During the first weekend I began to explore the psychiatric hospital. As I entered the hospital through a very small door, followed by a long and dark corridor, the only entrance to the large facility, I was confronted with a small hint of fear. I’m a little ashamed of that. But when I started meeting and talking to the people inside, I soon realized that nothing bad was going to happen.

I talked to Ivan, Laura, Ximena, Michael and his mother, Josefina, who was there for her weekly visit.

Josefina told me that Michael has been in the hospital since he was 14. He was a rather shy boy, who started isolating himself more and more. Until one day he fought with his mother, he became violent and attacked her. She was terribly scared, so she took him to the psychopedagogical centre for minors first and then in 2007 he was transferred to the psychiatric hospital Gregorio Pacheco. Michael is now 30 years old.

During all this time, Josefina sometimes had the feeling that Michael was doing better, so that it would be possible for him to go back home. But it didn’t happen. Josefina barely had enough resources to support herself. She wouldn’t have been able to feed her son and pay for his medication. That’s why Michael stayed in the hospital.

In the institution, there is an invisible line that divides some patients from others. The first group will eventually get out of the hospital at some point. Their families still support them, have resources to pay for treatment, visit them and can support them once they are back home. They don’t wear clothes given away by charity. They wear glasses, read books to spend the long hours in the sun. They speak Spanish. They have well-kept, gap-free dentures and sometimes even wear orthodontics.

Then, there is the second group. In some cases they are allowed to go out to work in the laundry, copy shop, or the parking lot for a few Bolivians (Bolivia’s currency), with the promise of returning at dusk. Their families don’t come for visits, or they appear only once in a while, at Christmas, on Mother’s Day, for their birthday. In some cases, families went through experiences that were too intense to understand, or too discouraging. They would have to face the misery that they themselves can’t help the ones they love. People from this group usually don’t get out of the hospital for good, ever.

On many occasions I could feel the daily struggle between patient and family, both left to their own fate. In the monthly report of the psychiatrist I was reading about the consultation that the parents have with the doctor. All he was asking them is if the medications were well tolerated. “Yes, doctor, they only make her very thirsty.” or “He gets some sleep in the morning.” That’s it, usually there is nothing more and the consultation stops here.

Families try to comfort themselves, prefer to see their son or their sister in here, stable, with access to medicines. “He’s well taken care of.” “I see her happy.” they think. If they would only know how lonely their relative are. For them the family was the only social connection and it gave in, came crashing down.


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