Patients and patience

Aaargghhh, just wrote loads and then lost it.... ANyway, in summary, 2 weeks in Villa Tunari, lots of patients, interesting cases, and a bit of frusttration with the system here, it takes ages to get anything done because thiungs are disorganised and sometimes people are lazy. Has had some serious and sad consequences for a few of the patients I´ve seen. I dont feel there´s much I can do to improve that, just have to bite my tongue and be patient, but hopefully I´m learning for the future. Medicus Mundi are involved in the hospital management with a project trying to imporve the organisational side of things.

For those medically minded, some interesting cases: abscess caused by human bite on foot, congenital (hopefully - if not congenital then not worth thinking about.....) neurosyphylis in a 7 year old, snake bites treated by local remedies (put flesh of dead snake on wound, put babies poo on wound!), hemoglobin of 2 in a 15 year old, and some amazingly impressive parasites (see picture - those were in a 8 yr old boy, you could feel the lump in his stomach and he cried like he was giving birth, not surprisingly...!)

Interesting to talk to the team of cuban doctors workign here, all paid for by the cuban government, in solidarity (or will Fidel ask for some Bolivian gas in return?). They have had an impact here and the aptients really like them as they give free treatment. Lots of rumours in middle class doctor circles about their poor treatment and how the Bolivian govt is paying for them, thuis robbing Bolivian Drs of jobs. Not true.... But shows level of oppostion to Evo and the things that he does in some circles. People in the countryside still really like him, there has been more investment in education, more health posts, and more health workers (even when you dont include the Cubans) and an agricultural bank which gives low interest loans with repayments on an annual basis - easier than monthly if you depend on seasonal crops.... But there are people here who are angry with Evo for not doing enough for them.

I was hoping to meet him yesterday, we were sent to provide first aid at a football match he was supposed to be attending, I took my camera all ready but in true Bolivian style he got delayed and didnt make it before a huge storm put an end to proceedings. Apparently hes back in 2 weeks so I may have another chance, he comes from a village 2 hours away from here, its strange to think that when we treat a young boy/man from that village who smells of coca leaves and sweat, and says he works on a chaco (plot of land), that was Evo 2o years ago.

Have been able to get into the community which has been interesting, talking to ladies and vacinating (I always seem to end up vaccinating dogs, the biggest and fiercest so far was aptly called Pinochet!) and then finishiung early and gong for swims in the river! Fun but would be good to use that time to do some health promotion talks, no-one knows about AIDS although here the rate is higher than most of Bolivia, and with it being a stop off point for truck drivers from Argentina and other aprts of Bolivia, its an important issue. However, few of the other interns seem interested in that kind of thing.

Have also been out a few times with the interns here, and some spanish volunteers in a nearby town, which has been fun. And playing in goal for the hospital 5 a side football team - let in 9 goals last match which was a bit depressing!

So thats it for now, I think Ive reached half way of my time in Bolivia, am really pleased to be here, I think I´m learning that in the end us people deep down are all the same everywhere, and with a bit of patience we can understand each other... if only it was that simple!