April 28, 2023

The same work - just completely different


Bolivia, La Paz - over 10,000 km away and a six-hour time difference - Dario Roche, an internist from Freiburg, has overcome this geographical and temporal distance: he spent two weeks in the Bolivian metropolis with the Street Doctors to provide support.

He was very quickly integrated into the daily routine of the doctors in the three mobile ambulances. The meeting point was at 9 a.m. at the Hospital Arco Iris for a short team meeting and planning of the deployment teams. Afterwards, one of the three ambulances went to the different locations. As a junior doctor for internal medicine, Mr. Roche accompanied patients with paediatric, general internal medicine and typical GP clinical pictures. Although this specialty is part of his everyday working life, the work differed in many areas from his activities in a German hospital. This was due to the different medical equipment, the changing availability of relevant medications and the outpatient setting. In addition, the patient population was extremely diverse. This included inmates from youth and women's prisons as well as homeless people who rarely have medical contact. He also met families in precarious housing situations who have to carry out their daily hygiene without clean water.

During his 7 - 8 hour working day, Mr. Roche was able to gain impressions of the working situation of his South American colleagues in many different situations.

Mr. Roche saw a lot of new things during his two weeks in La Paz, was able to help by using his clinical experience and learned a lot himself. "Due to the limited medical resources and the limited choice of medicines, I often had to improvise. My clinical skills were particularly in demand. This will also help me in everyday clinical practice at home. In view of limited financial resources, weighing up necessary and superfluous diagnostics is much more relevant. In my opinion, this is neglected too much in the context of overdiagnosis and therapy in Germany." He was particularly touched by the gratitude and openness of patients young and old towards an outsider: "I was immediately accepted and respected as a doctor. People often had a particularly high level of suffering and were therefore all the more grateful when help was provided. There was not much of a service mentality, as is sometimes the case in the German healthcare system. For these reasons, I found the work particularly meaningful."

He also used the time of his stay to analyze the working methods on site and to discuss possible improvements with the Street Doctors team. Together, they defined new acquisition options and expansions, the purchase and implementation of which are now being discussed with the Bolivian team and Artemed Stiftung .

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