|Medical Facilities and Health Information||
hroughout the country, both personal hygiene and sanitary practices in food handling are far below U.S. standards. Food and beverage precautions are essential. Medical care in large cities is adequate for most purposes but of varying quality. Ambulance services are limited to non-existent. Medical facilities are generally not adequate to handle serious medical conditions. Pharmacies are located throughout Bolivia and prescription and over-the-counter medications are widely available. Western Bolivia, dominated by the Andes and high plains (Altiplano), is largely insect-free. However, altitude sickness (see below) is a major problem. Eastern Bolivia is tropical, and visitors to that area are subject to related illnesses. Insect precautions are recommended.
Travelers to Bolivia should consult with a Travel Clinic well in advance of departure for further information on recommended vaccinations.
Dengue: Dengue is endemic throughout eastern Bolivia, including in the city of Santa Cruz. Since January 2007, there have been several thousand cases, representing a significantly increased incidence and part of a region-wide trend.
Rabies: Bolivia is a high risk area for rabies. Dog and bat bites and scratches should be taken seriously and post-exposure prophylaxis sought.
Yellow Fever: Yellow fever is present in subtropical Bolivia. Yellow fever vaccination certification is required for entry visa applications, and may be required prior to boarding by airlines flying into/transiting Bolivia, as well as at entry points to Bolivia. Please refer to the Center for Disease Control’s (CDC) information on Yellow Fever.
High Altitude Health Risks: The altitude of La Paz ranges from 10,600 feet to over 13,000 feet (3,400 to 4,000 meters) above sea level. Much of Western Bolivia is at the same altitude or higher, including Lake Titicaca, the Salar de Uyuni, and the cities of Oruro and Potosi. The altitude alone poses a serious risk of illness, hospitalization and even death, even for those in excellent health.
Prior to departing the U.S. for high-altitude locations (over 10,000 feet above sea level), you should discuss the trip with your healthcare provider and request information on specific recommendations concerning medication and lifestyle tips at high altitudes. Coca-leaf tea is a popular beverage and folk remedy for altitude sickness in Bolivia. However, possession of this tea, which is sold in bags in most Bolivian grocery stores, is illegal in the United States. "Sorojchi pills" sold in local pharmacies, contain high amounts of caffeine and are not usually recommended.
The State Department cautions travelers planning to visit La Paz to consider the following risks and advice:
Sickle cell anemia or sickle cell trait: persons with sickle cell trait may have a crisis at elevations of more than 8,000 feet. U.S. citizens with this condition have required urgent medical evacuation from La Paz to the United States.
Heart disease: Any person who has heart disease, or known risk factors for heart disease, should consult their doctor about their risks of ascending to high altitude, and whether any testing of their heart would be in order. Even U.S. citizens who adjust well initially to the altitude in La Paz have subsequently suffered heart attacks and been hospitalized.
Lung disease: Anyone with emphysema should consult closely with their doctor and seriously reconsider coming to La Paz or other, high-altitude areas. Anyone with asthma should consult their doctor; mild asthma may be manageable at high altitude, but it is important to remember that emergency care and intensive respiratory care are very limited even in the city of La Paz and are absent outside the city. U.S. citizens with respiratory ailments have previously been medically evacuated from La Paz to other countries to receive medical treatment.
Pregnancy: Given potential complications from altitude sickness, pregnant women should consult their doctor before travel to La Paz and other high-altitude areas of Bolivia. There is an increased risk of miscarriages and other pregnancy-related complications at high altitudes.
Everyone, even healthy and fit persons, will feel symptoms of hypoxia (lack of oxygen) upon arrival at high altitude. Most people will have increased respiration and increased heart rate. Many will have headaches, difficulty sleeping, lack of appetite, minor gastric and intestinal upsets, and mood changes. Try to limit physical activity for the first 36 to 48 hours after arrival, and avoid alcohol and smoking for at least one week after arrival.
|Drinking Water Source - percent of rural population improved||71.9%|
|Drinking Water Source - percent of total population unimproved||11.9%|
|Drinking Water Source - percent of urban population improved||96%|
|HIV/AIDS - adult prevalence rate||0.2%|
|Hospital Bed Density - beds/1,000 population||1.1|
|People Living with HIV/AIDS||12,000|
|Physicians Density - physicians/1,000 population||1.22|
|Sanitation Facility Access - percent of total population unimproved||53.6%|
|Sanitation Facility Access - percent of urban population improved||57.5%|
|Sanitation Facitlity Access - percent of rural population improved||23.7%|
|Major Infectious Diseases - degree of risk||very high|
|Food or Waterborne Disease (s)||bacterial diarrhea and hepatitis A|
|Vectorborne Disease (s)||dengue fever, malaria, and yellow fever|
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