So the last couple of weeks in La Paz were hectic. I did a surgery rotation with Dr. Galindo in the hospital, explored La Paz, met up with Gabriel and Maria who came over for the weekend from Santa Cruz, and spent my last night in La Paz drinking coca liquer and $2 mojitos on a latin night at a bar. There was also anticucho, pastries, and a lecture on anorexia and bulimia that was involved. All in all, a successful night and a successful trip.
Now that I am back in the states, at sea level, I have tons of energy. It's like a persistent natural high that lasts about 2-3 days i think.
It's nice to be back home, where you don't feel stupid reasking what someone said and where things are familiar and you know how to approach each situation. For the same reason, coming home is anticlimatic because nothing is so new anymore. Life becomes easier and with that, the constant excitement of basic daily living is lost. I miss the streets, the constant Spanish, and my host family. I also miss the lack of insects in La Paz. I've encountered a multitude of spiders and flies already, as well as an oppossum (or a raccoon) that was roaming around our front yard last night. Oh yeah, and the sound of crickets and frogs at night...ahhh, florida.
I am SO glad I have another month of vacation left. EEK!!! =D
Monday, July 18, 2011
Wednesday, July 6, 2011
El Alto otra vez
I made a big deal about wanting a full week at Hospital Los Andes with Dr. Gutierrez because I wanted to learn how to work with children, especially the crying children (apparently holding their hands down by force or tying them up in their sweater like a straight jacket works pretty well if you don’t mind going deaf while doing it). So, this week, Tuesday – Friday, I signed up to go back to El Alto. Except that when I got up at 6am on Tuesday, before dawn, I couldn’t make it out of bed. I needed to eat before ascending another 500m into the air, and the sight of food nauseated me. So I sent some texts to Cecilia and Gonzalo, hoping that they would receive them soon, and collapsed back into bed to sleep. I slept until noon, at lunch, read a while in bed, and then fell asleep again until 6pm. Got a light dinner, went back home, read a little, and was asleep by 10pm. Ahh, the adventurous life of a traveler…
This morning, after getting about 30 hours of sleep the day before, I felt energized. I ate a large breakfast full of peanut butter and Coca-cola and ran down the still deserted streets of La Paz to meet the doctor at 7:15am. Since I never got an answer neither from Gonzalo nor Cecilia, I was worried that they may not have ever received the message, thus never letting Dr. Gutierrez know that I wasn’t coming. Thus, she may have assumed I wasn’t coming the entire week and not meet me this morning on the steps of the church. Luckily, I was wrong on one of the points – Dr. Gutierrez did meet me on the steps but she never got the message that I wasn’t coming yesterday and she was worried that something happened. Even worse, a doctor at the hospital in El Alto told her he rode the micro with a gringuita, and Dr. Gutierrez had the horrible thought that I had disappeared somewhere in El Alto. Thankfully, it isn’t in the culture of Bolivians to worry too much, and today everything was okay.
We saw children from 9-12:30pm and examined everyone from newborn babies only 5 days old to 10 year olds. The older ones are much easier to check the throats of because they actually understand instructions of open your mouth and stick out your tongue, but the newborns are so much nicer because they can’t push you away with the tiny arms (muahaha). We saw a girl with scabies, many kids with gripe (flu), and a baby with a vaginal infection. I am getting really good at examining genitals, thanks to parents who never clean them.
This morning, after getting about 30 hours of sleep the day before, I felt energized. I ate a large breakfast full of peanut butter and Coca-cola and ran down the still deserted streets of La Paz to meet the doctor at 7:15am. Since I never got an answer neither from Gonzalo nor Cecilia, I was worried that they may not have ever received the message, thus never letting Dr. Gutierrez know that I wasn’t coming. Thus, she may have assumed I wasn’t coming the entire week and not meet me this morning on the steps of the church. Luckily, I was wrong on one of the points – Dr. Gutierrez did meet me on the steps but she never got the message that I wasn’t coming yesterday and she was worried that something happened. Even worse, a doctor at the hospital in El Alto told her he rode the micro with a gringuita, and Dr. Gutierrez had the horrible thought that I had disappeared somewhere in El Alto. Thankfully, it isn’t in the culture of Bolivians to worry too much, and today everything was okay.
We saw children from 9-12:30pm and examined everyone from newborn babies only 5 days old to 10 year olds. The older ones are much easier to check the throats of because they actually understand instructions of open your mouth and stick out your tongue, but the newborns are so much nicer because they can’t push you away with the tiny arms (muahaha). We saw a girl with scabies, many kids with gripe (flu), and a baby with a vaginal infection. I am getting really good at examining genitals, thanks to parents who never clean them.
Last day in servicio de adolescentes - i promise!
Since today is technically a holiday in CFHI world – the new students are doing orientation – instead of starting a new rotation, I went back, with Dr. Santivañez’s invitation (“What else would you be doing?” she asked me) to servicio de adolescentes. You guys are probably totally sick of hearing about this rotation but I kind of like it, so I will keep talking about it. Two things happened today:
1. I got to hold a child – like really, really hold it. Meaning, if I let go, it would fall and die. I had someone’s else life in my hands for a very long 5 minutes. The most surprising part was that I actually enjoyed it (it was a quiet child). She was pretty heavy in my arms, like holding a dog, and she sat in my arms silently, looking around with that unique child curiosity. Slowly, I’m coming around to thinking like my gender. Before, I wanted a child but only after it passed the toddler ages. Now I’m okay with a baby, but not with the giving birth part yet. One of these days…
2. Our homely, demure, donated instruments started failing us, one by one. First, the Doppler machine started wailing – it’s been wailing its low battery siren for the past few days now, but we had chosen to ignore it, until today, when it refused to do anything except wail in its piercing voice. I’m not sure which sound is worse, a crying baby or a crying Doppler machine. Both are eardrum-piercing and headache inducing after long-term exposure. Anyways, a patient later our BP machine did the same thing, except silently. So now we had patients coming in for prenatal checkups and we couldn’t check their BP nor their baby’s fetal heartbeats. Later, another doctor lent us a mini-doppler machine that turned out to not be able to pick up nada (nothing). It just statically sheeped (that’s not a word, I know) at us. Not to be deterred, the doctor continued to utilize the non-functioning mini-doppler machine on each patient that came on the prenatal visit, each time muttering that it’s useless. I’m pretty sure she kept up the charade specifically to make sure the patient didn’t feel as though they came for nothing.
At the end of the day, a girl came in who wanted an IUD put in but the clinic had run out, so Dr. Santivañez told her to come back Thursday instead. On my way out, I glanced at the trashcan – it still had the smeared blood on it from last Thursday. I think the doctor noticed and called the janitor woman. When the doctor questioned why the janitor woman wasn’t wearing gloves, she mentioned that they had none (or had run out).
Other than all of that, things went pretty smoothly.
1. I got to hold a child – like really, really hold it. Meaning, if I let go, it would fall and die. I had someone’s else life in my hands for a very long 5 minutes. The most surprising part was that I actually enjoyed it (it was a quiet child). She was pretty heavy in my arms, like holding a dog, and she sat in my arms silently, looking around with that unique child curiosity. Slowly, I’m coming around to thinking like my gender. Before, I wanted a child but only after it passed the toddler ages. Now I’m okay with a baby, but not with the giving birth part yet. One of these days…
2. Our homely, demure, donated instruments started failing us, one by one. First, the Doppler machine started wailing – it’s been wailing its low battery siren for the past few days now, but we had chosen to ignore it, until today, when it refused to do anything except wail in its piercing voice. I’m not sure which sound is worse, a crying baby or a crying Doppler machine. Both are eardrum-piercing and headache inducing after long-term exposure. Anyways, a patient later our BP machine did the same thing, except silently. So now we had patients coming in for prenatal checkups and we couldn’t check their BP nor their baby’s fetal heartbeats. Later, another doctor lent us a mini-doppler machine that turned out to not be able to pick up nada (nothing). It just statically sheeped (that’s not a word, I know) at us. Not to be deterred, the doctor continued to utilize the non-functioning mini-doppler machine on each patient that came on the prenatal visit, each time muttering that it’s useless. I’m pretty sure she kept up the charade specifically to make sure the patient didn’t feel as though they came for nothing.
At the end of the day, a girl came in who wanted an IUD put in but the clinic had run out, so Dr. Santivañez told her to come back Thursday instead. On my way out, I glanced at the trashcan – it still had the smeared blood on it from last Thursday. I think the doctor noticed and called the janitor woman. When the doctor questioned why the janitor woman wasn’t wearing gloves, she mentioned that they had none (or had run out).
Other than all of that, things went pretty smoothly.
Madre y Hija
Sunday I went to see another movie at the cinemateca boliviana, basically the La Paz version of the Hippodrome or the Gene Siskel Film Center. And since I have a little more time on my hands here than at home, I can finally take advantage of it. Madre y Hija (Mother and Daughter) is the latest of Iñarritu’s films, who also filmed Crash and Babel. The movie is mainly about abortion and how it affects people’s lives. It’s hard to talk about the movie without giving away the outcomes of the stories, but basically it follows different women through their lives and how their lives are affected by abortion. The thesis of the movie is that abortion is unnatural and created by society. I found it a pretty interesting point of view, first because I am a big fan of the movie Juno (it was one of the first movies in a while showing that life doesn’t end if you make a mistake) and secondly because I just finished a week working in Servicio de adolescentes with pregnant women. The movie follows a middle aged woman who gave up her daughter for adoption when she had her at age 14 and has never stopped thinking about her since, a 37 year old woman who was given up for adoption and thus never wants to have kids, a woman who can’t have kids but wants a child very badly, and a 20 year old girl who is pregnant with a child and wants to give it up for adoption. In almost all the cases, the supporting characters are against the adoption, maintaining the opinion that giving up a living thing that you bred inside of your body for 9 months is completely against our nature and that the baby is always better off with their birth mother. If the woman can’t have kids, then it just wasn’t meant to be. The movie obviously has a twist at the end and doesn’t maintain a black/white opinion on the subject by the end, but I thought it was a thought-provoking subject. Lately, with movies like Juno and documentaries on international adoptions, we see the many happy couples who are finally able to love a child of their own, and the conservative’s opinion on how adoption is better than abortion because a live is saved, but I haven’t seen as much media portrayal of the other side, of the mother who gives up her child for the rest of her life, making a decision that may later cost her years of her child’s life. Maybe in some cases, abortion may be a better option than adoption for the mother’s psyche, because then she has less time to get attached to the child while it’s in her womb.
Obviously, each case is different and what’s the best decision for one woman may not be the best for another woman, and to say that adoption (or even abortion) is always a good choice or a bad choice is juvenile and inconsiderate. Nevertheless, I appreciate it when someone creates a film, a book, or even a song about an intimate and powerful subject that causes people to re-evaluate their own beliefs, even if they don’t end up changing them.
Regarding Bolivia, abortion is pretty much illegal here except for special circumstances when the mother’s life is in danger. Almost every patient I have seen, no matter what age (I haven’t seen any girls younger than 16), whether or not they are married or with someone, choose to have the baby and keep it. Abortion or adoption doesn’t really seem to even be brought up in discussion. There are obviously other debatable issues that surface, since many of these babies end up living in poverty either because their mothers never finished high school or because it’s her 5th child and she can’t feed that many children. Is it better to live in poverty and be beaten by your alcoholic stepfather or not live at all? Is it better to be adopted into a nice family or to live in a slum with your birth mother? And of course, there are all those lovely gray areas in between where we must accept that we don’t really know how a child’s life will turn out based on only one decision – we can only guess and hope that we can live with the decision we have made. After all this, all I can say for sure is that the women I see in clinic who decide to go back to school after having a child are some of the strongest that I have ever seen, and I hope they are the ones who improve the amount of opportunities that their children have with the amount that they have had.
Obviously, each case is different and what’s the best decision for one woman may not be the best for another woman, and to say that adoption (or even abortion) is always a good choice or a bad choice is juvenile and inconsiderate. Nevertheless, I appreciate it when someone creates a film, a book, or even a song about an intimate and powerful subject that causes people to re-evaluate their own beliefs, even if they don’t end up changing them.
Regarding Bolivia, abortion is pretty much illegal here except for special circumstances when the mother’s life is in danger. Almost every patient I have seen, no matter what age (I haven’t seen any girls younger than 16), whether or not they are married or with someone, choose to have the baby and keep it. Abortion or adoption doesn’t really seem to even be brought up in discussion. There are obviously other debatable issues that surface, since many of these babies end up living in poverty either because their mothers never finished high school or because it’s her 5th child and she can’t feed that many children. Is it better to live in poverty and be beaten by your alcoholic stepfather or not live at all? Is it better to be adopted into a nice family or to live in a slum with your birth mother? And of course, there are all those lovely gray areas in between where we must accept that we don’t really know how a child’s life will turn out based on only one decision – we can only guess and hope that we can live with the decision we have made. After all this, all I can say for sure is that the women I see in clinic who decide to go back to school after having a child are some of the strongest that I have ever seen, and I hope they are the ones who improve the amount of opportunities that their children have with the amount that they have had.
Why I will never be a photojournalist
Saturday, Annie, Manu, Jolene, Jenna, Hannah, and I went to the World Press Photo 2010 exhibit. I’m pretty sure the 2011 exhibit is floating somewhere around the U.S. right now but Bolivia just received the 2010 exhibit. It’s a cool compilation of the best photojournalism of the 2010 events. Since photojournalism is the other main thing that grasps my attention and interest as much as medicine, I was very excited. I think I may have even ended up as a photojournalist if it wasn’t for my inability to take photos in the face of tragedy and suffering. The photos at the exhibit featured the Pakistani floods, the Haiti earthquake, the wars in Mexico and DRC, as well as the torture of women in Afghanistan. The images were informative, powerful, and heart breaking. The most intense was of a male Haitian nurse literally flinging a dead body onto a pile of other rotting bodies. The photos are important because even if we can’t do anything about it, it doesn’t mean we have to be oblivious to the horrific things that happen in the world. Just by acknowledging that they exist, it puts my life into a different perspective.
I see a lot of similar images of poverty in Bolivia. I would love to take a photo of the 18 year old mother who looks 15 years older than her age, of the cholitas and their goods in a multitude of colors that attempt to obscure the poverty, and the 16 year old girl with the smoothest skin and the darkest eyes who walks on the side of the road alone, with cut up wrists. I want others to see it as I see it and if not do anything about it, to at least be cognizant of the fact that these people exist somewhere, leading the same 24 hour days as us, with the same emotions. But something inside me won’t let me dare take out my camera – it’s not that I don’t want to stand out (as if I don’t stand out already) but more of how the camera will change my relationship to these people and these places. I change my place as a silent observer to an active intruder on their lives, and with a camera I run the risk of objectifying them.
I am not saying that photojournalism objectifies its subjects or that it shouldn’t exist. On the contrary, I admire the people who can do it as a profession and I wish I could do the same. For a while I thought I would grow out of it, that maybe on this trip I would feel more comfortable taking pictures but today, standing alone in El Alto waiting for a micro to go back home, I saw two Aymara women in their colorful skirts and shawls and braided hair selling oranges on the side of the street. It captures one of the main points in Bolivia and its large gap between the rich and the poor. Most poor Aymara women do just that – they are sellers of fruit, candy, food, spices, and even napkins on the ground of the street. I wanted to take a photo to show everyone else what I see everyday, but instead I just stared and stared, imprinting the image in my mind for later recall.
I always come back from trips with the worst pictures because my pictures are of landscape and empty streets while my stories are of the people and their daily lives. A great photojournalist creates a complete idea through photo and words. I will never be that photojournalist.
I see a lot of similar images of poverty in Bolivia. I would love to take a photo of the 18 year old mother who looks 15 years older than her age, of the cholitas and their goods in a multitude of colors that attempt to obscure the poverty, and the 16 year old girl with the smoothest skin and the darkest eyes who walks on the side of the road alone, with cut up wrists. I want others to see it as I see it and if not do anything about it, to at least be cognizant of the fact that these people exist somewhere, leading the same 24 hour days as us, with the same emotions. But something inside me won’t let me dare take out my camera – it’s not that I don’t want to stand out (as if I don’t stand out already) but more of how the camera will change my relationship to these people and these places. I change my place as a silent observer to an active intruder on their lives, and with a camera I run the risk of objectifying them.
I am not saying that photojournalism objectifies its subjects or that it shouldn’t exist. On the contrary, I admire the people who can do it as a profession and I wish I could do the same. For a while I thought I would grow out of it, that maybe on this trip I would feel more comfortable taking pictures but today, standing alone in El Alto waiting for a micro to go back home, I saw two Aymara women in their colorful skirts and shawls and braided hair selling oranges on the side of the street. It captures one of the main points in Bolivia and its large gap between the rich and the poor. Most poor Aymara women do just that – they are sellers of fruit, candy, food, spices, and even napkins on the ground of the street. I wanted to take a photo to show everyone else what I see everyday, but instead I just stared and stared, imprinting the image in my mind for later recall.
I always come back from trips with the worst pictures because my pictures are of landscape and empty streets while my stories are of the people and their daily lives. A great photojournalist creates a complete idea through photo and words. I will never be that photojournalist.
Friday - cozy day
Despite the time I went to sleep, I had to get up at 7am. It was less brutal than I expected. Plus, at the end I got coffee with the doctora. Then Annie and I came home for lunch and Isabel and Rodrigo (her bf) offered us coffee and cake. Two cups of real coffee in one day! Afterwards, Annie, Manu, and I watched “Atonement” on Manu’s computer. It was drizzling outside so we bundled up in our warmest socks, turned on the electric heater, and watched the movie. Then, Annie and Nathan wanted to get ceviche (marinated seafood – a Bolivian/Peruvian specialty) so Manu and I went back to the Thai place to try out some more dishes. Afterwards, I met everyone else at the Irish Pub for the Bolivian vs. Argentina soccer game, the first game of the Latin American Cup. It ended in a tie, 1:1. I obviously cheered for Bolivia but it was hard to ignore that the Argentinians played better. Bolivia had a great defense but the ball was mostly in Argentina’s possession throughout the game. Afterwards, we said goodbye to the people leaving Sat. morning which was most of them and then went home to our cozy beds.
Everything you ever wanted to know about coca leaves (not really...btw)
Sophie, Hannah, a girl from Cologne, Germany who just started a 2 month internship in La Paz, and I went to the Coca museum. It was tiny but packed in a lot of information. Here’s what I learned:
1. Coca leaves are native to Bolivia, Peru, Colombia, and Brazil. They grow in warm climates (like las yungas) but can grow in different altitudes so usually in order to breed diversity in the plant, they are grown on step-like terraces in the mountains. That’s pretty clever.
2. Coca leaves actually contain the cocaine molecule, as well as two other cocaine molecule derivatives in smaller quantities. Although its not concentrated in the coca leaf, that’s why the effects of the leaves are weaker versions of the cocaine’s effects.
3. The leaves, especially when chewed, act as an anesthetic, a pain reliever, a stimulant, and as a strong hunger suppressant. For a while, they were traded as money and its use was promoted among the slaves because it allowed them to work longer with less food.
4. Coca extract was used in Coca-cola (hence the name) until it was deemed too dangerous to health by some people. Apparently, a coca-enhanced wine was introduced in Europe first and was very popular among the elite. However, because of prohibition in the United States, the inventor had to create a non-alcoholic drink and came up with Coca-cola. Proof that suppression does indeed bread creativity.
5. The United Nations has listed coca leaves as the cause of poverty in Latin America, especially Bolivia. (I still haven’t figured out this one…)
6. About 92% of men and 82% of women in rural Bolivia chew coca leaves
7. The museum showed all the steps that are taken to make cocaine out of coca leaves. Cocaine ends up containing ammonia, sulfuric acid, as well as other chemicals that I cannot remember. Apparently, synthesizing cocaine exposes the workers to a lot of toxic chemicals and is detrimental to their health. I doubt the drug lords are the ones making the white powder.
8. The majority of the cocaine is exported to, of course, the United States
9. Coca leaves remind me of green tea, for its color, slightly bitter taste, and its ability to be used as a flavor in everything. Coca drinks/foods that I have tried:
- chewing coca leaves
- coca tea
- coca candy
- coca liquer
- coca smoothie
- coca cookies
*I’m on the lookout for coca-flavoured ice cream, it must exist somewhere, right?
After the coca museum, I went home to make myself look a little more presentable (I brushed my hair) and we all met up at a nice Thai restaurant for our last night together, since many had early Sat. morning flights. Silly, if you ask me. Don’t they know that the best way to NOT miss your flight is to never go to sleep and celebrate?
Anyways, we went to a very nice Thai restaurant to begin our night. At first glance at the menu, it looked expensive. 50B’s for a main plate?! Until we did the math and realized its about $8. My perception of what is cheap and expensive has been so warped by Bolivia that its going to be painful to come back to the States and have to pay $3 for a croissant. The restaurant and food was superb. There were 20 of us seated at one big, long table and everyone was in a jolly mood, downing cocktails and appetizers. After dinner, we caught the last 20 minutes of a happy hour in a café where we got 2x1 mojitos/caipirinhas for25B’s. (yup, that’s 12B’s, or $1.50 for each mojito). They weren’t the best mojitos ever, but they were drinkable. Then we went to Melangrina, a local dance bar. It was a non-descript place off a side street but inside it was decorated with maroon walls and Andean masks and textiles. There I tried Chuflay, which is Singani, the local clear liquor, with sprite. I liked it enough to buy 2 during the night. The music choice was eclectic but mostly Spanish and dancing was optional. Then, around midnight, the beating of African drums began. Five women and 5 men came out and performed African dances that were brought over by the slaves to Bolivia. The men beat the drums while the women danced and sang. It was pretty incredible. I wonder why most African-Americans in the U.S. don’t have similar dances and culture than the Africans that came over as slaves to the Caribbean or Latin America. They danced for about 20 minutes and then again at 3am. I was there for both performances…We walked home around 3:30am, when the streets were empty and quiet. This will be about the time I will have to catch a taxi for my flight home in two weeks.
1. Coca leaves are native to Bolivia, Peru, Colombia, and Brazil. They grow in warm climates (like las yungas) but can grow in different altitudes so usually in order to breed diversity in the plant, they are grown on step-like terraces in the mountains. That’s pretty clever.
2. Coca leaves actually contain the cocaine molecule, as well as two other cocaine molecule derivatives in smaller quantities. Although its not concentrated in the coca leaf, that’s why the effects of the leaves are weaker versions of the cocaine’s effects.
3. The leaves, especially when chewed, act as an anesthetic, a pain reliever, a stimulant, and as a strong hunger suppressant. For a while, they were traded as money and its use was promoted among the slaves because it allowed them to work longer with less food.
4. Coca extract was used in Coca-cola (hence the name) until it was deemed too dangerous to health by some people. Apparently, a coca-enhanced wine was introduced in Europe first and was very popular among the elite. However, because of prohibition in the United States, the inventor had to create a non-alcoholic drink and came up with Coca-cola. Proof that suppression does indeed bread creativity.
5. The United Nations has listed coca leaves as the cause of poverty in Latin America, especially Bolivia. (I still haven’t figured out this one…)
6. About 92% of men and 82% of women in rural Bolivia chew coca leaves
7. The museum showed all the steps that are taken to make cocaine out of coca leaves. Cocaine ends up containing ammonia, sulfuric acid, as well as other chemicals that I cannot remember. Apparently, synthesizing cocaine exposes the workers to a lot of toxic chemicals and is detrimental to their health. I doubt the drug lords are the ones making the white powder.
8. The majority of the cocaine is exported to, of course, the United States
9. Coca leaves remind me of green tea, for its color, slightly bitter taste, and its ability to be used as a flavor in everything. Coca drinks/foods that I have tried:
- chewing coca leaves
- coca tea
- coca candy
- coca liquer
- coca smoothie
- coca cookies
*I’m on the lookout for coca-flavoured ice cream, it must exist somewhere, right?
After the coca museum, I went home to make myself look a little more presentable (I brushed my hair) and we all met up at a nice Thai restaurant for our last night together, since many had early Sat. morning flights. Silly, if you ask me. Don’t they know that the best way to NOT miss your flight is to never go to sleep and celebrate?
Anyways, we went to a very nice Thai restaurant to begin our night. At first glance at the menu, it looked expensive. 50B’s for a main plate?! Until we did the math and realized its about $8. My perception of what is cheap and expensive has been so warped by Bolivia that its going to be painful to come back to the States and have to pay $3 for a croissant. The restaurant and food was superb. There were 20 of us seated at one big, long table and everyone was in a jolly mood, downing cocktails and appetizers. After dinner, we caught the last 20 minutes of a happy hour in a café where we got 2x1 mojitos/caipirinhas for25B’s. (yup, that’s 12B’s, or $1.50 for each mojito). They weren’t the best mojitos ever, but they were drinkable. Then we went to Melangrina, a local dance bar. It was a non-descript place off a side street but inside it was decorated with maroon walls and Andean masks and textiles. There I tried Chuflay, which is Singani, the local clear liquor, with sprite. I liked it enough to buy 2 during the night. The music choice was eclectic but mostly Spanish and dancing was optional. Then, around midnight, the beating of African drums began. Five women and 5 men came out and performed African dances that were brought over by the slaves to Bolivia. The men beat the drums while the women danced and sang. It was pretty incredible. I wonder why most African-Americans in the U.S. don’t have similar dances and culture than the Africans that came over as slaves to the Caribbean or Latin America. They danced for about 20 minutes and then again at 3am. I was there for both performances…We walked home around 3:30am, when the streets were empty and quiet. This will be about the time I will have to catch a taxi for my flight home in two weeks.
The fun part of the week - Part 1
So, I’ve described servicio de adolescents to everyone in excruciating detail, probably because it has been my favorite rotation so far, but I did other things that week besides medicine, I promise. We had no Spanish classes this week to I had the chance to go out and explore La Paz.
On Monday, I took a long nap after almuerzo and then went to Cecilia’s office for our meeting on malnutrition. It’s a big problem in Bolivia, and all pediatricians make sure to check for it at each checkup. Apparently, it wasn’t until recently that South America made its own growth chart for kids. Before, they had been using the one made by the United States and had a huge amount of kids who were malnourished and below the normal growth curve. Some smart people finally spoke up and said, hey, Bolivians in general are smaller than Americans so maybe we should make our own standards instead of using someone elses. So now they have their own standard growth curves which reduced the amount of malnourished children just by reducing misclassification, but the numbers are unfortunately still high. In Bolivia, most of the malnutrition comes from lack of enough calories, more so than lack of protein, and the reason for that comes mainly from poverty. Like most things in Bolivia, the poverty is not as obvious as you might imagine (or at least its not to me) but once in a while, you’ll see a patient that comes in and says that all they eat everyday is bread and water or a patient who comes to you in sandals with her feet wrapped in toilet paper because she doesn’t have shoes for the winter. At those points, poverty stands right in front of you and you can’t help but pay attention.
At times like these, I feel medicine can only do so much. This is when international public health workers, engineers, architects, and social workers can do more good internationally than a doctor can. Medicine can only fix so much and much too often, it only ends up being a temporary cure.
Tuesday, Sophie, Annie and I spent the afternoon working on our lovely “Lactancia” poster for Wed’s health fair. When Sophie came over, she said our flat looked “very posh” – apparently its more spacious and warmer than hers. I definitely lucked out with my host family here. For dinner, we met Jolene and Jenna for anticucho, beef heart that is grilled to tenderness and served with potatoes and a spicy aji sauce. Even though I’m not a fan of meat (except for ground beef of course), I thought it was quite delicious.
Wednesday, Sophie, Annie, and I decided to go visit the National Museum of Art. It was located east of El Prado in the financial district of La Paz (or so it seemed to me) and it was interesting to see a different side of La Paz for once. It was a well organized museum and spanned early colonial art to contemporary abstract art. I think prehistoric art has its own museum which I have yet to see. It was very cool to see the art because the themes (religion, portraits, landscapes) were the same as for European art of the same period, but the technique was distinctly different. In one sala, they portrayed religious figures with actual wings, and there was a few paintings where there were 3 jesuses, which apparently is called El Gran Poder (the Great Power) here. Obviously, indigenous faiths got incorporated into Catholicism and created a distinct Bolivian Christianity. All in all, a pretty cool museum. Afterwards, we had a meeting with Gonzalo and we had to make it across the city in 15 minutes. We tried to take a micro there but got stuck in paralyzing traffic and ended up walking the rest of the way. After the meeting where we got money for taxis to take to the airport (not me – I’m staying 2 more weeks!), we went to our empanada place for dinner. Lauren and Siobhan, two girls from the program who went to this place for dinner everyday, wanted a picture with the owner Fernando. At first, he seemed embarrassed by the request but then he went to the back, put on his jacket, and asked for a picture with his camera as well. Afterwards, he requested a picture of just him and Lauren and then just a picture of Lauren by herself. The next day, he befriended her on facebook. It was pretty hilarious and at that point, we were all cracking up uncontrollably. I’m not sure I’ll be able to go back to that empanada place for the remainder of my time in La Paz and keep a straight face. Thanks Lauren.
On Monday, I took a long nap after almuerzo and then went to Cecilia’s office for our meeting on malnutrition. It’s a big problem in Bolivia, and all pediatricians make sure to check for it at each checkup. Apparently, it wasn’t until recently that South America made its own growth chart for kids. Before, they had been using the one made by the United States and had a huge amount of kids who were malnourished and below the normal growth curve. Some smart people finally spoke up and said, hey, Bolivians in general are smaller than Americans so maybe we should make our own standards instead of using someone elses. So now they have their own standard growth curves which reduced the amount of malnourished children just by reducing misclassification, but the numbers are unfortunately still high. In Bolivia, most of the malnutrition comes from lack of enough calories, more so than lack of protein, and the reason for that comes mainly from poverty. Like most things in Bolivia, the poverty is not as obvious as you might imagine (or at least its not to me) but once in a while, you’ll see a patient that comes in and says that all they eat everyday is bread and water or a patient who comes to you in sandals with her feet wrapped in toilet paper because she doesn’t have shoes for the winter. At those points, poverty stands right in front of you and you can’t help but pay attention.
At times like these, I feel medicine can only do so much. This is when international public health workers, engineers, architects, and social workers can do more good internationally than a doctor can. Medicine can only fix so much and much too often, it only ends up being a temporary cure.
Tuesday, Sophie, Annie and I spent the afternoon working on our lovely “Lactancia” poster for Wed’s health fair. When Sophie came over, she said our flat looked “very posh” – apparently its more spacious and warmer than hers. I definitely lucked out with my host family here. For dinner, we met Jolene and Jenna for anticucho, beef heart that is grilled to tenderness and served with potatoes and a spicy aji sauce. Even though I’m not a fan of meat (except for ground beef of course), I thought it was quite delicious.
Wednesday, Sophie, Annie, and I decided to go visit the National Museum of Art. It was located east of El Prado in the financial district of La Paz (or so it seemed to me) and it was interesting to see a different side of La Paz for once. It was a well organized museum and spanned early colonial art to contemporary abstract art. I think prehistoric art has its own museum which I have yet to see. It was very cool to see the art because the themes (religion, portraits, landscapes) were the same as for European art of the same period, but the technique was distinctly different. In one sala, they portrayed religious figures with actual wings, and there was a few paintings where there were 3 jesuses, which apparently is called El Gran Poder (the Great Power) here. Obviously, indigenous faiths got incorporated into Catholicism and created a distinct Bolivian Christianity. All in all, a pretty cool museum. Afterwards, we had a meeting with Gonzalo and we had to make it across the city in 15 minutes. We tried to take a micro there but got stuck in paralyzing traffic and ended up walking the rest of the way. After the meeting where we got money for taxis to take to the airport (not me – I’m staying 2 more weeks!), we went to our empanada place for dinner. Lauren and Siobhan, two girls from the program who went to this place for dinner everyday, wanted a picture with the owner Fernando. At first, he seemed embarrassed by the request but then he went to the back, put on his jacket, and asked for a picture with his camera as well. Afterwards, he requested a picture of just him and Lauren and then just a picture of Lauren by herself. The next day, he befriended her on facebook. It was pretty hilarious and at that point, we were all cracking up uncontrollably. I’m not sure I’ll be able to go back to that empanada place for the remainder of my time in La Paz and keep a straight face. Thanks Lauren.
Servicio de Adolescentes - Day 5
Friday was a slow day – when we asked why there were fewer patients, Dr. Santivañez told us it was because of the cold. Today was a cloudy day in a place that rarely sees clouds, and as the houses rise on the slopes of the mountain, the temperature quickly drops. The past few days we’ve been wearing gloves to warm up our hands before touching the women’s bellies. I am very glad that at least my stethoscope isn’t metal, even though I am sure my hands are more freezing than metal could ever be. It’s a -1 point for my being human. We finished seeing patients early, around noon, and since this was our last day working with her, she invited us out for coffee. We happily agreed. Still in our white coats, we left the doors of the clinic and saw snow. SNOW! La Paz has a cool rainy season (summer) and a cool dry season (winter) when it doesn’t rain for months and clouds are non-existent. Although mornings and nights are cold, it rarely gets below freezing except in El Alto and during the day, the sun is strong enough to warm everybody up. I’ve acquired quite a bit of freckles since coming here… So, obviously no one was expecting snow. It fell slowly, in thick snowflakes, like it does in those magical nights in movies, except that it was in the middle of the day, it melted as soon as it reached the ground, and cholitas still passed by in the street in skirts and shawls, shivering. Our friends who had rotations down in central (i.e. lower) La Paz on the other hand, had not seen any snow, although they did say it rained for a while.
We ran across the street to a tiny open window in a wall of a building and asked for 4 cups of hot coffee. We huddled over the tiny awning and shivered. Then, the window closed, and the door opened. “Pasen, pasen” said the owner and ushered us inside the cluttered shop to a small table in the back. The room was packed to the ceiling with STUFF (newspapers, boxes, posters, broken appliances, etc), similar to severe hoarder’s house, to the point where only a tiny path was cut out that led from the entrance to the table and to the kitchen and sleeping quarters of the elderly couple that ran the shop. They brewed real coffee from Las Yungas and also brought out cheese and tomato sandwiches. Those were some of the coziest minutes of my life. This is exactly what makes traveling worth it. These are the moments that make up for the long, uncomfortable flights, the upset stomachs, and the constant awkwardness of being a foreigner and speaking in a foreign language. A steaming cup of sweet, strong black coffee inside a tiny shop in the middle of a non-descriptive neighborhood is more memorable than any cathedral or museum that I may see while traveling. As in all of life, it’s the little things that matter most.
We ran across the street to a tiny open window in a wall of a building and asked for 4 cups of hot coffee. We huddled over the tiny awning and shivered. Then, the window closed, and the door opened. “Pasen, pasen” said the owner and ushered us inside the cluttered shop to a small table in the back. The room was packed to the ceiling with STUFF (newspapers, boxes, posters, broken appliances, etc), similar to severe hoarder’s house, to the point where only a tiny path was cut out that led from the entrance to the table and to the kitchen and sleeping quarters of the elderly couple that ran the shop. They brewed real coffee from Las Yungas and also brought out cheese and tomato sandwiches. Those were some of the coziest minutes of my life. This is exactly what makes traveling worth it. These are the moments that make up for the long, uncomfortable flights, the upset stomachs, and the constant awkwardness of being a foreigner and speaking in a foreign language. A steaming cup of sweet, strong black coffee inside a tiny shop in the middle of a non-descriptive neighborhood is more memorable than any cathedral or museum that I may see while traveling. As in all of life, it’s the little things that matter most.
Servicio de Adolescentes - Day 4
Thursday was a hectic day because not only did the doctor have us do all the physical exams on prenatal checkups, but we also saw 3 pap smears and an IUD insertion. As I mentioned before, there was definitely a difference in hygienic standards. When she first inserted the IUD, she used a long metal rod that is usually only used to measure the length to the uterus for the IUD to also open up the cervix more because it was very tight. Then, she placed the instrument into a bucket with water (or some other solution?) that would eventually be washed and sterilized and used again. However, the IUD opened too early while she was inserting it, so she had to get a new IUD and repeat the procedure. To insert it again, she took the instrument out of the bucket, sprayed some alcohol on it to disinfect it, and inserted it back into the woman. It all looked very painful but the woman did not wince even once.
IUD’s are pretty popular here as a method of contraception, probably because of its efficacy and low maintenance. I wonder how often pelvic infections occur though. I guess it’s better than no contraception at all. A lot of the women here are distrustful of hormone contraceptive methods because they believe its carcinogenic or cause awful unknown side effects. It’s hard to persuade a woman that these methods are safe, especially when their family (most importantly mothers) say the opposite. Many women choose to listen to their mothers instead of the doctors and when the opinions oppose each other, it’s difficult to decide what is best for the woman.
IUD’s are pretty popular here as a method of contraception, probably because of its efficacy and low maintenance. I wonder how often pelvic infections occur though. I guess it’s better than no contraception at all. A lot of the women here are distrustful of hormone contraceptive methods because they believe its carcinogenic or cause awful unknown side effects. It’s hard to persuade a woman that these methods are safe, especially when their family (most importantly mothers) say the opposite. Many women choose to listen to their mothers instead of the doctors and when the opinions oppose each other, it’s difficult to decide what is best for the woman.
Servicio de Adolescentes - Day 3
Wednesday there was no consultorio because the clinic was holding a health fair. Annie, Sophie, and I prepared a poster and an explanation on breastfeeding (preparation, how to breastfeed, and what to do if breastfeeding becomes painful). I told you I am learning a lot. We worked on the poster most of Tuesday afternoon. The health fair itself was composed of 3 tents and held right outside the clinic, on the street. We were not welcomed by all the busses and micros that had to pass through a throng of people without running someone over. In true Bolivian fashion, at 9am when the fair was supposed to start, we were only beginning to set up the tents. It took about 30 minutes with a few failures where a tent actually collapses (luckily no one got hurt) but eventually, we managed to make ourselves look presentable. The 1st tent focused on the health risks involved with pregnancy, the 2nd tent measured weight, height, BP, and blood sugar, and the 3rd tent was composed of the posters of the Young Leaders on HIV/AIDS, violence, and contraception, and us 3, with our poster on breastfeeding. Annie was the artist and drew some very nice boobs. In order to keep it classy, we kept the drawings in black and white. Throughout the day, curious cholitas would stop by on their way and ask someone what this was all about. I might be feeling sentimental, but it gave the entire fair a very neighborhood feel. Lots of young women and couples came out (almost all were of indigenous descent whether they wore the traditional clothing or not) and I think it was truly educational for many. One girl learned about the IUD option at the fair and came by the clinic the next day to talk to the doctor about it. I noticed that a few mothers who came by our poster were actually grateful for our presentation, and it felt empowering when a young mother asked why her baby cries in the middle of breastfeeding and we were actually able to give her an answer and what she could do about it.
There was also another couple that came by and after we gave the speech to the expecting mother, the guy wanted a picture with us. I don’t particularly like it when men want their pictures taken with other women in front of their wife or girlfriend, so after the photo I asked him the take a picture of us with the expecting mother. The guy (and the girl) were both surprised, but he obliged.
Around noon, the fair was supposed to finish but there was still ton of people there, so a doctor came by to ask us if we wanted her to get us sandwiches. We were starving so we said yes. Yup, I am at the point of eating egg sandwiches with tomatoes off the streets now. Later, the same woman came by with a 2L bottle of Coca-cola and a small, used, clear plastic cup. “Do you want some to drink?” the doctor asked us. Annie: “I don’t have a cup though”. The doctor looked at her with a weird look and held out the used cup “Here, I have one”, as if it was obvious. We shared the cup of Coke between the three of us and then she moved on to the next group to offer them some Coke from the same cup. I think my immune defenses are getting stronger each day.
At the end of the day, when all the tents were packed up, the only trace of the health fair were the numerous opened condom wrappers and “used” condoms that littered a 3 meter long portion of the sidewalk. Imagine what a passerby might think if they walked past the sidewalk in the afternoon…
There was also another couple that came by and after we gave the speech to the expecting mother, the guy wanted a picture with us. I don’t particularly like it when men want their pictures taken with other women in front of their wife or girlfriend, so after the photo I asked him the take a picture of us with the expecting mother. The guy (and the girl) were both surprised, but he obliged.
Around noon, the fair was supposed to finish but there was still ton of people there, so a doctor came by to ask us if we wanted her to get us sandwiches. We were starving so we said yes. Yup, I am at the point of eating egg sandwiches with tomatoes off the streets now. Later, the same woman came by with a 2L bottle of Coca-cola and a small, used, clear plastic cup. “Do you want some to drink?” the doctor asked us. Annie: “I don’t have a cup though”. The doctor looked at her with a weird look and held out the used cup “Here, I have one”, as if it was obvious. We shared the cup of Coke between the three of us and then she moved on to the next group to offer them some Coke from the same cup. I think my immune defenses are getting stronger each day.
At the end of the day, when all the tents were packed up, the only trace of the health fair were the numerous opened condom wrappers and “used” condoms that littered a 3 meter long portion of the sidewalk. Imagine what a passerby might think if they walked past the sidewalk in the afternoon…
Servicio de Adolescentes - Day 2
Today was much of the same, except that we were given more of the responsibility in the physical exam. We saw many more pregnant women and we had to take their blood pressure, measure the height of their belly, find out where the back and the head of the baby was, and listen to the placenta and heartbeat with the little Doppler machine. Since there are so many patients to see everyday, and the doctor spends as much time as she needs with each one of them, we usually finish around 1:30-2pm, much later than many of the other rotations. But I realized that I don’t mind – I really like working with these women. This rotation is a good combination of learning, practicing, and listening to the patients stories. Some are heartbreaking and others are hopeful – most make you want to smile encouragingly because you hear they have been through a lot but you want to encourage them to have the strength to keep going and not lose confidence in themselves.
One 21-year old girl came in and Dr. Santivañez spent about 30 minutes just talking with the girl, giving her advice on her life and encouraging her to continue school. When she was 16 years old, she became pregnant but she didn’t want to marry her boyfriend, so they broke up. Her family was super distraught, especially her older brother, but they decided to help her raise the child so she could finish up school and start a career. Right now, she has one year left of accounting school. But lately she has been dating another boy, and once she accidently spent the night with him and didn’t come home until morning and of course, her parents flipped out. I wasn’t sure of her housing situation at the moment, but apparently the issue was not resolved and she wasn’t on good speaking terms with the parents. Dr. Santivañez was sympathetic and walked her through the different options (she either move in with her new bf, or she reconcile with her parents and stay at home). She asked her of any good reason she has to move in with her boyfriend and said she recommended that she stay at home, with her family who obviously care a lot about her. She made sure to mention that whatever the girl chose (and that the ultimate decision is up to her because she is an adult), the doctor would not stop speaking to her so she could always come to her for help if she needed it. At the end, she asked about the new boyfriend. “Does he have a future, is he in school?”. The girl replied that he recently dropped out of school but intended to go back in the future. “What does he do now?”. The girl said he worked in a breadshop (un panadero). “A breadboy?! Do you really want a husband and father who is a breadboy?!” I almost laughed but I did think it got the point across. The girl is obviously intelligent and has a lot going for her as long as she doesn’t get tied up with a breadboy who’ll keep her down. This is how Dr.Santivañez is with all of her patients. Even though she has limited resources to work with, she never makes it known that she is in a rush to see all the patients.
Another reason that we get out late is because of inefficiency. Once, the doctor searched for a specific form around her entire disorganized office for 10 minutes muttering to herself about how “tengo que organizarlo” (I have to organize [the office]) while the patient sat in the room and waited.
The last patient of the day was a woman who had just given birth and had a particularly severe cut from childbirth – it was bloody and moist and the sheets on the examining table got stained with blood while she was examined. This is when hygiene habits really came into question. The ants – they don’t really bother anyone. To change sheets for each patient who uses them would be nice but seems also kind of wasteful. To not change the sheets when they are stained with a patient’s vaginal blood that’s where I draw the line. In terms of American germophobia, I am not very hygienic. I share my glass and drinks with others, I let people use my mascara when they need it, and if I am really hungry I am even willing to extend the 5-second rule to 10 seconds. I know I know, it all sounds gross and not proper, but I argue that it builds up my immune system. But bloody sheets?! Putting a microscope slide with a pap smear culture on the windowsill where the ants crawl all over it? Throwing bloody tissue into the garbage can and smearing it with blood in the process (and not cleaning it for days – it was still there this Monday)? That goes even beyond my lax hygienic standards.
Then again, who am I to criticize a facility that lacks so many resources. At first glance, it’s not very noticeable. Yeah, it looks a little run down and everything from the seats to the doors and the floor is an older version of what is seen in the U.S. But at first, the care seems adequate – they see all the patients, they prescribe them medicine, and have the materials to perform pap smears and IUD insertions. But the more time I spend there, the more I learn about how much they truly need and do not have. There is no heating in the entire building – the actual exam rooms have little electric heaters but the waiting room is absolutely freezing. Since windows are small, the rooms don’t really heat up as the sun rises. Because of that, on super cold days, many less patients show up for their appointments. Today, the doctora also told me that the instruments that we use (otoscope, BP machine, and the Doppler machine) were all donated by previous CFHI students. She had to control her emotions when Sophie accidently dropped the otoscope on the floor and for a minute we thought it was broken. The little black caps that go on the otoscope that we throw out after each use? - They have 3 of them and clean them with alcohol before each patient. Regardless, the clinic and Dr.Santivañez are a great resource to these patients. The doctor takes her time with each patient, asking them about their academic future, encouraging them to finish school, and makes sure they know all the facts about family planning. I never saw her rush a patient, even when we were running late on time.
One 21-year old girl came in and Dr. Santivañez spent about 30 minutes just talking with the girl, giving her advice on her life and encouraging her to continue school. When she was 16 years old, she became pregnant but she didn’t want to marry her boyfriend, so they broke up. Her family was super distraught, especially her older brother, but they decided to help her raise the child so she could finish up school and start a career. Right now, she has one year left of accounting school. But lately she has been dating another boy, and once she accidently spent the night with him and didn’t come home until morning and of course, her parents flipped out. I wasn’t sure of her housing situation at the moment, but apparently the issue was not resolved and she wasn’t on good speaking terms with the parents. Dr. Santivañez was sympathetic and walked her through the different options (she either move in with her new bf, or she reconcile with her parents and stay at home). She asked her of any good reason she has to move in with her boyfriend and said she recommended that she stay at home, with her family who obviously care a lot about her. She made sure to mention that whatever the girl chose (and that the ultimate decision is up to her because she is an adult), the doctor would not stop speaking to her so she could always come to her for help if she needed it. At the end, she asked about the new boyfriend. “Does he have a future, is he in school?”. The girl replied that he recently dropped out of school but intended to go back in the future. “What does he do now?”. The girl said he worked in a breadshop (un panadero). “A breadboy?! Do you really want a husband and father who is a breadboy?!” I almost laughed but I did think it got the point across. The girl is obviously intelligent and has a lot going for her as long as she doesn’t get tied up with a breadboy who’ll keep her down. This is how Dr.Santivañez is with all of her patients. Even though she has limited resources to work with, she never makes it known that she is in a rush to see all the patients.
Another reason that we get out late is because of inefficiency. Once, the doctor searched for a specific form around her entire disorganized office for 10 minutes muttering to herself about how “tengo que organizarlo” (I have to organize [the office]) while the patient sat in the room and waited.
The last patient of the day was a woman who had just given birth and had a particularly severe cut from childbirth – it was bloody and moist and the sheets on the examining table got stained with blood while she was examined. This is when hygiene habits really came into question. The ants – they don’t really bother anyone. To change sheets for each patient who uses them would be nice but seems also kind of wasteful. To not change the sheets when they are stained with a patient’s vaginal blood that’s where I draw the line. In terms of American germophobia, I am not very hygienic. I share my glass and drinks with others, I let people use my mascara when they need it, and if I am really hungry I am even willing to extend the 5-second rule to 10 seconds. I know I know, it all sounds gross and not proper, but I argue that it builds up my immune system. But bloody sheets?! Putting a microscope slide with a pap smear culture on the windowsill where the ants crawl all over it? Throwing bloody tissue into the garbage can and smearing it with blood in the process (and not cleaning it for days – it was still there this Monday)? That goes even beyond my lax hygienic standards.
Then again, who am I to criticize a facility that lacks so many resources. At first glance, it’s not very noticeable. Yeah, it looks a little run down and everything from the seats to the doors and the floor is an older version of what is seen in the U.S. But at first, the care seems adequate – they see all the patients, they prescribe them medicine, and have the materials to perform pap smears and IUD insertions. But the more time I spend there, the more I learn about how much they truly need and do not have. There is no heating in the entire building – the actual exam rooms have little electric heaters but the waiting room is absolutely freezing. Since windows are small, the rooms don’t really heat up as the sun rises. Because of that, on super cold days, many less patients show up for their appointments. Today, the doctora also told me that the instruments that we use (otoscope, BP machine, and the Doppler machine) were all donated by previous CFHI students. She had to control her emotions when Sophie accidently dropped the otoscope on the floor and for a minute we thought it was broken. The little black caps that go on the otoscope that we throw out after each use? - They have 3 of them and clean them with alcohol before each patient. Regardless, the clinic and Dr.Santivañez are a great resource to these patients. The doctor takes her time with each patient, asking them about their academic future, encouraging them to finish school, and makes sure they know all the facts about family planning. I never saw her rush a patient, even when we were running late on time.
Servicio de Adolescentes - Day 1
Today I started Servicio de Adolescentes. For the most part, the patients are adolescent mothers but there are also other adolescents that come in with whatever problem they have. To get to the clinic, I first walk for 30 minutes uphill to get to Hospital Obrero. From there, I wait for Dr. Santivañez, and then together we catch a micro to take us up to the northern neighborhoods of La Paz, where there is almost no such thing as a flat street. The clinic is located in Alto Miraflores, a north central neighborhood and most of the patients come from the surrounding neighborhood for their check ups. Apparently, in order to be able to get an appointment at a hospital, everyone must first go through their neighborhood clinic which then refers them to a nearby hospital. It’s a good idea to reduce clogging of the health systems but here, it definitely hasn’t eliminated the problem, probably of just the sheer need for doctors, time, and resources.
The clinic itself is very similar to the clinic I described in El Alto, except here I think they have a much better education program. They hold classes for young mothers and pregnant women on how to take care of their baby, themselves, and teach them different skills like knitting or sewing so the women can make goods and sell them to make a living. They also created a Young Leaders program where they take a 10-20 young adolescents from the neighborhood schools (13-16yrs) and put them through an educational program on adolescent health – everything from STD’s and AIDS to contraception and domestic violence. When the teenagers pass the program, they are certified Young Leaders in their community who can go out and teach others about what they have learned and participate in health fairs. It seems like a great idea – we got to meet the current Young Leaders and they were a really cool group. They knew about some things more than I did and they were mature enough to discuss sexual matters and female and male anatomy without breaking into fits of giggles. Although they did play a lot with the condoms that they were supposed to be using for demonstration.
Anyways, the room where Dr. Santivañez works is frigid, just like the one in el Alto. It has a desk, a filing cabinet, an exam table, and a small (dirty by our standards) bathroom where women can change into gowns. The walls are painted yellow so it is not difficult to notice the permanent line of ants that crawl in a line around the window every day.
Monday, we saw a lot of pregnant women who were all under 20 years of age. It always surprised me when I saw their age on the chart because my guess was always around 3 years too high. They all looked older however and some were pregnant with their 2nd child. The doctor was a great teacher, and the first day she taught us how to measure the height of the stomach, find the baby’s back and head by feeling the mother’s stomach, and listen to the baby’s heartbeat. Everything in children is different – and being in this high of altitude doesn’t help. Apparently, normal percentage of oxygen saturation here is around 88%, Hb numbers less than 14.5 is deemed as anemia, and the HR of a newborn is around 148. It makes me feel like I know nothing but I am also learning a lot because of that.
We also saw some women who had just given birth and we had to look at their wounds to make sure there was no infection and that they healed well. Some of their wounds were kind of gruesome and one girl couldn’t sit down because it hurt too much. I think the obstetricians made the cuts in order to prevent natural tearing but it still seemed barbaric and made me want to never give birth.
We saw a variety of patients – pregnant women, women who have just given birth, and women coming in for other problems. We saw a couple of which we suspected domestic violence because the woman was unhappy, shy, and refused to make decisions, deffering to her husband instead. Sometimes it seems to me that the single women I see seem happier than the married women. Maybe its because their family is more willing to help them out or because they at least feel they have some independence. It’s obviously too small a size sample to make conclusions and I know that this is not something that can be generalized – each case is unique. Our last patient was a 16 year old girl whose mother brought her in because of self-mutilation. She asked to speak to the doctor in private, so we were given most of the details afterwards by the doctor. She was really pretty and had a wonderful, joyful smile. The doctor said she wanted to refer the girl to a psychologist/psychiatrist but that the mother did not have the money to pay for one. Instead, she introduced the girl to the “Young Leaders” group and said she should get involved. Dr. Santivañez blamed the depression on the dysfunctional family, as she called it. According to her, parents try to control their adolescent too much, causing the child to rebel and desire all the things they are not allowed to do, leading to bad behavior and depression. Makes sense to me.
The clinic itself is very similar to the clinic I described in El Alto, except here I think they have a much better education program. They hold classes for young mothers and pregnant women on how to take care of their baby, themselves, and teach them different skills like knitting or sewing so the women can make goods and sell them to make a living. They also created a Young Leaders program where they take a 10-20 young adolescents from the neighborhood schools (13-16yrs) and put them through an educational program on adolescent health – everything from STD’s and AIDS to contraception and domestic violence. When the teenagers pass the program, they are certified Young Leaders in their community who can go out and teach others about what they have learned and participate in health fairs. It seems like a great idea – we got to meet the current Young Leaders and they were a really cool group. They knew about some things more than I did and they were mature enough to discuss sexual matters and female and male anatomy without breaking into fits of giggles. Although they did play a lot with the condoms that they were supposed to be using for demonstration.
Anyways, the room where Dr. Santivañez works is frigid, just like the one in el Alto. It has a desk, a filing cabinet, an exam table, and a small (dirty by our standards) bathroom where women can change into gowns. The walls are painted yellow so it is not difficult to notice the permanent line of ants that crawl in a line around the window every day.
Monday, we saw a lot of pregnant women who were all under 20 years of age. It always surprised me when I saw their age on the chart because my guess was always around 3 years too high. They all looked older however and some were pregnant with their 2nd child. The doctor was a great teacher, and the first day she taught us how to measure the height of the stomach, find the baby’s back and head by feeling the mother’s stomach, and listen to the baby’s heartbeat. Everything in children is different – and being in this high of altitude doesn’t help. Apparently, normal percentage of oxygen saturation here is around 88%, Hb numbers less than 14.5 is deemed as anemia, and the HR of a newborn is around 148. It makes me feel like I know nothing but I am also learning a lot because of that.
We also saw some women who had just given birth and we had to look at their wounds to make sure there was no infection and that they healed well. Some of their wounds were kind of gruesome and one girl couldn’t sit down because it hurt too much. I think the obstetricians made the cuts in order to prevent natural tearing but it still seemed barbaric and made me want to never give birth.
We saw a variety of patients – pregnant women, women who have just given birth, and women coming in for other problems. We saw a couple of which we suspected domestic violence because the woman was unhappy, shy, and refused to make decisions, deffering to her husband instead. Sometimes it seems to me that the single women I see seem happier than the married women. Maybe its because their family is more willing to help them out or because they at least feel they have some independence. It’s obviously too small a size sample to make conclusions and I know that this is not something that can be generalized – each case is unique. Our last patient was a 16 year old girl whose mother brought her in because of self-mutilation. She asked to speak to the doctor in private, so we were given most of the details afterwards by the doctor. She was really pretty and had a wonderful, joyful smile. The doctor said she wanted to refer the girl to a psychologist/psychiatrist but that the mother did not have the money to pay for one. Instead, she introduced the girl to the “Young Leaders” group and said she should get involved. Dr. Santivañez blamed the depression on the dysfunctional family, as she called it. According to her, parents try to control their adolescent too much, causing the child to rebel and desire all the things they are not allowed to do, leading to bad behavior and depression. Makes sense to me.
Sunday after Uyuni
Our bus left Uyuni at 7pm and arrived in La Paz around 6am. Since the road from Uyuni to Oruro isn’t paved (about a 3 hour bus ride) – we jumbled along, trying to sleep but being jolted awake with every pothole and giant rock that the busdriver couldn’t avoid on the road. I also got the seat next to the broken window that wouldn’t shut – with each jolt, it opened up just a little bit until it got so cold that it drew me out of my stage 2 sleep and I shut it. Halfway through the bus ride though, the heating was turned on, or at least it did for me. My feet became so warm then that I eventually threw off my blanket and relished the opened window for some cool air. Yup, they give you blankets on public overnight Bolivian busses. At first I was surprised, but I’m sure that if they didn’t, there would be news coverage of the people who lost fingers or toes to frostbite during the trip. It’s that cold.
We arrived home at 7am, I took a shower, and went to Alexander Café to spoil myself with some coffee and warm chocolate chip muffin. Everything is better when its warmed up. It was a pretty uneventful day – I tried to upload as many photos as possible and then later we walked around the city. I crashed pretty early that night.
We arrived home at 7am, I took a shower, and went to Alexander Café to spoil myself with some coffee and warm chocolate chip muffin. Everything is better when its warmed up. It was a pretty uneventful day – I tried to upload as many photos as possible and then later we walked around the city. I crashed pretty early that night.
Sunday, June 26, 2011
Salar de Uyuni
3 days. 7 people in a jeep. 1000's of kilometers covered. Driven on salt, lake (yes, literally on a lake), desert, snow, rock, and mountain. Sun-burned and frost-bitten in one day. Slept with 4 pairs of socks on. Slept on a bed made of salt surrounded by salt walls. Spent most of my money on bathrooms. Shared a bottle of wine under the stars. Saw the stars closer than ever before.
When I read of people who traveled in Bolivia before going myself, everyone mentioned that Salar de Uyuni was the best part of the entire trip. I was disappointed when I thought I wouldn't have the time to go, but we took advantage of the holidays and decided to go. There is absolutely nothing else like it on earth.
Part I - getting to Uyuni
We had to take the overnight bus there because its a 12 hour bus ride. We opted for the unheated, non-bathroom containing public buses because we saved 200 B's ($28) that way. It's a good thing that the bus wasn't full because multiple people had tickets for the same seat. But eventually, we all settled in with our snacks and blankets and after passing cans of cookies and pringles around, settled into sleep. Until 2am of course, when all of the sudden, the entire bus started vibrating and rattling due to the loss of a paved road from Oruro to Uyuni (the last 4 hours of the trip). Metal on metal clanged with abandon as we rode over a rocky dirt road, people's bags and bottles fell from the spaces above the seats and actually hit one of the girls sitting beside me on the face, causing her to bleed. We patched her up with the use of a flashlight while the bus continued to rattle, toss, and jump from the bumps in the road. It was one of those moments when the situation feels surreal and you ask yourself if this is really happening to you at 2am in the middle of nowhere in South America? Yup, it really is.
We arrived in Uyuni at 6:30am but they were kind and let us stay on the bus until 7:30am because it was below freezing outside and nothing was open. Eventually, we got off, found public bathrooms (the beginning of my loss of money due to my bladder) and eventually had breakfast where we fed the fire in the fireplace with empty egg cartons. Then, the trip began.
Part 2 - The salt flats
There were 18 of us altogether - some Cali kids came with us. Our jeep had our driver Efrain and 7 of us. We spent the morning driving on the salt flats, stopping to take pictures and marvel at how we stood on salt and its similarity to snow. We ate lunch at the bottom of Volcano Tunupa (i think) and then walked around the shore looking at wild flamingo's and llamas. Then we drove to an island that was full of giant-sized cacti and saw the sunset. On our way to our hostel made of salt, we ran into water. The last 20 minutes of our drive we drove completely in water - we wondered which was denser - the car with us or the salt water. Fortunately, we never found out. We spent the night in the salt hostel which was suprisingly warm. Salt is a great insulator apparently. The next morning, we had breakfast and started driving across the dusty, mountainous land. We saw various rock structures that reminded others of Arizona and then we got to the lagunas. The lagunas are full of minerals and because of that, look different colors depending on the mineral. We got to laguna colorada right before the sunset where we looked out to see the stars but where it was absolutely cold! This hostel wasn't made of salt, and even with 7 people in one room, we all froze. Fortunately, we didn't have to sleep long there because we got up before sunrise on Saturday to reach the geysers by sunrise. They smelled of sulfur but blew hot wind across the snowy desert. For a while afterwards, we drove in snow and dust in a region where it never rains, only snows, because of the altitude (4,500m). 4.5k is almost a 5k - imagine that distance but only upwards instead of forwards. We visited some hot springs, visited more lagunas with flamingos, and then drove through a national park to get back to Uyuni by 7pm to catch our bus back to La Paz. Driving through such unique nature expanses with no outside contact in the middle of nowhere to the beat of Bolivian dance techno music was surreal and a great experience. I don't regret missing sleep for this.
My descriptions don't do this place justice at all and I'm hoping my photos will at least give you a glimpse of these desolate places. They are jarring and inhospitable and also humbling and breath-taking.
Now I am back in La Paz and I think I will take the next 3 weeks to explore La Paz more and try some more Bolivian street food. I'm pretty exhausted of traveling every weekend so i am looking to some more downtime these next few weeks. Spanish classes are over and I plan to spend a few days a week at Alalay, an orphanage organization, and the other afternoons relaxing, writing, and exploring. Tomorrow I go to a clinic that specifically caters to pregnant adolescent women. I need sleeeeeeeep before then!
When I read of people who traveled in Bolivia before going myself, everyone mentioned that Salar de Uyuni was the best part of the entire trip. I was disappointed when I thought I wouldn't have the time to go, but we took advantage of the holidays and decided to go. There is absolutely nothing else like it on earth.
Part I - getting to Uyuni
We had to take the overnight bus there because its a 12 hour bus ride. We opted for the unheated, non-bathroom containing public buses because we saved 200 B's ($28) that way. It's a good thing that the bus wasn't full because multiple people had tickets for the same seat. But eventually, we all settled in with our snacks and blankets and after passing cans of cookies and pringles around, settled into sleep. Until 2am of course, when all of the sudden, the entire bus started vibrating and rattling due to the loss of a paved road from Oruro to Uyuni (the last 4 hours of the trip). Metal on metal clanged with abandon as we rode over a rocky dirt road, people's bags and bottles fell from the spaces above the seats and actually hit one of the girls sitting beside me on the face, causing her to bleed. We patched her up with the use of a flashlight while the bus continued to rattle, toss, and jump from the bumps in the road. It was one of those moments when the situation feels surreal and you ask yourself if this is really happening to you at 2am in the middle of nowhere in South America? Yup, it really is.
We arrived in Uyuni at 6:30am but they were kind and let us stay on the bus until 7:30am because it was below freezing outside and nothing was open. Eventually, we got off, found public bathrooms (the beginning of my loss of money due to my bladder) and eventually had breakfast where we fed the fire in the fireplace with empty egg cartons. Then, the trip began.
Part 2 - The salt flats
There were 18 of us altogether - some Cali kids came with us. Our jeep had our driver Efrain and 7 of us. We spent the morning driving on the salt flats, stopping to take pictures and marvel at how we stood on salt and its similarity to snow. We ate lunch at the bottom of Volcano Tunupa (i think) and then walked around the shore looking at wild flamingo's and llamas. Then we drove to an island that was full of giant-sized cacti and saw the sunset. On our way to our hostel made of salt, we ran into water. The last 20 minutes of our drive we drove completely in water - we wondered which was denser - the car with us or the salt water. Fortunately, we never found out. We spent the night in the salt hostel which was suprisingly warm. Salt is a great insulator apparently. The next morning, we had breakfast and started driving across the dusty, mountainous land. We saw various rock structures that reminded others of Arizona and then we got to the lagunas. The lagunas are full of minerals and because of that, look different colors depending on the mineral. We got to laguna colorada right before the sunset where we looked out to see the stars but where it was absolutely cold! This hostel wasn't made of salt, and even with 7 people in one room, we all froze. Fortunately, we didn't have to sleep long there because we got up before sunrise on Saturday to reach the geysers by sunrise. They smelled of sulfur but blew hot wind across the snowy desert. For a while afterwards, we drove in snow and dust in a region where it never rains, only snows, because of the altitude (4,500m). 4.5k is almost a 5k - imagine that distance but only upwards instead of forwards. We visited some hot springs, visited more lagunas with flamingos, and then drove through a national park to get back to Uyuni by 7pm to catch our bus back to La Paz. Driving through such unique nature expanses with no outside contact in the middle of nowhere to the beat of Bolivian dance techno music was surreal and a great experience. I don't regret missing sleep for this.
My descriptions don't do this place justice at all and I'm hoping my photos will at least give you a glimpse of these desolate places. They are jarring and inhospitable and also humbling and breath-taking.
Now I am back in La Paz and I think I will take the next 3 weeks to explore La Paz more and try some more Bolivian street food. I'm pretty exhausted of traveling every weekend so i am looking to some more downtime these next few weeks. Spanish classes are over and I plan to spend a few days a week at Alalay, an orphanage organization, and the other afternoons relaxing, writing, and exploring. Tomorrow I go to a clinic that specifically caters to pregnant adolescent women. I need sleeeeeeeep before then!
El Alto - Day 2
Tuesday was Aymara New Year and we went to see Los Viejos - an artsy Bolivian film. It was totally open-ended and we are still discussing the details of the story between us. Most of the cinematography was focused on reflections. When I told other people about it, everyone was surprised to learn that Bolivian has a movie industry. EVERY nation has a movie industry of some sort I'm sure (except maybe Papua New Guinea).
Anyways, the next day I got up at 6am again in order to get ready to go to El Alto. This time, Dr. Gutierrez met us and we took the micro up to the hospital. We noticed that the doctora did not feel well on the way up and I offered her some Excedrin as a fever reducer. She said she didn't have a headache but wanted to throw up. As she spilled the contents of her locker in the office and scrambled to pick everything up, she muttered: "demasiada cerveza" (too much beer). Knowing her personality and the way she looked, we actually debated whether she was drunk. She finally found two bottles of an infantile dosed anti-vomiting medication, took a syringe and left the room. She came back 5 minutes later rubbing her ass. One perk of being a doctor is the ability to treat yourself with medication when needed. Apparently, she seemed to have food poisoning. I don't know if I already described it, but her office is just one of the many doors that leads into a tiny room with a locker, exam table, a desk, and a sink that is rarely used. The 3 of us could not fit in there with the doctor and the patient so I volunteered to shadow Dr. Cecilia Uribe in another building instead, who sees the children/babies of mothers who are under the age of 25. I was surprised to hear that because most of the mothers I saw seemed much older than me. I'm not sure if it was because I knew they were mothers or because they truly look older. On the way to the hospital, I saw a woman who looked like a senior citizen but most likely was no older than 40. It reminded me of the photos of Afghan women I saw in National Geographic, where the captions of their age seemed unbelievable. Poverty truly takes a toll on a human.
Dr. Uribe had a young girl of 9 years of age who worked as her secretary, so we had a very efficient system going. I examined the children, Dr. Uribe talked to the mothers, and Rachel recorded everything down on paper and filed documents appropriately. I was there until 12:30pm and at the end, I was exhausted. We saw many newborns who still had their umbilican cords clipped. They are cuter than I thought.. Many of them cried and I felt bad when we had to ask the mother to hold the hands of the child while we forced their mouth open to look at the throat. I saw plenty of diarrhea and vomit. Furthermore, I found it interesting that whenever the mother complained that the child did not want breast milk or that it was painful to breast-feed, the doctor made them do it right there and taught them how to sit, what to do, and how to tap the baby's back afterwards. At one point, we had one mother breast-feeding, another feeding through a milk contraption because she was HIV-positive, and I was examining another baby and talking to the mother. The room was freezing for the entire time I was there and the only way I could keep my hands warm was to place them on the electric kettle that kept boiled water in the room.
Although I was tired, I really enjoyed the experience and want to come back to do another week of the rotation. On the way home, since we were cold, we stopped by to drink some api and share a bunuelo.
I got home and found everyone sitting around the dinner table, beginning their lunch. The lunch was delicious and very interesting. It was a bed of lettuce with potatoes, carrots, hard-boiled eggs, and broccoli on top all covered with a peanut sauce. Super strange but really delicious. I am also falling in love with quinoa - I can't wait to come home and make pastel de quinoa and quinoa con leche.
Here, you can buy juice or a hot milk drink with quinoa right on the street for less than a dollar. They give them to you in knotted plastic bags with a straw stuck through and you walk on the street with the plastic bag drinking. You must have to be masterful in order to pour liquid into a plastic bag without spilling it and then managing to tie it into a knot as well.
After lunch, I packed for our 4 day Salar de Uyuni trip. We planned to go to the bus station right after Spanish class to catch the 7pm overnight bus to Uyuni, start the excursion Thursday morning and finish Saturday evening just in time to catch the overnight bus back to La Paz. So I packed and ran to my Spanish class. I managed to distract our teacher from actual Spanish exercises for the entire 2 hours by asking her questions about Uyuni, Potosi, and history of Bolivia. She mentioned what has been glaring me in the face ever since I arrived in Bolivia. Bolivia is best described as a "beggar that sits on a pile of gold". Bolivia is the poorest South American nation by GDP yet contains one of the richest piles of minerals and natural resources - silver, gold, copper, lithium, zinc, salt, etc. The list could go on. Blame is put on the government with which Bolivia has been relatively unlucky. Government after government make stupid decisions and rules and slowly lose more and more of Bolivian land - Bolivia has lost land to Paraguay by signing a peace treaty when Bolivia was about to win because the king was drunk and did not know what was going on with his army, Bolivia has lost land full of a unique stone that is only found in a specific area to Brazil because the king lost a bet with the Brazilian king of the time, and Bolivia lost its access to the coast to Chile which is still a sore point for many Bolivians. And still, there are miles and miles of undeveloped land full of minerals that is absolutely gorgeous and unique. I can't wait to show you the pictures!
Anyways, the next day I got up at 6am again in order to get ready to go to El Alto. This time, Dr. Gutierrez met us and we took the micro up to the hospital. We noticed that the doctora did not feel well on the way up and I offered her some Excedrin as a fever reducer. She said she didn't have a headache but wanted to throw up. As she spilled the contents of her locker in the office and scrambled to pick everything up, she muttered: "demasiada cerveza" (too much beer). Knowing her personality and the way she looked, we actually debated whether she was drunk. She finally found two bottles of an infantile dosed anti-vomiting medication, took a syringe and left the room. She came back 5 minutes later rubbing her ass. One perk of being a doctor is the ability to treat yourself with medication when needed. Apparently, she seemed to have food poisoning. I don't know if I already described it, but her office is just one of the many doors that leads into a tiny room with a locker, exam table, a desk, and a sink that is rarely used. The 3 of us could not fit in there with the doctor and the patient so I volunteered to shadow Dr. Cecilia Uribe in another building instead, who sees the children/babies of mothers who are under the age of 25. I was surprised to hear that because most of the mothers I saw seemed much older than me. I'm not sure if it was because I knew they were mothers or because they truly look older. On the way to the hospital, I saw a woman who looked like a senior citizen but most likely was no older than 40. It reminded me of the photos of Afghan women I saw in National Geographic, where the captions of their age seemed unbelievable. Poverty truly takes a toll on a human.
Dr. Uribe had a young girl of 9 years of age who worked as her secretary, so we had a very efficient system going. I examined the children, Dr. Uribe talked to the mothers, and Rachel recorded everything down on paper and filed documents appropriately. I was there until 12:30pm and at the end, I was exhausted. We saw many newborns who still had their umbilican cords clipped. They are cuter than I thought.. Many of them cried and I felt bad when we had to ask the mother to hold the hands of the child while we forced their mouth open to look at the throat. I saw plenty of diarrhea and vomit. Furthermore, I found it interesting that whenever the mother complained that the child did not want breast milk or that it was painful to breast-feed, the doctor made them do it right there and taught them how to sit, what to do, and how to tap the baby's back afterwards. At one point, we had one mother breast-feeding, another feeding through a milk contraption because she was HIV-positive, and I was examining another baby and talking to the mother. The room was freezing for the entire time I was there and the only way I could keep my hands warm was to place them on the electric kettle that kept boiled water in the room.
Although I was tired, I really enjoyed the experience and want to come back to do another week of the rotation. On the way home, since we were cold, we stopped by to drink some api and share a bunuelo.
I got home and found everyone sitting around the dinner table, beginning their lunch. The lunch was delicious and very interesting. It was a bed of lettuce with potatoes, carrots, hard-boiled eggs, and broccoli on top all covered with a peanut sauce. Super strange but really delicious. I am also falling in love with quinoa - I can't wait to come home and make pastel de quinoa and quinoa con leche.
Here, you can buy juice or a hot milk drink with quinoa right on the street for less than a dollar. They give them to you in knotted plastic bags with a straw stuck through and you walk on the street with the plastic bag drinking. You must have to be masterful in order to pour liquid into a plastic bag without spilling it and then managing to tie it into a knot as well.
After lunch, I packed for our 4 day Salar de Uyuni trip. We planned to go to the bus station right after Spanish class to catch the 7pm overnight bus to Uyuni, start the excursion Thursday morning and finish Saturday evening just in time to catch the overnight bus back to La Paz. So I packed and ran to my Spanish class. I managed to distract our teacher from actual Spanish exercises for the entire 2 hours by asking her questions about Uyuni, Potosi, and history of Bolivia. She mentioned what has been glaring me in the face ever since I arrived in Bolivia. Bolivia is best described as a "beggar that sits on a pile of gold". Bolivia is the poorest South American nation by GDP yet contains one of the richest piles of minerals and natural resources - silver, gold, copper, lithium, zinc, salt, etc. The list could go on. Blame is put on the government with which Bolivia has been relatively unlucky. Government after government make stupid decisions and rules and slowly lose more and more of Bolivian land - Bolivia has lost land to Paraguay by signing a peace treaty when Bolivia was about to win because the king was drunk and did not know what was going on with his army, Bolivia has lost land full of a unique stone that is only found in a specific area to Brazil because the king lost a bet with the Brazilian king of the time, and Bolivia lost its access to the coast to Chile which is still a sore point for many Bolivians. And still, there are miles and miles of undeveloped land full of minerals that is absolutely gorgeous and unique. I can't wait to show you the pictures!
El Alto - Day 1
There was supposed to be another paro de transportación this Monday and I was really hoping I’d have the day to recuperate. No such luck. The strike never happened and I had to get up at 6am to meet Dra. Gutierrez at a church to take the micro to El Alto. I got up before the sun. To be warm, because mornings in El Alto, which is even higher than La Paz, are bitterly cold, I put on tights underneath pants, another layer of socks, a long sleeve shirt, a t-shirt, a sweater, and a fleece on top of that. Then I heated some water and drank tea to stay warm as I got ready to leave. It’s fun to see a city wake up – for once, the city was peaceful and without many people. Most vendors had not yet opened up shop and the rising sun cast rays upon the cobbled streets. I saw a lone tourist taking money from an ATM and I wondered what she must be doing up so early. I also passed a military ceremony occurring in the middle of a plaza, and finally reached the church 10 minutes early. I saw a mountain-bike tour bus park near the church and the guys going into a pharmacy and a café to stock up on supplies. I saw a cameraman set up on the steps of the church nearby me as well. 45 minutes later, with two other girls (Jenna and Lauren) I saw the cameraman pack up and leave and the tourbus pick up its tourists and leave as well. After some calling, we eventually got a Dr. Cecilia, who is the medical coordinator of the program and also works in El Alto to pick us up. Somehow, we missed Dr. Gutierrez who was waiting for us at the same church at 7:30. Hopefully that doesn’t happen on Wed. Hospital Los Andes, the El Alto clinic, is nothing more than a large waiting room with lots of doors that lead to different consultorios. Each consultorio is comprised of a small room with a locker for storing medicines and coats, a radiator for heat, a desk for the doctor, and an examination bed. We were in the general pediatric clinic with Dra. Gutierrez. I couldn’t feel the effect of the radiator and just put my white coat over all my other layers, including the fleece jacket. Then the patients started coming and by the 2nd one, Jenna and I took turns revisándolo the patients at the orders of the doctors. At first, I had no idea what I was supposed to examine on the patient but soon enough, I learned that if it was a control case (a checkup) and they were a baby, we should check the genitals for infection or for complete development (we saw a boy who had one testicle that never came down), if they complained of cough to check the throat, if they had diarrhea to check the belly, and if they had a fever to listen to the lungs. I think this rotation will def. help me feel more comfortable working with children. It’s less intellectual than the Hospital del Niño where there are rounds and interesting cases, but here, I have the opportunity to see and examine many different children of all ages, and that’s invaluable practice. Since we only have two days of rotations of this because of Aymara New Year today (Tuesday) and San Juan (Thursday) and we are missing Friday because we are travelling to the Salt flats in Uyuni as a group, I am going to try to retake this rotation in the upcoming weeks again in order to get more practice. Yay for more days of being absolutely freezing. Unfortunately, when I go home at 1pm for lunch, the sun is up, and it is very hot with all those layers on.
I skipped Spanish class because I felt light headed (again!) and took the time to sleep an extra 3 hours. I made it in time for the meeting with Cecilia about teenage pregnancy and how common it is in Bolivia, especially El Alto. I learned that abortions are illegal in Bolivia but that the rich who can afford them get them done anyways, and that teenage pregnancy just continues the cycle of poverty that these girls get into. Some of them have children with each boyfriend they are with, each one abandoning them everytime they get pregnant. Many times, the families of the babies don’t want the extra mouth to feed and so there is a lot of child abuse within the families, further alienating the children from having a good environment growing up. Girls who grow up in this environment where parents/grandparents don’t really pay enough attention to them are more likely to become pregnant as adolescents as well, further perpetuating the cycle. Contraception is available but not used for a variety of reasons. One is machismo, that the man either just doesn’t want to wear a condom or else specifically wants to keep the woman pregnant because she will be dependent on him and/or it is manly to father many children, even if you cannot feed them. But women are not exempt from the problem, because there is a huge misbelief among the women that contraception causes cancer (I heard it from a patient herself who just had a child and Dra. Gutierrez was counseling her on contraception so she wouldn’t get pregnant again until she wanted to) and also because many women don’t marry before they get pregnant, allowing the man to disappear much more easily than if they were married. Then, there is no financial help from the father nor does the child have a father’s last name. In Bolivia, children take their father’s and mother’s last name so if a child doesn’t know their father, they only have one name and everyone knows that that child is “illegitimate” and taunt them. Again, perpetuation of the sad cycle.
To lift our spirits, we went out for gyros for dinner, then the Irish pub, and then Mongos, a bar/dance bar to celebrate Peter’s birthday (a guy from the program who just turned 19). Everyone made sure to get him plastered. I went home at 2am so I don’t know how the night ended for him – hopefully well. I learned of two alcoholic drinks I need to try before leaving, Singani (the local clear alcohol) with Sprite and a shot of coca liquer.
Today is the winter solstice here – summer solstice for the northern hemisphere – and thus is the new year in the Aymara calendar. Since Evo Morales is president, today has become a national holiday and I am so very glad because I really needed the time off. Tomorrow we have another day of rotations, our last day of Spanish class, and tomorrow night we are leaving for a 4 day trip of the salt flats in Uyuni. It’s supposed to be incredible but even colder than it is in La Paz. Eek!
I skipped Spanish class because I felt light headed (again!) and took the time to sleep an extra 3 hours. I made it in time for the meeting with Cecilia about teenage pregnancy and how common it is in Bolivia, especially El Alto. I learned that abortions are illegal in Bolivia but that the rich who can afford them get them done anyways, and that teenage pregnancy just continues the cycle of poverty that these girls get into. Some of them have children with each boyfriend they are with, each one abandoning them everytime they get pregnant. Many times, the families of the babies don’t want the extra mouth to feed and so there is a lot of child abuse within the families, further alienating the children from having a good environment growing up. Girls who grow up in this environment where parents/grandparents don’t really pay enough attention to them are more likely to become pregnant as adolescents as well, further perpetuating the cycle. Contraception is available but not used for a variety of reasons. One is machismo, that the man either just doesn’t want to wear a condom or else specifically wants to keep the woman pregnant because she will be dependent on him and/or it is manly to father many children, even if you cannot feed them. But women are not exempt from the problem, because there is a huge misbelief among the women that contraception causes cancer (I heard it from a patient herself who just had a child and Dra. Gutierrez was counseling her on contraception so she wouldn’t get pregnant again until she wanted to) and also because many women don’t marry before they get pregnant, allowing the man to disappear much more easily than if they were married. Then, there is no financial help from the father nor does the child have a father’s last name. In Bolivia, children take their father’s and mother’s last name so if a child doesn’t know their father, they only have one name and everyone knows that that child is “illegitimate” and taunt them. Again, perpetuation of the sad cycle.
To lift our spirits, we went out for gyros for dinner, then the Irish pub, and then Mongos, a bar/dance bar to celebrate Peter’s birthday (a guy from the program who just turned 19). Everyone made sure to get him plastered. I went home at 2am so I don’t know how the night ended for him – hopefully well. I learned of two alcoholic drinks I need to try before leaving, Singani (the local clear alcohol) with Sprite and a shot of coca liquer.
Today is the winter solstice here – summer solstice for the northern hemisphere – and thus is the new year in the Aymara calendar. Since Evo Morales is president, today has become a national holiday and I am so very glad because I really needed the time off. Tomorrow we have another day of rotations, our last day of Spanish class, and tomorrow night we are leaving for a 4 day trip of the salt flats in Uyuni. It’s supposed to be incredible but even colder than it is in La Paz. Eek!
Coroico
One of the main attractions in Bolivia is to bike the world’s most dangerous road. It runs from La Paz to Coroico and until recently (~5 years ago), it was the only road between the two cities, weaving through the mountains, where buses regularly ran off the cliff or collided with oncoming traffic, sending many passengers and drivers to their death. Quite recently, they finally constructed a new road that also weaves through the mountains, but that is wider (allowing two lanes of traffic) and is also less steep as well. The world’s most dangerous road now is open only to bikers looking for a thrilling experience of careening down the mountain with stunning views. Less people die now but every so often, at least once per year if not more, a biker gets too distracted by the view or loses control of the bike and dies.
8 of the 14 people on our trip decided to go. They got a reputable mountain bike agency and all of them safely returned. If you ask around, you get mixed reviews. The people who go and remain alive rave about the trip, saying its one of the best experiences of their lives. Others, like a surgeon that 2 of the girls shadowed said that the one thing they shouldn’t do in Bolivia is the bike ride, citing an accident 6 months ago where 5 French tourists died. The two girls opted not to go, and 5 of us who didn’t wish to tempt fate decided to take the new road down to Coroico for the weekend and relax.
Everyone told us that we should not be outside at night the evening of El Gran Poder because everyone is drunk to a stupor. So, we decided that would be a perfect time to leave La Paz for a place in the jungle where it will be much warmer and we could sit by the pool and relax as the others did a 5 hour bike ride. We met a roundabout where traffic goes both ways and hailed down a micro (or trufi, I still haven’t figured out if there is a difference) that was going pass Villa Fatima, the place where buses leaving for Coroico depart from. For those who don’t know, micros are minivans that have a vague route that they drive but that pick people up and drop them off wherever on the route – there are no set stopping points. I’ve seen these in Russia and Peru as well, but never have I seen such aggressive advertising for them. From each micro, there is the driver’s helper that sits or stands next to an open window and continuously yells the route of the van. Whatever for? A person either needs to get to a destination or they don’t – how many will hear the loud screaming and think “Hmm…I should go to that plaza” and drop whatever they are doing and catch the micro? Another unexplainable thing of Bolivia.
We rarely get haggled here as tourists, so we were not expecting Villa Fatima. Villa Fatima is a corner where minivans and larger minivans congregate, waiting to take passengers to Coroico. When we got dropped off, for the first time in this country, we were immediately surrounded by vendors trying to sell us tickets on their minivans. The only thing that distinguishes them from one another is that some are larger, holding around 22 people, while the others are smaller, with only around 6 people in a van. Since there was 5 of us and we had not really decided what type we were going to take, we got flustered. Trying to decide what all 5 of us wanted to do is difficult enough, but when you’re being shouted at from all sides, it makes it that much more difficult. Don’t they realize it makes us NOT want to take their minivan or whatever? Eventually, we spread out, each talked to a different person and decided on a 6 person minivan for 25B that Sophie got us a discount for. There were five of us, an old Bolivian man who leaned forward everytime the driver was about to do something risky and a Bolivian woman in the front who chatted with the driver part of the way. Off we went.
If the new road is safer than the old one, that it is terrifying to think what the old road looked like. People who do the bike ride can testify though, because after they finish the ride, they are taken up by bus on the same road, all the while the guide tells horrifying stories of how people died there. If you want details, ask one of them how it felt to ride a bus on the world’s most dangerous road. Our road was better but has eroded in some of the areas due to avalanches and rain. In order to avoid the potholes on the road, the driver swerved around them, edging close to the side of the mountain. At first, it was rocky mountains but soon we saw some frozen waterfalls on the walls of the mountain by the road. People would park cars and go over to touch them because they looked surreal. Then, at one point about 1 hour into the drive, the mountains suddenly became green, full of flora. Soon, mist ensued and then darkness fell. Yup, we were driving on a curvatious road on the side of a mountain in darkness and in mist where you couldn’t see a few feet in front of you. That said, the driver was careful and we only almost hit an oncoming car once. I’ve had a much more terrifying driving experience on the flat pan-american highway in Peru.
The last 30 minutes of the drive, we wove on the graveled roads of the Yungas, which was a strange mixture between lots of greenery and lots of dust which usually don’t go together in my mind. The bumpiness almost made me sick and making continous turns right and left did not help at all. Finally, around 8pm, we were dropped off at the plaza in the center of Coroico, or more accurately is Coroico, and hailed a taxi to our hotel, which was outside of the city up on a hill in the forested mountains. We decided to splurge on a nice hotel and got $20 rooms that had private bathrooms and hot showers. When we got the rooms, everything smelt and felt damp. Ahhh, the rainforest. (Coroico isn’t in the true rainforest, but it is definitely subtropical and the middle ground between the harsh altiplano of La Paz and the real Amazonian rainforest more east of Coroico). We were hungry and wanted to go back to the city (or village?) to eat, but we were apprehensive of walking down a desolate pitch black hill alone on our first night. So we got a taxi down to the plaza. This was a 20 minute debate for us but when you start to think about it, the taxi cost $1.30 overall, meaning about 30 cents for each of us. I am going to have such reverse culture shock on prices in the United States when I get back..
We get to the plaza, find a nice pizza place, relax, talk, and eat. Then, we try to find a taxi back. But this time, there is none. Finally, we hail one down. One of us goes into the front seat while the rest of us pile in the backseat. The driver starts up the hill to our hotel and his car stalls halfway up. He tries again, but no luck. He slowly backs up down the hill and tells one of us to get in the front to balance out the weight. Jenna gets in front and sits on Mary’s lap. We try again – but no such luck. “No lo puedo” says the driver and drives away after we get out. After all that, we have to climb that hill in pitch blackness anyways. At least Coroico is only 1700m above ground and for the first time since we arrived in Bolivia, we aren’t panting out of breath from a 5 minute walk uphill. I feel fit. It’s all an illusion.
Coroico reminded me on Florida. There was warmth, humidity, crickets, and plenty of birds chirping by sunrise –and this on their coldest night of the year. It was a MUCH needed break from the harsh weather in La Paz, where it may not snow, but is still bitterly cold at night. The showers were hot and spacious – and you can tell how luxurious that feels when the bugs on the sides of the shower and leaves that haves streamed in from the outside over time did not bother me one bit. What’s dirt when there is hot water? This begs the question: would you rather be warm but dirty or clean but cold?
The next morning, we wake up to chirping birds. We have a balcony and a would-be a nice view if it wasn’t obscured by humongous banana leaves and their bananas. Breakfast was included in the price and it was marvelous. Hot tea, non-instant coffee, milk, hot chocolate, fresh papaya and watermelon juice, oatmeal, eggs, toast, watermelon, clementines, and whole wheat chocolate cake. What luxury! Stray dogs lounged around the terrace as we breakfasted and enjoyed the gorgeous view of mountains and green coca farms in t-shirts and shorts. We were soon warned that you should not leave any part of your skin uncovered if you don’t want to be eaten alive by bugs. We had the whole day to do what we wanted so we decided to hike up to the waterfalls which were only a couple hours away before going to the center for lunch. As we left the hotel, we noticed that the stray dogs from breakfast followed us. We didn’t think anything of it at first but as we started up the path, they continued with us. Mary is terrified of dogs and none of us were too happy about being in close proximity to stray dogs, so we decided to stop and let them pass us by. But when we stopped, they stopped – as if waiting for us before continuing. We had no choice but to go along with them. At first they led the way. As we continued to climb and it became hotter, the oldest dog fell to the back and the youngest led the way. By the time we reached the 1st waterfall 1.5 hours later, the dogs were very tired. Mary and Jenna decided to go back and sit by the pool for an hour while Sophie, Jolene, and I continued onto the 2nd waterfalls. They were nothing spectacular but to get there, we followed a trail that went curved around the mountains, so we could see all the coca farms below us. I wondered if this was the sort of coca farm Sonia worked in before.
In the end, the dogs followed us the entire way and we even got to understand a little of the personalities. They helped us find the right way back when we got too distracted and followed the wrong path on the way back, and they were a fun distraction during the hike back when the sun was at its highest. Unfortunately, Mary and Jenna didn’t have a better time at the pool because 10 minutes into sitting out in the sun, they were bitten relentlessly by some sort of insect. But no worries, I think its still too high for malaria. My headache was gone completely in Coroico and Jolene said her stomach felt a lot better the minute we descended in altitude. Everyone seemed to breathe better. I wonder what it will feel like to actually descend to sea level in 4 weeks…
Afterwards, we got our stuff and went into the city. We treated ourselves to a real nice lunch with ice cream as dessert in a German restaurant before taking the harrowing bus ride back to La Paz. When we got to the station, they weren’t selling any tickets since apparently they only sell them when a bus comes back so we spread out and took up spots in line at every company available and eventually got tickets on a large minivan back to La Paz for an hour later. So much for not driving in the dark this time… I closed my eyes for most of the ride to keep myself from getting nauseous from the bumpy and curvy road but the others said it was more terrifying than the ride there since this time it started raining and the windshield wipers barely worked. All the Bolivian women on the bus were apparently crossing themselves. Leave it to South America to turn a quiet relaxing weekend into an adventure.
8 of the 14 people on our trip decided to go. They got a reputable mountain bike agency and all of them safely returned. If you ask around, you get mixed reviews. The people who go and remain alive rave about the trip, saying its one of the best experiences of their lives. Others, like a surgeon that 2 of the girls shadowed said that the one thing they shouldn’t do in Bolivia is the bike ride, citing an accident 6 months ago where 5 French tourists died. The two girls opted not to go, and 5 of us who didn’t wish to tempt fate decided to take the new road down to Coroico for the weekend and relax.
Everyone told us that we should not be outside at night the evening of El Gran Poder because everyone is drunk to a stupor. So, we decided that would be a perfect time to leave La Paz for a place in the jungle where it will be much warmer and we could sit by the pool and relax as the others did a 5 hour bike ride. We met a roundabout where traffic goes both ways and hailed down a micro (or trufi, I still haven’t figured out if there is a difference) that was going pass Villa Fatima, the place where buses leaving for Coroico depart from. For those who don’t know, micros are minivans that have a vague route that they drive but that pick people up and drop them off wherever on the route – there are no set stopping points. I’ve seen these in Russia and Peru as well, but never have I seen such aggressive advertising for them. From each micro, there is the driver’s helper that sits or stands next to an open window and continuously yells the route of the van. Whatever for? A person either needs to get to a destination or they don’t – how many will hear the loud screaming and think “Hmm…I should go to that plaza” and drop whatever they are doing and catch the micro? Another unexplainable thing of Bolivia.
We rarely get haggled here as tourists, so we were not expecting Villa Fatima. Villa Fatima is a corner where minivans and larger minivans congregate, waiting to take passengers to Coroico. When we got dropped off, for the first time in this country, we were immediately surrounded by vendors trying to sell us tickets on their minivans. The only thing that distinguishes them from one another is that some are larger, holding around 22 people, while the others are smaller, with only around 6 people in a van. Since there was 5 of us and we had not really decided what type we were going to take, we got flustered. Trying to decide what all 5 of us wanted to do is difficult enough, but when you’re being shouted at from all sides, it makes it that much more difficult. Don’t they realize it makes us NOT want to take their minivan or whatever? Eventually, we spread out, each talked to a different person and decided on a 6 person minivan for 25B that Sophie got us a discount for. There were five of us, an old Bolivian man who leaned forward everytime the driver was about to do something risky and a Bolivian woman in the front who chatted with the driver part of the way. Off we went.
If the new road is safer than the old one, that it is terrifying to think what the old road looked like. People who do the bike ride can testify though, because after they finish the ride, they are taken up by bus on the same road, all the while the guide tells horrifying stories of how people died there. If you want details, ask one of them how it felt to ride a bus on the world’s most dangerous road. Our road was better but has eroded in some of the areas due to avalanches and rain. In order to avoid the potholes on the road, the driver swerved around them, edging close to the side of the mountain. At first, it was rocky mountains but soon we saw some frozen waterfalls on the walls of the mountain by the road. People would park cars and go over to touch them because they looked surreal. Then, at one point about 1 hour into the drive, the mountains suddenly became green, full of flora. Soon, mist ensued and then darkness fell. Yup, we were driving on a curvatious road on the side of a mountain in darkness and in mist where you couldn’t see a few feet in front of you. That said, the driver was careful and we only almost hit an oncoming car once. I’ve had a much more terrifying driving experience on the flat pan-american highway in Peru.
The last 30 minutes of the drive, we wove on the graveled roads of the Yungas, which was a strange mixture between lots of greenery and lots of dust which usually don’t go together in my mind. The bumpiness almost made me sick and making continous turns right and left did not help at all. Finally, around 8pm, we were dropped off at the plaza in the center of Coroico, or more accurately is Coroico, and hailed a taxi to our hotel, which was outside of the city up on a hill in the forested mountains. We decided to splurge on a nice hotel and got $20 rooms that had private bathrooms and hot showers. When we got the rooms, everything smelt and felt damp. Ahhh, the rainforest. (Coroico isn’t in the true rainforest, but it is definitely subtropical and the middle ground between the harsh altiplano of La Paz and the real Amazonian rainforest more east of Coroico). We were hungry and wanted to go back to the city (or village?) to eat, but we were apprehensive of walking down a desolate pitch black hill alone on our first night. So we got a taxi down to the plaza. This was a 20 minute debate for us but when you start to think about it, the taxi cost $1.30 overall, meaning about 30 cents for each of us. I am going to have such reverse culture shock on prices in the United States when I get back..
We get to the plaza, find a nice pizza place, relax, talk, and eat. Then, we try to find a taxi back. But this time, there is none. Finally, we hail one down. One of us goes into the front seat while the rest of us pile in the backseat. The driver starts up the hill to our hotel and his car stalls halfway up. He tries again, but no luck. He slowly backs up down the hill and tells one of us to get in the front to balance out the weight. Jenna gets in front and sits on Mary’s lap. We try again – but no such luck. “No lo puedo” says the driver and drives away after we get out. After all that, we have to climb that hill in pitch blackness anyways. At least Coroico is only 1700m above ground and for the first time since we arrived in Bolivia, we aren’t panting out of breath from a 5 minute walk uphill. I feel fit. It’s all an illusion.
Coroico reminded me on Florida. There was warmth, humidity, crickets, and plenty of birds chirping by sunrise –and this on their coldest night of the year. It was a MUCH needed break from the harsh weather in La Paz, where it may not snow, but is still bitterly cold at night. The showers were hot and spacious – and you can tell how luxurious that feels when the bugs on the sides of the shower and leaves that haves streamed in from the outside over time did not bother me one bit. What’s dirt when there is hot water? This begs the question: would you rather be warm but dirty or clean but cold?
The next morning, we wake up to chirping birds. We have a balcony and a would-be a nice view if it wasn’t obscured by humongous banana leaves and their bananas. Breakfast was included in the price and it was marvelous. Hot tea, non-instant coffee, milk, hot chocolate, fresh papaya and watermelon juice, oatmeal, eggs, toast, watermelon, clementines, and whole wheat chocolate cake. What luxury! Stray dogs lounged around the terrace as we breakfasted and enjoyed the gorgeous view of mountains and green coca farms in t-shirts and shorts. We were soon warned that you should not leave any part of your skin uncovered if you don’t want to be eaten alive by bugs. We had the whole day to do what we wanted so we decided to hike up to the waterfalls which were only a couple hours away before going to the center for lunch. As we left the hotel, we noticed that the stray dogs from breakfast followed us. We didn’t think anything of it at first but as we started up the path, they continued with us. Mary is terrified of dogs and none of us were too happy about being in close proximity to stray dogs, so we decided to stop and let them pass us by. But when we stopped, they stopped – as if waiting for us before continuing. We had no choice but to go along with them. At first they led the way. As we continued to climb and it became hotter, the oldest dog fell to the back and the youngest led the way. By the time we reached the 1st waterfall 1.5 hours later, the dogs were very tired. Mary and Jenna decided to go back and sit by the pool for an hour while Sophie, Jolene, and I continued onto the 2nd waterfalls. They were nothing spectacular but to get there, we followed a trail that went curved around the mountains, so we could see all the coca farms below us. I wondered if this was the sort of coca farm Sonia worked in before.
In the end, the dogs followed us the entire way and we even got to understand a little of the personalities. They helped us find the right way back when we got too distracted and followed the wrong path on the way back, and they were a fun distraction during the hike back when the sun was at its highest. Unfortunately, Mary and Jenna didn’t have a better time at the pool because 10 minutes into sitting out in the sun, they were bitten relentlessly by some sort of insect. But no worries, I think its still too high for malaria. My headache was gone completely in Coroico and Jolene said her stomach felt a lot better the minute we descended in altitude. Everyone seemed to breathe better. I wonder what it will feel like to actually descend to sea level in 4 weeks…
Afterwards, we got our stuff and went into the city. We treated ourselves to a real nice lunch with ice cream as dessert in a German restaurant before taking the harrowing bus ride back to La Paz. When we got to the station, they weren’t selling any tickets since apparently they only sell them when a bus comes back so we spread out and took up spots in line at every company available and eventually got tickets on a large minivan back to La Paz for an hour later. So much for not driving in the dark this time… I closed my eyes for most of the ride to keep myself from getting nauseous from the bumpy and curvy road but the others said it was more terrifying than the ride there since this time it started raining and the windshield wipers barely worked. All the Bolivian women on the bus were apparently crossing themselves. Leave it to South America to turn a quiet relaxing weekend into an adventure.
El Gran Poder
June is the month of holidays in La Paz. Saturday was El Gran Poder (“The Great Power”). I had a lot of difficulty finding good information on this holiday on the internet, but from what I have gathered, its named after Jesus or God to celebrate him/them, but in reality, the costumes in the parade are anything but Christian. The indigenous people of Bolivia were smart and when the Spanish wanted to convert them to Christianity, they agreed, but continued to celebrate their own holidays under the pretenses of saints and Christianity. El Gran Poder basically consists of a super long parade of different traditional dances and costumes that begins somewhere in northern La Paz and ends in southern La Paz, and taking up the entire day from 7am to 2am. Lots and lots of drinking is involved. The entire parade seemed to be sponsored by Paceña, a local beer company, so beer was flowing freely. Many dancers had beer cans in their hands as they danced and some already had the glazed look of drunkenness by the time we were watching them pass by on the streets at noon. And these were the dancers!
Since I slept 12 hours that night, I was feeling very refreshed and happy. I went to the nearby coffee shop next to my apartment, got a real coffee (not instant!) and a chocolate chip muffin, and tried to upload some pictures onto the blog. They heat everything up at this café, so the muffin was warm and their croissants are warm, and and and... I just really like this place. Bolivian families were having Saturday breakfast there and friends were meeting up for morning coffee to catch up on each other’s lives. Annie joined me later, we had another cup of coffee, and then went home to get ready to go watch the parade.
Around noon, we walked up to the main street where usually everything happens. On the way there, there were much less people than usual. We didn’t have to bump into people and have our conversations disrupted by the people strolling along on a busy street as if they were the only ones there. La Paz is one of the capitals of Bolivia and a huge city, but it is agonizingly slow in relation to New York or Chicago or Boston, or even Madrid for that matter. On busy streets, people pass by slowly, almost never in a hurry, and very often stop in the middle of the street to look at a shop’s window, oblivious to the people almost running into to them. I guess that happens everywhere, but here in order to walk at a normal pace on the street, it is necessary to continuously hop around people, the vendors, and dodge the traffic that almost runs over your feet as you try to pass someone by on the street. It doesn’t help that the sidewalks are narrow.
On Saturday, none of that happened. We strolled along the streets peacefully. Until we got to El Prado, the main thoroughfare: vendors had already set up their wares, yelling “cerveza, cerveza, 5 bolivianos” over and over again at the top of their lungs, the smell of grilled meat and chorizo permeated the air with row upon row of stands displaying fried chicken, grilled meat on skewers, any type of chorizo or bratwurst you could ever want. I love festivals like this. The designated parade route was segregated from the vendors outside, where rows of plastic chairs were put on both sides so people could sit down and watch the parade while enjoying their food and beer. For bolivianos, it cost about 25B’s for a spot and about a 100B’s for foreigners. We chose to stand. I’m quite tall by Bolivian standards so even with people in front of me, I had a good view of the dancers (for once!). Sometimes it’s nice to stand out in a crowd.
The dances themselves were fun and the costumes were the most ornate I have ever seen. Literally. They sparkled with jewels and glitter in every color imaginable (except beige) with shoes that would put the spice girls to shame. I am NOT exaggerating. The pictures will speak for themselves. After a while, I understood what my Spanish teacher meant by the parade becoming monotonous. Although it’s a great display of traditional Bolivian dances and costumes, a lot of the dances repeated themselves and everytime a band went by, they played the same tune as all the other bands. Although, if sitting down, I think I could have stayed a lot longer just relaxing and watching the dancers and music go by. I am sure most dances had a lot of meaning and stories behind them but I didn’t know them. We did see dancers in ratty colorful clothes with chains and their faces painted black that I think signified an African dance that slaves brought over, but that is as deep as my knowledge goes.
On the way back, we grabbed some lunch from a café (We were a little nervous to try true street-food meat) and then I packed for Coroico!
P.S. Sorry for lack of pictures on the blog. I am have not been able to upload them at all! Eventually, they will be there!
I am really behind but in short words, last weekend was Gran Poder and we went to Coroico, and then this week we only had two days of rotations because Tuesday was Aymara New Year (winter solstice here) and Thursday was San Juan. We took advantage of that and took Friday off to travel to the Salt Flats (Salar de Uyuni) in the south of Bolivia. We just got back this morning and now I'm trying to catch up on internet. Hope everything is well with everyone else!
Since I slept 12 hours that night, I was feeling very refreshed and happy. I went to the nearby coffee shop next to my apartment, got a real coffee (not instant!) and a chocolate chip muffin, and tried to upload some pictures onto the blog. They heat everything up at this café, so the muffin was warm and their croissants are warm, and and and... I just really like this place. Bolivian families were having Saturday breakfast there and friends were meeting up for morning coffee to catch up on each other’s lives. Annie joined me later, we had another cup of coffee, and then went home to get ready to go watch the parade.
Around noon, we walked up to the main street where usually everything happens. On the way there, there were much less people than usual. We didn’t have to bump into people and have our conversations disrupted by the people strolling along on a busy street as if they were the only ones there. La Paz is one of the capitals of Bolivia and a huge city, but it is agonizingly slow in relation to New York or Chicago or Boston, or even Madrid for that matter. On busy streets, people pass by slowly, almost never in a hurry, and very often stop in the middle of the street to look at a shop’s window, oblivious to the people almost running into to them. I guess that happens everywhere, but here in order to walk at a normal pace on the street, it is necessary to continuously hop around people, the vendors, and dodge the traffic that almost runs over your feet as you try to pass someone by on the street. It doesn’t help that the sidewalks are narrow.
On Saturday, none of that happened. We strolled along the streets peacefully. Until we got to El Prado, the main thoroughfare: vendors had already set up their wares, yelling “cerveza, cerveza, 5 bolivianos” over and over again at the top of their lungs, the smell of grilled meat and chorizo permeated the air with row upon row of stands displaying fried chicken, grilled meat on skewers, any type of chorizo or bratwurst you could ever want. I love festivals like this. The designated parade route was segregated from the vendors outside, where rows of plastic chairs were put on both sides so people could sit down and watch the parade while enjoying their food and beer. For bolivianos, it cost about 25B’s for a spot and about a 100B’s for foreigners. We chose to stand. I’m quite tall by Bolivian standards so even with people in front of me, I had a good view of the dancers (for once!). Sometimes it’s nice to stand out in a crowd.
The dances themselves were fun and the costumes were the most ornate I have ever seen. Literally. They sparkled with jewels and glitter in every color imaginable (except beige) with shoes that would put the spice girls to shame. I am NOT exaggerating. The pictures will speak for themselves. After a while, I understood what my Spanish teacher meant by the parade becoming monotonous. Although it’s a great display of traditional Bolivian dances and costumes, a lot of the dances repeated themselves and everytime a band went by, they played the same tune as all the other bands. Although, if sitting down, I think I could have stayed a lot longer just relaxing and watching the dancers and music go by. I am sure most dances had a lot of meaning and stories behind them but I didn’t know them. We did see dancers in ratty colorful clothes with chains and their faces painted black that I think signified an African dance that slaves brought over, but that is as deep as my knowledge goes.
On the way back, we grabbed some lunch from a café (We were a little nervous to try true street-food meat) and then I packed for Coroico!
P.S. Sorry for lack of pictures on the blog. I am have not been able to upload them at all! Eventually, they will be there!
I am really behind but in short words, last weekend was Gran Poder and we went to Coroico, and then this week we only had two days of rotations because Tuesday was Aymara New Year (winter solstice here) and Thursday was San Juan. We took advantage of that and took Friday off to travel to the Salt Flats (Salar de Uyuni) in the south of Bolivia. We just got back this morning and now I'm trying to catch up on internet. Hope everything is well with everyone else!
Friday (a week and a few days ago) - Rheumatic Fever
Last Friday, Sophie and I bought stickers on our way to the hospital and distributed them amongst the kids on the pediatric floor. There was a tiny girl with nephritis, a boy named Marco with rheumatic fever, Edgar from the Yungas with Leishmaniasis on his leg, and Hugo, a 13 year old boy who presented with splenomegaly (enlarged spleen) but no one could figure out what was wrong with him. Some doctors suspected Munchausen syndrome because the mother is an alcoholic, and I think he was going to be released on Saturday. You can’t really fake splenomegaly though but I never figured out what they were planning on doing with that. The stickers were a big hit with everyone. It’s always interesting to see how different children’s personalities are, starting from when they are babies. Some babies smile back at you while others stare at you with inquisitive eyes, asking you to prove yourself worthy of being their friend. The older kids also reacted differently to the stickers – Edgar jumped right in and demanded 2 and then kept asking for me till we ran out, while Marco sat quietly by his bed and waited for us to approach him. Hugo was somewhere in between the other two. I wish I had taken pictures of them because today we actually had a lot of free time with the kids, but I didn’t bring my camera that day. I promise to post some pictures of La Paz very soon.
That afternoon, I went with a couple other people to Happy Api – a Bolivian chain restaurant that serves traditional Bolivian food, such as Api, chicha morada, and buñuelos and empanadas. Api and chicha morada are drinks made from purple corn that is grown around Peru and Bolivia. Chicha morada is cold and tastes like bubble gum, and Api is hot and tastes like apple pie according to Siobhan, another girl in the program. Since its pretty chilly at 6pm when we get out of Spanish class, we stop by this place and get a mug of Api for 4 bolivianos (around 50 cents). This time, we decided to try the buñuelos as well because I told Annie that they were similar to donuts. I was sooo wrong. Here, a buñuelo is a large piece of fluffy fried dough that is neither very sweet nor very savory, but somewhere in the middle. Halfway through eating ours, we realized everyone else poured either powdered sugar or something similar to maple syrup on theirs, adding flavor. Oops – for next time I guess. Then, some people went to a popular anticucho place nearby. Anticucho is alpaca heart, usually grilled and served on a skewer, sometimes by itself and sometimes with vegetables or potatoes. My stomach nor my head were feeling up for any meat at the moment but everyone who had it definitely recommended it so I will make sure to try it before I leave Bolivia. Afterwards, Annie and I tried to find cinemateca boliviana, which is an art-film cinema near our house that shows foreign and bolivian films, with each day of the week dedicated to films of a specific country. Since it was dark, we weren’t able to find it but our host mother recommended us the bolivian movie “Los viejos” (translated as “The old men” or the “Olds ones”) so we will try to go see that later next week. That night, everyone went out but I stayed in my warm cozy bed and slept 12 hours. It was really really nice!
That afternoon, I went with a couple other people to Happy Api – a Bolivian chain restaurant that serves traditional Bolivian food, such as Api, chicha morada, and buñuelos and empanadas. Api and chicha morada are drinks made from purple corn that is grown around Peru and Bolivia. Chicha morada is cold and tastes like bubble gum, and Api is hot and tastes like apple pie according to Siobhan, another girl in the program. Since its pretty chilly at 6pm when we get out of Spanish class, we stop by this place and get a mug of Api for 4 bolivianos (around 50 cents). This time, we decided to try the buñuelos as well because I told Annie that they were similar to donuts. I was sooo wrong. Here, a buñuelo is a large piece of fluffy fried dough that is neither very sweet nor very savory, but somewhere in the middle. Halfway through eating ours, we realized everyone else poured either powdered sugar or something similar to maple syrup on theirs, adding flavor. Oops – for next time I guess. Then, some people went to a popular anticucho place nearby. Anticucho is alpaca heart, usually grilled and served on a skewer, sometimes by itself and sometimes with vegetables or potatoes. My stomach nor my head were feeling up for any meat at the moment but everyone who had it definitely recommended it so I will make sure to try it before I leave Bolivia. Afterwards, Annie and I tried to find cinemateca boliviana, which is an art-film cinema near our house that shows foreign and bolivian films, with each day of the week dedicated to films of a specific country. Since it was dark, we weren’t able to find it but our host mother recommended us the bolivian movie “Los viejos” (translated as “The old men” or the “Olds ones”) so we will try to go see that later next week. That night, everyone went out but I stayed in my warm cozy bed and slept 12 hours. It was really really nice!
Saturday, June 18, 2011
Sonia's story
A few days ago, Sonia (the maid) and I were saying good bye to Isabel, and I sat down to pet Estrella, the family dog. Sonia stuck around and we started talking about our families. Soon, it turned into the differences between English, Spanish, and Quechua, and we ended up on my bed, exchanging phrases of Quechua and English. That afternoon, we continued talking, and for the first time, Sonia sat with us at the dinner table and we all ate together and she told us her story.
She was born north of La Paz, to a large family. She has 7 brothers and sisters, but 3 of them died as children, so now she only has 4. When she was little, her father made her go to school, but by the time she was 11, she hated it, started skipping it, and eventually ran away from home. At first, she came to La Paz looked for work, but no one wanted to hire an 11-year old so she went to the Yungas (the Amazonian part of Bolivia) and worked on a coca farm until she was 17. Then, she came back to La Paz and Isabel hired her. She has worked here ever since. Now, she goes to night school I think because she wants to learn to read, write and learn English. Apparently, Isabel’s favorite language is German, Lucia’s is French, and Sonia’s is English. I love this family. When she came back to La Paz, she also went home to her family, who haven’t seen her since she ran away 6 years before that. Her family thought she was dead because they haven’t heard of her, and when they saw her, they thought she had come home with a child or at least pregnant or married. But no such thing – it was just Sonia. Now, her mother visits her at least once a month and one of her sisters works in a household not too far from our house, so they visit each other about once a week. One of her other brothers lives in Brazil.
When I asked her where she liked it the most, since she’s been to many places, she says she loves La Paz, because its never boring to walk here (it’s always either up or down – never flat!). El Alto is too flat, and the rest of the country is much too warm. Once you get off the altiplano, there is a lot of discrimination against the indigenous people (las kollas) by the cambas (the lowlanders who don’t speak Aymara or Quechua). She spoke so matter of fact about it and I couldn’t begin to imagine what it must be like to be in her place, where her people are for the most part, second class compared to the European-descended Bolivianos. Not only is there a large gap between rich and poor here, but it’s also usually divided up by race as well, with the European-descendents being mostly the upper and middle class, and the indigenous people filling up most of the lower class.
A few days later, we switched from learning English and Quechua to talking about dreams. She mentioned how she wanted to go the United States and how she met a woman in her 30’s who stayed here before and told her that when she would have a child, she’d hire Sonia as the child’s caretaker, so the child could learn Spanish. Sonia lost the contact number of the woman a while ago, but I think she still hopes that maybe the woman will contact her. I was so torn at that moment. How do you tell someone that being an immigrant in America, especially Los Angeles, usually amounts to no more than a super harsh reality but at the same time, I know Sonia is strong and intelligent, you can see it in her eyes and the way she holds herself, and that if anyone would make it in America, it would be her. The country was created for people like her. She is only 20 but her maturity is way beyond that – I always forget I am older than her and when I remember, it startles me.
She was born north of La Paz, to a large family. She has 7 brothers and sisters, but 3 of them died as children, so now she only has 4. When she was little, her father made her go to school, but by the time she was 11, she hated it, started skipping it, and eventually ran away from home. At first, she came to La Paz looked for work, but no one wanted to hire an 11-year old so she went to the Yungas (the Amazonian part of Bolivia) and worked on a coca farm until she was 17. Then, she came back to La Paz and Isabel hired her. She has worked here ever since. Now, she goes to night school I think because she wants to learn to read, write and learn English. Apparently, Isabel’s favorite language is German, Lucia’s is French, and Sonia’s is English. I love this family. When she came back to La Paz, she also went home to her family, who haven’t seen her since she ran away 6 years before that. Her family thought she was dead because they haven’t heard of her, and when they saw her, they thought she had come home with a child or at least pregnant or married. But no such thing – it was just Sonia. Now, her mother visits her at least once a month and one of her sisters works in a household not too far from our house, so they visit each other about once a week. One of her other brothers lives in Brazil.
When I asked her where she liked it the most, since she’s been to many places, she says she loves La Paz, because its never boring to walk here (it’s always either up or down – never flat!). El Alto is too flat, and the rest of the country is much too warm. Once you get off the altiplano, there is a lot of discrimination against the indigenous people (las kollas) by the cambas (the lowlanders who don’t speak Aymara or Quechua). She spoke so matter of fact about it and I couldn’t begin to imagine what it must be like to be in her place, where her people are for the most part, second class compared to the European-descended Bolivianos. Not only is there a large gap between rich and poor here, but it’s also usually divided up by race as well, with the European-descendents being mostly the upper and middle class, and the indigenous people filling up most of the lower class.
A few days later, we switched from learning English and Quechua to talking about dreams. She mentioned how she wanted to go the United States and how she met a woman in her 30’s who stayed here before and told her that when she would have a child, she’d hire Sonia as the child’s caretaker, so the child could learn Spanish. Sonia lost the contact number of the woman a while ago, but I think she still hopes that maybe the woman will contact her. I was so torn at that moment. How do you tell someone that being an immigrant in America, especially Los Angeles, usually amounts to no more than a super harsh reality but at the same time, I know Sonia is strong and intelligent, you can see it in her eyes and the way she holds herself, and that if anyone would make it in America, it would be her. The country was created for people like her. She is only 20 but her maturity is way beyond that – I always forget I am older than her and when I remember, it startles me.
Nephrology Rotation
Yesterday I started my new rotation in Nephrology. I am with another girl, Sophie, and together we decided that our doctor, Dra. Bocangel, cannot teach. She is a really busy woman with a permanent expression of pursed lips that imply disapproval – reminds me a lot of my first Russian music teacher in America that never failed to make me cry at least once during the 1-hour long lesson. Yesterday, we were in consultorio with her, mostly seeing kids who had UTI’s for some reason or another – none were serious. I did learn that chronic constipation can lead to UTI’s, I think because chronic constipation begins to push on the bladder, somehow leading to insufficient emptying of the bladder. I would have asked her to explain further, but she never has a free moment, so it’s difficult to get her attention. At 11am, there was an academic talk by an American professor that we met first thing in the morning, where he questioned us what medical school we attended and whether it was a good school, by his standards. Northwestern was “okay” and “not bad”. He is a neotologist at Phildelphia’s Childrens Hospital and he talked about the interesting and therefore sad cases that he encountered at his hospital. Apparently, he did Peace Corps in Bolivia many years ago and has since then been coming to Bolivia to interact with the doctors in the Children’s Hospital in La Paz. He usually brings his family as well, so we got to meet his daughter, who is 16, and has already traveled much more around Bolivia than I ever have. He gave his speech in Spanish, which wasn’t very fluent but it’s not as if I really could have done better. Switching between English and Spanish all day really doesn’t help with learning Spanish – but oh well, that’s not the main reason I came here. The auditorium was freezing!! I had a shirt and a sweater under my white coat, and still, at the end, I couldn’t concentrate on the lecture because I spent all my energy trying to stay warm. Today, we had grand rounds where medical students and/or residents present interesting cases. They finally started heating the auditorium, but the waiting rooms where patients wait to be seen by a doctor are still freezing. Very little sun comes through the windows and all the patients are bundled up in their coats. I kind of envy them because at least they are wearing their coats. One of the cases in grand rounds was of a little boy who got basically mutilated in a car accident. Both of his legs were completely gone below the knees and somehow, the groin area was also brutally damaged. Later on in the day, we actually got to go to the ICU and see him. He didn’t respond to anyone – not even the nurses or the doctors. Instead, he just blankly stared at the television. In grand rounds, someone mentioned that hopefully his parents won’t abandon him now. There are no pedestrian lights here and cars don’t stop for passengers when turning so I wonder how often this type of accident happens. The ICU was small – just one large room that probably held around 14 beds. I asked if they ever had too many patients for the beds, and the doctor said “all the time, many of them end up dying because we don’t have room”. It’s weird that from a distance, there doesn’t seem to be many falta of resources until you start hearing the stories of people who never got the treatment they needed because there was no space or no medication available. Is it fairer to have the medication but not allow everyone access to it, or to not have the medication available at all?
Right now, I am at home, in my room, writing this blog while a little dog named “Estrella” (“star”) is sleeping on the bed right next to me. I miss having a pet. I skipped Spanish class today because I think I am getting the flu. Being around sickly kids all day kind of has that effect. I think my immune system finally realized that I have settled in in La Paz, and so now would be a great time to get sick. Going out and trying cinnamon and milk ice cream tonight didn’t really help either. Oh well, I think I will have plenty of time to recuperate next week because there is supposed to be a huge transportation strike on Monday and then the Aymara New Year on June 21st, and then another hold that Thursday. If I can hold out until after this Saturday’s Gran Poder Fiesta, I think I will be alright.
Right now, I am at home, in my room, writing this blog while a little dog named “Estrella” (“star”) is sleeping on the bed right next to me. I miss having a pet. I skipped Spanish class today because I think I am getting the flu. Being around sickly kids all day kind of has that effect. I think my immune system finally realized that I have settled in in La Paz, and so now would be a great time to get sick. Going out and trying cinnamon and milk ice cream tonight didn’t really help either. Oh well, I think I will have plenty of time to recuperate next week because there is supposed to be a huge transportation strike on Monday and then the Aymara New Year on June 21st, and then another hold that Thursday. If I can hold out until after this Saturday’s Gran Poder Fiesta, I think I will be alright.
Tuesday, June 14, 2011
Transportation strike
Today, rotations were cancelled due to a transportation strike. The only thing that gave it away was that the roads were clearer because no buses were on the streets. Taxis still worked and micros still drove around collecting people until they filled every inch of space in the vehicle. Nevertheless, I was very happy to have half the day off (we still had Spanish class in the afternoon). So, I did some errands – washed my clothes, internet, cleaned my room and then Annie, Jolene, Sophie, and I went shopping. We went to the markets in the northern part of the centro where they sell all the touristy stuff, but without the touristy prices. At first, we just asked about the prices, but eventually, we all succumbed and bought something. Most of the things sold are actually of good quality, and the vendors tell you the difference between materials (cotton, synthetic, 100% baby alpaca wool, acrylic) and how it was made (hand-made vs. machine-made). I rarely get hand-made things, primarily because I simply cannot afford it. Except here. Even the best quality items aren’t that expensive, so I have a feeling that my suitcase which weighed 47lbs. when I left, may weigh a lot more than that when I come back. I made two major purchases – a cotton blanket that ALL the indigenous women tie around their shoulders and carry stuff in (babies, produce, more blankets, money, whatever) and a stuffed llama animal (un peluche). It is very cute and Lucia even named it but I already forgot the name =(
Then, we came home, ate lunch, and ran back out again for Spanish classes. Spanish classes are okay – our teacher finally realized that we wanted to learn more medical Spanish so we are focusing on case-studies. I would have liked to learn a lot more Bolivian slang but I am hoping to pick that up just by interacting with people. So far, I know that chompa = sweater and it’s a word only used in Bolivia. Now that I know, I hear it everywhere. It’s always like that with slang and colloquial words. Also, the teacher wouldn’t let me use the word “trekking” even though the guide used that word in Spanish, and when I used to a word meaning “to spend the night = pernoctar” that I learned in class with my host mother, she told me no one uses that word anymore. It doesn’t help that we are using workbooks from Spain, where certain words have completely different meanings than here. But enough complaining – any Spanish is better than any Spanish.
After Spanish, we went to a lecture on Chagas in Dr. Uribe’s office. Chagas is caused by a protozoan that is transferred from a vincucha (a type of bug similar to a cockroach) to a person when the vincucha bites. The bugs are usually found in makeshift houses that are made of mud or wood. Chagas is really common in Cochabamba, Sucre, and Tarija, and the worst part about it is that after two days of an itchy bite, there are no symptoms for years. Until the organs begin to fail and symptoms like tachycardia and difficulty breathing show up – at that point, it’s too late to really do anything about it because the damage has already been done. 2-8% of pregnant women with Chagas pass on Chagas to their child. We talked a lot about how to treat a recently born child – it is more effective if the treatment is given before 6 months of age, but of course, not everyone gives births in hospitals so of course, many cases are not identified. The most disheartening part is that even when the baby is treated and cured of Chagas, if they live in poor living conditions, they are most likely to be bitten again sometime soon. It makes you realize that medication and technology can only help so much and that at some point, we need to improve basic necessities for people, with which we can probably reduce the number of illnesses by a huge amount.
For dinner, I got a vegetable empanada which is hot and delicious – the baked dough melted in my mouth. I love street food!!
Then, we came home, ate lunch, and ran back out again for Spanish classes. Spanish classes are okay – our teacher finally realized that we wanted to learn more medical Spanish so we are focusing on case-studies. I would have liked to learn a lot more Bolivian slang but I am hoping to pick that up just by interacting with people. So far, I know that chompa = sweater and it’s a word only used in Bolivia. Now that I know, I hear it everywhere. It’s always like that with slang and colloquial words. Also, the teacher wouldn’t let me use the word “trekking” even though the guide used that word in Spanish, and when I used to a word meaning “to spend the night = pernoctar” that I learned in class with my host mother, she told me no one uses that word anymore. It doesn’t help that we are using workbooks from Spain, where certain words have completely different meanings than here. But enough complaining – any Spanish is better than any Spanish.
After Spanish, we went to a lecture on Chagas in Dr. Uribe’s office. Chagas is caused by a protozoan that is transferred from a vincucha (a type of bug similar to a cockroach) to a person when the vincucha bites. The bugs are usually found in makeshift houses that are made of mud or wood. Chagas is really common in Cochabamba, Sucre, and Tarija, and the worst part about it is that after two days of an itchy bite, there are no symptoms for years. Until the organs begin to fail and symptoms like tachycardia and difficulty breathing show up – at that point, it’s too late to really do anything about it because the damage has already been done. 2-8% of pregnant women with Chagas pass on Chagas to their child. We talked a lot about how to treat a recently born child – it is more effective if the treatment is given before 6 months of age, but of course, not everyone gives births in hospitals so of course, many cases are not identified. The most disheartening part is that even when the baby is treated and cured of Chagas, if they live in poor living conditions, they are most likely to be bitten again sometime soon. It makes you realize that medication and technology can only help so much and that at some point, we need to improve basic necessities for people, with which we can probably reduce the number of illnesses by a huge amount.
For dinner, I got a vegetable empanada which is hot and delicious – the baked dough melted in my mouth. I love street food!!
Lake Titicaca - Day 2
We woke around 7am, had breakfast with fresh squeezed orange juice (the variety and quality of juices here is amazing!) and set off on a 4 hour hike to the northern part of the island. Along the way, the views were unbelievable – all around you were the lake and mountains in the distance. I’ll put up pictures soon so you can see for yourself, but there is really no way to really see it but to go there. Bolivia is probably one of the least visited countries in South America but it has so many interesting places and such kind people. Maybe people get scared off by the poverty statistic, but while there is a lot of poverty, there is also a middle and upper class here as well, and the tourism industry is much less corrupt than in most other places. It’s a contradiction because as much as I want other people to see how beautiful this country is, I don’t want it to be overrun by tourists either. Anyways, about the island. We saw the sacred rock, which, if you look at it from a certain point, looks like a puma head. A puma is called “titi” in Aymara (I think) and because of that rock, the lake was named Titicaca. This could all be wrong by the way, but you know how when you don’t understand the complete picture/idea, your brain starts filling in the blanks? That happens to me a lot in Spanish so take whatever facts I say with a grain of salt, especially ones about indigenous legends.
Throughout the hike, the landscape changed from mountainous dirt to wavy rocks and finally to a beach. On the beach, there was a small village with a school, a playground, and many restaurants and hostels. We found a boat there to take us to lunch. On our way though, our guide suggested that we hike some Inca steps (as if we hadn’t hiked enough yet – but just our luck, our guide was an expert in trekking so these hikes were nothing for him). We were too stubborn to admit we were all tired and accepted the suggestion. There was really nothing special about the steps except that apparently, if you shower with the water out of the spring at the top, you are supposed to get younger. I decided I don’t really need any of that at the moment. Then, we got on the ferry again, and docked at an isolated island 10 minutes off, where there was only one house that also served as a restaurant. If we weren’t with our guide, we would never have been able to get to this place. When we sat down, they brought out sacks (SACKS!) of 2 different types of potatoes wrapped in blankets. They also brought out chicken, beef, and trucha (trout), 2 types of Bolivian cheese (one tasted like feta, the other like sharp mozzarella), a bowl of hard-boiled eggs, a blanket of corn on the cob (except it was lighter in color and the kernels were much larger – we think that’s where the large popcorn comes from), beans, a type of root vegetable, and probably other things that I forgot about. It was a lot of food and they were terribly upset that we didn’t eat all the potatoes. If you look at my photos, you’ll see that it was a lot of potatoes. They are kind of a big deal in Bolivia.
Afterwards, we finally got back to Copacabana and took a bus back to La Paz. We were all exhausted and sun-burned. On the way back home, I couldn’t help but think of how unknown this country really is. I feel really lucky that I am getting to know this country and the people who live here as much as I really can in only 6 weeks. It seems that everyone who comes here falls in love with it and doesn’t want to leave. Manu, our other housemate, has extended her project for another month and says that if she had the option, she’d stay here an entire year. This country is not at all as scary and depressing as people and governments make it out to be.
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