For my Independent Study Project, I have been in Putre for the past two weeks. The majority of that time I have been traveling with the healthcare team to many of the smaller towns for what they call Rondas. Essentially what that means is that the entire team of the Family Health Center or Centro de Salud Familiar (CESFAM) travels in a van with the basic equipment needed to provide healthcare services to the more rural towns in the Andes. The team includes a doctor, medical technician, nurse, nutritionist, psychologist, child education/development specialist, as well as a Qulliri and Yatiri, who are the traditional healers. The full Rondas with the entire CESFAM team travels to each town once a month. During this time they set up in the town for anywhere between 2 to 5 hours. Patients are usually waiting or trickle in during the time we are there. I went with the team for all 6 days of full Rondas this month. We went to a total of 10 towns in 6 days. For the majority of the patients we saw, this is the only time they have access to healthcare unless they have a vehicle to drive to Putre. Putre is on average about 2 hours away from these towns but many people come from even farther just to visit with doctors during the Rondas. This is even more complicated when you factor that most of the patients tend to llamas and alpacas. Generally, they don’t have another person around to take over the care of their animals and are forced to put them in a pen on Ronda days.
During my time in each town, I have a short questionnaire of 10 questions that focus on what type of healthcare and treatments the patients tend to use since they have access to traditional doctors and a clinical doctor during this time. What I found was that almost 80% of patients visit with both doctors during the Rondas and that roughly 70% use both traditional remedies, as well as prescribed medication. However, the majority of the people I talked with also told me that they generally take traditional remedies and only take pills if they have a chronic disease or if their sickness has not cleared up while taking traditional treatments. This was not surprising to me though. I had anticipated that traditional medicine would still be a large part of the culture in the Andes. What did surprise me was the conversations I had with the traditional doctors. I had expected that they would believe the current intercultural healthcare system was a step in the right direction but would have many suggestions for improvements. What I found instead was that for the most part, they are exceptionally pleased with how the system is currently working. This has changed a lot of the outlook of my Independent Study Project.
Going on the Rondas has been a very eye-opening experience for me. It completely redefined what I think of as rural. Many of the people I met live with only their family members close to them. They don’t have access to stores to buy food and need to choose their vegetables carefully to have ones that will last until the next opportunity they have to go shopping. They live off of the animals that they care for and that is the majority of what they consume. Also, at first I thought that seeing a doctor once a month might not be necessary. I don’t go to the doctor that frequently and nor do many of the people that I know. However, I realized that’s the difference between having the privilege and luxury of deciding when I need to go to a doctor. These people don’t have an option many times to go to a doctor whenever they feel sick. They have a single day every month to get any prescription pills they need to handle any sudden illnesses. Additionally, only three of the towns that we went to had children in them. The majority of the patients we were seeing were elderly and many were battling with some sort of chronic illness that needs to be controlled. Even with the Rondas, often patients have to come to Putre, or even as far as Arica which is an additional two hours away from Putre, to get some sort of testing done. While the Rondas help bring more accessible healthcare to these people, maintaining a healthy life is still an obstacle for many of these people.