Saturday, September 26, 2009

a visit to my backyard

It's easy for me to get caught up in my work and life here at the UAC-CP that I often forget to see the reality of the people who live in the surrounding communities. They are the people whose lives serve as very real, but sad reminders of why the College is so important.

This past Wednesday morning, when I joined UAC-CP's public health team for their regular rounds to homes in the local area, I was reminded of the poverty that exists in my backyard. And the work the College does to address it.

With the ambulance loaded with simple supplies, the six of us ventured out at 6 a.m. In the front seat sat our driver Salvador, Hugh's mom Elizabeth, and UAC-CP Nursing student Alcira. I sat in back on the sideways seat with the College's full-time public health staff: Dr. Wendy and nurse Micaela (UAC-CP '08).

Doc Wendy and Mica walking along a trail leading to a family's home.

As we made our way to the first stop, Dr. Wendy and Mica filled me in on some public health care basics. "We go out to the communities for home visits at least 12 times per month," Wendy explained. "We serve 12 area communities, plus Carmen Pampa [where the central health post is located and managed by the UAC-CP]." In total, Wendy estimated, they serve a population of approximately 3,000 people (including the College).

The UAC-CP's primary goal when doing community visits is attending to pregnant women and children ages five and under--as the Bolivian government reimburses the College for certain medicines prescribed and attention provided to those targeted groups. They also provide a gas allowance, though Wendy said the 10 gallons a month aren't enough--they rely on assistance from the College for extras (like their salaries, for example).

Dr. Wendy asks one of her younger patients about his regular diet.

At about 6:20 a.m., seemingly in the middle of nowhere, we pulled over to the side of the road. Everyone jumped out and I followed their lead. Measuring stick, scale, immunization cooler, health charts, and registries in hand, we made our way down a narrow trail lined with banana trees. "How do you know where you're going?" I asked. Experience, they responded.

At our first stop, a two-story adobe home, Dr. Wendy and Mica spoke with the mother of a newborn baby. The mother, whom I would guess to be 18 or 19-years-old, wasn't familiar with the country's new Juana Azurduy bonus program which pays women up to $28 US for pre-natal health check-ups and pays parents when they vaccinate their small children.

At this particular stop, the new mother seemed unfamiliar with the program and Dr. Wendy explained that she needed to register herself and her child at the mayor's office in Coroico and then start vaccinating her child. The catch? The child can't be vaccinated at the hospital--he has to receive regular care from public health nurses. Dr. Wendy explained that hospitals are overburdened with "basic things" that health posts, such as the one in Carmen Pampa, can really handle.

A young patient is weighed. In this particular case, there was some worry about weight loss.

The rest of our visits throughout the morning were similar--we would stop the ambulance, get out, walk on a narrow, mountain path and arrive at homes to find mostly young, teenage moms with either infants or toddlers. The health problems were pretty consistent: diarrhea, respiratory problems, weight loss, and Tuberculosis. Dr. Wendy and Mica, regulars to the homes, also had sad stories of abuse present (physical, sexual, mental, and alcohol) and poverty ("this family struggles just to put bread on the table"). Seeing all this makes me all the more amazed that many of our students come from situations like this; it's amazing that they've prioritize their education and have arrived here--at college.

Our youngest patient on Wednesday morning was the one-month old. The oldest was a 94-year-old Aymaran woman--completely bent over at the waist from, I imagine, years of working in the field. Unable to speak Spanish, Mica served as our Aymara to Spanish interpreter. "She said she stopped taking her [TB] medicine. She said it just made her sick," Mica translated. As we were leaving the home, we ran into the woman's son and Dr. Wendy and Mica talked to him about caring for his mother.

Alcira and Mica measure a little patient.

Much of the care they provide is often on the road. Literally. "We have to get to the homes early in the morning," Mica explained, "because people leave early to go out to their fields." If they miss people, they often find them later by coincidence--passing each other on the road. It doesn't matter," Dr. Wendy said, "we can do a quick consultation right in the middle of the road. We give immunizations that way frequently."

"We forget, don't we?" I asked rhetorically as we finally started back to the UAC-CP and mind wandered to the morning's visits. "How good we have things in Carmen Pampa." Mica and Dr. Wendy nodded in agreement. "We have running water, toilets, showers, electricity, Internet, ..." I listed off. And Dr. Wendy continued, "...and regular transportation and an on-site health post." All the things so many of us take for granted in the U.S., I am reminded after a visit to my backyard, are luxuries throughout the developing world.

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