As it was stated in the introduction, there were some clear reasons for choosing Bolivia for this analysis as a country with high mortality rates. The Central Intelligence Agency (2016) states, Bolivia ranks at or near the bottom among Latin American countries in several areas of health and development, including poverty, education, fertility, malnutrition, mortality, and life expectancy (para. 7). The statistical data of the World Health Organization (WHO) confirms this assertion. The average life expectancy for both sexes makes 68 years (World Health, 2015). Ischemic heart disease was the leading cause of death, killing 7.4 thousand people in 2012. (World Health, 2015, p. 3). Other common causes of death are lower respiratory infections and stroke. The level of under-five mortality rate has significantly reduced since 1990. Today, it makes 49 per 1000 live births; the figure is still high (World Health, 2015). Acute respiratory diseases together with prematurity are common causes of the child death. There are some more purely economic and social factors, which should be considered in this regard, namely malnutrition and inappropriate living conditions, which contribute to children dying before the age of five years (World Health, 2015). These health issues are accompanied by some social problems in the state, which also contribute to the high level of victimization.
Place New Order
There is a significant number of strikes and manifestations in Bolivia, which are more aggressive than violent. They are a result of the citizens dissatisfaction with the government. People usually join in protests, but while disruptive, especially to transportation, violence is usually limited and localized. (United States Department, 2016, para. 18). The assault rate in Bolivia makes 54.2, and the state has the 54th position among 93 countries. Its murder rate per million people is 87 (the 32nd place out of 86 countries) (Bolivian Crime Stats, 2014). Drug-related crimes in Bolivia are common, as well, because the state is a producer and transporter of coca leaves (United States Department, 2016). The police response to different types of crimes is not very effective because they have limited resources and lack personnel (United States Department, 2016). It is worth noting that traffic accidents, which involve vehicles only or pedestrians and vehicles together, are common in the country. Following the data of the WHO, the number of traffic accident deaths in Bolivia reached 2,002 or 3.16% in 2014 (World Health, 2015). The reason for this fact is ignoring traffic rules by the drivers. The police almost do not patrol the roads (United States Department, 2016). The lack of administrative control in different spheres is an obvious problem of Bolivia.
Culture and Traditional Medicine
Bolivia has a very rich and diversified culture. It was formed by more than 30 tribal groups (Bolivian Traditions, n. d.). Different regions of Bolivia have peculiar cultural traditions. Immigrants have also made their contribution to the development of the Bolivian culture. As a result, the state has many unique legends, myths, traditional games, and food recipes (Bolivian Traditions, n. d.). It is impossible to find a typical Bolivian home since there are so many different cultures (Bolivian Traditions, n. d., para. 10). The Bolivian mix of traditions makes the states culture very authentic.
Various cultural rituals have promoted the development of traditional medicine in different tribal groups. This medicine is mostly based on the herbal treatment and some rituals, which are not appropriate in the modern world (DeLoge, 2012). Nowadays, medical scholars and healthcare workers try to mix Bolivian traditional medicine and biomedicine in order to improve the quality of the medical service in the country. They learn languages of indigenous tribes and strive to understand their needs (DeLoge, 2012). However, some economic problems create additional barriers to the healthcare, People elect to use traditional medicine at times out of necessity because they cannot afford services or treatments of biomedicine (DeLoge, 2012, p. 36). Therefore, there is a serious conflict between the modern healthcare delivery and traditional medicine of tribes in Bolivia.
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Healthcare System and Delivery
Governmental Health-Related Agencies and Health Regulatory Organizations
The Ministry of Health and Sports of Bolivia is the main body, regulating healthcare issues in the state. Vice-Ministry of Traditional Medicine and Interculturality was created by the government in 2006 for regulating the conflict between the indigenous medicine and biomedicine (Deloge, 2012).
Healthcare Personnel and Hospitals
According to the official website of the Central Intelligence Agency (2016), the total number of physicians that work in Bolivia today is 47 per 100,000 people, while the total number of nurses is 1000 per 100,000 people. In line, the number of beds is 110 for the same number of people according to the official website of the World Bank (2015).
Nursing Education System and Accrediting Organizations
There are 52 universities in Bolivia, which are mainly situated in La Paz, Santa Cruz, and Cochabamba. Universidad Mayor de San Simon, Universidad Mayor de San Andres, Universidad Catolica Boliviana, and Universidad de Aquino Bolivia are only some of them (Top Universities in Bolivia, 2016). All universities, if they do not teach engineering and technical disciplines only, have accredited nursing schools (Top Universities in Bolivia, 2016). In various levels, the Bolivian nursing encompasses the auxiliary level, the high level (nursing Bachelor or nursing and obstetrician Bachelor) and postgraduate level - Specialization, master and PhD (de Oliveira Salvador, de Lima, Alves, & Pereira Santos, 2014, p. 2031).
High mortality rates in Bolivia and a low life expectancy level make it necessary to have some organized nursing communities. The Bolivian nursing professionals have the
College of Nurses of Bolivia (CEB) as a scientific and professional organization (Salvador et al., 2014, p.2030). The membership of this organization is mandatory for all practicing nurses.
On the basis of the information, presented in the paper, it is possible to state that the main health priorities for Bolivia include: (1) creating an effective healthcare system, services of which will be affordable for all social groups; (2) developing the culture of biomedical treatment in the indigenous groups, who are used to the traditional treatment; (3) attracting international nursing organizations in order to fight the diseases, which cause the majority of deaths and create a significant health burden.
Conclusion: Nursing Implication
Though Bolivia is a relatively small country, it has a number of serious health problems, which need joined efforts of nurses, medical specialists, and international organizations to be solved effectively. The role of nurses in this process is significant. They should assist physicians in the provision of primary and emergency care. Nurses can provide some statistical and research data about outbreaks and symptoms of diseases, as well as resources, which they need in order to offer high-quality healthcare. They can establish contacts with international nursing organizations, join their efforts, and assist nursing colleges in developing different internship programs. With the purpose of revealing the potential of nurses for solving the most important healthcare issues in Bolivia, the government should also play its part. Nursing in Bolivia, especially fighting respiratory diseases, which kill children, needs a proper financing and a sufficient number of nurses. Hopefully, the Bolivian government will contribute to overcoming the main barriers to growing healthy generations in the country.