying two hours to La Paz. The hospital was built with 50 percent of the funding from Bolivia and the other 50 percent from Japan, a partnership I’m still not clear on. The two countries did not pool their funds and hire one contractor; they each built one half of the hospital. So there are glaring differences in architecture when you walk from the east wing to the west wing (and in case you’re curious, as I was, the side built by Japan is a bit better in construction). The following day, we had lunch with the nursing and medical staff we met at Urquidi. A lengthy Q&A session on the differences between North and South America were identified, including pay. Nurses here receive $1,960 Bolivianos a month for their work. That´s roughly $280 U.S. dollars, a figure the nursing girls I´m traveling with gasped at. As you can imagine, Bolivian nurses gasped even louder when they were told the average monthly pay of an American nurse. But, while America is leading the race in technology (by a lot) and pay (by a whole lot more) the Bolivian medical staff exceed at compassion and intimacy. For example, a Bolivian nurse, while taking on 42 patients by herself (yup, 42-1) will take time to braid a patients hair or rub their shoulders, anything to make the patient comfortable. While this sort of intimacy is typical in Latin American culture I suspect it’s necessary to do all that you can when medication, specifically pain medication, is in short supply. Regardless of why though, the staff and patient relationship is much stronger here in Bolivia and, having worked as a Certified Nursing Assistant at Jefferson Hospital in a previous life, can tell you America could learn a thing or two from how they do things down here.

Enough about health care, medicine, and the like. The moon last night was so bright I had to squint! Behind it, an object I could not place in the memory of my Northern sky back home. With my handy SkyView iPhone app it turns out, at the 10,000 foot elevation Bolivia has to offer, I can see the Hubble Telescope at night, reflecting the sun´s rays just as the moon does. The stars are just as bright and with minimal light pollution, the night sky here looks spectacular. And every evening around 11 p.m., like clockwork, the sky flashes with lightning, a distant thunderstorm far off atop the Andes. When it storms proper the thunder is deep and percussive. It is difficult to describe just how much I enjoy being here and, with so much to do to better a community I’m easing into, wish I could come up with some excuse to stay longer.

By Anthony Cooksey, senior biology major at RutgersCamden

Rutgers students from various academic disciplines are blogging from a service learning trip to Bolivia this winter. They are sharing their experiences with RutgersCamden NewsNow.

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