HISTORY OF MEDICINE AND HEALTH IN BOLIVIA

HEALTH IN THE CHACO WAR

SUMMARY.-

The history of medicine is a branch of history that is dedicated to the study of

different medical knowledge and practices over time. Since the origins of human
beings, they have tried to explain reality and its events, such as: life, death and
illness.

INTRODUCTION.-

Since the history of the Empire of the Children of the Sun, the Inca Empire, all the
information already known regarding this culture is contradictory according to the
research and studies that were carried out over time. And not only that, but there is
also an absence of data, many historians have omitted valuable information
regarding the medicine, health and illness of this time, the information we have is
light, and this, therefore, is harmful. for paleopathology or the interpretation of the
lived reality in terms of health at that time.

An important event was the Citua, a festival of four solemn ones that was
celebrated in September. This was not just any party, it was one where the
objective was to banish all the evils and diseases that the population could suffer,
they did it through a series of procedures that ranged from fasting and total
cleansing of internal and external evils and then holding a party. giving thanks for
having been freed from these evils.

This activity could be similar to what is now Public Health and the taking of
preventive measures. In homage to the symbolic value of the Citua Incaica,
September 21 was declared the National Doctor's Day, which in other countries is
considered Pan American Day. Of the health.

Also with this, in 1967, in the Second Congress of the Medical Union
Confederation of Bolivia, the regulations of this festival were approved so that it
would be in force in the country: one of the points it contained was the award to
doctors who had stood out during the administration. respective. At the end of that
same year, a positive response was obtained from the then president Luis Adolfo
Siles Salinas who decreed December 29 in which he declared the National
Doctor's Day and Bolivian Health Day.

In pre-Columbian history, we can see that there are cases of different diseases.
Coya was the name given to the wife of the Inca, the Fifth Coya, married to Capac
Yupanqui, according to history, after marrying she fell ill, probably according to the
clinical picture, it was a case of epileptic psychosis. World history also refers to
other psychiatric cases.

With the discovery of America by Christopher Columbus on October 12, 1492,

more and more conquerors, their black slaves, and therefore their diseases,
arrived to a virgin land, which according to Fray Bartolomé de las Casas was the
most appropriate place to live.

The migration of the black race brought with it diseases such as: leprosy, scabies,
anemia due to parasites, measles and chickenpox. The white people brought
venereal diseases with them. Of all of them, smallpox stands out, a disease that
predominated in the 15th century. The slaves had immunity to this disease but the
natives did not have it.

The disease took the natives of America as victims, becoming an epidemic. But
there was not only this condition, but also that of Hemoglobin “S” called
faciformism, a variety of abnormal hemoglobin with a high incidence in Africa.

But not only the natives were affected, the black race also had health problems
when arriving in a territory with a cold climate in addition to its height. A significant
number died in these conquests and doing work that required physical strength,
since their condition was not suitable to live in these regions.

That was the reason they migrated to the Yungas regions where the climate was
similar to their habitat of origin, in these places they grew fruit, coca, and quinoa.
Currently, the pathology of Hemoglobin “S” is one of the main public health issues
worldwide due to the number of black people that exist.

Going little by little through time, we can highlight Doctor José Salbani Lleopart,
surgeon, born in Cervera between 1776 and 1777, who always stood out for being
a studious and hard-working professional. He was appointed in 1803 to be part of a
philanthropic expedition to America for his knowledge of smallpox vaccination. He
and his team carried out more than 250,000 vaccinations in the Charcas Court
before his death in Bolivia. He is currently considered a martyr in the medical
profession because he dedicated his life to it until his last days.

The San Francisco Xavier University of Chuquisaca (fig1) celebrated the first
anniversary of its medical school in 1992, remembering that on April 10, 1798, King
Carlos IV ( fig1.1) issued a Royal Ordinance that authorized the creation of new
Chairs of Medicine and Mathematics to this university, based on various
precedents since 1770, the year in which the need for a Chair of Medicine was
discussed.

In 1804 an epidemic occurred in Sucre, which filled the Hospital and caused a
scandal regarding the problem that there was no professor of Medicine in said
Hospital. It remains to be said that until 1823, despite many requests made,
Medicine was still not taught in Sucre.

(fig1)

( fig1. 1)

Thus, another
character appears in the story, Mr. Miguel Antonio de Luna, a Spanish surgeon
who arrived in Chuquisaca in 1825, declared Honorary Doctor of the Deliberative
Assembly of Upper Peru. It was he who taught the first known Medicine courses,
becoming the professor and professor at the San Cristobal School, which would
later change its name to the College of Sciences and Arts. When the Republic was
founded, the teaching of medicine in our country was born along with it.

On May 3, 1826, the San Juan de Chuquisaca School opened its doors and the
first Medicine classes would be taught.

An important event was the attack against President José Antonio de Sucre (fig2)
in 1928, who was not treated by Dr. Luna but by one of his 18-year-old students
who would later become one of the most recognized doctors in the whole country;
Dr. Manuel A. Cuellar .(fig2.1) Dr. Carlos Augusto Torally also treated him.

(fig2) .(fig2.1)

Dr. Luna was probably the only doctor in Sucre until 1827, the year in which the
law of January 9 was approved, an important basis for the Legal Foundation of
Medical Teaching in Bolivia. This law had curriculum regulations that could not be
applied to the reality that the country was experiencing at that time. There were
several regulations and standards that could never be met. The only one of the
Governments that achieved it satisfactorily was that of Melgarejo in 1866, who
presented to the medical schools of Sucre, Cochabamba and La Paz, a plastic
specimen and a skeleton that had been brought from Europe. This act was
recorded as the most advanced of medical instruction in Bolivia.

The Decree of August 25, 1845, issued during the Government of José Ballivián,
made a legal reference to the Faculty of Medicine for the first time. But despite
these facts, it could be said that there was no official faculty. Later, on October 7,
1891, the Faculty of Medicine was founded by law passed by the National
Congress and was promulgated on October 9 of the same year. This was the
initiative of Dr. Cuellar, who observed the state of medical education in Sucre.
The teaching of Medicine in Sucre in the 19th century was always a cause of
concern for the rulers who made decrees and laws without obtaining results, since
the failure was in other points such as the requirement for environments and
libraries.

This is how the change began, the first thing to be organized was the provision of a
library, but for this money was required, and as an example we give Dr. Cuellar
(fig2.1) who gave even his income in order to finance and maintain this goal. This
went on for fifteen long years. Bacteriology and Chemistry laboratories were also
installed. But there were still many things missing that had to be brought from
Europe, at that moment, hope appears, Mr. Carlos Arce who was the son of
President Arce, who was a man of business and fortune, he offers his help to meet
the objectives that had to be fulfilled, he would bear all the expenses that would be
returned to him according to the possibilities . (fig3) With everything already
complete, the Medical Institute of Sucre would be founded on February 3, 1845.

Finally, our country had a true medical school, which had all the requirements to be
one. It began operating on February 1, 1892. From everything that happened, Dr.
Manuel Cuellar (fig1) stands out, along with his colleagues, doctors Gerardo Vaca
Guzmán (fig2,), Valentín Abecia, Cupertino Arteaga ( fig3), Héctor Vásquez and
Ángel Pone as founders (fig4), among many others.
Advancing further in history we enter 1879, the year in which the so-called War of
the Pacific began on February 14 (fig4), in which Bolivia participated in a single war
action in its territory, being that of Calama, in which Dr. . Gregorio Saavedra
(fig4.1), who was recruited along with other men who totaled 135. This doctor
helped improvise an aid station for the wounded in this war.

Reference is also made to Surgeon Constantino Doria Medina who was

recognized as the inspector of blood hospitals and ambulances, he belonged to the
Bolivian Army that went to Tacna.

The military health situation in the country was poor since ambulances and
materials were urgently needed to care for those wounded in war. For this, the
collaboration of the population was even requested. The press also highlighted the
work carried out by the Red Cross (fig4.2) on the battlefields caring for the fallen,
other wounded were cared for by rabonas who accompanied the battalions and
finally, the situation, despite this, was so bad that Several of the fallen were left to
fend for themselves on the battlefield due to the lack of necessary help. Faced with
this situation, on May 7, 1880, the Ambulance Committee was established and the
organization was carried out for the collection of food and material necessary to be
taken to the places of battle.
The Senior Surgeon, Dr. Zenón Dalence, was the creator of the Organic
Regulations for the general health service of the Bolivian army operating in Peru,
which was approved in 1880 and which established the Management and
organization of the Ambulance Committee. This document was based on the
ambulance regime of the Geneva Convention, the name ambulance referred to the
temporary hospitals that followed the troops for their respective care. So, 15 days
before the Battle of Alto de La Alianza, the health personnel who would accompany
this fight were officially presented.

As nurses in the war, the incredible dedication of two women stands out: Mrs.
Ignacia Zeballos and Vicenta Paredes Mier, who of their own volition were part of
the ambulances, an action that was only recognized by Mrs. Zeballos with the sum
of 80 bs. (fig5.1)
The formation of ambulance companies was well organized, and even after the war
ended due to the withdrawal of the Bolivian troops, they continued their work
because there were wounded that still needed to be treated. Even, for the
repatriation of the wounded, Dr. Dalence gave the Director of the Chilean
ambulance a reward, in this way the wounded Bolivians were returned to the
country.

That was the summary of the actions that the health personnel had, together with
the ambulance organization from its creation in Tacna until the withdrawal.
MILITARY HEALTH IN THE CHACO WAR

Another relevant event in our country was the so-called CHACO WAR in 1933, an
event in which, speaking in terms of health, countless doctors, nurses, health nuns
and other support personnel participated, limiting themselves only to fulfilling the
obligation they had, but rather who even carried out heroic interventions on the
battlefields (. The health personnel stood out with the actions they carried out,
although on the other hand there were also comments and even publications
against that devalued the work carried out, such is the case of Dr. Landívar and the
speculations about him, accusing him of carrying out experiments surgical
procedures with wounded soldiers.

On February 6, 1933, President Dr. Daniel Salamanca issued a Supreme Decree

to improve the quality of care for the wounded from the War who were treated in
Potosí. The Red Cross also acted to support the field hospitals with the necessary
material. The Central Bank of Bolivia also inaugurated a hospital to care for the
wounded, in what is currently Plaza Bolivia.

The participation of Dr. Enrique Berríos Vargas stands out, who was the one who
controlled the care and treatment that the wounded received. He said that the
health personnel ran the same risk as the combatants.

Many other institutions cooperated in this war, among them the Company of Jesus,
known as Jesuits, who inaugurated a hospital and would cover all the expenses.

There were several heroic actions by the health personnel, who, even at risk of
their own lives, preferred to die caring for their wounded rather than flee. As is the
case of the Rivas brothers doctors who fell prisoner, or the nurses who died on the
battlefield.
President Salamanca and
General in Chief of the Army
Enrique Peñaranda

PHOTO: BOLIVIAN CAMP, AN INJURED IS ATTENDED BY HIS COMRADES.

CHACO WAR 1932-1935
BACKGROUND OF THE CREATION OF HOSPITALS AND HOSPITAL
ADMINISTRATION IN BOLIVIA.-

We also make reference to the creation of hospitals and their administration in our
country in the colonial and republican periods. It can be divided into two periods:
the colony and the republic.

In the colony, some important events were:

In 1541, by Royal Ordinance of Charles V, the foundation of hospitals was

requested in Upper Peru for the care of the sick and the exercise of Christian
charity.

In 1551, the San Juan Evangelista Hospital was founded in La Paz, which was run
by the Franciscan brothers to care for Spaniards and Indians.

In 1582 the San Salvador Hospital was founded in Cochabamba eight years after
its founding.

In 1610, the Hospital of San Juan de Dios was founded by Spaniards in Potosí.

In 1632, the San Juan de Dios Hospital was founded in Tarija.

In 1700, upon the arrival of the Betlemites, the Córdova Hospital was founded; they
gave authorization for the founding of hospitals.

In 1791, the first Hospital Regulations were presented by Fray Mariano Alarcón.

In 1816, the first Military Hospital was founded in Santa Cruz.

Already in the republic, the important events were:

In 1826, the first health provision in the country, the first general hospital
regulations, was issued by Marshal Sucre.

In 1864, a Supreme Resolution established that medical students should replace

the empirical workers who served in hospitals.
In 1865 and 1866, voluntary societies were organized, one of them being the
“Ladies of Charity”, who intervened in the investments of funds for hospitals.

In 1808, public clinics were established for the first time, at the proposal of the San
Vicente Paul Humanitarian Society.

In 1875, military healthcare was organized by Zenón Dalence, as previously

mentioned.

In 1914, the first maternity hospital in Bolivia was founded, in Sucre by Dr. Nicolás
Ortiz.

In 1920, the Miraflores General Hospital was put into operation in the city of La
Paz.

In 1932, the Surgery and Orthopedics Hospital was founded in La Paz, as a

consequence of the Chaco War.

In 1934, Said Eye Hospital was founded.

In 1948, construction began on the current Children's Hospital in Miraflores in the

city of La Paz, which was inaugurated in 1972.

In 1957, the Supreme Decree was issued that created Clinical Hospitals in the
three departments with Medical Schools, which were La Paz, Sucre and
Cochabamba.

In 1960, the National Thorax Institute was inaugurated.

In 1967, the General Hospital, by agreement, was transferred to the University of

San Andrés, currently becoming the Hospital de Clínicas.

In 1969, the first public health conference was held in La Paz.

In 1970, through Supreme Resolution 1540, the National Statute of Hospitals was
approved, and later the hospital regulations were added.

These were some of the outstanding events in both eras.

IMPORTANT PEOPLE OF NATIONAL AND INTERNATIONAL MEDICINE.-

DANIEL BRACAMONTE.-

Among other relevant personalities in the history of Bolivian Medicine that are little
known is the figure of Daniel Bracamonte, born on October 20, 1840 in Potosí. An
outstanding student who continued his studies at the San Francisco Xavier
University, a memorable man in the medical profession, considered a disciple of
Hippocrates, whose uniqueness was having a devotion to medical assistance to
the poorest, he carried out charitable actions, visited his patients in their homes,
and then visited the rooms of the hospital in which he worked and which bore his
name, his actions were very sacrificial and worthy of recognition. He criticized the
way of teaching, also the erroneous thoughts of the medical profession. that was
had then. He also even participated in various positions in the Pacific War, being
named Surgeon Major of the Army in 1880.

He had an exemplary galenic life, dying at the age of sixty in his hometown.

THOMAS SYDENHAM.-

He is another important figure worldwide, born in 1624, who unfortunately is not

very well known.

but for his studies on Korea that bears his name,

“Syddenham Korea,” a nervous disease that occurs
especially in childhood.

He also clarified the confusion at the time that

existed between measles and scarlet fever. All his
teaching made reference to the diagnostic haste
widespread at the end of the 20th century, which
was observed at that time, he believed that there should be a prolonged and
careful observation of the patient, he said that "a house should not be built, before
establishing the foundations".
Due to his way of thinking, he came to receive the name of restorer of Hippocratic
methods, since he gave value to observation and experience for formulating the
diagnosis.

With the discovery of the new world, he was considered the discoverer of malarial
fever, he demonstrated the effectiveness of treatment with cinchona. He had
followers as well as characters who underestimated him.

He had an enriched philosophical orientation, dying at the age of sixty-four in 1689.

INFANT MORTALITY IN BOLIVIA.-

Mortality is an important health indicator because it allows us to reflect the

standard of living and development of a town, but there is also a difficulty when
executing it since there is poor administrative organization.

Going back in history, Valentín Abecia is mentioned who was a recognized doctor
in Sucre and in 1883 he established statistics and achieved the publication of
“Bolivian Demography and Statistics” where he demonstrated that a high mortality
rate in Sucre that corresponded to 48 per thousand , and that the majority
corresponded to families of the plebs, a term that referred to sectors in precarious
living conditions.

A follower of his, Jaime Mendoza, continued to publicize the worrying situation of

the standard of living of the mine workers and their children. Which carried out
research on the negative influence on health of a hostile ecological environment.

Then, Doctor Carlos Ferrufino, pediatrician and public health specialist, addressed
this issue in 1949 in a conference on the problems of medical care for Bolivian
children, where the statistical data available at that time was analyzed, very
alarming data. The majority of these cases were due to respiratory diseases and
gastroenteritis. At that time there were no health plans for the children's sector of
the population.

The stage of the National Revolution that occurred in 1952 brings with it important
changes in the economic and social structure. Our country had to implement plans
if it wanted to have foreign support, so the Government created the National
Planning Board, which after many changes became a Ministry.

The plans and programs that would be implemented were based on health policies,
on indicators of the standard of living and health of the Bolivian people.

The mortality rates, which in 1971 were 250 per thousand, and in 1995 were 75 per
thousand, there were abysmal differences between the two, there was no
coherence in the data, we could not speak of real data; But this information was
used by the rulers to boast about unattained achievements and to obtain even
more international support, a fact that harmed the country since true data was not
available.

But if one thing is true, it is that infant mortality was higher in rural areas than in
urban areas, due to many factors, such as: education, living conditions, hygiene,
among others. The basic cause of death, as explained above, was diseases of the
respiratory system. Data that continues to be a problem to this day, but with the
implementation of health programs such as IMCI Infant mortality rates have been
reduced in our country.

Currently the IMCI strategy “Integrated care for prevalent childhood diseases” has
a long history in Bolivia; It has been just over 10 years since the implementation
process of this strategy began. Different components were developed:
improvement of the skills of health personnel “clinical IMCI”, and improvement of
family and community practices “community IMCI”.

This strategy has contributed to the reduction of childhood mortality, which has
been evident in the results of the national Demographic and Health survey. But it
has not been immune to the problems that exist in a weak health system, for
example: poorly developed reference and counter-reference networks, a follow-up
and monitoring system with low coverage, constant rotation of health personnel,
training and others.

Recently, in 2013, by Supreme Decree 29894 of February 7, 2009, the document

“Integrated Care for the Continuum of the Adolescent Life Course - Women of
childbearing age - Women during pregnancy, childbirth and puerperium - Newborn
was approved - Child under 5 years old - Older adult. To achieve better quality
care for the general population, not just children. It allows providing comprehensive
health care to the population; According to this principle, the population has access
to qualified services throughout the life course, in addition the continuum of care
approach promotes the integration of the different care settings: the home, the
community, health facilities. These services must be aimed at health promotion,
prevention, care and rehabilitation of diseases.

This new approach that was given is framed within the National Development Plan,
the SAFCI policy “Intercultural Community Family Health”

COMMENT
To make a reference to such a combative and moving story, we ask to observe the
basis that has been dragging on the history of medicine in Bolivia. Because this
story, not the Chaco War, does not come alone..
We were able to cover pre-Columbian history in a brief way because at this time
we can confirm that cases of different diseases occurred. They celebrated a party
but it was not just any party, this party consisted of banishing all the evils and
diseases that the population could suffer from.
We realized that this activity is similar to what is now celebrated “public health” and
the taking of preventive measures where it is celebrated as a national doctor's
holiday on September 21.
The date of October 12, 1492 was a very important date for America because
Christopher Columbus discovered these lands but with him he brought diseases
unknown to our native men. Christopher's black slave race brought diseases such
as; leprosy, scabies, anemia due to parasites, measles and chickenpox. As for the
white race, they brought venereal diseases, this became an epidemic in American
lands, many of our natives had to lose their lives; But not only our men died, the
black race also died due to the altitude of our lands and migrated to the Yungas
through similar African lands.
What our native men experienced was very cruel.
Later in the area of medicine they began to put things in order due to the lack of
instrumentation and environments to train doctors.
Later in the years 1776-1777, in those years it was possible to notice DR. Joses
Albanir Leopart, a good surgeon at that time, very aware of smallpox vaccination, a
good doctor in our opinion.
In Bolivian medicine, an epidemic occurred in the city of Sucre. In this city, the
places where the sick were treated were filled. This caused a very strong
discussion among the authorities because they did not have equipment or teachers
or doctors to care for them. . Our surprise was that until 1823 medicine was not
taught in the Sucre hospital, then a surgeon named Miguel Antonio de Luna
appeared who came to Sucre to teach medicine from Europe. This doctor
appeared in the appointment of upper Peru to our lands in 1825, declared an
honorary doctor. Thus, it covered the first medicine classes at the San Cristóbal
school; This doctor was the only doctor probably until 1827.
There was also an event that impacted us was the attack on President José
Antonio de Sucre in which the president was not treated by Doctor Luna but rather
by his student who was 18 years old at the time who would later become one of the
most recognized from Bolivia, Dr. Manuel Cuellar.
These events make us reflect on a very complex situation that this student went
through in front of a well-known character in the country.
Asila medicine in Bolivia is advancing, starting to create and found universities first
in Sucre, La Paz and Cochabamba.
One of the governments that was successfully achieved was that of President
Melgarejo with the collaboration of a plastic specimen and a skeleton transported
from Europe to Bolivia.

The joy that this country received was in 1891 where the medical school was
officially founded so that our compatriots could receive better health care for each
one, taking leaps and bounds with the governments that passed, yet our Bolivia
still needed to develop more in terms of health. until today we would say.

Later, Bolivia was going through conflicts with neighboring countries over lands
that belonged to Bolivia.
One of the battles was the “battle of the high alliance” that was where the health
personnel also showed up, strong women Ignacia Ceballos and Vicenta Paredes
who, being women, risked their lives to save those of other people, these brave
women.

Later, the renowned “Chaco War” occurred, where nurses, doctors and even health
nuns and many more showed up to offer their service to help the combatants of
that war.
There was great pride in the fact that our ambulances were also present to be able
to risk their lives in those lands fighting for Chilean soldiers.

We also highlight the bravery of Dr. Dalence who gave a reward to the director of
the Chilean ambulances so that they could bring our wounded Bolivians to treat
them and save their lives.
Our team of ambulances, nurses, doctors, nuns and more in the health area were
highly recognized and recognized for the high value they put on the battlefield to be
able to rescue wounded combatants, although not all the brave men in battle could
be saved due to lack of personnel, perhaps. But these health heroes gave us a
great example of how to be able to carry out our health work in order to save lives
and also entire families. They were recognized by the population even though they
not only said that there were heroes, they also said that there were doctors who
only practiced on soldiers or battle combatants, such as, for example, they
highlighted Dr. Landinvar, many speculations about his image as a doctor, these
speculations became to the entire population in the entire Bolivia.

Even despite these good and bad comments; The entire population of Bolivia was
very grateful for the bravery of the combatants to represent a country that lacks
much economic development and social order.

They also thanked, although as strong as they were, the doctors, nurses, nuns,
etc., for their bravery in risking their lives because many medical colleagues lost
their lives in those battles and nurses in rescuing combatants, but even so they did
not give up and continued. helping many more people.
There were several heroic actions by health personnel in these wars and battles
that our country faced. We had doctors imprisoned in our country and nurses killed
in these battles.

We were also seeing that many institutions cooperated in this cold-blooded war,
such as the Jesuits who inaugurated a hospital and they paid everything for its
possible construction and they were with the economic pending, they did it for good
health treatment and to advance in Bolivia with health.
It caught our attention that the doctors not only dedicated their hands to save
people from that war but also gave their heart and soul to return their bodies and to
risk everything for those people who needed them, that war was lost but Also on
those dates, hero doctors were gained who continued to help, more development
was gained in terms of health since the health team needed attention, support to
be able to obtain instrumentation and environments to be able to provide better
care to an entire Bolivian population.

QUESTIONNAIRE.-
1. WHAT WERE HIDING HISTORIANS AT THAT TIME?
They hid valuable information regarding medicine, health and illness at
that time, a history that was detrimental to palentology or the
interpretation of the reality experienced in terms of health at that time.
2. WHAT IS THE HOLIDAY YOU CELEBRATE AND WHY?

They held the festival in September with the aim of banishing all the evils
and diseases that the people could suffer.

3. WHO WAS THE MOST RECOGNIZED DOCTOR IN CHUQUISACA

AND WHAT ACHIEVEMENTS DID HE OBTAIN?

Miguel Antonio de lupa, declared honorary doctor of the deliberative

assembly of Alto Pero, was the one who taught the first medical courses,
becoming a professor at the San Cristóbal school.

4. WHAT GOVERNMENT SUPPORTS HEALTH CARE?

 It was the Melgarejo government in 1866, who observed medical schools
in Sucre, LaPaz, Cochabamba and a plastic specimen and a skeleton
that had been brought from Europe.

5. DID THE MIGRATION OF THE BREED BRING WITH IT DISEASES

LIKE?
Leprosy, scabies, anemia due to parasites, measles and chickenpox.

6. WHO DISCOVERED THE ANTI-VARILLICA VACCINE?

Dr. José Salbani LLeaport
7. WHEN AND BY WHOM THE MEDICAL INSTITUTE OF SUCRE WAS
CREATED
February 1845 by MR. Carlós Arce and DR. Manuel Cuellar.
8. WHICH COMMITTEE WAS ESTABLISHED IN THE YEAR 1880
Ambulance and organization are carried out for the collection of goods and
materials necessary to be taken to the battle sites.
9. WHICH DOCTOR WAS THE CREATOR OF THE ORGANIC REGIME
FOR THE GENERAL HEALTH SERVICE OF THE ARMY AND IN
WHAT YEAR WAS IT APPROVED?
The senior surgeon Dr. Zenón Dalence in 1880
10. IN THE CHACO WAR 2 WOMEN WERE STANDING OUT THEY
WERE NURSES IN THE AMBULANCE BY OWN WILL WHO WERE
THE NURSES
Mrs. Ignacia Zeballos and Vicenta Paredes Mier

11. WHICH DOCTOR WAS ACCUSED OF SURGICALLY

EXPERIMENTING ON WOUNDED SOLDIERS
Dr. Landívar
12. WHAT DATE AND WHAT PREVIOUSLY ISSUED A SUPREME
DECREE TO IMPROVE THE QUALITY OF IMPROVING THE
WOUNDED FROM THE WAR WHO WERE TREATED IN POTOSÍ
It was February 6, 1933.dr Daniel Salamanca
13. THE CENTRAL BANK OF BOLIVIA INAUGURATED A HOSPITAL
FOR THE CARE OF THE INJURED AND CURRENTLY IS.
Bolivia Square
14. WHAT DOCTOR SAID “THAT THE HEALTH STAFF RUN THE SAME
RISK AS THE FIGHTERS” WHO WAS THE ONE WHO CONTROLLED
THE CARE AND TREATMENT OF THE WOUNDED
Dr. Enrique Berrios Vargas
15. IN WHAT YEAR WAS MILITARY HEALTH ORGANIZED AND BY
WHOM?
In 1875 military healthcare was organized by Dr. Zenón Dalence
16. 1932 A HOSPITAL WAS FOUNDED IN LAPAZ AS A CONSEQUENCE
OF THE CHACO WAR ABOUT WHICH THE HOSPITAL WAS
TREATED
Surgery and orthopedics hospital
17. WHO WAS DR DANIEL BRACAMONTE AND WHAT WAS HE
CRITICISTICING AND WHAT WAS HE NAMED?

Considered a disciple of Hippocrates and his criticism and annoyance

was to the way of teaching and erroneous thoughts of medical
protection, he also became the chief surgeon of the army in 1880.

18. WHAT IS THE NAME OF THE NERVOUS DISEASE THAT FEARS

ESPECIALLY IN THE CHILDHOOD OF DOCTOR THUMAS SYDE?

THE KOREA OF SYDDENHAM

19. WHO ESTABLISHED STATISTICS IN 1883 AND WHAT

ACHIEVEMENTS DID THEY OBTAIN?

Valentín Abecia was a renowned doctor in Sucre who established

statistics and achieved the publication of Bolivian demographics and
statistics where he demonstrated a high mortality rate.

20. WHAT WAS DUE TO THE MAJORITY OF THE CASES OF INFANT

MORTALITY AND WHEN WAS THE STATISTICAL DATA
AVAILABLE IN 1949 ANALYZED?

Most cases of infant mortality were due to respiratory diseases and

gastroenteritis.

21. WHAT YEAR WAS THE RESOLUTION STAGE AND WHAT CHANGE
DID IT BRING?
 The revolution in 1952 brought with it changes in the economic and
social structure.

22. THE MORTSLITY RATES OF 250 PER THOUSAND IN 1971 AND 75

PER THOUSAND IN 1995 BECAUSE IT WAS SAID THEY WERE NOT
REAL DATA
because this information was used by the rulers to boast and to obtain even
more international support
23. WHICH HEALTH STRATEGY WAS ABLE TO REDUCE THE RATES
OF INFANT MORTALITY IN OUR COUNTRY

IMCI “integrated care for prevalent childhood diseases

24. WHAT IS THE PROPOSAL THAT EMERGED FROM THE CURRENT

GOVERNMENT TO IMPROVE THE HEALTH OF THE BOLIVIAN
POPULATION?

SAFCI intercultural community family health, which is a new

management model being gradually implemented.

BIBLIOGRAPHY.-

 History of medicine in Bolivia/ JUAN MANUEL BALCAZAR /Editorial: la Paz

Bolivia, 1956

 MINISTRY OF SOCIAL PROTECTION AND PUBLIC HEALTH . Sectoral

Planning Office. Guide for the management of the SNIS. Peace. 1990

 NATIONAL INSTITUTE OF STATISTICS INE - Informative Magazine. Peace.

1987

 MENDIZÁBAL LOZANO G. History of Public Health in Bolivia. Peace . Year

2002. p. 63. 70. 104. 234 and 298.
 BOLIVIAN ARCHIVES OF THE HISTORY OF MEDICINE / official organ of
the Bolivian society of history of medicine of La Paz / ISSUE DEDICATED TO
THE CHACO WAR July December 1996-volume 2 La Paz- Bolivia