I’ve come to loathe the term third world. When someone speaks of a nation as being third world, they generally use it in a derogatory fashion, a catch-all for insinuating that every aspect of a culture is essentially primitive and unrefined. Lazily calling a nation like Bolivia “third world” could never reflect the genuine hospitality of its people, the dramatic contrast of natural beauties in the land, or the rich, vibrant cultures that thrive here. The same goes for the healthcare institution. Without a pensive glance, it’s sadly too easy for people to remissly apply third world logic to healthcare: Bolivia is a third world country, so its citizens are dumb and uneducated, so its medical schools are atrocious, so its doctors are woefully unprepared, so therefore the entire healthcare system is reprehensible.
In my short time here, this logic has been quickly debunked. Having talked to a handful of Bolivian physicians, I see that the doctors here are generally more than sufficiently prepared. In fact, those that work in the public sector have to be really capable in that they see some horrendous cases but have little to nothing to work with to solve the problem. To work in a public clinic in Bolivia, one has to be resourceful, confident, methodological and most of all creative. Moreover, dedication and tenacity are key as public physicians are met with long hours.
Despite my tirade against the concept of third worldness, I never said that Bolivia is not a developing nation with its fair share of institutional problems. It’s more than obvious in its healthcare system. The Bolivian doctors I talked to exhibited all the necessary traits I enumerated and then some; they had a true passion for medicine and all spoke numerous languages to cater to their patients. But they all were in the private sector. Not even having applied to medical school yet, it’s easy to think that I am going to be a world changer and devote myself to the greater good as a physician. Yeah, but I’m also going to have a family and other responsibilities like other real people and like the doctors do here. The doctors described situations where the government asks for more and more effort while paying less and less. Many doctors find better job opportunities for their families in the private sector or even out of the country. Seeing this dynamic play out here in Bolivia, where the poorest citizens are in desperate need of adequate public healthcare, has certainly opened my eyes to look at the problem differently. Though the negative results are more stark here, this is something that occurs in many places. I can see similarities of this trend to places like in the rural counties of Mississippi and this is something I will be observing for the remainder of my time here in Bolivia and back home.