Last week I spent my clinical rotations in a clinic for Adolescents in Mira Flores, a neighborhood on the outskirts of La Paz. Most of the patients come from the surrounding neighborhoods as apparently in order to get an appointment at a hospital one must first get a check up at a local clinic (like this one) and then be referred to a hospital. The clinic serves boys and girls from ages 10-25 with any problem that they might have, however the most frequent cases are adolescent mothers who come in to check on their babies or to get help for any illness they might have.
One of the main goals of the clinic is education. They hold classes for pregnant mothers on how to take care of themselves during their pregnancy and their babies after birth, as well as knitting classes (Christine and I sat in on one of these classes during one of the days). They also empower youth leaders to go and inform the youth of the area about forms of birth control to prevent teenage pregnancy. We worked with Dr. Santivañez, a fantastic doctor and even better teacher (it's interesting how the two professions seem to go hand and hand) and we could tell right away how much each patient really respected her. Her office is small and very cold filled with a desk, a filing cabinet, and an exam table. There is also a small dirty bathroom where the patients can change (and take urine tests). The walls are painted yellow so it is not difficult to notice the permanent line of ants that crawl in a line around the window every day (it never seems to bother Dr. Santivañez). The office was not very hygienic at all (particularly using USA hopsital standards), as they used the same sheet for every examination (which even had a small bloodstain already on it) and there was dirt all over the floors.
During our time at the clinic we took patients' blood pressure, learned how to feel the baby in the mother's stomach, listened for the fetal heartbeat and placenta sounds as well as measured the height of their stomachs. By the end of the week we were experts at this. As I said before, we mostly saw pregnant adolescents, and they all seemed much older than the age on their chart, both physically and emotionally.
On our first day we saw a girl who was pregnant with her second child at the age of 16 which I found very interesting. Even more difficult to believe was that she had listed her pregnancies as "planned". When I asked Dr. Santivañez about this, she said that although not common, this occassionally occurred here in La Paz. She gave a hypothetical situation of a girl in a poor family with 8 kids that struggled to give each child enough food -- an extremely tough existence. Along comes a man who gives this girl an opportunity to escape from this tough life through the possibility of beginning another family. She takes this opportunity, becomes pregnant and hopes that maybe this other life will be better. Unfortunately, according to Dr. Santivañez, what these girls fail to realize is that from that moment on they become "slaves" to this new family and household, unable to get any education or to ever escape the obligation of providing for this new family. It's a vicious cycle that can exist in many of the poorer families of La Paz.
All in all it was a fascinating insight and experience.
Tomorrow I'll hopefully post about this past weekend and my adventures on the "World's Most Dangerous Road"!
Hasta Mañana!
Whitaker
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