My name is Cory Kosche. I am a student at Northeastern University in Boston, MA spending a semester immersing myself in the cultures of South America.

So here I am. In South America. I spent my first two months teaching English in Cusco, Peru and now I´m participating in two programs through Child Family Health International.

The first month I will spend doing ¨Pediatric and Adolescent Medicine¨in La Paz and the second month with ¨Doing More With Less-Healthcare in Remote Southern Bolivia¨ in Tarija, Bolivia.

I´m keeping this blog so that you can read about my travels through the country of Bolivia, read some advice and travelling tips, and to share what I have learned.

If you want to read about something specific, use the labels to the right, I've organized the trip into Tarija and La Paz, as well as specific aspects.

If you want to start from the beginning, Click Here

If you have any questions at all, don't hesitate to Email Me





Medical Reflection

I came to Bolivia with Child Family Health International to learn a few a different things. I hoped to gain some medical experience and to see if I enjoyed working in the clinical environment. I hoped to begin forming an opinion as to what type of medicine I might want to dedicate myself to. Lastly, and most importantly, I hoped to learn about the medical system and how it functions in regards to the Bolivian culture. I will always have the ability to see and learn about modern medicine in the United States, but I came to Bolivia to learn about the cultural aspects of a developing country and how they influence healthcare.

And I did.

In Bolivia the variation in standard of living is so great even without traveling very far outside of the city. For this reason, working in a clinic or hospital means that the doctor has to be able to seamlessly transition between working with wealthy, informed patients and some of the poorest, uneducated patients. The differences in explanations, communication, and approaches are completely different. There is no comparison--no analogy.

One of the hardest things to hear while working in Bolivia was the explanation of what could be done for the patient had he or she been in the United States. That this woman would lose her baby because they lacked the medicine here in Bolivia to help her, but in the United States we would be able to stop the contractions.

Lastly, the religious aspect of the culture also played a large role in the medicine. Bolivia is a very catholic, very macho culture. The men never came in for the controls of the baby. Many women were very hesitant to start birth control. Even as a doctor, the conversation had to be treated with sensitivity so as not to offend the patient, or step over the boundaries.

While I learned a great deal about medicine: treatments, diagnostics, evaluations, patient communication, and daily life of a doctor, I learned so much more about the importance of cultural sensitivity in the field. Medicine can often appear cut and dry. We are the medical professionals and we know what's best. We'll explain it in a way that sufficient enough for us and we'll lay out the options in a simple manner without an in depth exploration of them. I learned why this is wrong. I learned why being a medical professional means so much more than being a scientist. I have influence over people's lives, happiness, and peace of mind. I am responsible for taking into account their culture, level of understanding, and necessities when communicating, evaluating, and treating.

I am now certain that medical school is the path I want to take. I feel that I have left my two programs with Child Family Health International as a more global individual. A global individual with increased compassion for other cultures --with a definite future in the field of medicine.

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