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!