For the past two weeks, I have been in Putre again. I’ve been working on my Independent Study Project or ISP. The theme of my ISP is how the community of Putre, especially those who practice traditional medicine, feel about the intercultural healthcare system that Putre has within it’s Family Health Center. The current system is that a Yatiri and two Qulliris (both traditional medics/spiritual guides) work within the Health Center of Putre. Essentially, the system is meant to have both traditional medicine and biomedicine within the same system where they can share information and refer patients to each other. My topic is seeing if the community believes that this is working and if they have any suggestions to improve the system.
The first week in Putre was a little rough. There were no other students from my program there with me. While I did get the surprise of an old high school friend of my from a different SIT program doing her ISP in Putre as well, I didn’t really get to see her as our projects paths didn’t cross that much. Also, no one spoke English. I know that being in an immersion program abroad is the best thing for language learning, but I also really wanted to talk to someone and hash out ideas for my ISP. This would have been very helpful and much more helpful in English.
While in Putre, I have been talking/interviewing the Yatiri, Qulliris, and community members about their perspectives on the topic. I’ve also been traveling with the healthcare team on Rondas, which are medical rounds to the other small towns that don’t have their own health centers. Here, I’ve been able to observe a lot of the interactions between the biomedical doctors and the traditional doctors. Something that’s important to keep in mind with this project is that the complete medical team of Putre changes, at least, every three years. That’s if all of the team stays for their full three-year commitment but often times people will leave within months of their arrival. This is due to the fact that places like Putre are part of a system where doctors can go work for three years after they graduate from medical school and then at the end of that time, their courses required for a specialty will be paid for. It’s pretty similar to buy back programs in the US. Doctors go to underserved areas for a certain amount of time in order to get schooling paid for. This, however, means that the community of Putre does not have a consistent doctor who understands the patients coming to them. This lack of understanding could stem from a lack of understanding the culture of Putre, the history of the Aymara community, or from simply not having the background medical knowledge of the community they are serving. Even with a doctor and medical team who are willing to learn about the Aymaran culture, medicine and the community they are working in, this takes time. Unfortunately, Putre isn’t always so lucky to have a team that takes in interest in learning all of these things.
This has been really interesting to see as I am looking to use a buyback program to help pay for medical school. I hadn’t really thought of the impact that this could have on a community if doctors don’t choose to remain in their location after their commitment is over. It’s really luck of the draw as to who comes each time.