Addressing Challenges to Women’s Healthcare in Bolivia

At Solidarity Bridge, our commitment to global health equity often goes hand-in-hand with addressing the compounded inequities of gender. According to the Pan American Health Organization (PAHO), “gender inequity in health refers to those inequalities between women and men in health status, health care, and health work participation, which are unjust, unnecessary, and avoidable.”

In Bolivia, one of the most evident examples of gender-based health inequity is the lack of access to quality gynecological care. This issue has been a part of Solidarity Bridge’s mission since our second mission trip in 2000. Many women, especially mothers, suffer silently from conditions like abnormal bleeding, pelvic organ prolapse, fibroids, urinary incontinence, and other health problems often linked to multiple childbirths. Unfortunately, these conditions are rarely addressed until they become severe.

US medical missioners, Dr. Robert LaPata and Dr. Enrique Via-Reque, first encountered the urgent need for specialized gynecological care during their early Solidarity Bridge mission trips. In 2008, they responded by leading the first trip solely dedicated to gynecologic surgery. This initiative shaped the beginning of our year-round gynecologic surgery program, launched in 2012, which continues to evolve as we collaborate with Bolivian doctors to provide advanced training, essential tools, and medical equipment donations.

In recent years, the focus of our Gynecology program has shifted toward gynecologic cancer surgery, in response to this pressing need identified by our local partners. Women in Bolivia make up the majority of cancer-related deaths, with cervical, breast, and gallbladder cancers being the most prevalent. Cervical cancer, in particular, disproportionately affects the country’s poorest and most vulnerable women, having a devastating social and economic impact on families, especially in rural areas.

According to the WHO, Bolivia has the highest incidence rates of cervical cancer in Latin America, and the second-highest mortality rate.

For the past eight years, Solidarity Bridge has worked closely with Bolivia’s two public cancer hospitals, providing specialized training and essential resources. One of these hospitals, located in southern Bolivia, was founded primarily by female practitioners and is especially dedicated to treating women’s cancers.

However, gender inequities are not addressed solely through our  gynecology program . In our general surgery program, we have seen how  gallbladder cancer affects women at higher rates than men in Bolivia, and female patients often face more challenges accessing care. Many are the primary or sole caregivers in their families, which creates additional burdens.

We remember one woman in particular: Rina, a mother of seven, had been living with debilitating gallbladder pain for years. When she finally came to us for surgery, her first concern was not the procedure, but whether we could help her children. She wanted to know the cost of treating her children’s parasitic infections before she could proceed with her own surgery. Her story is not unique.

A report by Oxfam Bolivia reveals that women in the country spend nearly seven hours a day on caregiving—almost double the time spent by men. Seven out of ten women report being the primary caregivers in their households, a responsibility that often delays or prevents them from seeking their own medical care.

Social workers at Puente de Solidaridad, our sister organization in Bolivia, work closely with patients, offering both emotional and logistical support during their treatment. Social worker Marizol Mamani shares, “It’s much more complicated for a woman to decide to undergo surgery because she prioritizes her family’s needs first. Only when women are truly sick do they come to us and say, ‘I need surgery.’”

To help address this issue, Puente de Solidaridad’s work goes beyond the operating room, accompanying patients throughout their care journey. They make home visits before and after surgery, offer transportation to and from the hospital when needed, and step in when no one else can. These efforts help reduce the risk of post-operative complications, smoothing the recovery process, and making patients feel supported.

Another improvement to patient care is our focus on training local doctors in minimally-invasive surgery techniques to use when appropriate. This approach allows for quicker recovery, which is especially important for patients who need to return to work and other daily responsibilities quickly— particularly mothers. By reducing recovery times, patients are more likely to undergo surgery sooner rather than delay until their conditions become unbearable.

By addressing these disparities that affect equal access to care, we strive to ensure that all patients, regardless of gender, have the opportunity to live healthier lives free from avoidable suffering.

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