Women’s Health

womenhealthInstituted in 2000, the Millennium Development Goals target factors that can affect the health of a nation, such as disease, hunger, illiteracy, and poverty. Included in this plan are goals of improving maternal health and reducing child mortality; accordingly, these are two of the most important issues faced by citizens of Bolivia. For non-pregnant women under the age of 59, SUMI, a national insurance program, covers PAP smears and family planning services. However, many of the common screening tests familiar to us in the United States are not covered or affordable for the women of Bolivia. Mammograms cost $25-95 US dollars which proves to be too much money for many of the women that we treat at CMHP. Bone density scans for osteoporosis screening come at a huge cost to the Bolivian patient of almost $200 US. We have fortunately found yearly campaigns that fund these services, allowing us to bring a new level of care to our female patients.

In order to identify our female patients in need of these services, one of our med-student volunteers, Katie Burns, developed a guideline for PAP, mammogram, and DEXA screening as well as a chart to record past and future results. This information, as well as patient answers to questions such as "family history of breast or ovarian cancer" and "age of menarche and menopause" are permanently placed in each patient's chart by the front desk staff; this serves as a record of the patient's past screening tests and also alerts the doctor if a new study is needed. As of May 2013, over 20 women have received their osteoporosis screening and over 50 have had their annual PAPs thanks to our new program!

The Pediatric Anti-parasite Program

parasiteMuch of parasite prevention is relatively simple and straightforward. It requires taking one dose of anti-parasite medication (albendazole) once every six months.  In the past, parents routinely came to the clinic with their children and list off the symptoms of stomach parasites, better known as "bichos." Our doctors would then administer the anti-parasite medication.

Gretchen Myers, a volunteer nurse, developed the program in 2008, with some help from a local hospital and health education center.  The program continued, and subsequently flourished under the guidance of Alice Baumgartner when she became a coordinator in 2010.  It has flourished since.  CMHP volunteers have been going to local schools and administering this treatment to all students.  Most importantly, education is incorporated to the children on parasite prevention and hand washing.  Children are weighed and their heights are measured to screen for both malnutrition and obesity.

In 2013, dental care was added due to the tooth disease that is abundant and this program gave us good exposure to the kids.  Tooth brushes are given to all of the children we treat for parasites.  For many kids, this is the first time they've ever owned a toothbrush!

The Cervical Cancer Prevention Project

CINCervical cancer is a major concern in Bolivia and all over the world. It is the second most common cancer among women worldwide and strikes more than 490,000 women each year. Women in developing countries are disproportionately affected; more than 80% of deaths due to cervical cancer occur among women in developing nations.

Bolivia has one of the highest rates of cervical cancer in the world.

Centro Medico is fortunately able to test patients for cervical cancer in partnership with a hospital in Santa Cruz. They are able to process our results within a week, and then we can treat whatever is found. We also have agreements with local gynecologists and oncologists who will follow up with any of our clinic patients found to have an abnormal result. In collaboration with the Women's Health project, we are able to document these results in the patient's charts to improve the likelihood of follow-up and maintaining screening in the future

 

 

The Chronic Care Program

diabetes disease

Diabetes and hypertension are foremost health concerns in Bolivia, particularly in the department of Santa Cruz where Centro Medico is located. A striking 11% of the local population has diabetes compared to 8% of the population in US. 22% of the local population have high blood pressure. Centro Medico is trying to address this problem through our Diabetes and Hypertension Chronic Care Program.

Diabetes and hypertension are serious, chronic diseases that need constant maintenance. Poorly managed diabetes can lead to strokes, blindness, heart disease, kidney failure, foot amputations and nerve damage. Untreated hypertension puts patients at risk for heart attacks, strokes, and atherosclerosis. We are very aware of these problems and follow our diabetic and hypertensive patients every month to promote medication and lifestyle compliance. We also have our health promoters out in the communities regularly checking patient's blood sugars and pressures to help promote good control.

 

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