AWAY ROTATION, LA PAZ, BOLIVIA JD Armstrong Graduate School of Biological Sciences, Robert Wood Johnson Medical School, Piscataway, NJ 08854 About Bolivia Bolivia is a primarily Spanish- speaking country in South America. Hospital Arco Iris is a charity care hospital in Miraflores, La Paz, that offers quality, free medical care. It hash a focus on serving children from and on the streets. Primary Care Clinic I spent two weeks working with Dr. Panozo in a primary care clinic, that functioned similarly to an urgent care clinic. I was responsible primarily for discussing diagnosis and plan for patients. The patient population included children and adults, mostly living in the streets. Patients had common colds, infected wounds, untreated fractures, pyelonephritis, and a whole range of other diseases. My Rotation I spent 4 weeks in Bolivia, supervised by local doctors. The rotation was entirely in Spanish. I spent 2 weeks in neonatology, and 2 weeks at an outpatient, primary care clinic. I also spent a day in a mobile medical unit that served La Paz’s homeless population in multiple locations, and worked with a US doctor at the American Embassy for a day. Hospital Arco Iris Economic Facts and Stats -Bolivia’s economy is considered “Repressed” by the World Bank -In 2011, 45% of Bolivia’s population was living below the national poverty line -In 2013, 8% of Bolivia’s population was living with under $1.90 per day -Bolivia has also had a 5-7% annual rise in GDP over the last 4 years -Bolivia holds and estimated 50-70% of the world’s Lithium reserves 3. “Pachamama”, a painting by Bolivia’s most famous artist, Mamani Mamani. He has been a supporter of Hospital Arco Iris and has donated multiple paintings to the hospital. Neonatology I spent two weeks in the inpatient neonatology department, reserved for sick infants. I was responsible for following patients, creating a 10 minute presentation on a topic of my choice, and attending deliveries and caesarean sections. At deliveries I was able to participate in the newborn exam and initial prenatal care. Patients had problems ranging from sepsis to respiratory distress to child abuse. La Paz is the governmental capital of Bolivia, the highest altitude capital in the world, and the third largest city in Bolivia by population. The city sits in a bowl in the Andes mountains. The wealthiest parts of the city tend to be in the center, with poverty increasing as one increases altitude. LA PAZ Photo of La Paz taken from the Teleferico, La Paz’s public trans-portation system in the sky! Dr. Panozo and I at the primary care clinic in Miraflores, La Paz. Tourism Salt Flats: See the famous plains of salt, flat for miles, and sometimes appear like a mirror. Lake Titicaca: The beautiful, highest navigable lake in the world. Amazon Rainforest: Incredibly diverse plant and wildlife. Mountains: incredible views from the Andes Mountains, Illimani being the highest peak near La Paz. Ancient Ruins: Bolivia bosts some of the oldest ruins in the mountains, older even than Macchu Picchu! Conclusions My experiences in Bolivia taught me several things. I was amazed to see how similarly medicine was practiced in some areas, and how differently in others. I was challenged by situations where the physician’s limited access to resources affected patient care, and the patient’s socioeconomic status affected their healthcare. I also improved my Spanish and enjoyed the sights, smells and sounds of a beautiful country.