Work

How could I have predicted what this would be like?

My first day on the job, Dra. Gutierrez asked me to perform physical exams on Aymara babies and analyze some x-rays for hip displacements. I work at Hospital de Los Andes. What an incredible place. I mean really unbelievable. After driving an hour up the mountain in a minibus, (which is just a large van with a sign and boy shouting out the window), we arrive in an indigenous barrio. It is dusty, cold, bright and windy. There are cars speeding in both directions down the main street. Women sit on the curb and entreat us to buy cheeses, fish, and fruit spread out on their blankets on the ground. Children weave through the traffic, selling candy and gum. The native dress is a colorful, rainbow pattern blanket worn on the back to carry small children, a floor length skirt, shawl, and round-bowl hat. The men are less notable. The children are strikingly beautiful. They have piercing brown eyes and melting smiles, dimples and all.

Doctora Gutierrez reminds me of my sixth grade teacher. She asks me tough questions in front of patients. She puts me on the spot and challenges me because she is a good teacher and knows I can handle it, although sometimes I feel like I am so inexperienced, I have to think on my feet and admit I what I still don't know. She's a wonderful doctor, chastising mothers for descuida (poor parenting), a tough love kind of woman. She makes you want to impress her. Her love for children and her dedication to this place left me speechless, feeling so small. This hospital is no bigger than my home in Cleveland. And even less equipped than your average suburban bathroom! The don't have exam gloves, masks, medicine, enough personnel...Dogs wander around the waiting room. The line is out the door with Aymara women, carrying babies on their backs. I saw two live births last week and the poor women received just one local anesthetic just moments before delivery. (By the way, I'm totally adopting.) The delivery room was adjacent to a public hallway. The doctors took Kristen and I aside after we dressed the babies and very sincerely lamented the conditions. They said, we are doing the best we can. We don't have what we need. We are providing service for these people but they deserve better. We work for them and we need help. We need so much help.

Hip displacement is a common problem in babies here. The Aymara wrap the babies very tightly, often with a strip of tough cloth, resulting in grossly distorted bone growth. Usually it can be corrected with time, if the baby is young enough. If not, a harness or corrective surgery is needed. Malnutrition is also a problem here, like anywhere. But malnutrition is not an economic phenomenon. It is a question of ignorance. Americans have more money than Bolivians but I no longer maintain the illusion that we are better nourished thanks to our paychecks. Education makes all the difference. There is currently a political movement, Desnutricion Cero, which advocates nutritional awareness among all families in order to reduce health problems related to poor nutrition in Bolivia.

Every week we have a presentation on a special health topic. Last week was insurance/health care in Bolivia. SUMI is a wonderful program that covers pregnant mothers, and children under 5 years of age, free of charge. Being here has definitely given me a different perspective on the upcoming health care crisis in the United States. During a late night discussion with my roommates, Alex put it best- do we really want sick people to go untreated? This week's topic was malnutrition and next week will be hip displacement. I love the presentations, they put the week into perspective. Health care is a complicated topic, the more I learn, the less I feel I know. There are so many problems and new solutions create new problems. Helping people shouldn't be so complicated, but it is. It comforts me to know that people like Doctora Gutierrez and the doctors at Hospital de los Andes are out there, working tirelessly in conditions I had never imagined could be real, just doing the best they can.