Editor’s note: Missioner Allison Dethlefs reflects on early mornings, long lines, and the frustrations with the healthcare system in Bolivia from her experiences on mission, and how—through these encounters—she has felt called to deeper solidarity with the families she accompanies.
The darkness pressed in on me as I fumbled to shut off my alarm. I used to be a morning person, I thought groggily, checking my watch to make sure it was still before 5:00 a.m. But over a year of living in Cochabamba, Bolivia had softened me, and it is no longer my norm to wake up before the sunrise. I slipped out of bed, dressed, grabbed an apple, and checked to make sure I had everything: photocopies of the IDs, money, and the small, yellow card with a girl’s name and birthdate stamped on it.
It wasn’t a far walk—maybe fifteen minutes—but it seemed much longer strolling down empty streets than in the bustle of daytime. The glow of the streetlights revealed my only company: a taxi, a wandering dog, and a few people sleeping huddled in the shadows. I quickened my pace; I should already have been there.
When I finally arrived at the pediatric and maternity ward of the public hospital, the line winding towards the front door was already about fifty people long. I wondered how many families had arrived the night before and slept there to reserve their spots. It was barely after five, and the doors wouldn’t open until at least seven, which meant that the line was only going to increase in length. I thanked my lucky stars I had gotten there as early as I had.
We waited as light slowly ate its way into the sky, nibbling at the earthbound edges and whisking the moon away.
“Is this the line to get a ficha (a spot to see a doctor)?” newcomers would ask.
“For pediatría (pediatrics)?”
The little girl I was waiting in line for was almost five years old, yet she was unable to move her limbs, sit up, talk, or eat solid foods. She was terribly malnourished, weighing only about eleven pounds, her bones clearly visible beneath tautly-stretched skin. We were visiting a pediatric neurosurgeon today to see if there was anything to be done about her condition. But the family, like so many I accompanied, lived hours away from the public hospital. Had I not been able to go early to save a place in line for them, they would have had to spend the night in line as well.
The minutes dragged by.
“I’m in front of you, okay?” said the woman ahead of me. She left to get some breakfast from the vendors selling hot beverages to the early hospital crowd. I had come to learn of the unspoken accord between people in hospital lines in Bolivia: You save my place, I’ll save yours. She returned with a plastic cup of steaming tojorí (a thick, corn-based beverage), the baby slung across her back still asleep.
At last it was 7:00 a.m. I shook myself out of my stupor to see a man emerge from inside and unlock the front doors. Instead of opening them, he came outside and taped up a sign. Everyone crowded around to hear as he turned around to speak.
“Buenos días,” he said. I strained to hear and moved closer. “I’m sorry, but we won’t be offering attention today. There will be no doctors seeing patients for the morning or afternoon shifts.”
There was an uproar from the waiting crowd.
“Come back again tomorrow,” the man said simply.
Several people tried to argue or ask questions, but the man went back inside, leaving the exhausted families to slowly disperse. Shaking my head, I trudged away with the rest, knowing this meant I would have to be up again at 4:30 a.m. tomorrow, knowing that many of these parents and children would spend another sleepless night, and knowing that there was nothing we could do about it.
This was merely one of the many frustrating mornings I’ve spent waiting at the public hospital here in Cochabamba. Some days there are hours of waiting in lines just so a mother and child can get a five minute appointment with a doctor who tells them there is nothing to be done. Sometimes, it means three days of going from one building to another to get this lab test done, these forms signed, and those questions answered—all in preparation for a quick check-up where we’re told to get five more tests and then come back. And all of this to provide necessary care for a sick child, a pregnant mother, a disabled young girl.
I am under no impression that the healthcare system in the U.S. is perfect. It is equally unjust to vastly overcharge hundreds of thousands of dollars for a needed surgery, to let the people in the most need slip through the cracks, to deny people with chronic or severe health problems coverage. In both of these systems, it is the poor and marginalized that receive the least comprehensive care. Some days, I am swept up in the hopeless complexities of it all and the fact that I have no easy fixes for the tangled systems at work.
So, instead of trying to right the wrongs, I have simply allowed myself to walk alongside these marginalized patients for solidarity’s sake, entering into their fatigue, frustration, and confusion. For in bearing witness, I have seen that in the darkness, no one should have to stand alone.
Reflection Question: Oftentimes, social injustices are opposed most powerfully by quiet solidarity with others. How can you accompany another in their daily struggles?