Miguel Cunha interviews Dr Renán Antelo Galarza, general and colorectal surgeon and Chief of the Colorectal Sector of the Surgery Department at Hospital de Atención Integral - Caja Nacional de Salud, Tarija-Bolivia.

Miguel Cunha: Dr Renan, thank you for agreeing to speak with us about the reality of the COVID-19 crisis in Bolivia. As a Portuguese interviewer, who proudly speaks Spanish, muchas gracias por la disponibilidad, es un placer para nosotros contar con su colaboración! 

To start, the impact of COVID-19 worldwide is well known. But what has the major impact been for Bolivian surgical patients in particular?

Renán Antelo Galarza: Thank you for the interview! I think that we are seeing a major impact in patients with life-threatening conditions, such as oncological patients, because a delay in their treatment could potentially lead to a negative impact on their disease outcomes. We are making major efforts with these types of cases and with patients who need urgent surgical care.

MC: In what way do you think the situation in Bolivia differs from the other South American countries?

RA: I have spoken with colleagues from other South American countries and I think that our situation differs in the sense that for years and years our governments haven’t given healthcare the importance it deserves, so when the pandemic struck we found ourselves with a very weak and unprepared healthcare system.

MC: Concerning surgery postponement in general, was this also an initial approach in Bolivia? Are you already seeing any consequences from the delayed surgeries? What are your main concerns at this moment, and in the long term?

RA: Yes, it was. All elective surgeries were postponed. We are seeing patients coming to the emergency rooms with more advanced stages of urgent conditions, maybe because of fear of getting the virus. My main concern at the moment is the patients that had to undergo cancer surgery and the impact this could have on their results because their treatment plans had to be changed.

MC: Do you feel your government or healthcare system is aware of the consequences of postponing surgery? Are these entities in your country advocating any solutions for these issues?

RA: I feel my government is not aware of this problem. They are dealing with the pandemic and a lot of sociopolitical and economic problems in Bolivia right now, the healthcare system is aware, but they have given us autonomy to deal with this issue.

MC: Were your residents or any of your senior surgeons redeployed to other services during the pandemic? How do you think we can continue to provide surgical education during the upcoming months?

RA: Luckily at my hospital we haven’t needed to redeploy any of the residents or members of the staff surgeons yet. I personally think that nowadays we have so many tools at our disposal that we can and should use to continue providing surgical education in many different platforms - for example the number of medical webinars has skyrocketed during this pandemic.

MC: How has the current situation affected your own practice? Are you taking any precautions in your social life?

RA: My own practice has been affected because I had to postpone all my elective surgeries and procedures. My social life does not exist right now - I think that practicing social distancing is key in fighting this virus.

MC: That brings us to the end of the interview! I would like to thank you for giving us the local insight on the COVID-19 pandemic in Bolivia, and I would like to ask you a final question. What is the main lesson we can take from this pandemic so far?

RA: That an unprecedented pandemic like this could happen again in the future and we need to be prepared. Without health, nothing is possible. We need to learn from our own mistakes and, if possible, from others’ mistakes too.

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