Two Encounters of IEA's HAFAPII Interfaith Encounter Group for Healthcare Professionals - 14th April & 28th May 2008:

The last 2 HEFAPII meetings took place on April 14th and May 28th at the Henrietta Szold/Hadassah-Hebrew University School of Nursing. We had the privilege to have one of our members, Eudice Yudelevich discuss her experience in Bolivia when she worked and conducted research for her master's degree. Eudice is a registered nurse and had the opportunity to work in a remote village in the Andean mountains with the Aymara people. With very little resources, such as no running water in the homes, located at an altitude of 4,000 ft, and one ambulance to serve the population of 19,000, Eudice described working in the small hospital used as a delivery room as well as a general hospital. Named Corpa, the hospital also served as a pharmacy for the population–most of whom lived deep inside the Altiplano siturated far from the this small medical center.

She described the women who would walk hours with family members or alone, to give birth in the hospital. Many women labored at home, where husbands substituted as midwives, but sadly many women developed complications. Some bigger hospitals in the cities required laboring women to undress. The small Hospital in Corpa, however, allowed women to maintain their culturally accepted customs, such as leaving their clothes on during delivery because of the importance of body warmth. Due to the fact that the medical staff was all themselves Aymara, all were familiar with the peoples' customs, language and dress. Equipment that was in stock was used very sparingly. Eudice described how grateful the staff was with the supplies that she brought with her. (Such as gauze bandages, disposable gloves, pills such as acamol and vitamins for children).

Nurses serve in all capacities whether it be working in the pharmacy dispensing medication, serving as midwives, surgeons (suturing many of the vicious dog bites inflicted on the people), maintaining records of vaccinations for each child, autoclaving instruments and veterinary services such as vaccinating the wild dogs as rabies is a threat.

On market days, the one ambulance also served as a mobile clinic and the staff would attend to patients at great distances from the hospital itself. The nurses vaccinated children throughout this sparsely lived in population, and also performed health education in the local schools. As a result of poverty and poor nutrition the almost only feasible dental treatment would be to extract teeth Again, due to cultural norms, no one expresses pain verbally during the extraction (which is done with local anesthetic).

Cultural beliefs include gods that are good and bad and the belief that the bad gods can cause death. Eudice also went into detail about the traditional healing that is done in this region. She described Andean healing methods. There is a healer that uses Coca leaves, and healing ceremonies. Others such as herbalists perform traditional care and recommend that people combine the traditional care with conventional care. The practice of Ch'alla (libations) was described using llama blood that was sprinkled on homes and the ground (given to Mother Earth who protects all that feed her), for good luck. People use offerings, prepared by healers and religious specialists. Each specific offering has a different meaning Those seeking traditional care know where to find them, as they are widespread throughout Bolivia, and people make much use of their services.

The Hospital in Corpa incorporated various cultural competence concepts by allowing the population to maintain their culturally accepted practices in regard to health and illness. A discussion of the similarities and differences that are found in different cultures around the world was discussed. Cultural competence concepts were elicited by the group from the different experiences that were described. This meeting also served as a springboard for culturally competent practices that can be further incorporated into practice with our culturally diverse clients.

Our next meeting will take place after the Jewish holidays.

Wishing everyone a happy and healthy summer.

Reported by Vered Kater & Anita Noble
 

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