Saturday Morning
Saturday is interesting in La Paz. It still seems to be a regular workday for many, with stores open until noon or so. It seems to be a big cleanup day, with hundreds of younger soldiers on the sidewalks scraping up trash, which there is not much of in the first place downtown.
I think that in addition to waiting in line for documents to work, it seems that one of the biggest reasons I keep seeing the several block long lines each morning and afternoon outside various public record buildings is to get kids necessary documentation to attend school. Apparently it is not possible to begin mid-year, from what I hear.
I saw a similarly long line of people at eight yesterday morning in El Alto. After passing the hospital where I had spent the first part of the week, El Alto came into better focus for me. It seemed to be an endless maze of one and two story brick buildings, many which seemed either in disrepair or abbreviated contstruction. Many lacked windows, many had rubble in front or in the first floor. Occasionally something hanging in the window, like lace or some decoration indicated it was a home. Between blocks were streets which seemed very alley-like. Many had rocks and garbage scattered across them, and the few drains in the streets were plugged with garbage, leaving a nice flowing layer of muddy water running over most of the streets. At times it felt like a long-abandoned city, except for the fact there were people living there and walking along the sidewalks.
Traffic lights appear to be suggestive at best in El Alto. The drive involved much creative merging. The hospital to which we were headed was on the opposite side of the airport from where I had been to begin the week, about a 30 minute drive from downtown La Paz. The clinic was filled with about 150 people in a space the size of an elementary school classroom when we arrived. There were a few patient visit rooms, but the majority of the building seemed to be a space for waiting. There was a small pharmacy, a tiny room with an X-ray machine from long before I was born, and a room with several beds next to each other that served as the labor and delivery area.
My time was spent doing well-child (or not-so-well child) checks. Malnutrition is a huge issue in Bolivia and El Alto especially. Half the kids we saw were iron-deficient, based on exam. Many of the infants were dehydrated and listless. There seems to be a cultural tendency for mothers to feed infrequently, perhaps due to their own infrequent meals. Perplexingly, when a child has diarrhea, parents stop giving liquids, which often results in stopping the diarrhea, if the child survives the volume depletion. I saw a ten day old girl who probably weighed about two and a half pounds, usually the sized infant one only sees in the neonatal ICUs of developed countries. She had been born at home and had yet to visit a clinic or hospital. Surprisingly and fortunately, she was doing well and feeding without trouble. I have a picture whenever I find a USB port.
One two year old boy came in who was malnourished, had a chronic cough for two months, and the past two days had been coughing blood. His chest X-ray, story, and the prevalence of TB in the community makes it very likely he had TB. He looked so sad and resigned. Treatment is available, but sometimes it is difficult to get parents to recognize what needs treatment and what can be treated if they seek care. Some interesting beliefs still have a strong hold amongst Bolivians. There is still the idea that one can die due to surprise. On mother with a two week old infant said that her three year old boy had died ten days ago from a surprise or shock he had weeks earlier. The fact that she told us he was completely yellow with diarrhea makes it more likely it was Hepatitis A, another prevalent disease here.
Some kids are remarkably healthy, but many are not. Two programs to provide free care to kids were started over the past five years. One is a national program that covers pregnant mothers and kids from birth to age five. Surgeries for congenital diseases, such as heart defects or cleft palate, are not covered. Much of the routine care, immunization, and general kid illnesses are, however, and already doctors say they can see the effect of prenatal care and routine immunization. Nevertheless, kids still die of neonatal tetanus and other preventable maladies. The other program is specific to El Alto, that covers kids from six to eighteen if they are going to school. That, I think, is one of the main reasons parents are in line to get documentation for their kids. It's an interesting self-fulfilling program. One needs immunizations to be in school, and to be in school to get free health care. So, the byproduct is more healthy kids and more attending school, one would hope.
More later...
I think that in addition to waiting in line for documents to work, it seems that one of the biggest reasons I keep seeing the several block long lines each morning and afternoon outside various public record buildings is to get kids necessary documentation to attend school. Apparently it is not possible to begin mid-year, from what I hear.
I saw a similarly long line of people at eight yesterday morning in El Alto. After passing the hospital where I had spent the first part of the week, El Alto came into better focus for me. It seemed to be an endless maze of one and two story brick buildings, many which seemed either in disrepair or abbreviated contstruction. Many lacked windows, many had rubble in front or in the first floor. Occasionally something hanging in the window, like lace or some decoration indicated it was a home. Between blocks were streets which seemed very alley-like. Many had rocks and garbage scattered across them, and the few drains in the streets were plugged with garbage, leaving a nice flowing layer of muddy water running over most of the streets. At times it felt like a long-abandoned city, except for the fact there were people living there and walking along the sidewalks.
Traffic lights appear to be suggestive at best in El Alto. The drive involved much creative merging. The hospital to which we were headed was on the opposite side of the airport from where I had been to begin the week, about a 30 minute drive from downtown La Paz. The clinic was filled with about 150 people in a space the size of an elementary school classroom when we arrived. There were a few patient visit rooms, but the majority of the building seemed to be a space for waiting. There was a small pharmacy, a tiny room with an X-ray machine from long before I was born, and a room with several beds next to each other that served as the labor and delivery area.
My time was spent doing well-child (or not-so-well child) checks. Malnutrition is a huge issue in Bolivia and El Alto especially. Half the kids we saw were iron-deficient, based on exam. Many of the infants were dehydrated and listless. There seems to be a cultural tendency for mothers to feed infrequently, perhaps due to their own infrequent meals. Perplexingly, when a child has diarrhea, parents stop giving liquids, which often results in stopping the diarrhea, if the child survives the volume depletion. I saw a ten day old girl who probably weighed about two and a half pounds, usually the sized infant one only sees in the neonatal ICUs of developed countries. She had been born at home and had yet to visit a clinic or hospital. Surprisingly and fortunately, she was doing well and feeding without trouble. I have a picture whenever I find a USB port.
One two year old boy came in who was malnourished, had a chronic cough for two months, and the past two days had been coughing blood. His chest X-ray, story, and the prevalence of TB in the community makes it very likely he had TB. He looked so sad and resigned. Treatment is available, but sometimes it is difficult to get parents to recognize what needs treatment and what can be treated if they seek care. Some interesting beliefs still have a strong hold amongst Bolivians. There is still the idea that one can die due to surprise. On mother with a two week old infant said that her three year old boy had died ten days ago from a surprise or shock he had weeks earlier. The fact that she told us he was completely yellow with diarrhea makes it more likely it was Hepatitis A, another prevalent disease here.
Some kids are remarkably healthy, but many are not. Two programs to provide free care to kids were started over the past five years. One is a national program that covers pregnant mothers and kids from birth to age five. Surgeries for congenital diseases, such as heart defects or cleft palate, are not covered. Much of the routine care, immunization, and general kid illnesses are, however, and already doctors say they can see the effect of prenatal care and routine immunization. Nevertheless, kids still die of neonatal tetanus and other preventable maladies. The other program is specific to El Alto, that covers kids from six to eighteen if they are going to school. That, I think, is one of the main reasons parents are in line to get documentation for their kids. It's an interesting self-fulfilling program. One needs immunizations to be in school, and to be in school to get free health care. So, the byproduct is more healthy kids and more attending school, one would hope.
More later...
posted by Aaron Clarke Shur @ 11:25
<< Home