The Fishers in La Paz, Bolivia

We have unfortunately had more interactions with the Bolivian health care system lately, so I thought it might be interesting to blog about. Unfortunately, not because they were bad experiences, but just because Avery and I have been sick and no one likes to be sick in a foreign country while trying to find a competent doctor who speaks English.

First of all, we had a wonderful experience with a pediatrician. Though she speaks less English than the other doctors we’ve met, she did three things that would NEVER happen in the United States:

1. We called her cell phone number directly, which was given to us by a friend. She answered and was completely happy that we contacted her personally.

2. She came to our house in a matter of a few hours to see Avery.

3. She did not charge us anything because she had to refer us to another doctor. (FYI – the diagnosis was that Avery had an allergic reaction to a bug bite, which caused a rash all over her body, so we had to see a dermatologist.)

Our other doctors’ visits have been more traditional, such as going to the office and having to wait a bit. But we have observed some interesting differences, such as. . .

1. Having a comfortable environment seems to be of higher importance than having a sterile environment. They don’t seem to be caught up in that whole “if it can’t be disinfected, it doesn’t belong here” thing you find in the U.S. Both doctors had their desk, computer, books, chairs, etc. in the same room with the examining table and all the equipment. One doctor had stuffed animals all over the kids’ examining table and the other had a nice comfy cloth cover over the table instead of paper, which I really hope they wash regularly. Everything was clean in these offices, just not what I would call sterile.

2. Neither doctor worked with a nurse. They took their own information and checked vital signs, etc. themselves. Exact temperature of a fever seems to be unimportant as neither of them ever produced a thermometer to check me or Avery.

3. You may find this hard to believe, but we did not have to fill out any forms for any of the doctors. The doctors took our medical history directly during the visit, and since you pay up front for everything, they don’t ask you for an insurance card, your address, where you work, etc. It doesn’t really matter to them since they get the cash before you leave the office.

4. Both doctors scheduled free follow-up visits for a few days later because they wanted to monitor our care.

So, my summary is that I felt we were treated well by the doctors we’ve seen and that we received good care at a reasonable price. Doctors’ visits here run about $20, no matter what kind of doctor it is. Drugs and labwork are also quite affordable.

As far as I can tell, there are two major health care issues here. There are more than enough doctors in the cities for wealthy people, but there are millions of people in poverty here who may never see a doctor or dentist. The second issue is that I don’t think the care for serious illnesses is anywhere near the quality of what you can find in the States. I visited a friend who had to spend the night in the hospital. Although she was well-attended to (at one point, I counted 2 senior doctors, 2 junior doctors and 2 nurses crowded around her bedside) and the clinic was clean, I felt like I was in a skit set in a 1950s hospital. Much of the equipment is kept for decades, as long as it works, such as mercury thermometers. None of the staff wore gloves, but the nurses did wear those cute, stiff little white hats – that counts for something, right? Just like with a doctor’s visit, they will not let you leave until you’ve paid the bill in full. Perhaps another problem with health care here. . .