Experience in Bolivia

Arizona Nurse,  Mar 2000  by Beck, Lasca

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A Medical Missions Seminar with 43 health care providers from throughout the United States was held in Bolivia from May 15-23, 1999. I was fortunate to be selected to represent the Desert Southwest Conference for the event, which was sponsored by the General Board of Global Ministry for the United Methodist Church. Bolivia is the poorest of the South American countries. The average income is $ 100 per month and unemployment is about 32%. There is a 30% illiteracy rate. Three cities with community health projects were visited. The first experience was in Cochabamba at the Comprehensive Community Based Primary Health Care (CCPHC) project which is directed toward meeting basic needs of people living in the barrios. Project events occur in buildings around the Methodist church. The project began in 1994 and is now reaching about 5,000 children along with parents and other family members in the barrio areas.

Benefits realized to date include ii-immunological control of disease from vaccination, control of parasites, immediate and follow-up care for sick children, and improved nutritional status of participants. The average life span is 58 years old in urban areas but 47 years old in rural areas where tin and other mineral mines are located. On average, one woman out of every 250 dies from childbirth complications. They are now vaccinating women 15 to 40 years of age for tetanus and pre-natal care has been implemented. A number of mothers and other women from the barrios work at the CCPHC as seamstresses, manning the washroom, housekeepers, and caterers of snack stands. The income of the women receive for the work averages about S 120 per month, which supplements what their husbands earn and gives them a better standard of living. Their positive experiences with earning income have made them strong proponents of encouraging others to work to get education and improve living conditions.

The next site after Cochabamba at an elevation of 8500 feet was La Paz with an attitude of 12000 feet. Temperatures in La Paz average 45 degrees. We traveled by buses to the altiplano which is the flat areas of the high Andes Mountains. The project we visited is the Andean Rural Health Program. The health needs there are very basic as was the case in Cochabamba but in a different way. At 13000 feet of elevation, the temperature is cold and the people have no heat in their homes or buildings. We were told that there is no arthritis on the altiplano. Pneumonia is very common. Lack of potable drinking water and malnutrition are major problems. The daily diet commonly consists of rice and potatoes and very little fluid or water. As a result, intestinal tracks and linings dry out. A water sanitation project is one of the program goals. Another goal of the program is infant mortality reduction but even with the program's involvement and positive results, the infant mortality rate is 60%. Other foci of the project include farming and creation of irrigation systems, animal husbandry to learn how to care for their animals, building of bathrooms, and reduction of the illiteracy rate. Girls often stop school at the third grade and boys rarely graduate from high school. The children are taken from school so they can help with work in the fields. The people on the altiplano are Aymara (Indian) which are thought to be the earliest known inhabitants of Bolivia. Various small communities are located throughout the altiplano. Pacharia is one of those communities which some of us visited. We visited with a woman in Pacharia and she showed us her home.

Santa Cruz which is low in altitude with a warm, humid, semitropical climate was the third site we visited. The program in Santa Cruz has the highest rate of vaccination in the Rural Health Project with more than 90% having been vaccinated. All three sites utilize "Health Promoters" who are trained volunteers. The Health Promoters make home visits to assess vaccinations given and needed, presence of illness, needs of the home such as water, latrines, and to teach how to eat. Volunteer nurses and physicians are utilized in the projects especially on the altiplano and in Santa Cruz. Length of terms for volunteerism varies from a minimum of two weeks to three months to one year.

About the Author: Lasca is a former AzNA board member and Nursing Liaison, College of Nursing, ASU West. She was recently appointed Coordinator for the Volunteers in Mission (VIM) for the Desert Southwest Conference.

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