Yarn

Hi Aunt Jean,

This little post is just for you: I got you a TON of 100% fine spun Alpaca yarn today. There's three colors and it smells good too. My senora said I went to the best store in Bolivia to buy it, but I just happened on it by chance today during my afternoon shopping! They take it off of these giant spools and weigh it for you, it was fun. I can't wait to see what you make with it. One of the colors I got was pink because I thought maybe you could make something for Clare to wear. It's very soft. I also got a blue color too in case Ellie and Ron get any ideas. Miss you and see you soon! Love!

Girls and Ladies

Kristen left yesterday. We knew each other for only 4 weeks but I can't stop saying how much I will miss her. Casey put it best when we were walking home last night- she has the very rare ability to pacify everyone around her. I learned a lot from her as my rotation partner, it won't be the same now that she's gone. But Kristen, if you are reading this, you promised to visit me, so I will see you in New York this winter!

The goodbye dinner was so delicious. My stomach decided to feel better just in time too! We went to this Italian bistro and I ordered a really good mushroom stuffed ravioli with a white wine, lemon, garlic, three cheese sauce. I wish I had brought a camera, the plates were so pretty when the waiter brought them out from the kitchen. It's amazing how our group has become so close in such a short amount of time. It's not that surprising however. Everyone is very interesting and passionate about medicine; we all want to change the world in more or less the same way.

Today, I happened to take the same mini-bus as Molly, a new arrival for the August program. She's fantastic! We chatted all the way to El Alto, which took longer than usual because of a protest about banking. (To my understanding, the Bolivian government takes 10-12% of everyone's salary and these funds are managed by a foreign company. Recently, the government nationalized these funds, taking them away from the private, foreign company, promising to redistribute the money in favor of the campesinos and lower income bracket. However, the government revoked the deal and decided to leave the funds privatized, which angered the campesinos. So the campesinos rushed a building, took to the streets, and wrecked a door with some dynamite. We walked past it today, there were a bunch of guards milling around the door. Not very exciting, I promise. But traffic sure was a mess!)

Anyways, we arrived at Hospital de los Andes to work with Dra. Uribe. She is married to Dr. Chavez and they have three kids together. They are the most beautiful, smart, philanthropic couple I've ever seen. Dra. Uribe has taken under her wing the case of a three year old boy with primordial dwarfism. There are only 5 known cases in the world of this birth defect. I met the little boy, Israel, and he just steals your heart. He is no larger than a 3 month infant but he is more cognizant- he gave me a hug and kiss on the cheek when he met me, and he will be in the clinic again tomorrow. His father left his mother, who is a wonderful, loving woman but obviously very scared for her son. She does not have the financial resources to give him the medical attention he desperately needs. With a lot of help, he may live until he is in his twenties but he will always have serious health problems. If anyone is interested in donating to this hospital to help children like Israel, please visit www.cfhi.org.

I was happy today because I performed several wellness exams and I am getting better! It's hard to provoke a gag reflex in small children but I finally did it and I am getting the hang of checking vitals as well. This adorable couple came in with two girls and boy. The oldest girl liked me because I taught her how to use a stethoscope to listen to a stuffed frog and monkey. They are both of excellent constitution in case you were curious. The girl was jumping around the exam room and the father joked to me that she is more like son sometimes. They have eight children in total, not uncommon for families in El Alto.

There was another memorable case today as well. A girl named Lady came in and she was only fifteen. Her baby boy was over a year old and she had had a very rough life. It breaks my heart to see young girls in Lady's situation. When she walked in, her baby had no socks on his feet, so Dra. Uribe gave him a pair of booties and lectured Lady in a firm but gentle tone about her son's health. Lady left a social work facility and returned to her boyfriend, who disallows her to find work. Knowing everything this girl has been through, it's hard to criticize her for her decisions, but her little boy shouldn't have to continue the cycle of victimization. My God, they are both still children. And what can I say when she wraps him in the rainbow Aymara blanket, smiles "gracias doctoritas, ciao!" and walks out the door?

Finally, I will begin work at Alalay on Monday. I'm excited to work there with girls like Lady. It will be an opportunity to establish relationships and make a small difference. Thank you Gonzalo (program director in La Paz) for arranging this for Alex and I. You're the best.

Any Given Sunday

On Sunday, Marie, Casey, Lysi and I went to San Francisco for mass. The walk there was fun because every single Sunday in La Paz, the streets are blocked off for a carnival. Bands, dancers, performers all set up little stages and shopkeepers set up kiosks with jewelry and hand-made goods. Because the referendum is coming up, there were several cars which were absolutely drenched in posters proclaiming Evo Morales as the savior of Bolivia, and people would walk around with megaphones saying vota por Evo! vota por Evo! Flags and posters everywhere, you can't escape anything.

San Francisco was so beautiful. Although my stomach wasn't in the holiest mood that day, the church is quite arresting. It affronts all your senses and then some. Gold inlay is everywhere you look, and the exterior is just as exquisite. It was built in 1549 and you can see a picture of it on this website: http://www.twip.org/image-south-america-bolivia-la-paz-church-san-francisco-church-gl-9346-2840.html

Anyways, during the offertory ceremony, an usher grabbed me and Casey and asked us to bring up this doll of a Bolivian woman riding a horse to the priest. We just walked really slowly and gave it to the priest but I felt so weird, like everyone was watching me. Well, they were. Also, I still haven't figured out why the priest needed this doll as part of the mass.

Afterwards, I bought Señora some roses that a woman was selling outside of the church. We had lunch together with Jovita in Café Fridolin, this Austrian pastry shop that is my new wifi hangout. I am here right now eating this cake called The Black Rose, which actually looks like rose, but the petals are thick slivers of dark chocolate. Jealous? Anyways, after lunch, the CFHI gang went to see some wrestling. I know, it sounds weird, but people get really into it here. There is an old tradition, Cholita wrestling, in which Cholitas from different villages fight each other before the harvest. If you water the ground with your blood, you will be rewarded with an abundant crop. Okay. Now mix this ancient tradition with Fox's WWF wrestling and there you have it. A Cholita cracking a wooden box over a guy's head, while a midget dressed like Aquaman runs between their legs. It was oddly entertaining but I don't think I need to see it again.


I forgot to mention something. When Alex and I took the minibus to El Alto to see the wrestling fight, I sat next to this old guy who was the nicest guy ever. I promised myself I would mention him here. He told us how to get to the stadium and to be careful, etc. and was so cute besides. He acted like it was the coolest thing that I was from the U.S. and asked me, how do you like Bolivia? Are we being good to you? Um, Yes!!! Big, hearty handshake on the way out of the bus. And then, when I was waiting in line to buy a ticket for the wrestling match, the guy in front of me in line gets me going on the same conversation. Wow! You're from the states? How do you like Bolivia? What have you seen so far here? Everyone is so proud of this country, they have a real team spirit going on. I think this will be what I miss most when I leave.

Any excuse for a parade...

Today there was a parade, celebrating 78 years of UMSA’s (Universidad Mayor de San Andres) autonomy. Bolivians know how to parade. I took a lot of pictures. The costumes and dancing are incredible, they block off main streets all day and go crazy. This was even better than the parade on the Day of La Paz. The band played the same 12 notes for 3 hours and Alex and I wove our way in and out of the band, attempting to get home before Senora’s lasagna got cold. We almost made it too.

Night Life

Friday afternoon was Ben’s birthday. We went to Café Beirut for some food and then headed out to this bar called Utopia. It was radical. The bar was a little more than a hole in the wall, but it was a really funky place. It was very dim, only 5 candles lit the two small rooms. The candle holders were these iron cast mini skeletons of horses, people, and dragons. There was a 10 page drink menu, but since I drink red wine and since there is only one type of wine, my life is pretty easy. There were 2 fish tanks, each with one enormous fish in them. The fish were the size of a bicycle tire and very scary looking in the glow of the candlelight. I would be sipping my drink and forget they were floating there and then turn my head to see this giant fish staring back at me. After Utopia, we went to a disco, the first proper dancing place I’ve been to since arriving. It was awesome; they played a mixture of Spanish and American rock and hip hop. The whole CFHI bunch was all together because it was Ben’s birthday and we were the only white people in the club. I’m sure we looked funny, but I was having so much fun I didn’t notice. The other really nice thing about Bolivia is that you have everything you want close to home. This dance club is two blocks from my house, as is the bar and the café in which I am writing this journal. I can’t believe it’s been three weeks, it feels like so much less.

My Rapier

The shopping here is amazing. I really mean it. Near Plaza de San Francisco there is a market district where you can find all sorts of hand made goods. The quality and price are unbeatable. Haggling is fun and the shop keepers are very nice. I bought a rapier from this adorable family, the dad sat out front and the mom was tucked inside the little store, breast feeding her wawita (the Aymara word for child). The rapier is a cool weapon, it has horse hair and porcupine quills on the sheath. They had a small store with a little bit of everything, dolls (yes, mom), weapons, porcelains, rugs, you name it. Kristen, Marie and I walked for hours through the incredible traffic on the sidewalks and streets. There are so many people. It always looks like the rock concert just got out. Kristen is more cautious about crossing the streets and has better side vision, so I’m sticking with her. No close calls, but they drive like 10,000 maniacs.

A hard day

Friday morning was hard. We saw a lot of sad cases in Dr. Velasco’s office. A young mother, an HIV positive baby, a little girl with a serious skin problem, and mothers who couldn’t afford medicine for their kids. Sorry to sound sensational. The emotions were very real and I’ve been thinking a lot about these people so it feels right to mention them. I felt sad and awkward at the same time that morning. The shoes I wore cost more than the medicine required for a little boy to get well. There are some things in this world I don’t understand and can’t begin to justify. We said goodbye to Dr. Velasco and Pamela and it was sad to leave, but I hope this is just the beginning.

My roommates

Thursday night Casey, Alex and I went to this Argentine restaurant. Just when I thought the food here couldn’t get better. The waiter was such a classy guy, and he looked like a movie star. The food was really good, especially the bread which came with four kinds of dip. It was nice having dinner just the three of us. This roommate situation is marvelous. We are all so different but I love just talking with them, Casey and Alex are such smart, funny, engaging fascinating people. I’m so glad they are here with me. I’m learning so much from them. Good friends share experiences and great friends make them. No doubt, they’re great. We got ice cream afterwards at Dumbo, it’s like Bent Spoon meets Mitchell’s. In other words, it’s also great. I finally remembered to take a picture of the mural on the Prado. It’s a work in progress and it’s awesome. I saw a Cholita working on it during the day, and boy do I wish I had a trace of artistic ability with a paint brush. I know that I maxed out with eyeliner. The graffiti here is cool, mostly religious and political, but all very positive. My favorites are the bible passages on Puente de Americas and the random Te Amo messages on side streets.

Some musings

If I could change anything, I would make the water pressure in my shower triple what it is now. And hot.

There are vendors on the street for everything. Shoelaces. Watches. A Bolivian version of popcorn, but it is sweeter and each piece is 4 times the size of normal popcorn. It’s a bit softer as well. Toilet paper. Fresh squeezed papaya juice. I’m not kidding, everything.

Sometimes Arminda recites Spanish poetry after lunch. I can’t keep up, she’s so damn good. She does Neruda, Machado, Lorca, P. Diddy, the whole bunch. Okay, not P. Diddy.

I love the people in this city, they are so friendly and nice, it’s surprising. People hold open doors for you, greet you at every hour of the day, and are courteous in general. But if you ask them for directions and they don’t know, rather than admit it, they just lie. So you have to be careful.

I like hearing the music of the city. The car horns, the dogs barking…But this sound is my favorite: when you walk on a street, cars go by, and you hear their radios fade up and out. So it’s like a patch work quilt of sound, you get some talk shows, some rap, some instrumental, radio DJ’s. Maybe it just sounds cooler because it’s in Spanish. I’m in a café now, and I like listening to the music video mixed with the waiters chatting quietly behind the counter.

Today Gerrardo suggested the four of us give Dr. Velasco a gift certificate to his favorite restaurant, as a thank you for his wonderful mentoring. We all agreed, Gerrardo's absolutely right, too much kindness goes un-thanked in the world.

I'm sick of the same car alarm going off everywhere.

The other week, a bunch of us went to see Batman. Heath Ledger and Aaron Eckhart were amazing. Go see that movie.

Veronica

Yesterday was wonderful, the best day so far, no doubt. My health is improving and I’m actually adjusting to the altitude, which is really exciting, as it should be. We always learn so much from Dr. Velasco, he is so kind and such a great mentor. In the afternoon, Fernando and I browsed around for teaching supplies for English classes, but it’s really expensive! I decided to wait it out and it was a good thing too because after meeting with the program director, it became abundantly clear that I just don’t have enough time here to teach an effective class. That day, we had dinner at a Thai place, which was fancy, expensive and delicious. The waiter wore a tux and had the deepest voice I’ve ever heard. Actually, it was funny. I had shrimp in a coconut lime sauce and my new favorite wine, Campos de Solana. It’s very grapey and not too strong. You can tell I’m a true connoisseur from that description. Anyways, we went to a jazz club after dinner. Bolivian jazz is awesome! The club was called Thelonius, imagine that! Mom, aren’t you glad you forced me to take piano? I loved it so much, and the singer came over to our table later to chat with us while the band took a break. She was from Canada, like Kristen (= automatic love connection) and her name was Veronica! (= another automatic love connection.) She lived in Canada for 20 years and moved back to Bolivia because she needed anarchy instead of the 9 to 5 life in Canada. She had a really sultry voice and was a very interesting person. I can’t get over the fact that she shares my sister’s name. We were the only people in the club for most of the night; the bartender gave us free drinks as a thanks for coming on a Tuesday. After we got home, Alex and I stayed up late talking about life, love, friendship. It was a good night.

Grace

Grace is the nurse from Holandes. At first, I thought she didn't like me. She is very beautiful and quiet. After a few days, I realized she was a lovely person. She invited Kristen and me to assist her in the delivery room tomorrow night! I'm so excited. Last week, Grace asked me to translate an article for her. It was a long, technical publication of a study on pneumonia. I was horrible! My limited Spanish was supplemented by many hand gestures and circuitous explanations but we got it done :) and Swati told me that Grace was talking about me to the other students this week. We sat on her bed in the living quarters of the med students and forced it out. It was kind of like giving birth, but much less so obviously. Did I mention I'm adopting?

Week 3

This week Kristen and I are working at Hospital del Nino. It is a fifteen minute walk away from my home on 6 de agosto. This is great for two huge reasons: 1. I can sleep in. 2. I don't have to take public transportation. We cross the bridge and arrive on Monday morning in the medical district of La Paz. Women sit on the sidewalks selling white lab coats, hospitals line both sides of the street, and scrubs appear to the community uniform. There are so many hospitals in this area!

Hospital del Nino is a three story building, wealthier than either hospital from the two previous weeks. There are computers in the exam rooms, soap and warm water, heat, and many other things that I feel surprised to see again. I used to take things like this for granted. The cool thing about this hospital is that it specializes in infectious diseases, so I get to see some interesting cases in addition to the normal check-ups.

Doctor Velasco is so amazing. He greets us with a huge hug, smile and kiss on the cheek. As if we didn't feel welcome, he keeps asking us questions, how are you doing? do you understand this? The first day, we see some very seriously sick children. We sit in on a meeting of the doctors, discussing possible courses of treatment. The cabeza of the department is very intimidating. He throws his weight around, raises his voice with patients, other doctors, residents, nurses, everyone. I don't like him, although I must admit, I really respect his expertise. Dr. Velasco stands up to him, it's impressive. He's just as confident but less aggressive. Anyways, Dr. Valasco is amazing for so many reasons. Aside from being a sweet man, he is a great doctor and mentor. He gives us a power point presentation on Tuberculosis, encourages questions, answers questions in lengthy detail, praises our efforts, allows us to work closely with patients, asks us to analyze x-rays, gives us homework...Oh yeah, and he begins the day by praying with Pamela, his assistant, for the grace to help every patient he sees. In short, I feel very lucky to be here, I have so much to learn from him.

Jovita

I have a new goal. I want to get the phone numbers of the nurses I work with each week. I am two for two so far. I met Jovita at Los Andes, she is such a sweet girl. She took Alex and me out dancing, it was...interesting. At the first club we visited, the people lined up in two lines. You face your partner but do not touch. Also, by some silent agreement, everyone knew the moves to songs that used to be popular in 1994. We left, feeling a bit too old for that establishment. The other place we went to was also interesting. I danced with this 70 year old man named Juan who worked for the mayor or some such thing. He and his company kept praising Evo Morales, tourism, America, and how much they loved Alex and me. I doubt we have a future, but he sure could get down and dance, as Alex will unfortunately not let me forget. Jovita has also introduced me to an organization that assists orphans and street children, where I plan to teach English lessons starting Tuesday. She is such a sweet girl and a true friend.

El Camino de Muerte

This weekend we went to Coroico, riding a bus on the Road of Death. Its name derives from its record of the highest mortality rate in the world. I wasn't worried until we went around the first corner- I totally understand the name. It was like riding a really, really bad roller coaster. The bus had no shocks, we felt every bump from the unpaved road. The road dips and twists unexpectedly, cars appear out of nowhere, and as we drive through clouds trucks materialize like ghosts. Coroico is a small city on a hill, much warmer and lower than La Paz. It took leaving La Paz to realize a few things I hadn't noticed. There are no clouds or trees in La Paz. When I saw these things again for the first time weeks, I was surprised to say the least.

We stayed at the Hotel Esmeralda, it was lovely. Marie, Alex and I shared a room overlooking the mist-covered, tropical mountains. We had lunch in a German restaurant, it was delicious food, most people ordered these German noodles and beef. Swati and I shared a veggie pizza and for dinner we went to Bamboo, the best Mexican food I've ever had. The burritos were out of this world. Afterwards, our group spent the night hanging out and drinking wine in the social room of our hotel. The ride back was uneventful but it felt longer. It's good to be back in La Paz.

This week Kristen and I will work in Hospital de los Ninos, for which I am very excited. Last week we worked in Boliviano Holandes. Dra Gemio was less engaging than Dra Gutierrez but still very sweet and knowlegeable. Holandes has much more money and resources than Hospital de los Andes. Holandes is three stories tall, with many doctors and nurses bustling everywhere, announcements floating over the PA system. Dr. Chavez let us follow him one morning in the NICU, it was so wonderful. He took pains to explain the biochemical processes involved behind the medical procedures we witnessed. I am in such awe of the grace and wisdom these doctors so effortlessly display. And the best part is there is still more to come.

Work

How could I have predicted what this would be like?

My first day on the job, Dra. Gutierrez asked me to perform physical exams on Aymara babies and analyze some x-rays for hip displacements. I work at Hospital de Los Andes. What an incredible place. I mean really unbelievable. After driving an hour up the mountain in a minibus, (which is just a large van with a sign and boy shouting out the window), we arrive in an indigenous barrio. It is dusty, cold, bright and windy. There are cars speeding in both directions down the main street. Women sit on the curb and entreat us to buy cheeses, fish, and fruit spread out on their blankets on the ground. Children weave through the traffic, selling candy and gum. The native dress is a colorful, rainbow pattern blanket worn on the back to carry small children, a floor length skirt, shawl, and round-bowl hat. The men are less notable. The children are strikingly beautiful. They have piercing brown eyes and melting smiles, dimples and all.

Doctora Gutierrez reminds me of my sixth grade teacher. She asks me tough questions in front of patients. She puts me on the spot and challenges me because she is a good teacher and knows I can handle it, although sometimes I feel like I am so inexperienced, I have to think on my feet and admit I what I still don't know. She's a wonderful doctor, chastising mothers for descuida (poor parenting), a tough love kind of woman. She makes you want to impress her. Her love for children and her dedication to this place left me speechless, feeling so small. This hospital is no bigger than my home in Cleveland. And even less equipped than your average suburban bathroom! The don't have exam gloves, masks, medicine, enough personnel...Dogs wander around the waiting room. The line is out the door with Aymara women, carrying babies on their backs. I saw two live births last week and the poor women received just one local anesthetic just moments before delivery. (By the way, I'm totally adopting.) The delivery room was adjacent to a public hallway. The doctors took Kristen and I aside after we dressed the babies and very sincerely lamented the conditions. They said, we are doing the best we can. We don't have what we need. We are providing service for these people but they deserve better. We work for them and we need help. We need so much help.

Hip displacement is a common problem in babies here. The Aymara wrap the babies very tightly, often with a strip of tough cloth, resulting in grossly distorted bone growth. Usually it can be corrected with time, if the baby is young enough. If not, a harness or corrective surgery is needed. Malnutrition is also a problem here, like anywhere. But malnutrition is not an economic phenomenon. It is a question of ignorance. Americans have more money than Bolivians but I no longer maintain the illusion that we are better nourished thanks to our paychecks. Education makes all the difference. There is currently a political movement, Desnutricion Cero, which advocates nutritional awareness among all families in order to reduce health problems related to poor nutrition in Bolivia.

Every week we have a presentation on a special health topic. Last week was insurance/health care in Bolivia. SUMI is a wonderful program that covers pregnant mothers, and children under 5 years of age, free of charge. Being here has definitely given me a different perspective on the upcoming health care crisis in the United States. During a late night discussion with my roommates, Alex put it best- do we really want sick people to go untreated? This week's topic was malnutrition and next week will be hip displacement. I love the presentations, they put the week into perspective. Health care is a complicated topic, the more I learn, the less I feel I know. There are so many problems and new solutions create new problems. Helping people shouldn't be so complicated, but it is. It comforts me to know that people like Doctora Gutierrez and the doctors at Hospital de los Andes are out there, working tirelessly in conditions I had never imagined could be real, just doing the best they can.

The Floating Lake

Fifteen of us went to Lake Titicaca over the weekend thanks to Andrea and Brandon’s awesome planning. We rode a bus for several hours on Saturday morning and then crossed the lake on a boat to Isla del Sol. The lake and island are high, high up, about 4500 meters I would guess. They call it the floating lake. The lake is surrounded by mountains capped with snow and the moon rises at 4 in the afternoon. The sun is strong and the sky is absolutely cloudless, a harsh cold wind stirs the dusty heat enveloping the Incan ruins scattered along the slopes of the mountain. We hiked up to our lodge and spent the night recovering from the trip. The greatest part of the weekend was sitting under the stars, wrapped in blankets and talking until dinner time. The night sky was a clean, pure black and the stars hung low, burning bright over our heads. The immense quiet was broken only by laughter and voices in conversation. The night was freezing cold but by early morning the sun had baked the dry air completely. Up in these mountains, the breathtaking beauty is preserved by harsh extremes, a great place to see but an inhospitable home for visitors.

La Calle

The trufi’s line up on Calle Mexico. If the passenger doors are open, feel free to jump in the car. Every morning, Kristen and I take a trufi up to El Alto. The ride is terrifying. The streets reach 20 degrees with the horizontal and the cars dangerously flirt with back gliding. In spite of this, the drivers find ways to make our commute even more exciting, passing over double yellow lines, crashing lights, speeding up on mountain road curves, you name it. And they never fail to wave or honk in acknowledgment of other trufi drivers sporting double flags as they pass each other. The mini buses are my favorite. They have 3 digit numbers on their roofs and a cardboard sign on the dash, indicating the route. Young boys work with the drivers, leaning far out the window, shouting the stops in two seconds or less. 6 de agosto, Calle Peru, el Alto, un Boliviano! Little boys dress up in zebra and donkey suits, mocking rude pedestrians. The city employed street children to keep aggressive pedestrians in check and reduce pedestrian related accidents. The real motive was to creatively occupy young boys living in the dangerous conditions of the street. The streets are never a boring place.

Week 1

I live on Independence Street. 6 de Agosto. Every morning I wake up to the sound of car horns and dogs barking. La Paz is a vibrant city, full of colors, smoke and music. The streets and sidewalks are twisty, uneven, and all uphill. I run out of breath so easily, I have to let old women carrying babies on their backs pass me as I struggle for air at this altitude. The Andes Mountains are also breathtaking in the non-literal sense. Truly magestic beauty. As we drove to our homes from the airport in El Alto, I fell in love with the panorama- the golden sunrise striking the homes stacked along the mountainside. Donkeys and llamas and children, whizzing past my view as we descended into this city full of unknowns.

The air is cold, dry and thin, striking my face as I step out of the car to meet my host mother. Arminda Chavez. La declamadora. She is in her early seventies, though I would never have guessed so. She speaks and moves with such energy, her passion for life exudes from every inch of her tiny stature. The first night in her home, she shared with me a poem she wrote, a hymen to the sea, lost to Chile. I love my mamita. She fills her home with her love for her family. Her son's family spends every Sunday with her after they attend mass. She is a proud Mormon, a rarity in this Catholic country. I feel as though I have known her all my life. With people such as my mamita and her beautiful grandchildren, I know that I will come to love this country too.