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!
Sunday, June 26, 2011
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.
Lake Titicaca
For the weekend, we all decided as a group to go to Lake Titicaca, the highest lake in the world. We arranged a private 2-day tour for the 14 of us where everything would be taken care of. The best idea in the world. We left La Paz at 7am, picked up some other travelers from hostels, found a new market to explore in la plaza juariste equino, which Adriana wrote down so we could come back to it, and watched the city wake up on a winter Saturday morning through the windows of the bus. We passed through El Alto, the city sitting atop a hill above La Paz, and which has slowly been encompassed into La Paz as a neighborhood. As we drove up the mountains, side streets turned to unpaved dirt roads and the number of indigenous women in traditional dress increased. We got to drive through the markets of El Alto, where they sold everything from fruit and juice to shoelaces and mobile phones. It was strange seeing colorful banners advertising a phone company next to unfinished brick houses and the layer of dust and sand that hovered on everything. None of the buildings were finished. Later on, we found out it is because Bolivians aren’t required to pay taxes on housing until its finished, so people never finish building them, having an open 3rd floor with no roof, or never painting the outside of the house. Once we left the city, the landscape turned into farmland and mountains in the background. There were many donkeys around and small, seemingly insignificant farm houses dotted the plains. In order to get to Copacabana, we had to travel up mountains on curvatious roads. Then, we encountered a river. To get across, we all exited the bus and bought tickets for a small motor boat to take us across the river while the bus took its own private boat across the river as well. We met up with the bus on the other side. When we asked how many boats are underneath the water in the river, he mentioned some number around 20 and mumbled about how that is why they take people across the river in different boats. It’s definitely a sight to see. After the river crossing, we rode the bus for another hour until we were in the middle of Copacabana, the city. We took a tour of their white-washed sparkling church, walked along the markets and the popcorn street (popcorn is HUGE here, literally, and sold in large bags) and then finally took a side street to a fancy hotel restaurant with a beautiful view of the lake. Here, we had trucha (the fish they catch in lake Titicaca – it was brought over by the Spaniards) and tried Bolivian white wine. Yup, Bolivia has its own wine and its quite delicious. It reminded me of Kim Crawford wine from New Zealand – it had an unripe tomato aftertaste. Después, we went down to the shore and caught a ferry to the Isla del Sol (Island of the sun), which is a large, mountainous island on the Bolivian side of Lake Titicaca with lots of Tiwanaku and Inca ruins. It about another hour to get to the island but the view of the lake and islands on the way was incredible. When we arrived, we began our 2 hour trek uphill to our hostel. There were a lot of steep stairs and we all complained, but when we finally reached the top, where the hostel was located, we all shut up. It was a beautiful stone building of 3 stories with a large balcony on the 2nd and 3rd floor that looked out on the lake, the mountains, and the terraces beneath. We were all given coca tea, I shared my bar of chocolate, and we all just hung out, mesmorized by the view. After dropping off our things, we climbed another 30 minutes to a spot to watch the sunset and I met an Argentinian couple who found my hat after I dropped it, who are planning on doing a North America roadtrip with 3 kids. That night, we fell asleep early, squished into the bed by 3 heavy blankets on top. At least I wasn’t cold.
Last day in infectología
Last day in infectologia – I am really going to miss it. We started off with rounds again. Most of the same kids were there. Miguel, the boy with diphtheria, looked a lot better. His eyes were animated and he interacted with the nurses who came in to attend to him. The baby of the HIV positive mother was still there. While we were in outpatient clinic that morning, Dr. Velasco received the news that the baby was indeed HIV positive. Everyone’s spirits fell in the room for a moment, as it dawned on us that another person (a baby) now has to live with HIV. In Bolivia, due to the stigma of HIV, whenever they talk about HIV, they say “known disease”. So when the doctor received the news, he was told that the baby was positive for an known disease (diagnostico conocido). Since privacy is hard to come by in hospitals, they use code words for sensitive news and illnesses. Josef, the boy who went into surgery to remove the cyst in his lung due to hidatodosis, came back from surgery, and I helped the nurses transfer him from the stretcher to the bed.
Then we went to the outpatient clinic on the first floor. Outpatient clinic consists of each doctor getting a small office in which to see patients while all the patients mingle about outside the doors, sometimes getting inpatient enough to barge into the office, demanding that their child be looked at. The hospital is also terribly cold, as only the inpatient rooms are heated. The minute you step out into the hallway or a waiting area, the temperature drops by at least 10 degrees (from 70 to 60). Many doctors and nurses have begun wearing vests and jackets on top of their white coats. In consultorio, there were 6 of us medical students, and we took turns doing the physical exam on the children. I had to examine the ears, the lungs, and the heart on the child. They are all so terribly cute and innocent. Mostly, we saw children with fevers, the flu, and middle ear infections.
At one point, I saw one of the medical students come in with a small bag and a 2 liter bottle of coca-cola. I assumed he had brought his lunch and thought nothing of it. Then, after a patient left, the doctor told the nurse to tell the patients waiting outside that “we are cleaning the bed, or something”. Then, once the door was closed, he mentioned to the medical students, and said “quick, lets eat fast”. The coca-cola was opened, plastic cups were filled, and the bag revealed a heap of tucumanas and salteñas. I opted for a tucumana, the other special Bolivian empanada, which is filled with potatoes and spices. We chatted for about 10 minutes, escaping from the world that awaited us outside the small office, where children were crying and mothers were agitated from waiting so long. Afterwards, we hid the coca-cola and saw more patients. Eventually, he said we can all go, and I went up to him to tell him how much he has taught me this week and how I was interested in infectious diseases. After hearing that, he told me I could stay to see more patients with him. It was great, but I also had plans to exchange phone numbers with one of the medical students, and since they left, I never got to do that. On the other hand, the next patient we saw was a 2 month old baby. The mother was carrying him on her back, tucked into one of the blankets that the indigenous women wrap around the shoulders. When we asked her to put the baby on the bed, she untied the blanket and swung it around to the front. A baby was in there! Then she unlayered him of the 4 blankets that he was wrapped up in. Dr. Velasco then told me what I should check for (lungs, heart, development such as holding up his head by himself and the grip reflex, and hip dysplasia) and then left the room. I did the physical exam and checked for hip dysplasia by trying to separate the hips to 90 degrees. After about 30 degrees, the hips resisted. That’s a sign that there is hip dysplasia. The baby was half sleeping while I was doing the exam, and his hands trembled. They looked like convulsions. I asked whether these convulsions happened anywhere else, and the mother said they also happened in the legs as well. For the past two weeks, they woke the baby up and he couldn’t sleep at night. I asked about the tongue, and she said she has seen that as well. She could tell that it wasn’t a good sign. “Doctora, él va a estar bien?” she asked me if the child would be alright, if the convulsions could be fixed. I told her that I was only a medical student and silently hoped Dr. Velasco would come back soon. When he did come back, we ordered an x-ray for the hip dysplasia as well as a neurology consult and an EEG. I hope the child does not have epilepsy and I wonder how epilepsy is treated in Bolivia – do they have access to the same medicines as in the states, and how is the quality of life for someone with epilepsy in Bolivia compared to someone in the US. The mother had a simple and honest look of worry on her face – I hope the child will be alright.
Then we went to the outpatient clinic on the first floor. Outpatient clinic consists of each doctor getting a small office in which to see patients while all the patients mingle about outside the doors, sometimes getting inpatient enough to barge into the office, demanding that their child be looked at. The hospital is also terribly cold, as only the inpatient rooms are heated. The minute you step out into the hallway or a waiting area, the temperature drops by at least 10 degrees (from 70 to 60). Many doctors and nurses have begun wearing vests and jackets on top of their white coats. In consultorio, there were 6 of us medical students, and we took turns doing the physical exam on the children. I had to examine the ears, the lungs, and the heart on the child. They are all so terribly cute and innocent. Mostly, we saw children with fevers, the flu, and middle ear infections.
At one point, I saw one of the medical students come in with a small bag and a 2 liter bottle of coca-cola. I assumed he had brought his lunch and thought nothing of it. Then, after a patient left, the doctor told the nurse to tell the patients waiting outside that “we are cleaning the bed, or something”. Then, once the door was closed, he mentioned to the medical students, and said “quick, lets eat fast”. The coca-cola was opened, plastic cups were filled, and the bag revealed a heap of tucumanas and salteñas. I opted for a tucumana, the other special Bolivian empanada, which is filled with potatoes and spices. We chatted for about 10 minutes, escaping from the world that awaited us outside the small office, where children were crying and mothers were agitated from waiting so long. Afterwards, we hid the coca-cola and saw more patients. Eventually, he said we can all go, and I went up to him to tell him how much he has taught me this week and how I was interested in infectious diseases. After hearing that, he told me I could stay to see more patients with him. It was great, but I also had plans to exchange phone numbers with one of the medical students, and since they left, I never got to do that. On the other hand, the next patient we saw was a 2 month old baby. The mother was carrying him on her back, tucked into one of the blankets that the indigenous women wrap around the shoulders. When we asked her to put the baby on the bed, she untied the blanket and swung it around to the front. A baby was in there! Then she unlayered him of the 4 blankets that he was wrapped up in. Dr. Velasco then told me what I should check for (lungs, heart, development such as holding up his head by himself and the grip reflex, and hip dysplasia) and then left the room. I did the physical exam and checked for hip dysplasia by trying to separate the hips to 90 degrees. After about 30 degrees, the hips resisted. That’s a sign that there is hip dysplasia. The baby was half sleeping while I was doing the exam, and his hands trembled. They looked like convulsions. I asked whether these convulsions happened anywhere else, and the mother said they also happened in the legs as well. For the past two weeks, they woke the baby up and he couldn’t sleep at night. I asked about the tongue, and she said she has seen that as well. She could tell that it wasn’t a good sign. “Doctora, él va a estar bien?” she asked me if the child would be alright, if the convulsions could be fixed. I told her that I was only a medical student and silently hoped Dr. Velasco would come back soon. When he did come back, we ordered an x-ray for the hip dysplasia as well as a neurology consult and an EEG. I hope the child does not have epilepsy and I wonder how epilepsy is treated in Bolivia – do they have access to the same medicines as in the states, and how is the quality of life for someone with epilepsy in Bolivia compared to someone in the US. The mother had a simple and honest look of worry on her face – I hope the child will be alright.
Sunday, June 12, 2011
Salteñas
Today, I finally tried salteñas, a traditional bolivian version of an empanada. It’s juicier than an empanada, and packed with meat, vegetables, potatoes and egg. Delicious! As of yet, I am not sick. I just might make a salteña and yogurt my evening snack. For lunch, we usually eat a vegetable soup, rice or barley, some potatoes, and some type of meat. Apparently, Bolivia is the birthplace of potatoes and so there are thousands of different varieties. Yesterday, we tried a variety that was called “chuño” I think, it was small (a little bigger than a bean), black, and had a thick taste. I think I liked it. Today, we had pastel de quinoa, which was delicious! It looks like cornbread, but is made of quinoa, cheese, and egg. I’ll try to learn how to make it before I go back home. Other than that, I’ve been severely lacking on trying different foods. I’m giving myself a week to acclimate to the altitude before I try Bolivian wine =)
Hospital de los ninos - Rotation #1
Each week, I get to go on a different pediatric rotation, in different hospitals or in different specialties. The rotations are:
- Hospital de los Ninos (Children's hospital):
-Infectious diseases, Nephrology, Pulmonology, and Surgery
- Hospital los Andes: a pediatric clinic in El Alto (the poor neighborhood of La Paz)
- Servicio de Adolescentes: a clinic serving pregnant adolescents in La Paz
- Hospital Metodista: a methodist hospital with a pediatric ward
- Cardiology: a 2 week rotation with a pediatric cardiologist
The first 2 weeks we are already assigned rotations but I get to choose the next 4 weeks after that. Any suggestions?
This week, I was assigned to the Hospital de los Ninos, with Dr. Velasco in the infectious diseases ward. It is the only hospital to which I can walk to, and its about a 20-30 minute walk from where I live. The first day, I walk up to the 4th floor of the hospital and enter the infectologia ward - I immediately meet Dr. Velasco and his group of medical students and residents, and we begin rounds. The ward itself is quite small, with 14 beds, 2 beds in each room. The upper half of all rooms are glass though, so everyone can see each other, and the nurses can keep an eye on all the patients at once. The first child we see is Josef, a 5-6 year old who is diagnosed with hidatodosis (Echinococcus granulosa) - a parasitic infection that is common in Bolivia. It is usually contracted in children through dog feces which are left everywhere in the parks and streets of La Paz, within the reach of children. Once the parasite is inside the child, it lays eggs, which then create a cyst inside the child, usually either in the liver or the lungs (in this case it was the lungs). There are no symptoms until the cyst is large enough to impair function of the organ, at which point the child usually goes to the hospital, where they do an X-ray and see a large cyst in the lungs. Unfortunately, at that point, the only treatment is surgery (removal of the cyst) and this morning I saw them wheeling a crying Josef out of the infectologia ward to surgery. After seeing the patient, Dr. Velasco spent a few minutes talking about public health and regulations and its implications in the health of Bolivian children. If there were regulations that required owners to pick up their dog's feces and if street dogs were taken of the streets, then maybe the incidence of hidatodosis in children would decrease dramatically. Unfortunately, most people here get dogs for protection, and do not have enough money to feed them and take care of them. Next, we saw a little girl Victoria who had Leishmaniasis. Today, we did rounds again and I realized that there were 6 kids with Leishmaniasis in the ward. The infection can be visceral (inside organs) or cutaneous (cutaneous lesions). All these kids had cutaneous Leishmaniasis which is characterized by a lesion that starts out as a papule, turns into a nodule, and eventually develops into an ulcer with a center depression. The lesions do not cause any pain and continuously grow bigger, even as the center heals.
Dr. Velasco had me do a summary of a clinical history of one boy with Leishmaniasis that I had to present today along with all the other Bolivian medical students. The boy is 2.5 years old, who presented with a large lesion on his cheek 6 weeks ago that grew over the course of a few weeks. His mother tried different creams that she had around the house but the lesion did not go away, and 4 weeks later, developed a serous secretion from the lesion. The mother took him to the local clinic in the jungle (where they live) and the boy was referred to Hospital de los Ninos for treatment of cutaneous Leishmaniasis. What is interesting is that many of the patients in the infectious diseases ward are not from La Paz, where many of these infections do not occur, yet La Paz sees many of them solely because most cases get referred to La Paz, especially Hospital de los Ninos, which is the largest children's hospital in Bolivia.
Another case that we saw that day was a boy who had bloody ulcers inside his mouth and on his lips. His mother said he has had a fever for the past 15 days, had difficulty swallowing and breathing, but no soreness or lumps on the neck. The doctors went in to see the child and came back 5 minutes later with the diagnosis of Diphtheria - one in a few in Bolivia in the last 15 years. They immediately called a meeting of all the medical students and nurses, advising everyone to use all precautions necessary when caring for the child, especially since even vaccinated people can be carriers of the bacteria and spread the infection to other immuno-compromised patients. They also called doctors in other wards and hospitals to see whether there were any other cases of the infection. When I came in today, they mentioned how they contacted all the family members of the child and prescribed them antibiotics in order to prevent the spread of the infection. The boy looked utterly miserable, with sad and depressed eyes and with a mouth slightly parted that showed the bloody lesions that covered his lips and mouth.
The mother was questioned about whether he got all his vaccines when he was younger, and even though she says he did, the doctors believe he probably didn't.
The last case we saw that day was in the pulmonology ward, where a boy came in for some respiratory problems, and was found to have a thumbtack located inside his right lung that he inhaled around 2 years ago and had not presented with any symptoms until now. They performed a bronchoscopy to remove the thumbtack and now he is doing pretty well, recovering on antibiotics.
During all of this, Dr. Velasco was wonderful. At first he explained the basic points to me in English, and as I get more comfortable in Spanish, he involved me more in the learning and asks me questions as well as other medical students. the first day he taught us how to distinguish different pulmonary problems from the X-ray (alveolar vs. interstitial vs. pleuritis vs. hyperinflation) and what causes each type of pulmonary distress and thus how to treat it. Yesterday, we had grand rounds where we heard about an emaciated child with a hypothalamic pharyngioma, a little girl who burned her left hand by playing with an electrical cable, and a 14 year old girl who presented with intracranial hypertension and was found to have a large parieto-occipital tumor on the right side and also glioblastoma. Today, we presented our clinical history summaries and he gave us feedback. Tomorrow, I am presenting the clinical history of a 14 year old girl who was brought in by firefighters after they found her in an inebriated state with signs of physical and sexual abuse. Teen pregnancy is very common here, even in girls as young as 13-15, who usually become pregnant due to sexual abuse either by strangers or by people they know. Older adolescents usually get pregnant because they are not educated on contraception options or do not have the power to regulate their contraception use. Dr. Uribe, the medical director of the CFHI program, works with adolescent pregnant women and she says she enjoys seeing CFHI students because she sees that there are adolescents that do have a bright future and value education.
The doctors I work with here are incredibly altruistic and do phenomenal work with the people who need it most. Dr. Velasco is a strong proponent of public health and shadowing him this week really made me realize how important public health is to a society. You don't realize how important something is until you see what occurs in its absence. If anything, these 6 weeks will really help me understand why we learn the things we learn in medical school, besides the science. It seems that many of the illnesses I have seen so far could be prevented with better parental supervision. However, as Dr. Velasco was saying today, there are no beds and waiting areas designed for parents who come to the hospital to be with their kids (often from places outside of La Paz). When they do come, they leave the rest of their kids at home, many times unattended, where they can hurt themselves or burn themselves while cooking food. It seems like a never ending cycle. Also, today, we saw a girl whose mother was by her side. Dr. Velasco asked her whether she understood what was wrong with her daughter. The mother shook her head. Dr. Velasco went on to explain the swelling in the girls legs, how they had to drain the pus, and that she was going to recover well. Then, he asked the mother to repeat what he said back to him (just like we were taught!), but she said nothing. He finally asked whether she spoke spanish and she shook her head. So he said he'll have a nurse explain everything in her language. "Quechua or Aymara?" he asked. "Aymara" she answered. When we walked out of the room, he turned to me and said "None of us speak those languages" and Maria, a medical student mumbled "We really should learn." It's interesting to see the same things occurring in two very different countries, which are usually thought of being worlds apart. It was very similar to a Spanish patient who doesn't speak English, except here Spanish took the role of English.
Terribly sorry for the long post but I thought this would be interesting to most of you. I promise future posts will be a little more organized...maybe.
- Hospital de los Ninos (Children's hospital):
-Infectious diseases, Nephrology, Pulmonology, and Surgery
- Hospital los Andes: a pediatric clinic in El Alto (the poor neighborhood of La Paz)
- Servicio de Adolescentes: a clinic serving pregnant adolescents in La Paz
- Hospital Metodista: a methodist hospital with a pediatric ward
- Cardiology: a 2 week rotation with a pediatric cardiologist
The first 2 weeks we are already assigned rotations but I get to choose the next 4 weeks after that. Any suggestions?
This week, I was assigned to the Hospital de los Ninos, with Dr. Velasco in the infectious diseases ward. It is the only hospital to which I can walk to, and its about a 20-30 minute walk from where I live. The first day, I walk up to the 4th floor of the hospital and enter the infectologia ward - I immediately meet Dr. Velasco and his group of medical students and residents, and we begin rounds. The ward itself is quite small, with 14 beds, 2 beds in each room. The upper half of all rooms are glass though, so everyone can see each other, and the nurses can keep an eye on all the patients at once. The first child we see is Josef, a 5-6 year old who is diagnosed with hidatodosis (Echinococcus granulosa) - a parasitic infection that is common in Bolivia. It is usually contracted in children through dog feces which are left everywhere in the parks and streets of La Paz, within the reach of children. Once the parasite is inside the child, it lays eggs, which then create a cyst inside the child, usually either in the liver or the lungs (in this case it was the lungs). There are no symptoms until the cyst is large enough to impair function of the organ, at which point the child usually goes to the hospital, where they do an X-ray and see a large cyst in the lungs. Unfortunately, at that point, the only treatment is surgery (removal of the cyst) and this morning I saw them wheeling a crying Josef out of the infectologia ward to surgery. After seeing the patient, Dr. Velasco spent a few minutes talking about public health and regulations and its implications in the health of Bolivian children. If there were regulations that required owners to pick up their dog's feces and if street dogs were taken of the streets, then maybe the incidence of hidatodosis in children would decrease dramatically. Unfortunately, most people here get dogs for protection, and do not have enough money to feed them and take care of them. Next, we saw a little girl Victoria who had Leishmaniasis. Today, we did rounds again and I realized that there were 6 kids with Leishmaniasis in the ward. The infection can be visceral (inside organs) or cutaneous (cutaneous lesions). All these kids had cutaneous Leishmaniasis which is characterized by a lesion that starts out as a papule, turns into a nodule, and eventually develops into an ulcer with a center depression. The lesions do not cause any pain and continuously grow bigger, even as the center heals.
Dr. Velasco had me do a summary of a clinical history of one boy with Leishmaniasis that I had to present today along with all the other Bolivian medical students. The boy is 2.5 years old, who presented with a large lesion on his cheek 6 weeks ago that grew over the course of a few weeks. His mother tried different creams that she had around the house but the lesion did not go away, and 4 weeks later, developed a serous secretion from the lesion. The mother took him to the local clinic in the jungle (where they live) and the boy was referred to Hospital de los Ninos for treatment of cutaneous Leishmaniasis. What is interesting is that many of the patients in the infectious diseases ward are not from La Paz, where many of these infections do not occur, yet La Paz sees many of them solely because most cases get referred to La Paz, especially Hospital de los Ninos, which is the largest children's hospital in Bolivia.
Another case that we saw that day was a boy who had bloody ulcers inside his mouth and on his lips. His mother said he has had a fever for the past 15 days, had difficulty swallowing and breathing, but no soreness or lumps on the neck. The doctors went in to see the child and came back 5 minutes later with the diagnosis of Diphtheria - one in a few in Bolivia in the last 15 years. They immediately called a meeting of all the medical students and nurses, advising everyone to use all precautions necessary when caring for the child, especially since even vaccinated people can be carriers of the bacteria and spread the infection to other immuno-compromised patients. They also called doctors in other wards and hospitals to see whether there were any other cases of the infection. When I came in today, they mentioned how they contacted all the family members of the child and prescribed them antibiotics in order to prevent the spread of the infection. The boy looked utterly miserable, with sad and depressed eyes and with a mouth slightly parted that showed the bloody lesions that covered his lips and mouth.
The mother was questioned about whether he got all his vaccines when he was younger, and even though she says he did, the doctors believe he probably didn't.
The last case we saw that day was in the pulmonology ward, where a boy came in for some respiratory problems, and was found to have a thumbtack located inside his right lung that he inhaled around 2 years ago and had not presented with any symptoms until now. They performed a bronchoscopy to remove the thumbtack and now he is doing pretty well, recovering on antibiotics.
During all of this, Dr. Velasco was wonderful. At first he explained the basic points to me in English, and as I get more comfortable in Spanish, he involved me more in the learning and asks me questions as well as other medical students. the first day he taught us how to distinguish different pulmonary problems from the X-ray (alveolar vs. interstitial vs. pleuritis vs. hyperinflation) and what causes each type of pulmonary distress and thus how to treat it. Yesterday, we had grand rounds where we heard about an emaciated child with a hypothalamic pharyngioma, a little girl who burned her left hand by playing with an electrical cable, and a 14 year old girl who presented with intracranial hypertension and was found to have a large parieto-occipital tumor on the right side and also glioblastoma. Today, we presented our clinical history summaries and he gave us feedback. Tomorrow, I am presenting the clinical history of a 14 year old girl who was brought in by firefighters after they found her in an inebriated state with signs of physical and sexual abuse. Teen pregnancy is very common here, even in girls as young as 13-15, who usually become pregnant due to sexual abuse either by strangers or by people they know. Older adolescents usually get pregnant because they are not educated on contraception options or do not have the power to regulate their contraception use. Dr. Uribe, the medical director of the CFHI program, works with adolescent pregnant women and she says she enjoys seeing CFHI students because she sees that there are adolescents that do have a bright future and value education.
The doctors I work with here are incredibly altruistic and do phenomenal work with the people who need it most. Dr. Velasco is a strong proponent of public health and shadowing him this week really made me realize how important public health is to a society. You don't realize how important something is until you see what occurs in its absence. If anything, these 6 weeks will really help me understand why we learn the things we learn in medical school, besides the science. It seems that many of the illnesses I have seen so far could be prevented with better parental supervision. However, as Dr. Velasco was saying today, there are no beds and waiting areas designed for parents who come to the hospital to be with their kids (often from places outside of La Paz). When they do come, they leave the rest of their kids at home, many times unattended, where they can hurt themselves or burn themselves while cooking food. It seems like a never ending cycle. Also, today, we saw a girl whose mother was by her side. Dr. Velasco asked her whether she understood what was wrong with her daughter. The mother shook her head. Dr. Velasco went on to explain the swelling in the girls legs, how they had to drain the pus, and that she was going to recover well. Then, he asked the mother to repeat what he said back to him (just like we were taught!), but she said nothing. He finally asked whether she spoke spanish and she shook her head. So he said he'll have a nurse explain everything in her language. "Quechua or Aymara?" he asked. "Aymara" she answered. When we walked out of the room, he turned to me and said "None of us speak those languages" and Maria, a medical student mumbled "We really should learn." It's interesting to see the same things occurring in two very different countries, which are usually thought of being worlds apart. It was very similar to a Spanish patient who doesn't speak English, except here Spanish took the role of English.
Terribly sorry for the long post but I thought this would be interesting to most of you. I promise future posts will be a little more organized...maybe.
Orientation
Monday. A busy day. We had breakfast, which consists of coffee or tea, different types of bread, cereal, and butter or marmalade or nutella. Our host mother, Isabel, is really nice and she said we should make ourselves feel at home. So we are allowed to make eggs, toast the bread, take whatever cereal we want, and have coffee and tea whenever we want. Afterwards, we met our director at Plaza Avaroa, and then we walked to his office for lectures. He talked a lot of Bolivian culture – how it’s a very multinational country with many different beliefs. This obviously makes medicine difficult, as well learn in the United States because you have to adapt to your patient’s beliefs while also making sure they get the best care possible. Apparently, around 65% of Bolivia’s population is indigenous, and they speak a myriad of languages, the main ones being Quechua and Aymara. The other 3 countries with an indigenous majority are Mexico, Guatemala, and Peru. Overall, Bolivia is a safe country. It has no serious international disputes with any nation, no guerillas, and very little drug-trafficking relative to other countries. Bolivians prefer to keep their coca leaves natural. Side note: I finally chewed coca leaves. It was pretty good but I think I prefer the tea.
When I knew I was going to Bolivia, I thought I was going to stand out in the crowd. And I do. But I’ve noticed that most Bolivianos don’t notice me, or if they do, they don’t really care. Of course, there are pickpockets everywhere, but so far, no one has taken covert pictures of me or stared at me like they do in China apparently. Maybe the beggars plead a little bit more when I walk by than another Boliviano, but besides that, I don’t feel too inconspicuous.
Later that day, we had a Spanish placement exam. Two students opted out of the language lessons and are volunteering at an orphanage (Alalay) instead. It’s an organization that takes kids off the streets and provides them with a daily routine in their lives. They go to school, have chores, play in the playground, and have set meal times. I think after 3 weeks of language classes, I am going to volunteer there too. For now, I need to learn some Bolivian slang. Apparently, in Spain, “tirando” means bothered by, or annoyed. In Bolivia, it’s a slang term for having sex. Sigh, why does each Hispanic country have to have its own dialect and vocabulary?
After the placement exam, we went to another meeting, this time at the office of the medical director – Dr. Cecilia Uribe. Her office was small and cozy, with hard wood floors. It reminded me of my mother’s work in Russia – everything seemed so similar – a little run down, cozy, cold but with warm people (even if they pretend to be cold) and a certain air of simplicity. There is something magical about how simple life becomes when you travel. All of a sudden, you only know 5 people, and your decisions consist of where to eat, where to go, and when to sleep. My free time here usually consists of writing, reading about various diseases, or talking to people. When there aren’t too many choices, I feel more at peace. During traveling, indecisiveness doesn’t play a huge role in my life and probably is the cause of most of the stress of life at home. Anyways, Dr. Uribe talked to us about health coverage in Bolivia. At the moment, they are working on universal health coverage, but they haven’t achieved that yet. Here are some of the health insurances that cover people (all are from the government):
- SUMI: for pregnant women, 6 months after birth, and all children under 5 years of age.
- All government workers (inc. physicians)
- 6-18 year olds from El Alto who go to school
- Bank workers
- People in the oil industry
- People over the age of 60 (I think)
You can also buy insurance, most likely. But everyone who doesn’t have insurance can go to a public hospital which is very cheap. There, a social worker goes over your salary and assets and dependents, and decides how much you can pay. Its not the best system in the world, but it seems to be pretty good. Dr. Uribe says the problem is that many people never go to the hospital – especially among the indigenous populations (unless it’s the children who are sick). They only go when the person is very sick. This makes it very difficult to promote preventive healthcare. The doctor also works with pregnant adolescents, which she says is a huge problem in Bolivia. Contraception is not very popular here and sometimes the man wants to have the upper hand, so he prevents the mother from using contraception. Abortion is also very rare. Among the very young teenage girls (13-15), pregnancies are usually caused by sexual abuse and are probably the only cases in which abortions are done. Overall, it was a very informative talk.
Next, Hospital de los Ninos.
When I knew I was going to Bolivia, I thought I was going to stand out in the crowd. And I do. But I’ve noticed that most Bolivianos don’t notice me, or if they do, they don’t really care. Of course, there are pickpockets everywhere, but so far, no one has taken covert pictures of me or stared at me like they do in China apparently. Maybe the beggars plead a little bit more when I walk by than another Boliviano, but besides that, I don’t feel too inconspicuous.
Later that day, we had a Spanish placement exam. Two students opted out of the language lessons and are volunteering at an orphanage (Alalay) instead. It’s an organization that takes kids off the streets and provides them with a daily routine in their lives. They go to school, have chores, play in the playground, and have set meal times. I think after 3 weeks of language classes, I am going to volunteer there too. For now, I need to learn some Bolivian slang. Apparently, in Spain, “tirando” means bothered by, or annoyed. In Bolivia, it’s a slang term for having sex. Sigh, why does each Hispanic country have to have its own dialect and vocabulary?
After the placement exam, we went to another meeting, this time at the office of the medical director – Dr. Cecilia Uribe. Her office was small and cozy, with hard wood floors. It reminded me of my mother’s work in Russia – everything seemed so similar – a little run down, cozy, cold but with warm people (even if they pretend to be cold) and a certain air of simplicity. There is something magical about how simple life becomes when you travel. All of a sudden, you only know 5 people, and your decisions consist of where to eat, where to go, and when to sleep. My free time here usually consists of writing, reading about various diseases, or talking to people. When there aren’t too many choices, I feel more at peace. During traveling, indecisiveness doesn’t play a huge role in my life and probably is the cause of most of the stress of life at home. Anyways, Dr. Uribe talked to us about health coverage in Bolivia. At the moment, they are working on universal health coverage, but they haven’t achieved that yet. Here are some of the health insurances that cover people (all are from the government):
- SUMI: for pregnant women, 6 months after birth, and all children under 5 years of age.
- All government workers (inc. physicians)
- 6-18 year olds from El Alto who go to school
- Bank workers
- People in the oil industry
- People over the age of 60 (I think)
You can also buy insurance, most likely. But everyone who doesn’t have insurance can go to a public hospital which is very cheap. There, a social worker goes over your salary and assets and dependents, and decides how much you can pay. Its not the best system in the world, but it seems to be pretty good. Dr. Uribe says the problem is that many people never go to the hospital – especially among the indigenous populations (unless it’s the children who are sick). They only go when the person is very sick. This makes it very difficult to promote preventive healthcare. The doctor also works with pregnant adolescents, which she says is a huge problem in Bolivia. Contraception is not very popular here and sometimes the man wants to have the upper hand, so he prevents the mother from using contraception. Abortion is also very rare. Among the very young teenage girls (13-15), pregnancies are usually caused by sexual abuse and are probably the only cases in which abortions are done. Overall, it was a very informative talk.
Next, Hospital de los Ninos.
Thursday, June 9, 2011
The first few days
The altitude hit me. I didn't take prophylaxis pills before coming, so while my roommate Annie was ready to explore La Paz, I buried my head into a pillow and slept. It felt (I imagine) like a really bad hangover. Eventually, i crawled to the kitchen to get some water, and from that moment on, things got better. Annie came home soon after and we went back out together to exchange money and get to know each other. We just walked up the main street (6 de agosto - Bolivia's independence day) and eventually found a cafe - apparently one that is popular in the Bolivian dating scene. It's easy and difficult to get lost in La Paz. There are no street signs so I finally understand why people give directions by landmarks (turn right at the 2nd roundabout, then look for the bridge, pass that bridge, take a right on the first street after the bridge, and look for a red and yellow house) - Those were our instructions to the language school. If we were given street names instead of landmarks, we would never have found the school. It's difficult to get lost though because north is always uphill and south is always downhill.
Sunday we met up with the other participants. All together, there are 14 of us. Most of the people are from the US and in university or doing a post-bac. Then there are the two Canadian girls from Montreal who just finished their 2nd year of medical school, 2 girls from New Mexico that just finished 1st year of medical school, and a girl named Sophie from London who studied Russian and Spanish at university and now wants to apply to medical school. We are pretty loud together and overwhelming, but when I'm with just a few of them, we get along well.
We decided to walk through the centre of La Paz, and stumbled upon a sunday market on the main street. Instead of just selling trinkets and cheap things, the market also included activity booths for children, such as face painting, health education, how to care for the environment, and other things like that. It made me smile that there was something for the kids. I also noticed that there were no other foreigners. The few that we saw (3) were dread-head hippies. Maybe its because its winter, but I almost never encounter other tourists in La Paz. Maybe when we start traveling to the touristy spots, we'll see more. After the Sunday market, we walked up to the mercado de hechiceria (Witches' market). Yup, I saw the llama fetuses - they are used for good luck when you buy a new house apparently. Anyways, if anyone wants anything specific from Bolivia, please let me know. Alpaca sweaters, fuzzy gloves/mittens, scarves, pachamama figurines...
Then, we went to the mercado negro, where there were people selling everything. Each street sold a different product: Rice street, potato street, Spices street, toilet paper street...I'll have to go back to get some souvenirs.
This is very behind, I know, but I will catch up eventually, I promise.
This week I am rotating at Hospital de los Ninos (Children's hospital) in the infectious disease ward with Dr. Velasco - so far, it's amazing. More on that later.
Sunday we met up with the other participants. All together, there are 14 of us. Most of the people are from the US and in university or doing a post-bac. Then there are the two Canadian girls from Montreal who just finished their 2nd year of medical school, 2 girls from New Mexico that just finished 1st year of medical school, and a girl named Sophie from London who studied Russian and Spanish at university and now wants to apply to medical school. We are pretty loud together and overwhelming, but when I'm with just a few of them, we get along well.
We decided to walk through the centre of La Paz, and stumbled upon a sunday market on the main street. Instead of just selling trinkets and cheap things, the market also included activity booths for children, such as face painting, health education, how to care for the environment, and other things like that. It made me smile that there was something for the kids. I also noticed that there were no other foreigners. The few that we saw (3) were dread-head hippies. Maybe its because its winter, but I almost never encounter other tourists in La Paz. Maybe when we start traveling to the touristy spots, we'll see more. After the Sunday market, we walked up to the mercado de hechiceria (Witches' market). Yup, I saw the llama fetuses - they are used for good luck when you buy a new house apparently. Anyways, if anyone wants anything specific from Bolivia, please let me know. Alpaca sweaters, fuzzy gloves/mittens, scarves, pachamama figurines...
Then, we went to the mercado negro, where there were people selling everything. Each street sold a different product: Rice street, potato street, Spices street, toilet paper street...I'll have to go back to get some souvenirs.
This is very behind, I know, but I will catch up eventually, I promise.
This week I am rotating at Hospital de los Ninos (Children's hospital) in the infectious disease ward with Dr. Velasco - so far, it's amazing. More on that later.
Tuesday, June 7, 2011
Homestay
As I thought, I live on the south side of the center of La Paz, in the Sopocachi district, which is known for its lovely cafes, restaurants, and nightlife. Zona Sur is south and the rest of the city rises up to the north, via La Paz's main road (El Prado). I share a room with a Quebec girl Annie, who is great. We get along very well and she is just as adventurous, so we had fun exploring the city the day we arrived. We live in a spacious 3-bedroom apartment in a high-rise, overlooking a plaza that has a playground and a cevicheria stand that says: "Si no esta rica, no paga" (If it doesn't taste good, don't pay). Via the cevicheria stand, I find my way home, since there are no street signs (Molly would go crazy!). Our host mother is a Bolivian woman in her 30's, who has an 8 year old daughter who is super cute and loves nutella. There is also a maid named Sonia, who is 20 years old, and knows 3 languages (Quechua, Aymara, and Spanish). Informally, we decided that I'll teach her English words and she'll teach me Aymara words. There is also another exchange student from California who is staying with the host family. She is doing a 10 week public health program in La Paz, interviewing public health and hospital directors in La Paz, as well as women who come to a certain clinic she is working with about sexual and reproductive practices among the people in La Paz, and its association with cervical cancer, which is apparently the most common cancer present in Bolivianos. It is interesting to come here when HPV is so common and where the vaccine is an important part of preventive care, in contrast to the US where I feel like the vaccine is only now beginning to become popular and known among everyone. So, that's our family. We all meet for lunch at around 2pm, as that is their biggest meal of the day. Dinner is usually no more than a small snack, because due to the altitude, digestion is slowed, and eating a lot before going to sleep means you won't be able to fall asleep for hours. I am getting used to the altitude, no more waking up with a sober hangover - yay! Although, I still get out of breath when walking up the constant hills, and get a pounding headache 10 minutes into exercising. But looking out the window of my bedroom and seeing snow-capped mountains beyond all the buildings makes it sort of worth it.
Sunday, June 5, 2011
First Impressions
The flight to Bolivia was uneventful, full of other program participants. We landed in the world's highest public airport in El Alto. The airport itself was one huge room, sectioned off into a nice little gift shop, an immigration line, 4 immigration booths, and one baggage claim belt. It also smelled like vomit. When a guy in fatigues checked my documents, he muttered "Una Rusa con documentos americanos, interesante..." (A russian with american documents, interesting) and handed them back to me. It never fails to confuse people.
We finally gathered everyone from the flight that was in the program, and were ushered into taxis. It was 7am in the morning and the fog was thick. Unfortunately, it made it difficult to see the rest of La Paz from el alto until we were halfway down the mountain. The road was just like you would imagine, we careened down the mountain in circles, making those aware of the consecutive loops terribly nauseous. The air was practically opaque, and I couldn't really decide whether it was the fog or pollution, or a thick mixture of both. The smell flip flopped back and forth between vomit, exhaust from the trucks, or burned trash, although eventually it all got mixed together that I couldn;t tell one from the other. Despite all this and the lack of sidewalks on the mountain road, there was an abundance of joggers (both male and female), all Bolivians, running both up and down the mountain. Some of these joggers were running up the mountain at an elevation at 4,000m. Incredible. I wonder why Bolivians don't run marathons more frequently. As the taxi made its way down the mountain, the brown shacks of El Alto turned into the city of La Paz itself. Whereas most of the European cities are gray and clean, La Paz is colorful and dirty. Old buses and trucks rumbled on and many yellow-colored walls were adorned with graffiti and iron bars. Luxurious inns are nestled between unpainted make-shift food stands and tall buildings, though far from soviet-style, display a similar stoicism in the exterior. In contrast, the people are beautiful. I think in Europe, our eyes are first drawn to the architectural sites, whereas here, there is nothing to distract you from people-watching. There is a huge contrast between traditional and modern. Cholitas (indigenous women who live in the city) still wear traditional dresses with bowler hats, while chatting with their younger relatives who wear jeans, converses, and brand-name t-shirts. People are the same everywhere, no matter how different they may look or how different their living conditions might be. As we drove through La Paz in the morning, people woved in and out of traffic, made small talk with other vendors around them, rushed to work, and couples flirted with each other. Noticing such similar things taking place everywhere makes the place a little less foreign, when you realize that in the end, we're all human. I think I'm going to like this city.
We finally gathered everyone from the flight that was in the program, and were ushered into taxis. It was 7am in the morning and the fog was thick. Unfortunately, it made it difficult to see the rest of La Paz from el alto until we were halfway down the mountain. The road was just like you would imagine, we careened down the mountain in circles, making those aware of the consecutive loops terribly nauseous. The air was practically opaque, and I couldn't really decide whether it was the fog or pollution, or a thick mixture of both. The smell flip flopped back and forth between vomit, exhaust from the trucks, or burned trash, although eventually it all got mixed together that I couldn;t tell one from the other. Despite all this and the lack of sidewalks on the mountain road, there was an abundance of joggers (both male and female), all Bolivians, running both up and down the mountain. Some of these joggers were running up the mountain at an elevation at 4,000m. Incredible. I wonder why Bolivians don't run marathons more frequently. As the taxi made its way down the mountain, the brown shacks of El Alto turned into the city of La Paz itself. Whereas most of the European cities are gray and clean, La Paz is colorful and dirty. Old buses and trucks rumbled on and many yellow-colored walls were adorned with graffiti and iron bars. Luxurious inns are nestled between unpainted make-shift food stands and tall buildings, though far from soviet-style, display a similar stoicism in the exterior. In contrast, the people are beautiful. I think in Europe, our eyes are first drawn to the architectural sites, whereas here, there is nothing to distract you from people-watching. There is a huge contrast between traditional and modern. Cholitas (indigenous women who live in the city) still wear traditional dresses with bowler hats, while chatting with their younger relatives who wear jeans, converses, and brand-name t-shirts. People are the same everywhere, no matter how different they may look or how different their living conditions might be. As we drove through La Paz in the morning, people woved in and out of traffic, made small talk with other vendors around them, rushed to work, and couples flirted with each other. Noticing such similar things taking place everywhere makes the place a little less foreign, when you realize that in the end, we're all human. I think I'm going to like this city.
Wednesday, June 1, 2011
Preparation
It’s gotten to the point where there are a few scattered books and pieces of clothing lying around, reluctantly discarded during the packing process. I feel the tingling butterfly excitement that I always get right before a trip. It peaks when the bags are almost full, and there is a rush to put all the little outliers in my life back in their place.
La Paz is the highest capital in the world, ranging from 3,600 – 4,100m as it slopes upward towards the pointy, white-capped Andes mountains. Height correlates to wealth, as most of the wealthy live in the lower portions of La Paz (Zona Sur) and the poorest live in El Alto, roughly translated into “the heights”. I get to live somewhere in between, in the center.
I am sure most of you have heard me whine about how terrified I am of kids and how uncomfortable I feel around them. So why pediatric health of all things? I have no idea.
Probably because I am addicted to new things. It's like a game - "can you handle this? Can you handle that? Hmm...seems you can. Okay, we'll try something harder." Yes, I do talk to myself in dialogue. This wasn't what I had in mind when planning this summer, but the best things are never planned anyways. I cannot wait to be oxygen deprived.
It's finally summer! =D Eek!
La Paz is the highest capital in the world, ranging from 3,600 – 4,100m as it slopes upward towards the pointy, white-capped Andes mountains. Height correlates to wealth, as most of the wealthy live in the lower portions of La Paz (Zona Sur) and the poorest live in El Alto, roughly translated into “the heights”. I get to live somewhere in between, in the center.
I am sure most of you have heard me whine about how terrified I am of kids and how uncomfortable I feel around them. So why pediatric health of all things? I have no idea.
Probably because I am addicted to new things. It's like a game - "can you handle this? Can you handle that? Hmm...seems you can. Okay, we'll try something harder." Yes, I do talk to myself in dialogue. This wasn't what I had in mind when planning this summer, but the best things are never planned anyways. I cannot wait to be oxygen deprived.
It's finally summer! =D Eek!
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