Week 3 - Centro de Salud - Adolescent Pregnancy

I spent my third week here in La Paz working with Dra. Santivañez in the Centro de Salud in Alto Miraflores, a poor neighborhood in the outskirts of La Paz.
Centros de Salud are first level clinics, which means they have consultations, can give shots, but can't do surgery or have inpatients. The same as an American doctors office.
Dra. Santivañez is a specialist in adescrnt medicine at one of these clinics in a poor neighborhood of La Paz. She is well recognized in her field! She was one of three contributing authors to the book of diagnostics for the Bolivian public health insurance manual for mothers and children (SUMI). She is often asked to contribute to studies, attend conferences, and give opinions. More than that though she is a very amiable and funny person to work with.

Week 4 - Hospital de los Andes - Infant medicine

I spent my fourth and final week in La Paz working with Dra. Cecilia Uribe at her consultation in the Hospital de los Andes in El Alto.
First let me fill you in correctly:
I was supposed to work with a Dra. Gutierrez at the Hospital de los Andes during my final week here, but on Sunday, my medical director, Dra. Uribe texted me telling me that Dra. Gutierrez wouldn't be in so I should go back to Hospital de los Niños.
So I did. I went back and found Dra. Cruz, an incredibly nice maxillofacial surgeon I had been with when I was in the surgical room in my second week. I asked her if there was anything to see in surgery, and she said no, but I was welcome to come with her on her rounds!

This was an incredible experience because as she is a specialist and surgeon, we got to go to all of the departments to offer inter consultation on the difficult cases. We started in oncology and looked at some solid tumors and talked about surgery options. Then we went to Gastroenterology and saw a boy born without eyes, a cleft palate, all of his organs reversed (eg, heart on right side), scoliosis, severe malnourishment, and anemia. It was a heartbreaking case.

Vacation Week - Potosi and Sucre

This past week, I was in between my two programs. I finished my program in La Paz and had ten days to get to the southern-most city of Tarija. I decided to spend the time visiting the cities Potosi and Sucre.
Potosi is the ancient mining town. The Spanish first discovered massive amounts of silver in the mountains in Potosi, and the mines are still active today!

I left La Paz on a Friday night to arrive in Potosi on Saturday morning. When I arrived I checked into my hostel, Koala Den, and made friends with some other people in the dorm right away. They told me they were going on a tour of the mines that morning. I decided to join. So within an hour I was in protective clothes, boots, helmet and headlamp, and off to the mines!

They were awesome! We actually crawled through levels of the mine, rode around in an actual mine cart, and hung out with some miners who were working there, drinking some 96% miners whiskey and all.

Week 1 - Centro de Salud Nestor Paz

My first week in Tarija!

First thing, I absolutely love this city. It's warm and so friendly. It's much smaller than la Paz, so it's very common to run into people you know.

I spent my first week working in the clinic of Dra. Amanda Delgadillo. She works in a neighborhood here in the outskirts of Tarija. It has a relatively poor patient population and offers basic services such as consultation, vaccinations, dentistry, and a minor inpatient room if people need to stay to let stitches heal.

Dra. Delgadillo is a super nice doctor and the whole clinic in general has such a welcoming, family vibe. All of the nurses were hilarious and always joking about the "pretty new student." We all had coffee and snacks after the work day together and I really felt like I was a part of the clinic.

The one downside to this week was that Dra. Delgadillo already had a student in the final stages of her internship about to enter residency. Because of this, I felt like I was really an unnecessary third wheel in her clinic. She is a general medical doctor, so we had cases ranging from pregnant women, to a man with tuberculosis, and a lot of sore throats. The coolest parts of the week were the occasional moments I spent working with the doctor in the laboratory looking at fluid samples and diagnosing different parasites!

On Friday, I accompanied two of the interns on their community work. It was a lot of fun! It was National Children's Day, so we walked around farmland to different houses asking if they had young children and distributing nutritional supplements to help kids get their vitamins.

Overall, the week was rather low-key, but a super friendly environment to be working in!

Week 2 - Hospital Obrero - Internal Medicine

For a very interesting ward in the second largest hospital in the district of Tarija, this was by far my most boring week.

I realized here what an immense difference in my experience the personality of the doctor I'm working with makes.

I spent my time here working with Dr. Victor Vilcaez.

Monday was Tarija's anniversary, so no one worked. So my first day was on Tuesday, and I arrived at the hospital at 7am. In Internal Medicine I asked if Dr. Vilcaez was there and they said not yet. After about twenty minutes I asked again and they said Oh yeah, he's in that room. I introduced myself but he told me to wait and then came out and said we were going to do rounds.

As per usual, rounds consist of the residents taking the doctors around to all of the patients and explaining their case and any recent developments. They're always the hardest for me to understand because the Spanish is so fast and mumbled.

Sunday 4/13

Yesterday one of my friends from Tarija and I went out to the famous Wine Route! We got in a bus early in the morning that took us out through the beautiful Valley of Conception where there are vineyards and wineries. We got to visit over five different spots ranging from a large industrial winery to a small family owned shop where they make artisanal wines. Tarija is famous for its wine, and while I personally don't like many of them because of how sweet they are, they do have some pretty good ones!





Today me and another gringo rented bikes from this awesome agency. It only cost us just over $10 for the whole day with gear included. We took the bikes out to the neighboring pueblos of San Lorenzo, Coimata, and La Victoria.

San Lorenzo was a super quaint little pueblo with very friendly people! The day was beautiful for bikes: not too hot and not too cold.

Coimata is an awesome little spot back in the mountains with a gorgeous waterfall and natural pools to swim in.

Over all a really great day!!!

Sunday 4/21

Today some friends and I brought a bunch of wine a cheese out to this beautiful spot called Tomatas Grande and spent all day swimming in the river, drinking wine, and enjoying each others company!

Thursday 4/25

Started today getting picked up by the doctora at 5:30am and we went out to the farm of one of our patients. She is a super friendly old woman who invited me out there to try the Bolivian drink Ambrosía. It consists of fresh cows milk, the grape liquor Singani, and cinnamon.


The farm was beautiful in the sunrise and she and her husband were such nice company!!

Week 3 - Centro de Salud Hospital San Lorenzo

I spent this week working with Gynecologist Dra. Mary Yucras in her consultation in Hospital San Lorenzo. San Lorenzo is a pueblo about a fifteen minute drive outside of Tarija. Thankfully the Dra picks me up in the morning and I don't have to worry about trying to catch a bus to get out to San Lorenzo.

Dra. Yucras is a very extroverted women and loves teaching and having me practice everything she does to become familiar with the procedures. Over the week, we performed several PAP Smears, did some routine pregnancy check-ups, diagnosed various infections, and gave information about and performed various methods of birth control. By the end of the week I was able to conduct many of the visits all by myself thanks to all of the practice I got working with Dra. Yucras.

Week 4 - Plataforma de Chagas

I spent my fourth week working in a clinic for Chagas Disease.

Chagas is a tropical disease caused by the parasite T. Cruzi, usually carried by the vinchuca bug. This bug lives in many natural environments but has also been found in many homes in the farming regions of Bolivia. The disease is found in all of Bolivia, as well as Argentina, Peru, chile, and many other South American countries. It has also recently been encountered in the United States and Spain.
There is a cure for the disease, but because it can go up to twenty years without displaying any symptoms, many people do not know they have it or do not want to seek treatment.

In the platform, I worked in the diagnostic laboratory, in the consultation of Dr. Rodriguez, and with the nurses. At the end of the week I had an exam on Chagas to make sure I had learned as much as possible while I was working there.

Educacion y Futuro (EdyFu

So for my month in Tarija, instead of taking more Spanish classes I decided that my Spanish was good enough to speak conversationally and that I could put my time to better use. Instead, every afternoon I volunteered at the local children's center, EdyFu.

EdyFu is a center for poor children to come to in the mornings or afternoon to either get help on homework for those struggling in school, or to take classes in trade jobs like gardening, electricity, or cooking. They have a kitchen which provides breakfast or lunch to kids who need it and they have an actual temporary housing facility for children.
Lastly, they have a system of godparents they use to get children sponsors in other countries.

While working at EdyFu, I spent some days assisting the gardening class (including taking the money that would have gone to my Spanish lessons and using it to buy earth, flowers, and seeds to build a new outdoor garden). I spent the other days assisting in the school help class. I also took two days to teach swim lessons in the pool they have on site!

Cochabamba

After I finished my program in Tarija; which, by the way was very hard to leave. My friends and I had a big going away party and I'm really going to miss that place! I headed to the bustling town of Cochabamba. Cochabamba is a huge city by Bolivian standards, with many large buildings and a super warm climate.


Going into it, I had heard that the city was also pretty dangerous, and that I had to stick to the safe parts of the city, which I did so no problems there. When I arrived I checked into my hostel, made a friend, and went off exploring the city. We hiked up to the Christ statue; the second largest in the world! And I know you're probably thinking the biggest is in Rio; it's not. The biggest is in Poland.

The next day I met up with two friends from Tarija, who were also there and we explored some more, including getting lost in the largest market in South America!! It was a really beautiful city with a lot of life and almost no gringos, which I've really grown to love.

Now for the bad part: BLOQUÉO. Bolivians love to protest by blocking off major roads throughout the country. There's always one going on somewhere and the police do nothing to stop it. Probably something to with the fact that current president Evo Morales (the one who never finished high school and imposed a tax on those who didn't have children) used to participate in them himself. At this particular time people were protesting tax increases by blocking off the road from Cochabamba to La Paz. My flight out of La Paz was on a Wednesday morning and I intended to leave Cocha on Monday night by bus to arrive Tuesday morning. The bus company told me that should be fine because bloquéos usually ended before my 10:30 bus would be leaving. I confirmed at 6pm that my bus was still leaving that night and they said yes! No problems. Well, I got there at 10 and as it turns out: problems. They refunded my ticket and I was PANICKING. I had to wait until the next day to rush to a travel agency and buy a last minute plane ticket. The earliest they had was 6pm. So I got to La Paz at 7pm. Took a minibus from the far away airport to my friends apartment. Slept. Got up at 5am and was back to the airport to head home!