Salud!

One would be hard-pressed to think of a developing nation where the poor have better access to health care than Bolivia. Perhaps Cuba. Financed by its own national resouces as well aid from countries like Venezuela, Bolivia provides its citizens with free universal health care. Pregnant women and infants are guaranteed free medical assistance under the SUMI. Small communities like Chimeo have their own health posts, complete with a doctor, nurse, and dentist, to provide basic services to denziens. As a good friend of the doctor and nurse in Chimeo, I am constantly turning down assistance and medications for whatever might ail me. I am obligated to exclusively see Peace Corps’s fancy, Georgetown-educated doctor in Santa Cruz. Furthermore, I dont feel right taking the ibuprofin that could potentially benefit another commuity member who doesnt have the outside resources that I do.

The blockades and civil strike of the past month, however, had me turning to Maribel, my dear friend and Chimeo’s resident nurse. A year of long bus rides, terrible matresses, and copious hoeing knocked something loose in my back. Unble to do the things I need to, like hike through the monte, carry heavy boxes of honey, and clear my yard, I asked Maribel what I could do to heal myself. She diagnosed my problem as likely sciatic nerve pain, explained how the over-worked muscles, nerves, and tendons had left me in bed for days. She did conclude, however, that I needed to see a doctor.

This time I accepted her ibuprofin and vitamin B and went back to bed to contemplate my options. The roads to Santa Cruz were heavily blockaded, so getting there would involve walking many kilometers and spending at least 200 Bs (a 500% increase in the normal price as a result of gas scarcity and general Bolivian entrepeneurism.) I had 70 Bs and an inability to walk. For the first time, I was truly adversely affected by Bolivia’s uniquely turbulent politics.

In the end, the PC medical office set me up with an “approved” doctor in a town just two hours north of Chimeo. I sold some homemade beeswax chapsticks to Maribel to raise money for my passage and set out. The kind doctor, who matches every word with gesture and ends every appointment with an awkward hug, perscribed for me all sorts of pills and, of course, what Bolivian illness would be complete a few shots of vitamins in the butt. To make sure it was merely muscular and not my kidneys, a jocular ecografista checked out my insides with an ancient sonogram machine while he practiced his broken English on me. A large lady with drawn on eyebrows unfazedly handled my bodily fluids to rule out any abnormalities. I refused, however, to have my entire trunk, where my baby making apparati reside, peered into by an x-ray machine that may have been built by Madame Curie.

Thoroughly prodded and reassured, I then spent 600 Bs on medications. Include consultation fees and transportation, and the trip cost me about 1000 Bs, about $125. Such medical extravagance would be out of reach of the typical Bolivian. This one illness would suck the entire monthly pay of a school teacher with ten years of experience. Earning 30 Bs for eight hours of work, a day laborer could not afford it even if he worked all day everyday for a month. Sure, campesinos have basic uiversal health care, but this is basic. Vaccines and antibiotics. No ecographs. No x-rays. No surgery. Awakened by my brief inability to access theattention that I needed, I began to wonder what it really means to lack access to modern medicine. We hear a great deal about providing areas ravaged by AIDS with retrovirals, but that is just the big stuff. What about the uiversal small stuff? The ladies with sciatic nerve pain? The strange rashes? The hearing problems? Truly tiny, elisive stuff that can keep people home from work for months. Throw in a lack of understanding of germ theory and a dash of literay, and ones health becomes a fey, ephemeral, inscrutable animal.

It is truly unfathomable. No matter how long one remains within another country or another culture, she remains concious of her other-ness, the parts of herself that are not as those that surround her. As a citizen of any wealth, western nation, perhaps moreso as a US citizen, one holds certain impregnable priveledges that can present unparrallelled opportuities. Freedom to travel. Access to education. Protection under the hegemon. Nonetheless, this same ushakable priveledge can prevent one from truly understanding, truly experiencing life in a poorer nation. Empathy a plenty with a scarcity of sympathy.

Despite the kind doctor’s embrace, the pain remains today, and I am in my fourth week of understanding that animal that Chiminenas know so well. The pills didnt seem to work. The expensive machines revealed nothing. My body keeps me from my thrilling fascinating work, while the worsening blockades keep my here in this large town. Bit by bit, I am starting to understand so much about life, about my own priveledge, about the back pain that seems to afflict most women on this planet, and about the harsh reality of healthcare that, if you crunch the numbers, afflicts most of the human beings on this planet.

All this in a very social democracy with universal health care. Imagine what could be.