Preventative Health Care in Bolivia

By Lexie Adams
Stress is all around us and in us. That’s what I am noticing here too in Bolivia, it’s all over the world. It manifests itself in many ways, many of which are negative: from violence to depression, from hectically scrambling around to lack of patience, from feeling physically sick to verbally bringing down others. How do we recognize that we are stressed and what can we do about it?
Generally speaking from my experiences here in Bolivia and in the United States, there are stresses that seem to be common between the two: work stress, economic stress, family stress and stress from loss. The stress that I notice to be a bit different is that stress in the United States is often part of specific expectations while the stress here in Bolivia seems to be more related to uncertainty and to the resignation people express for the current situation, summed up as “eso es la vida.”
Two days a week I help out at a community health center where I mainly focus on preventative health care. One exercise class is focused specifically on releasing tension in the muscles and decreasing stress. It involves deep breathing, gentle music, some imagery and slow movements. Some days I wait alone in the outdoor gazebo reading a book while I wait to see if anyone takes me up on the invitation for free classes. Those days help me with managing my own stress, the stress of disappointment that no one wants to participate and the self-consciousness that arises in me sitting all alone. Other days, many people come, and the whole group seems to enjoy the time learning different techniques, or at least becoming aware that they feel stressed sometimes, and that it feels good to release the tension that is often huddled in a muscle, not wanting to come out. Young children, adults and elders have all participated and have added to the experience.
One of my favorite classes was a session mainly with children. One eight year old boy was very present during all of the movements. He had his eyes closed and unlike the other kids who were a bit embarrassed or nervous, he slowly went through all the arm circles, breathing techniques and stretches. At one point I even saw that he was more in a meditative stance with his palms faced upwards. After the class he asked me if he could buy a CD of the music used in the class. I said it was 2,50bs, approximately 30 cents. He came back to me with his hand held high with the 2,50bs for his copy of the ocean sounds and instrumental music.
On a different day, there were two women attending the class and while we waited for others to join, they spent the time sharing in their stresses, struggles and sadness while offering tidbits of wisdom here and there. I found that the opportunity to gather also offers a safe space where people could share and listen without any expectation for such. Many people say that they would like to attend the class on a different day.  I think this may be partly cultural because I have found that people often don’t like to say “no.” I also think about it and try to put myself in others shoes. If I were them, I probably wouldn’t come either when health issues didn’t already bring me to the clinic. I recognize that when you feel stressed, one more thing to do can be challenging.
Normal chores of the day can take a long time. For example, cooking from a gas tank that needs to be refilled, with water that comes from a truck that needs to be boiled thoroughly, and with fresh food that needs to be cleaned properly. Cooking with fresh ingredients is super, but the food can also spoil quickly, so frequent trips to the market is also a necessity. Washing clothes by hand and traveling everywhere by public transport also take time.
One man came to attend the class and he told me he had a lot of pain in the back of his head. I asked if he had fallen and hit his head and he said no, but that he was having pain in this specific place because he and his wife were having problems. He had a harder time being present during the exercises and was a bit more fidgety, but at the end he wanted to know if my husband and I would be there on a different day to talk about our experiences with conflict. He hasn’t visited us yet at the clinic, but I hope the awareness of conflict and stress is helping him to take things one step at a time. In fact, there is a lot of violence between couples here in Cochabamba. In the past year, there have been many homicides against the woman in the relationship. Stress is real and the underlying issues need to be addressed.
While I am not saying that a stress relief exercise class will be the only answer, it is telling that people admit to the stress and come to the clinic with stress related symptoms. These classes are also a window for me to understand more deeply what situations people are in here, and why people react the way they do. While I’m still learning how people here in Bolivia respond, I do know to recommend for myself and others, to put things into a different perspective. Enjoy the moments with the people around us and focus on your response instead of having set expectations. Breathe in, breathe out and don’t forget to smile!