Archive for health care

6 de Noviembre: La feminización del VIH/SIDA

Posted in Bolivia, HIV/AIDS with tags , , , , , , , , , , on November 6, 2010 by eugeniadealtura

I’d like to apologize to my readers; lately, teaching and research responsibilities have made me unable to update the blog as regularly as I would like.  However, an article published today in La Paz’s La Prensa paper has prompted me to draft this brief post.  The article, entitled, “The La Paz resident with HIV/AIDS is young, male, heterosexual, a worker, and a city dweller,” explores the (growing) phenomenon of HIV/AIDS in the Andean city.  Despite the title of the article, it goes on to explain a trend occurring around the world–the feminization of HIV/AIDS.  Despite the fact that most known HIV/AIDS carriers in Bolivia are male, new cases of the virus are found just as often in women now as in men–particularly among younger generations.

Not surprisingly, local health department official René Barrientos noted that women are likely infected due to the infidelity (and sexual carelessness) of their partners.  “Generally,” states Barrientos, “women who complete domestic tasks are at home and are infected by their partners, since these also pursue sexual liaisons outside the household and then take the infection home.  In absolute numbers, 69 women who work in this area were found positive across the period [of study]…This is alarming because it places the household at risk” (all translations mine).

Barrientos also notes that life expectancy of HIV/AIDS carriers in Bolivia is considerably shorter than that of carriers in other countries, since people often do not know they have the virus.  In July and August of 2010, 38 new cases were discovered in the city of La Paz.  18 of these individuals already had AIDS.

Having spoken with a number of people of different social classes in the cities of La Paz and El Alto about sexual and reproductive health, I am convinced that few people seek testing for sexually transmitted infections (STIs).  In general, the population seems to believe that STIs affect only “dirty,” “promiscuous,” or “sexually deviant” individuals–ie., not them.  Attitudes such as these do not reflect the realities of STI infection and transmission, and typically stem from abstinence-only education and an atmosphere of fear and shame around the discussion of sex.  This article is a good reminder that abstinence-only education, the shaming of sex, the lack of acceptance and availability of condoms, and people’s reluctance to seek STI testing, equal death.

26 de Septiembre: El aborto en México

Posted in abortion, Mexico, reproductive rights with tags , , , , , , , , on September 26, 2010 by eugeniadealtura

When the tide begins to turn for women in Latin America, the right wakes up.  An article in the New York Times this week reports on the growing list of abortion restrictions being passed in states in Mexico since the country’s capital legalized elective abortion some three years ago.

26 de Septiembre: Hasta en las ciudades…

Posted in Bolivia, health care with tags , , , , , , , , , , , on September 26, 2010 by eugeniadealtura

Earlier this week, the UK’s Guardian released a video chronicling the efforts of UNICEF representatives and their local allies to improve sanitation and access to clean water in Bolivia’s rural communities.  The video features interviews with Bolivian community members about the frequency of child death due to diarrhea and describes recent latrine construction projects in what looks like the country’s temperate and tropical regions in the east.  Sanitation projects in the area are being undertaken by UNICEF in an effort to speed progress on the UN’s “Millennium Development Goal” 7: to decrease the population lacking access to clean water and sanitation services by half by 2015 (the MDGs were established in 2001).

The infamous “camino de la muerte,” on which this truck is driving, carries travelers between La Paz and rural communities in the Yungas.

The state of sanitation services in Bolivia is undoubtedly the worst in rural areas, where lack of running water and sewer systems make illness frequent, even for the most dedicated of hand-washers.  If UNICEF truly wants to speed progress on MDG 7 in Bolivia, however, it would be wise to install potable water in city taps, and to support hand washing in cities, as well as rural areas.

In La Paz and El Alto, the majority of Bolivians buy their produce and other food stuffs in busy outdoor markets lacking adequate bathroom facilities.  Vendors and customers have to pay .50Bs to visit public toilets where, even if there is running water, soap is rare.  Market-goers then handle produce, passing whatever bichos they may have acquired at toilets on to consumers back at home. While it is standard practice in these cities to wash fruits and veggies before eating them, most use tap water to do so–a water that is so contaminated that it often emerges from the tap smelling of sewage.

This health care facility sits right above a public market.  The fact that hand washing is rare in both arenas provides ample opportunity to spread communicable disease.

Even more distressing, many hospitals and clinics in La Paz and El Alto fail to provide adequate sanitation services to patients and their families.  Over the past couple of years, my work has taken me for several hours each week to both public and private medical facilities in La Paz and El Alto. At the public hospitals I visited, neither public nor staff bathrooms provided toilet paper or soap to users. This means that not only patients’ families, but likely medical personnel had a hand in passing illness on to patients with vulnerable immune systems.  At one private clinic I visited in El Alto, three pans of blood and human tissue lay on the floor in the corner of the bathroom, ostensibly standing in for legitimate biohazard containers.  I was lucky to not have tripped over them and spilled them on the way to the toilet.

Poor hygienic conditions in Bolivia have often been explained in racist terms by policy makers and other professionals who pointed the finger at the country’s “dirty Indians” as vectors of disease transmission.  Arguments that indigenous populations were “naturally filthy” or resistant to personal hygiene were often promoted by western doctors attempting to push indigenous midwives and traditional medicine practitioners from the country’s health care scene.

The above observations, however, reveal a different truth: Bolivia’s western, state-run hospitals lack proper sanitation infrastructure.  Doctors, nurses, and patients alike are denied the tools they need to ensure their own and others’ safety.  And this is occurring not just in rural communities miles from the nearest “modern” clinic–this is happening in your mother’s, your sister’s, or your daughter’s hospital room in the center of La Paz city.

27 de Agosto: No se necesita receta

Posted in Bolivia, health care, sexuality, United States with tags , , , , , , , , on August 27, 2010 by eugeniadealtura

This week at Womanist Musings, I’ve written a post on the difference in over-the-counter access to drugs and other items in the U.S. versus Latin America, particularly Bolivia. What inspired the posting?  A visit to a U.S. pharmacy where customers can now purchase vibrating sex toys right off the shelf, without visiting a sex toy store or buying online.  Check out the posting here.

25 de Agosto: El aborto y la inmigración

Posted in abortion, blogging, immigration, reproductive rights with tags , , , , , on August 25, 2010 by eugeniadealtura

I would like to bring to my readers’ attention a few articles that have emerged in the last couple of weeks highlighting the particularly vulnerable situation of immigrant women seeking access to reproductive health care, especially abortion.  In light of recent debates in the U.S. on immigration reform, including the anti-immigration legislation passed in Arizona and other states, it seems particularly important to consider how these policies affect the reproductive rights of women immigrants.  In general, the forecast is not good–while ABC News notes that immigrant women are frequently  customers of “cheap, do-it-yourself abortion,” guest writer Marcy Bloom of the blog “Trust Women” points to the dual attacks of the right on immigration and reproductive rights.  I encourage you all to read these pieces, and join in on the debates.

15 de Agosto: Noticias

Posted in abortion, Argentina, birth control, Bolivia, Latin America, reproductive rights, women with tags , , , , , , , , , , , , , , on August 15, 2010 by eugeniadealtura

This week, a variety of news bits on Bolivia and reproductive rights around the world.

First, a story of social and political conflict in Bolivia’s Potosí department, where for the past 18 days, strikers have blocked roads and led social protests in the area.  Protestors are attempting to hold the Evo Morales government responsible for a number of projects that, although promised some time ago, have scarcely advanced.  The projects include an the construction of an international airport in the city of Potosí, the establishment of a new cement factory in the region, and government preservation of the historic Cerro Rico–the mountain pictured below whose silver deposits essentially financed the Spanish conquest of Latin America over 500 years ago.

The Andean Information Network (AIN) interprets recent protests in Potosí as evidence that Evo Morales’ traditional bases of support are disappointed with the administration’s failure to keep its promises.  While the Morales government often describes protests as led by the right wing, the AIN notes that, “seventy-eight percent of Potosí voters chose Morales in the 2009 presidential elections, second only to voters in the La Paz department.”  La Paz’s paper La Razón reports today that a variety of officials of the Morales government have been in negotiations with the Potosí protestors, and that some progress has been made on at least one point of contention, the plan to construct an airport.  However, hunger strikes and street blockades have continued, since five other major grievances have not yet been addressed.  Meanwhile, in the city of Potosí, families have been subsisting largely on noodles and rice, since blockades have prevented meat from reaching local markets.

None of the coverage of the Potosí protests that I have encountered thus far has discussed women’s particular participation in the protests or how women and girls are being affected by the conflicts.  In similar mobilizations in Bolivia, however, women have taken an active role.

This photo of the Cerro Rico mountain and Potosí city courtesy of Gerd Breitenbach, a user of Wikimedia Commons.

As political conflict rages in Bolivia, Argentina received an embarrassingly poor report card last week on women’s reproductive and sexual rights.  Last Tuesday, Human Rights Watch released a 52-page report chronicling, “the many obstacles women and girls face in getting the reproductive health care services to which they are entitled, such as contraception, voluntary sterilization procedures, and abortion after rape.”  Regular readers will remember that these are also common problems in Bolivia.  Their prevalence in Argentina, however, is even more appalling considering that this country’s socioeconomic indicators tower above those of Bolivia, even after the economic crisis of 2000-2001.

Similar to conditions in Bolivia, the report, entitled, “Illusions of Care: Lack of Accountability for Reproductive Rights in Argentina,” notes the high prevalence of illegal abortion, high rates of maternal mortality due to abortion, and the failure of judges and doctors to authorize and perform those abortions that are legal (ie., in cases of rape). Access to contraceptives is also restricted due to a variety of issues, such as long waits at clinics, the (unauthorized) demand that a husband sign for a woman’s sterilization procedure, and financial costs.  These issues–and other, similar ones around the world–prompted one Guardian blogger to call for a UN agency specifically devoted to women. That’s an idea that’s easy to get behind.

The Human Rights Watch report on Argentina can be downloaded here.

The San Telmo neighborhood of Buenos Aires, Argentina.

Finally, good news from the U.S.A.: the Food and Drug Administration (FDA) in that country approved a new pill to be used to prevent pregnancy after intercourse. The medication, called “Ella,” is considerably more effective than the morning-after pill that is currently on the market, Plan B.  While Ella will prevent pregnancy for up to 5 days following sex, Plan B is only effective for 3 days, and becomes less effective the later it is taken after the event.

This move by the FDA has been interpreted as “evidence of a shift in the influence of political ideology at the FDA,” since its approval moved more quickly than that of Plan B, and, as one activist mentioned, was “‘based on scientific evidence, not politics.'”  This does not mean that the battle has been won, however–anti-abortion activists have been quick to describe Ella as an abortifacent, and some are planning campaigns against the drug.  At the moment, women can obtain Ella with a prescription from their health care provider at any time, so they can keep a supply at home.  Go get yours today!

4 de Julio: Un caso de abandono

Posted in Bolivia, child abandonment with tags , , , , on July 4, 2010 by eugeniadealtura

When you ask people in La Paz and El Alto whether there are many children abandoned in Bolivia, they will often comment on the infants that are left in garbage heaps.  I have always been under the impression that so many cite these cases not because they are common circumstances in which children are abandoned, but because they are so horrible that they make a lasting impression.  The garbage bin stories, however, seem to be sometimes true–last Thursday, La Paz’s daily La Razón reported on a two-month-old child that died after being found in a garbage can.

One of the questions I often ask people in Bolivia is why some individuals facing unwanted pregnancy abandon their children rather than having an abortion during the pregnancy.  Many believe that those who abandon their infants are typically adolescents who were unable or unwilling to “deal” with their pregnancies during the gestational period. Others, such as some orphanage workers, note that many abandoned children suffer from a variety of physical and psychological disorders that may have been factors in their abandonment.  Differently abled children or those who suffer from physical deformities not only present challenges to parents that they may not feel willing or able to face, but they also may suffer discrimination due to societal taboos.

The two-month-old that was discovered about two weeks ago in a garbage bin close to the El Alto airport had Down’s Syndrome and a cleft lip.  While Down’s Syndrome is a chromosomal disorder that can cause some developmental disabilities, cleft lip is a genetic deformity that can be treated with surgery, usually shortly after birth.  When the child was discovered by a market vendor, he was still alive, but suffered from respiratory difficulties due to malnutrition and exposure.  After being treated unsuccessfully at two El Alto hospitals, the infant died last Sunday.

This story sparks compassion in me from many angles.  On the one hand, it is crushing to realize that disability is burdened by so much discrimination in Bolivia that many children–not just this one–are abandoned due to it.  On the other hand, in the poorest country in South America, parents raising children with abnormalities enjoy very little state support, even when these kids’ conditions are treatable, such as the cleft lip.

Finally, we must return to the image of the garbage bin.  Why do some who abandon their children choose to leave them in garbage bins? While the idea of a parent leaving their child in a garbage can obviously sparks the thought that the parent thinks of their child as something unwanted and disposable, the reality could actually be quite different–perhaps parents leave their kids here because they know it’s a place where the child is likely to be found, either by neighbors or city workers.  Or maybe they leave their kids here because, despite the filth, it is a communal place where any person may take responsibility of the child–rather than leaving him or her on an individual doorstep, which targets one family as the new caretakers.  In any case, this story sparked a sort of realization in me this week–not only do these stories of garbage bin abandonment indeed leave an impression; sometimes, they are true.