Bolivia - Centro Medico Humberto Parra

---

http://hamantfoundation.org/centromedico/index.php

So I found out about the clinic through my friend at Northwestern in the beginning. I spent one of the most amazing months of my life in Guatemala in 4th year med school and now that I have some Spanish ability and a strong desire to get out of backup/weekend coverage/general blahness of residency(!), another international rotation and the chance to explore South America is just perfect.

So Bolivia is actually the poorest country in S Am, also used to have a coastline at one point in history but sadly (I believe) stronger militaries of its neighbors succeeded in losing it a lot of its territory. At the northwestern part it shares Incan heritage with Peru. The other large indigenous groups where I was are the Quechua and Guarani and there are a lot of others in different parts of the country.

Drs. Molitch (Northwestern) and Hou (Loyola) who founded the clinic in 2001 sound like really amazing, selfless people. Loyola has a pretty intense commitment with tracks for med students who want to spend a year down there as a coordinator, and also there was a large group who came from there for 2 weeks coinciding with me. One of the big pluses is the strong coordination of the whole setup.

The clinic is about 2 hours from Santa Cruz (Portachuelo is a nearby larger town that is actually mappable on Google). Unfortunately the clinic is accessed by a dirt road which takes 20 mins from the main highway on a dry day and about 40 on wet when there is a LOT of mud. On rainy days patients typically don't come because they all come together in a van and sometimes from far away. Each town has a set day where they are arranged to come and they have also health "promotores" who can do education and do glucose checks.

Frequently seen diseases include diabetes, bichos or GI parasites, gastritis, Chagas. In the city they see a fair amount of malaria and dengue hospitalizations also (not too much at the time of year now). The clinic patients are asked to pay 5 Bolivianos for the total visit if they can which is less than US$1. Funding for the clinic and house in Santa Cruz comes from the Hamant Foundation and volunteers pay US$100 a week which includes housing, transportation, food. The clinic has living quarters right next to it.

Would've liked to explore a lot more of Bolivia (famous esp for Lake Titicaca and the salt flats of Uyuni) but didn't want to risk navigating around the bloqueos. These are physical barricades of major highways and places in cities that is a typical form of protest in Bolivia. When I arrived the doctors had been on strike and there had been bloqueos for about 5 weeks. They were protesting being asked to work 2 more hours/day without any increase in pay. The government finally caved 1 week after I was there, but I still hit a bloqueo (probably a different group!) a week later.

---

Photos

Bolivia & Argentina 003
roasting coffee beans in the back yard

Bolivia & Argentina 007
very cute granddaughter of the Bolivian caretakers of the clinic

Bolivia & Argentina 017
rough geographical approximation of the communities the clinic serves

Clinic lab form
The nice thing about the clinic is that you could get your results within an hour. The patient would stay and you would tell them the result and be able to make decisions right away. They had Chagas and H. pylori testing also. Things like TSH were sent into town to come back in a week.

Bolivia & Argentina 025
Frequently get traffic on the road

Bolivia & Argentina 026
Thatched huts in Palacios. The roofs can be where the insects that have parasites that cause Chagas live.