Tuesday, June 9, 2009


On Sunday afternoon Hugh and I got a whirlwind tour of about four different government hospitals that are all clustered together in the Mira Flores neighborhood of Bolivia's capital city, La Paz.

Lic. Lidia Cuevas, Director of the UAC-CP's Nursing Department, invited us to accompany her and UAC-CP Nursing instructor, Lic. Maria Luisa Rodriguez, on a brief tour of the hospitals so that we could see our Nursing students in their element.  Not wanting to cause disruptions (as our students were officially on-duty), we briefly said our hellos, snapped pictures, and went on our way.

UAC-CP Nursing students check the vitals of a baby in the neonatal section.

But between the children's hospital and our final stop at the intensive care unit, I couldn't help but feel a little awkward. Though we weren't entirely random and Lic. Maria Luisa served as our guide, I felt a bit intrusive.
The big, institutional space provided nothing in the way of privacy. In one area, makeshift "rooms" were made of curtains that separated every two beds. In another part, 20 single beds all lined up against the wall, filled a room. With no walls or dividers, conversations and physical consultations were for all to hear and see. If privacy laws exist, they are definitely not enforced.

UAC-CP Nursing instructor, Lic. Maria Luisa helps one of our students insert an IV into a patients arm.

As Hugh and I walked through areas of the hospital compound that I'm not convinced we should've been allowed to enter, I realized how much we, in the U.S., take our privacy for granted. For us,  it's a right we've come to expect, for Bolivians it's a seemingly foreign concept--personal space and privacy are essentially not recognized.

This is especially true in the countryside. Our students, for example, come from homes where often their entire family of 5 - 6 people lives in one or two rooms; beds are commonly shared by at least two siblings (when I've stayed with UAC-CP families, they've slept three to a bed to accommodate me with my own place to slumber). Here at the College, our students live 20 to a room; bathrooms, showers, everything is shared.  

The same is also true for health care. I clearly remember a trip to a local community with the UAC-CP doctor.  I overheard each patient describe their symptoms; I saw people give urine samples in the corner of the room; I saw shirts pulled up and pants pulled down...and all their neighbors saw and heard the same thing.  It's no wonder Bolivians often say: "Pueblo pequeño, infierno grande."  (Little town, big hell) Private lives are hard to keep and gossip is a popular alternative for those without televisions.

Though the majority of UAC-CP Nursing majors are women, there are a handful of men who choose the profession.

I believe there is a sense of dignity that comes with having access to privacy--knowing that your business is your own; that it is for you to decide with whom you want to share it, assuming, of course, that you want to share it. 

Hopefully that's part of the training our Nursing students receive--the ability to treat people with tender care and attention...and with concern for their privacy.  In this way, the sick can at least know the feelings of security and peacefulness...that is privacidad.

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