Doctora Pamela

My 12th annual Bolivia medical mission trip was special in a couple of ways. First, this was the first trip in which I could actually be called “Doctora” and have it be practically true (though I don’t officially receive my MD degree until next week). Most of the week I worked with Doctor Doug, a psychiatrist, seeing children and adults with a variety of complaints – from headaches to stomach aches to leg cramps – most of them related to depression and anxiety. We prescribed medications for some, counseling for others and deep breathing exercises for all. More importantly, I had the opportunity to pray for several of these patients, which is a distinct privilege and probably one of the most healing things I know how to do.

Click on the photo below to link to my album.

Bolivia 2010

One mother brought her 9-year-old son with brain damage from birth to see if we could help him. He could not walk or talk and was confined to a wheelchair and dependent on his mother for all of his daily needs. Unfortunately, there wasn't a lot we could do for his brain. However, in the course of the visit, it became clear that mom was severely depressed. As you can imagine, having a disabled child is very difficult, but compound that with being poor, alone (her husband worked out of town), and in a town where there are no social services available for special needs children. Often, disabled children are ostracized, and mothers are blamed for doing something to cause the child's problems. Families spend all their money going from one doctor to another in the hopes of a cure, buying endless quantities of expensive "medicines" and "tonics" that they are told will improve their child's brain development. Upon investigation, we found that most of these tonics are simply vitamins that can be obtained in a normal diet. While they may have some role in neuronal function, they certainly are not able to reverse the damage done from oxygen deprivation or swelling of the brain at birth. So this poor mother, after nine years of caring for her son alone, was suffering from guilt, loneliness, hopelessness, poverty and desperation. Through the generous donations of our group sponsors, we were able to offer her a chance to send her son to a special education program in town. At the very least, it will give her a couple of days of respite during the week. We will also be able to help her see a counselor to get some support and have someone to talk with about her daily struggles. I ended the session with a prayer and encouraged her to find a church where she could pray with others and nourish her spirit.

The last day of the week, we went out to a small, rural indigenous community. Half of our group had spent the week there building a brick house for one of the families. Little by little, our partners in Bolivia, with the help of groups like ours, are providing improved houses for these Guarani villagers in order to keep out the vinchuca, a beetle that lives in cracks and crevices of wood and thatch houses and causes the dreadful disease, Chagas. For half a day on Friday, the medical team saw patients in the community health post. To make things go faster, I got to see patients by myself and managed to see 16 patients in 4 hours, which is pretty good for a recent medical school graduate! Of course, I had to ask lots of questions. For example, I had no idea what to do for the 65-year-old grandmother who came in with a blood pressure of 220/80. She was completely asymptomatic - no chest pain, no blurred vision, sharp as a whistle and no complaints at all. She did have a large heart and a heart murmur, possibly from Chagas disease, but she had never seen a cardiologist. She'd had a prescription for blood pressure medication but had not filled it, either because she didn't want to go to town to get the medicine, or because she couldn't afford it (or both). We didn't have any blood pressure meds with us, and I wouldn't have felt comfortable prescribing it for her without adequate monitoring of her pressure and symptoms over the next days and weeks. All I could do was urge her to go see a heart doctor and follow their recommendations. However, I doubt she'll go. She was perfectly comfortable and likely prefers to remain at home with her family rather than spend lots of money on doctors, tests, and medicines that might prolong her days but can't promise an improvement in the quality of her life. It was a humbling experience for me and a good reminder that doctors can't always do something for every patient.

Click on the photo below to link to my album.

Yapacani Bolivia 2010

After the medical part of the trip was over, I went out to Yapacani (where I lived several years ago) to see my friend Yolanda and her family. Yolanda was my first friend in Yapacani. She adopted me when she was 8 years old. In other words, she followed me home from the town square one day and asked me to be her godmother. I wasn't quite ready to take that on at the time, but over the years I grew close to her and her five sisters - Veronica, Maribel, Karen, Rosandra and Daniela. I have seen them all grow up and done what I could to help their mother, Rosa. Veronica is now a teacher in Santa Cruz (the nearest big city) and has three children. Maribel has a small store in Yapacani and has one little girl. Karen is studying law and wants to be a forensic specialist (like CSI). The two youngest, Daniela and Rosandra, are still in high school. Yolanda spent two years in Houston living with me and studying English, so we have a special relationship. I try to call her every month or so, and we keep in touch by email and Facebook. She now has 4 children - Jeffrey, age 5; Pamela, age 4 (named after yours truly I think); Stacey, age 2; and Matthias, age 3 months. They are all happy, healthy and cute, and I loved spending time with them as their "Tia Pamela". While I was in Yapacani, the youngest three were baptized, and I was the “madrina” (godmother). Although I do not necessarily agree with the Catholic church's view of baptism, I will still take my responsibility as godmother seriously and do my best to influence my godchildren to know and love Jesus.

Over the course of the weekend, Yolanda and I made several of her favorite recipes - meatloaf, apple crisp, brownies, lasagna, banana bread and pancakes with maple syrup! I brought a lot of ingredients with me from the US, and it was fun shopping for the rest in the Yapacani market. From past experience, I know that you should not buy already ground beef in the market - no, you can't find those nice plastic-wrapped packages of ground beef in Yapacani. Picture big slabs of meet hanging from hooks in the fresh air with flies buzzing all around. Several years ago, when my parents were visiting me in Bolivia, we bought ground meat to make spaghetti. After getting it in the pan, my dad commented that the meat was moving. Ha-ha! Good joke, Dad. But he wasn't joking. Turns out, ground meat is probably made from the meat that hasn't been sold after sitting out all day (or several days?) and is bound to contain extra protein (use your imaginations). But Yolanda, having lived in Yapacani all her life, is an expert at buying meat. She deftly selected the best pieces of hanging cow carcass and had the butcher grind it on the spot. And I didn't see anything moving in it at all. Now, making lasagna, which calls for three different cheeses, was a bit of a challenge. There is basically one type of cheese available in Yapacani, so that is what we used. Nevertheless, it came out very tasty, if I do say so myself. Yolanda's mom and sisters seemed to love it, but her children were less impressed. Jeffrey's comment was, "Wak-a-la" - yucky! (I don't think he tried anything I made, actually.)

Overall, it was a fantastic week. The group of volunteers was wonderful - hard-working, creative, and lots of fun. We had a party for the 112 girls in the Sacred Heart orphanage - they danced and sang, and we provided cake and ice cream, a real treat for them. Our group also, through donations, was able to buy all new dishes (plates, spoons, bowls, cups...) for the orphanage, as well as toys, school supplies, arts and crafts items and toothbrushes. The girls are always extremely affectionate and love to spend time with anyone who visits - grabbing your hand to show you their room, their garden, their bed - and hugging and being hugged as much as possible. I wish I could adopt all of them! Some of the older girls from the orphanage who have graduated from high school have a separate house where they live while attending university. The Laura Vicuna house (named after some Catholic missionary lady, I think), was started several years ago and now hosts 22 young ladies studying nursing, law, business administration, and many other subjects. Our group, through my dad's church (Palmer Episcopal), is providing support for the operating budget of the house (food, rent, electricity, etc.) so that the girls can focus on their studies and not have to work. On the weekends they help out at the orphanage with cooking, cleaning and caring for the 112 younger girls. According to the orphanage director, more and more girls are thinking about higher education because of the example of the Laura Vicuna group. Before, many of the girls would leave the orphanage at age 14 or 15 to work (mainly as domestic help) and usually end up pregnant and poor. Now, they see that they have an option and that there is support for them if they choose to pursue a career in teaching, nursing, medicine, law or other careers. We feel very privileged to be a part of such a wonderful and successful endeavor. The orphanage staff and volunteers do all the work, of course, and they do an amazing job of loving and raising all the girls.

Overall, it was a wonderful trip, filled with friendship, service, beautiful scenery and wildlife (we spent a day at an eco-reserve in Santa Cruz with a bird and butterfly sanctuary). I don't know if I will be able to fit in a trip next summer with my residency schedule, but I hope so. It is always a pleasure to share the Bolivia experience with others and to reconnect with the place that has been such an important part of my life.