Medicine & Healthcare in Bolivia by Karen Ball
My name is Karen Ball and I am 32 years old. Last year, I had the opportunity to spend two months abroad as part of my studies in medicine. I had previously travelled around South America, but never had the opportunity to visit Bolivia and after hearing how beautiful the country is, I very much wanted to return.
I also wanted to go somewhere that was not a typical tourist destination and where I could be fully immersed in the local culture and work. After seeing the projects available in Cochabamba, I decided to spend one month on a care placement and the second month on a medical placement at the local hospital.
My care placement
My care placement was at Maria Christina, an orphanage for children and young adults with a range of mild to profound intellectual disabilities. I worked for three or four hours each morning and took Spanish classes in the afternoons. It was exhausting! The children give so much unconditional love and immediately accept you the moment you walk in the door, calling “Tia! Tia!” (aunt) and constantly hugging and kissing you.
I spent time with the children drawing, playing games and doing activities to help them practise activities of daily living such as tying laces and buttoning. But of all the activities we did, the girls absolutely loved having their nails painted and make-up applied more than anything else. It was quite a bizarre sight to see all the girls with ragged old clothes, sitting on dirty mattresses in the dorm with nicely manicured nails and lipstick smeared on their faces!
Overall, the experience was physically and emotionally demanding and the conditions verging on indescribable. It was quite traumatic to see how the children lived. But even with these difficulties, I absolutely loved my time at Maria Christina and would recommend it if you like a challenge. The work was hard but rewarding.
My medical placement
For the second month, I worked at a public hospital called Hospital Viedma in the paediatric burns unit. The unit is famous throughout Bolivia for its work in treating paediatric burn injuries and for reconstructive surgery following traumatic injuries and congenital malformations.
I spent the initial few days in the unit assisting the nurses on the ward to get a feel for the work and to settle in. I then spent my time in theatre observing the operations. Once the surgeons got to know me, I was allowed to scrub in and assist the surgeons on many of the operations. I practised suturing, assisted in skin grafts, wound debridement, and various other procedures, including a fasciotomy on a boy with severe electrical burns.
In the countryside, families live in poverty and often live in one room, sleeping in one corner, cooking in the other corner on a fire. Many of the burns that I saw were as a result of young children being left unattended to look after the babies at home while the parents go to work or go begging. Many women carry their shopping, food or babies in a brightly coloured cloth called an ‘aguayo’, slung over their back. I helped treat one baby that had fallen out of the aguayo into the cooking fire as his mother bent over to cook.
I was shocked to see a couple of toddlers brought into the unit who had received burns from their parents; as a form of potty training, some traditional families believe in scalding their children with hot water if they wet the bed.
The burns unit is very underfunded and relies on donations. Whilst I was there they ran out of bandages. I saw nurses look through the bins to rescue used bandages so they could be boil washed and used again. They do not have the equipment that we are accustomed to using in the UK. There is no piped oxygen. There are not enough cots for the babies; some have to be tied down to adult size beds with bandages.
It was also a very hot and dehydrating environment to work in because you would be in thick reusable cotton surgical scrubs and working by an electrical heater whilst it is 30 degrees centigrade outside; they do not have the warm air blankets that we use in England and have had children die of hypothermia in theatre.
It struck me just how incredibly dedicated the medical staff were and how hard they worked in difficult circumstances. My experience in the hospital was amazing. The staff were very welcoming, friendly and more than happy to let you get stuck in and get your hands dirty. Dr Romero and his colleagues even took me out for dinner to say goodbye when I left. I was so sad to go, and would love to go back when I have more medical experience to offer.
My host family and Spanish language classes
My host family were fabulous! Incredibly welcoming, cooked good food, relaxed about times coming and going and patient with my dodgy Spanish. We went on local trips together too, which was a great way to see more of the local culture. My Spanish teacher was also a legend...a good teacher and great fun. I wanted to bring her back to England with me!
Along with the other volunteers, I managed to see a lot of Bolivia. The salt flats were beautiful and we had a great time in the Amazon rainforest. There’s a lot to do in Cochabamba too....salsa dancing, bars and restaurants. Just don’t eat the street food; you’ll end up in hospital.
By the end of my time in Cochabamba, I was comfortable with life there, confident getting around and had made great friends. What I wasn’t expecting was the reverse culture shock of returning home. Everything seemed a little too ordered and organised......I look forward to returning to Cochabamba sometime in the future!