"We Have to Continue Helping": A conversation with our social workers
“The pandemic is teaching us many lessons … it also presents us with great opportunities to serve in new ways, to reinvent the “hows,” in our relationships with patients.”
Marizol Mamani and Carmen Salses are the staff social workers at Puente de Solidaridad (PdS). They are the first people that patients meet when they reach out seeking help with their health care.
Carmen visits a patient’s home in Santa Cruz, 2019
Some of their usual tasks, at least until early this year, were to interview people seeking help and create a socio-economic report in order to assess their eligibility for help from one of our medical programs. In creating this report, both Marizol and Carmen regularly made visits to patients' homes.
For Carmen, these visits allowed her to connect with the patient in their humanity. “They open the door of their home to us; they open the door for us to know them, to know their lives, their fears, their problems,” she said. “It is then that we can inform and counsel them on a personal level, but also support and accompany them on their path towards health.” These home visits, an essential part of their work, have been halted since the strict quarantine was decreed by Bolivia’s government in March—a measure that has been harsh and has caused hardship, but also serves to protect the social workers and patients.
For Marizol, one of the biggest changes that she has experienced since the pandemic started—one that marks a sort of “before” and “during” the pandemic—is the way that her work is organized. In the past, she had clear office hours in which she could schedule meetings with patients and doctors, make phone calls, and write reports. Patients would come to the office in the morning, and if they were not able to come one day, she could reschedule for the next. “Now, there is no structure at all,” she explained. “In the past, I felt I had time. Now I don’t have time. Patients call at any hour, even at midnight. And I answer the phone because I know it is a matter of life and death…there is urgency in every call. Whether they need a referral or a particular medical supply, if they call us it’s because it is an emergency.”
Carmen also noted a change in the way she relates with patients over the phone. When the quarantine started, she reached out to all the mothers of children who have been part of our Heart Surgery Program to check on how they were doing. But as the quarantine wore on, she feared receiving a call from one of these mothers telling her that their child needed medical attention.
For over 90 days of strict quarantine, hospitals in Bolivia were treating only emergencies. Most of Carmen and Marizol’s work during this period focused on linking patients with doctors via phone in order to postpone the surgeries they urgently need for as long as possible. Most of Bolivia’s second and third level hospitals are still crowded with COVID-19 patients; only now are they beginning to open their clinics to treat others.
A patient visits with Marizol at the Cochabamba office, August 2020.
Since the government’s move to a partial quarantine, Carmen and Marizol continue to do most of their work by phone. But, Marizol has begun seeing patients again in Cochabamba. These “relationships are mediated by masks, face shields, and even bio-security clothing, ” she shares. This makes it hard to fully understand how patients are feeling. And yet in some ways, she explained, one feels even more empathy towards the people behind the masks.
Carmen reports that among our patients in Santa Cruz, those who need healthcare are having a lot of problems accessing it. The pandemic has caused many people to lose their jobs, and made it hard to come by any form of income, so “those who had little before [the pandemic], have even less now. We have to help even more… and if one person is sick, the whole family is in trouble.”
If there is a silver lining, it is that the pandemic has also moved Marizol and Carmen to innovate and try new initiatives. One of them is the Programa de Ayuda Solidaria Extraordinaria in which PdS has established partnerships with laboratories and hospitals to provide COVID-19 testing at reduced “solidarity rates.” PdS has also partnered with the Red Médica Solidaria Covid Online, a network of physicians who treat patients pro bono since the quarantine started. These new initiatives strengthen our mission to increase access to essential health care during this challenging time.
The pandemic has also affected Marizol and Carmen on a personal level. Both have had family members infected by the virus, and some have gotten seriously ill. Family members of the broader PdS community have died due to the virus, and these losses are closely felt. Carmen reflected on how the pandemic needs to soften our hearts, to make us more compassionate, to see how important it is to be grateful to God for every single day, for the possibility of serving others each day, and for being close to loved ones.
Many challenges lie ahead. For our social workers, the main goal is to “activate” each medical program again and resume their surgical campaigns. This work is more crucial than ever, as patients face increasingly complex barriers to care. For Carmen “we have to keep moving forward and search for new and alternative ways of helping our patients, doctors, and hospital partners.” Marizol adds that it is “imperative” to search out new ways of helping patients. “Patients are coming to us with more health needs that they have not tended during this time, and we are trying to help. We have to continue helping.”