It feels like so much has happened since last time I wrote even though it has only been a few days! Judithe and I started our clinics Monday at Hospital del Niño, which is the largest children’s hospital here in Bolivia with around 150 beds. Children come from all over the country to be seen by pediatric specialists here! Gonzalo, the local coordinator through CFHI, met us at our apartment building Monday morning and brought us to the hospital. He showed us how to work the bus system here, which is actually pretty easy. And when I say bus, I mean vans that are usually packed with people (I haven’t seen very many big buses here like the ones I see in American cities, mostly just vans and smaller taxis called trufis). The most difficult thing about getting around is crossing the street because cars don’t stop for pedestrians here. It is somewhat of an art form!
Anyways, back to the hospital. Once we arrived, Gonzalo introduced us to Dr. Velasco, a pediatric infectious disease specialist who was very welcoming. I was relieved to find out Dr. Velasco speaks both English and Spanish. He brought us down to the hospital library, where he gave us an introduction on the hospital itself as well as the medical education system in Bolivia. There were 3 Bolivian medical students who were present in the library during this introduction, so it was very interesting to hear their perspective. After graduation from high school, Bolivian students generally take one year off to study for entrance exams into whatever specialty they are interested in (medicine, law, dentistry, etc.). If they pass these exams and are accepted, their training begins. My understanding is that it is hard to get into these programs- they are competitive because they are mostly free, paid for by the government. Medical school here is 6 years (no college in between), after which the new doctors can practice family medicine if they want. However, if they want to specialize, they apply for residency. Residency here is 3-7 years depending on the specialty, just like at home. It is difficult to get into a residency program here as it is very competitive. The students we met in the library were in their 5th year of medical school. They were very nice!
Following the introduction, Dr. Velasco brought us down to a clinic on the first floor to meet Dra. Salete, the doctor we will be working with this week (Dra. is short for doctora, a female doctor). She is a general pediatrician from Brasil who works with children with disabilities, and in particular Down Syndrome. Monday we got to participate in her general pediatric clinic. She let Judithe and I do physical exams and help transcribe progress notes onto their form of an electronic medical record, which was interesting because everything was (obviously) in Spanish. Dra. Salete does not speak much English but I was thankfully able to understand most of what was going on medically – she loves to teach and there were several times when she would stop her conversation with the parents to teach Judithe and I. We saw a young girl with Down Syndrome who had pneumonia, a little girl who was having problems concentrating in school (sounded like ADHD although I don’t know if that diagnosis ever came up), an infant with bronchiolitis who had to be admitted, etc.- all things I have seen in clinics back home. It was a great experience!
Yesterday morning (Tuesday), we worked with Dra. Salete in the infectious disease unit at Hospital del Niño. She was one of two attending physicians on that unit this week. Judithe and I got to participate in rounds on the 12 patients in the unit, which was very neat. Attending physicians, 2 pediatric residents, several medical students, a nutritionist, and the unit nurses all participated. They were very much like rounds at home with the residents presenting cases and the attending physicians (nicely) grilling the residents and medical students 🙂 The residents spoke very fast so it was difficult for me to understand everything, but I was able to get the gist of the patients’ cases (Judithe and I read through the charts after rounds so that helped, as well). Some of the cases we saw- Well’s syndrome, osteomyelitis of the mandible, periorbital cellulitis, bronchiolitis, empyema.
As a side note, our host mom has taken us downtown a couple of times. Last night we got to go to the main plaza in La Paz, where all the government buildings are located. We also got to go inside a beautiful Catholic church on the plaza from the 1700’s (our host mom called this a “newer” church). We found out that our host mom is a Christian and she invited us to her weekly Bible study on Wednesday nights as well as church on Sundays. Love how God works out all those details!!
I have to go now – we start Spanish lessons today at 3! I have so much more to say but will save it for the next post 🙂