Our mission trip was set to visit Montero, a town approximately 60 km north of Santa Cruz in the Eastern region of Bolivia. The town of Montero has a population of around 100,000. The people of Montero are a mix of Easterners – called “Cambas” – who are of mestizo or mixed descent (native and Spanish), and Highlanders – called “Kollas” – who are of Quechua or Aymara background who have migrated to Montero in search of work. The economy of Montero is largely based on sugar cane, and there is a sugar processing factory on the edge of town. Other industries include other agriculture (soy beans, rice), cattle, and of course all the other professions and informal sector jobs one finds in a big city. The city continues to grow as more people move from the highlands, and there are a number of new barrios on the outskirts of town, including squatter settlements with no water or electricity.
Our team included four physicians – three pediatricians and one family physician – one college student and six general volunteers. Between 200 and 250 patients were treated with a range of services to address a multitude of different illnesses. The most common conditions among the adults were diabetes, hypertension, back and joint pain, headache. Among children the most common complaints were gastrointestinal problems, nutritional problems, upper respiratory infections, urinary tract infections, and dental problems. Through donations, we were able to obtain laboratories and diagnostic studies, provide medications to the vast majority of
patients and send many for dental, optical and other treatments. Our practice is to identify patients who need further work-up, treatment, surgery, or follow-up and support the local clinic/organization with whom we work to oversee these follow-ups.
During our time in Montero, we worked with two orphanages. The Sacred Heart (Sagrado Corazon) Girls’ Home houses 120 girls of all ages who are completely or partially orphaned or abandoned by parents who cannot afford to care for them. The boys’ orphanage, Hogar John Baumrucker, houses 24 boys ages 5 to 18. Both homes run on a shoestring budget, receiving about $4 per month per child from the government and relying on donations for the rest of their operating expenses. All of the children attend school and have volunteer teachers to help them with homework, computer and music lessons, and sewing classes (for the girls). During our clinics, we saw many of the orphans for a variety of health problems. Most of the boys needed glasses. Almost all of the children had dental problems, including lots of cavities. Thanks to the generosity of the Henry Schein Cares Foundation, all of the children received dental care products.
Another project our team tackled was construction of a special education/rehabilitation center which will also serve as a day care center for the children of healthcare staff. The bottom story will have facilities for physical, occupational and speech therapy, classrooms and a safe play area. The upstairs will have an area for homework and tutoring, nap rooms and a kitchen for snacks. One goal of the program is to integrate the children of healthcare workers enrolled in the daycare with special needs children to encourage compassion, understanding and acceptance. While in Montero, our team helped with all kinds of construction tasks.
Stories from the Trip
One 32-year-old woman came to clinic with blurry vision, fatigue, frequent urination and thirst. Using the donated glucometer and testing supplies, we checked her blood sugar, which was 337 (that’s really high!). The patient was tearful and upset when she found out she had diabetes. However, we were able to get her into a diabetes education session. She was started on medications and given information about diet and exercise. The organization we work with – Andean Rural Health Care – will be following up with her monthly to see how she is doing, both through home visits and in clinic. We ensure that there are enough funds to cover these needs and supervise/support them by email throughout the year.
We saw one 9-month-old boy with Kwashiorkor – a severe form of malnutrition. In this condition, children get very swollen, making them look well-nourished, when actually they are very deficient in protein, the building block of muscle, brain, and all essential functions of the body, including fighting off infections. This child had pneumonia too, and was immediately hospitalized for treatment. Weaning is the most common time for infants to have malnutrition, when they are not getting as much breast milk or formula and yet are not able to effectively fend for themselves when it comes to table foods. More than likely, this child was getting watered-down milk or formula and soup. Meat is expensive and scarce in the Bolivia diet, especially for low-income families, and soup is a staple. Infants and toddlers tend to be fed the broth and soft vegetables or potatoes from soup, not the meat (which is difficult to chew). Arrangements were made to help this child and his family with nutritional supplements. Unfortunately, the patient died in the hospital from overwhelming infection and malnutrition. We are grateful to our partners in Montero for their comprehensive program of home visits with health surveillance and growth monitoring for all children under 5 in their catchment area.
Thank you to the Henry Schein Cares Foundation for the health and dental kits!