Being schooled...

At the end of the day today, we all agree that it has been one of the most educational days of the trip. We started with our usual delicious breakfast, threw on our scrubs, and headed to Hospital Obrero, a worker's hospital, one of the largest hospitals in La Paz.

Here we divided into small groups and entered the operating rooms where we witnessed everything from gall bladder removals to a femur fracture repair to an Achilles tendon repair to a varus (bow leg) deformity correction. Although we experienced different degrees of communication and sanitation during surgery, the mutual consensus was that the doctors, nurses and anesthesiologists knew how to have a good time!

After the morning at Hospital Obrero, we ran to grab a quick bite (saltenas--baked pastry shells filled with meat, potatoes, egg, raisins, olives and cumin; a common mid-morning Bolivian snack) before heading into another operating room at Clinica Alemana, the German hospital.

Here we took turns entering two by two into a very complicated repair of an ankle fracture. At this private hospital we immediately noticed the difference in sanitation, precautions taken, and up-to-date medical equipment compared to the OR's at Hospital Obrero. Everyone here was very welcoming; they even provided cookies and coke after the procedure.

Our post-op afternoon was filled with some relaxing down time, tea, and dessert in the

sunshine at Karola's. We then spent some time with Karola's friend, also a PT, and discussed the differences in patient care, expectations, and beliefs about disease and healing between Bolivia and the US. We also discussed how, as health care providers, we can connect with our patients in a meaningful and respectful way, balancing science and spirituality.

We wrapped up the night with another traditional Bolivian meal--sushi. :) It was delicious, but we are still being gentle to our GI systems and gradually weaning ourselves onto the typical Bolivian diet. Tomorrow we are looking forward to a day trip out of La Paz where we will explore some Inca ruins. We are also looking forward to seeing more comments from all of you, so please send us your thoughts and questions!

Hasta manana!