Hospital Los Andes

This past week I was working with Doctora Guiterrez at Hospital Los Andes. Los Andes is also a municipal hospital located in El Alto, which is located about 30 minutes from La Paz by el autobus. Los Andes is a small hospital that primarily serves the poor, marginalized, and indigenous population of El Alto and surrounding communities. Dra. Guiterrez was a joy to work with and was so patient with my spanish (or lack there of!). Here are some of the interesting things I saw this week to share...

Displacia de la cadera (dysplasia of the hip), which is where the acetabulum is unable to hold the head of the femur, is very common amongst children here primarily because the mothers wrap the infants very tightly in blankets and carry them on their backs. To assess for hip dysplasia in the clinic, we looked for uneven gluteal folds, a positive Ortolani's sign, and limited abduction of the infant's hip with pain. If dysplasia was suspected, it was confirmed with an x-ray. Dra. Guiterrez showed me how to evaluate the x-rays and explained what the normal angles are based on age. Treatment for hip dsyplasia for infants under 6 months involves wearing a Pavlik harness which keeps the hips in an abducted position for 3-6 months until the hip is stable. For older children, a hip spica cast is used to stabilize the hip.

The most common complaint in the clinic was gripe (cold) and tos (cough). Even with runny noses and congested lungs, the kids still steal your heart...












On Wednesday I met Israel who is a FIVE year old boy living in El Alto. He was born with a rare genetic disorder called Seckel Syndrome known for microcephaly (small head), low-birth weight type dwarfism, potential mental retardation, and cranial-facial and dental anomalies. Despite the setbacks caused by this syndrome, Israel is able to walk with a small walker and was carrying on a full conversation with me and blowing me kisses by the end of our visit! Unfortunately though, many of the health services that Israel needs now and will need in the future are not covered by the Bolivian national health insurance. Below is a picture of him and his precious madre.Today I had the opportunity to visit the maternity ward in the hospital and see the birth of a little muchachita! As expected, the labor and birthing process here is quite different from my experiences in the US hospitals in nursing school. The first picture shows the laboring room with beds for 4 women, the second is the birthing room (note, the only thing in that IV bag is 5% dextrose....no pain meds), and the last picture is the postpartum "hallway" where the mothers are left to re-coup after birth (note, I never saw anyone checking on them). Below that is a picture of the little baby girl just after birth in "warmer" -- although the light was not working and although you can see the big oxygen tank in the picture, there were no ambu bags nearby which would be necessary in case of respiratory distress.