This weekend we began some adventures around the beautiful country of Bolivia!
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During our final day at Centro de Salud Chasquipampa, we were able to see more of the same types of patients: cold and flu, regular check ups, and other various minor health conditions. However, today several mothers came in with issues lactating and/or getting their baby to latch during breastfeeding.
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Bolivia’s universal healthcare system is not the only major public health initiative found within the country. Many of the pediatric patients that are seen in the centros de salud are coming to complete their bimonthly check ups as a required of the Bono Madre Niña-Niño Juana Azurduy program. This program, which began in 2009, is a method in which the government provides money to mothers and families who attend their regular check ups throughout pregnancy until the child is two years old.
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Day 2 at the Centro de Salud Chasquipampa was not much different than the prior day. As Bolivia is beginning to enter into their winter season, cold and flu-like symptoms persisted as the main chief complaints. Most of these pediatric patients were young, often under 7 years old with only a handful of patients older than seven. Dr. Delgadillo explained to many of the mothers, especially those under the age of 3, that the likelihood that there were problems with their child’s tonsils were very rare, if not impossible. He explained that the tonsils are not fully grown until around that age so they do not have to worry, though many of them had concerns due to hearing of the potential for tonsilitis from a general practitioner.
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Today was my first day in the primary health care clinic, Centro de Salud Chasquipampa. It was a long and windy Pumakatari, the local bus, ride down to southeastern La Paz, we finally arrived to a much quieter, more residential region of the city. Somehow, the mountains seemed even bigger here than in the central area of La Paz. After walking a couple of blocks from the bus stop, we came across this teal blue building which was the centro de salud. Here, unlike the tertiary facility, it felt as though the team worked more as a family as they sat down to have a breakfast full of muffins, sweets, coffee, and tea. They discussed reiki and its potential benefits and had general conversation about how they were all feeling and doing that morning.
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Today, I started my rotation with Dr. Chavez on the neonatal unit of Hospital de las Mujeres. I learned about the challenges that they are seeing as larger babies are being born due to rising obesity throughout the country. During a presentation, two first year medical residents discussed the challenges of diabetes and its impact on the babies that are being born significantly bigger than in the past, as diets are becoming worse and more people are becoming increasingly sedentary.
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The Andes Mountains run through Ecuador, Peru, and Bolivia. Hence, the high altitude in La Paz. I have personally never seen a mountain range outside of the mountains in Puerto Rico, which are tiny in comparison. This morning, I sat on the Teleférico facing the opposite direction of transport and I was finally able to see the beautiful horizon of the Andes Mountains in contrast to this bustling city. Please admire this beautiful and unique city!
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Today, I began my set of clinical rotations at Hospital de la Mujer, a tertiary level hospital for women, whose patients mainly consist of pregnant women. My rotation started by going to the cambio de guardias, where residents and attendings discussed patient care from the previous night and ways that things could have gone better or were done poorly. After going to the Obstetrics floor, the Women’s Emergency Room, and the Labor and Delivery floor and each floor either having completed their rounds or having no patients, I was escorted to the ultrasound room where I observed two radiology doctors who saw patient after patient.
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What a long day! I flew with Avianca from Dulles International Airport to El Dorado International Airport in Bogota, Colombia (5+ hour flight) and then had an hour layover where I scrambled to make it to my next flight from Bogota to La Paz, Bolivia…but at 2 am BOT/EST I made it! Phew!
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You may be wondering, Adrianna, what is this practicum for and what will you be doing during your time there? Well, as I stated before, the practicum is the culminating component that is required in order to obtain my degree. It is an intensive, month long, fieldwork experience which will allow me to utilize the information and competencies learned throughout my program and apply it to a real-world experience.
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