Fighting Cancer And COVID-19
Despite the distancing this pandemic demands, we have maintained close relationships between our US and Bolivian medical partners. Recently, our March 2020 oncological surgery mission team gathered via Zoom with their friends at our host hospital, the Instituto Oncológico del Oriente Boliviano (Cancer Institute of Eastern Bolivia), the country’s first and foremost public hospital dedicated exclusively to cancer care. Doctors and other team members on both sides of our bridge were eager to check up on each other and swap professional and personal experiences of the pandemic. Here we share the story of the pandemic as seen from our colleagues at the Cancer Institute. This is only an example of one hospital, in one city, and yet we hope it invites you into the reality of our partners who are providing care for patients with complex illnesses during this difficult time.
As in many places around the world, COVID-19 was introduced in Bolivia by international travelers. Upon learning of the diagnosis of the first Bolivian case, the Cancer Institute’s staff reached out to colleagues in Spain for advice. Early studies suggested that cancer patients were especially vulnerable to the worst effects of the virus, so they focused on protecting their patients from infection. They procured testing supplies and screened each patient before admitting them to the hospital. If positive, the patient was referred to one of the local hospitals designated as a “COVID facility”. They were hopeful to keep the virus at bay. However, the pandemic quickly exploded in the department of Santa Cruz and hospitals of all types were overwhelmed. The moment came when there were no beds available elsewhere.
The Institute then converted one small ward into a care center for cancer patients with COVID-19. That ward quickly expanded to two and three, and patients kept arriving. Finally there was no more room. Every available hospital bed in the city of Santa Cruz—in every public and private facility—was full. The collapse of the local health system affected everyone, regardless of power, prestige, or economic means. At one point, the founder of the Institute and his entire family were sick with COVID-19 but were unable to find care at any hospital. Gratefully, they all survived.
Confronting this reality, the leadership at the Cancer Institute decided to build a new 500m² ward on an adjacent plot of land. The nonprofit organization which has supported the Institute since its founding, La Legión Cruceña de Combate al Cáncer, launched an aggressive fundraiser to privately fund the construction. The ward was designed for 23 standard adult and pediatric beds, six ICU beds, as well as consult rooms and other essential facilities. It would be outfitted with biomedical security measures that almost no other Bolivian hospital offers. Construction was completed in early September, and some essential equipment and funding for staff were contributed by the government. At the time of our Zoom call, the staff of the Cancer Institute planned to inaugurate the new ward within the next few days. This achievement was cause for joy after such a trying period for their team and the entire department of Santa Cruz. The new ward is one positive development that will endure and continue to serve the population long after COVID is vanquished.
During our gathering, we mourned the loss of one Institute nurse to COVID-19. Two young gynecologists who recently completed their residencies at the Institute and were employed elsewhere also died from COVID. The coronavirus has taken an especially devastating toll on Bolivia’s healthcare professionals, and the losses are very personal to our colleagues. Personal protective equipment is still in short supply and is prioritized for those with the most direct contact with COVID patients.
Today coronavirus infections have leveled off in Santa Cruz. However, as strict quarantine measures are lifted and activities resume, health officials and workers are concerned that a second wave of cases could occur. Whatever comes next, the staff at the Institute feel better prepared to care for and protect their patients.
The new ward was inaugurated on Tuesday, September 29. The leadership at the Cancer Institute faces ongoing challenges to finish furnishing all that’s needed and sustain funding for staff. But we are inspired by this concrete commitment to do whatever is needed to care for patients in spite of all the obstacles. Solidarity Bridge and Puente de Solidaridad contributed multiple pieces of equipment and supplies from our Bolivian warehouse, and invited the Institute to submit a “wish list” of additional priority items that we are currently purchasing locally for the ward. We know that patients with complex health needs are among those most impacted by this pandemic. And we are grateful that they can receive high quality care at this new facility. As soon as it is safe for medical mission teams to return to Bolivia, our missioners look forward to touring it themselves and supporting this expansion of cancer care services in Santa Cruz.