Instituted 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!