I have an ongoing connection with healthcare in Bolivia and a deep affection for the Bolivian people. I want to use this week’s blog to discuss some current events that are unlikely to find their way into our newspapers but highlight the vast differences between life for a doctor there and life for a doctor here.
Many of you will be aware of the continuing frustration, concern and anger that UK doctors have expressed about changes to the NHS, GP led commissioning groups and changes to public sector pensions that will have a deep impact on doctors and other healthcare professionals.
Yesterday, I spoke to the director of nursing at the diabetes centre that I helped to set up in the department of Oruro, Bolivia. She described to me the traumatic and disrupted state of affairs in the city. You need to remember that Bolivia is a volatile country that has more than its fair share of demonstrations and protests but events this week are unique because they are centred on members of the medical profession.
The government has issued a decree that all doctors who work in public hospitals and clinics must work eight hours a day rather than the current six hours and will receive no additional pay. On the face of it, you may wonder what all the fuss is about and tell them to count their lucky starts at such generous conditions. The full truth, as ever, lies in the detail. Currently, Bolivian public sector doctors make roughly $200 per week, receive no benefits and no overtime pay. Many have to work an additional half day in a private hospital or clinic, after their public health duties, in order to supplement their state sector earnings. The arbitrary extension of their hours will have an enormous impact on the lives of the majority of doctors in Bolivia.
Their response has been an incredible show of unity across the country. Marches and demonstrations have taken place in every department, from the Amazonian lowlands of Santa Cruz to the extreme altitude of La Paz. This week, over 500 doctors have gone on hunger strike to protest against the legislative decree. Medical students have joined the protest and were dispersed by riot police firing tear gas. All elective work in public hospitals has been cancelled and only emergency cases are being attended to.
I first went to Bolivia in 2006 and since then I have never ceased to be amazed and enthralled by the country and its people. I am passionately committed to helping some of the poorest communities there through my work with the charity Project Paria. Despite living and working there as a volunteer doctor for a year, I am still flabbergasted by the events unfolding on the streets of this fascinating country. I am reminded once again, that whilst doctors of all countries have many things in common, there are colleagues and fellow doctors across the world that lead completely differing professional lives to me.