Adventures in Bolivia

La Paz Does Tango

2007-09-10T16:22:00.001-04:00

This past Friday evening I had the wonderful (and kind of crazy) opportunity to play live tango music for the La Paz Tango Club. I’ve rehearsed a few times with a pianist that I met at the one and only Milonga (tango dance) that I went to during my first month here. Tango is very different from classical music, obviously, so although I had the music, it was quite different to have to “interpret” the music. We went down to Café Berlin in the Zona Sur – by 8:30pm the café had filled with 50 or so people, smoking and drinking, sitting around a nice wooden dance floor. We played two sets of 4 songs each for a surprised and very happy crowd of dancers (I think it has been a while since they had live music), including one improvisational “techno tango” song.

I’m so used to having easy access to group violining, like chamber music and orchestras in the United States, so it was so nice to be able to practice with another human being instead of locking myself in my living room and staring at music. We had only practiced 3 or so times, but after a 2 hour dress rehearsal in the cafe the music was so effortless and fulfilling. The actual playing went by very smoothly (yes, the music was a bit easy), and as I walked off of the dance floor I got a few very big applauses. We played an incredible song written by Astor Piazzola, as a memory for his dead grandfather, called “Adios Nonino” that apparently moved a few of the audience members to tears.

I suppose the highlight of the evening, and perhaps the scariest moment for me as well, was when the crowd asked for an encore – Stefan (the pianist) and I had briefly rehearsed the Czardas by Monti, which I haven’t touched for about 6 years. It’s not a very difficult piece…after you practice it for a while…but it has a series of very, very fast runs. The crowd was cheering and smiling, so I looked at Stefan, shrugged my shoulders, and began to play the music. At the beginning of the most memorable part, the whole place started clapping and stomping. My mind and fingers were basically on autopilot. I heard myself playing in to the microphone, thinking to myself “Wow, this is fast. Wow, this actually sounds pretty good.”

I still don’t have much of an idea how I managed to play the piece without practicing – I credit the success to adrenaline and relaxation. Usually when I play in front of crowds I get incredibly nervous and start shaking, but this time, because the focus of the evening was dancing, I didn’t really feel agitated or worried. I just let myself be.

Tonight is actually my last night here. I spent the day running around and doing errands, visiting the doctors at the hospital and buying a few last minute gifts (including coca tea, but don’t tell the US Government or I might get in trouble.) I have a bunch of pictures to post of Tihuanacu and Lake Titicaca, which will be coming en seguida, but I think now I am going to sit back and let the night flow…and reflect later.

The Parentals Have Arrived

2007-09-06T17:29:00.002-04:00

As you can gather from the title, my parents have arrived in Bolivia for a more or less two week stay. As their unofficial tour guide, it’s been an interesting and ultimately awesome experience being able to show them the sights and sounds of “my” country. They don’t speak a shred of Spanish (my mother claims that she can sometimes understand what is being said, but I don’t believe her), so it’s been my job to make reservations, hail taxis, translate museum tours, and order food. They’ve been less shocked by the life here than I would have expected, but they credit that largely to the pictures that I’ve been showing them. They seem to find the markets and the animals running wild in the streets the most interesting, although the altitude has also made it’s mark when we walk up steep hills (and yet my pulse seems to be as high or higher than both of theirs, go figure.)

Their flight was delayed from Thursday night to Friday morning due to some plane difficulties in Washington DC (typical), so I arrived at the El Alto airport at 5:00am to pick them up. They had the chance to see the fantastic view of the city as the sun creeps over the canyon ridges, marveling as much at the crude brick houses as at the sputtering vehicles (and accompanying smoke-filled streets.) From practically the moment he stepped off the plane, my father has been obsessed with taking photos. Taxis have had to stop at viewpoints, and we’ve had to wait for him on the streets – all I can say is that the photos (it’s a brand new digitial SLR) better be worth it…

The stay in La Paz involved a visit to the cemetery, some time wandering the markets, and a visit to a peña – a Bolivian folkloric musical experience sometimes accompanied by music. Although we arrived at about 9:30, we didn’t end up getting our food until 11:00 (these South Americans eat late). We all ordered typical Bolivian food – my mother had her first experience with chuño, the freeze-dried potatoes, which she now refers to as “the sewer potatoes,” and my father had his first experience with Bolivian-style food poisoning (he had a meat dish, other than that we have no idea what made him sick.) After much deliberating over the decidedly meat-filled menu, I decided to order “charque,” strips of dried llama meat, the classic Bolivian version of beef jerky. Despite being a vegetarian, I’ve been looking for charque since I saw the strips of llama meat being dried on the adobe rooftop of a house on the way to Tarabuco. Suffice to say it was quite chewy and didn’t have much flavor, but I’m glad I ordered it nonetheless.

In Sucre and Potosí we went to a lot of the same sights that I had seen on my week and half adventure through the country. We flew to Sucre and took a cab to Potosí, so my parents didn’t get to experience the 10+ hour bus rides back and forth between cities (flying is definitely worth the money.) Our hotel in Sucre (Hostal de Su Merced) was stunning – described as being “in true Sucre style,” it was a beautiful white building with a central courtyard filled with flowers and stained glass. All of the rooms were furnished with antiques, and there was a rooftop terrace with a beautiful view of the city, where my mother and I enjoyed a nice afternoon coffee while my father slept off his bought with food poisoning.

Potosí was the same stunning colonial city that I remembered – for me, it gives off a serene air, and the feel of colonial times is almost tangible as you explore the 16th century churches and walk down the cobblestoned road. My parents had a bit of a time walking through the markets – my father was put off by the smell of Bolivian cheese (I think it brought back memories of being sick), and my mother had a hard time with the various animal parts hanging from the booths. I’m a bit surprised that as the resident vegetarian I was able to tolerate the sight of a cow head with the tongue hanging out, the top part skinned and showing the muscle and eye sockets. My dad, of course, was running around taking pictures of all of the stalls and the bloody tracheas.

In Potosí I also took my parents out for their first salteña (met with generally positive reviews). The owner started chatting with me, and after I gave him a particularly satisfactory answer of my opinions on Evo Morales, he took me to the back of the restaurant and showed me how they make salteñas. It was great, because I tried to make a vegetarian version about a week ago, and although they were tasty, the definitely didn’t look or taste anything much like the street-vendor version. And thanks to my father, we now have a picture of my awkwardly standing next to the 70-year old owner in the back of his kitchen (soon to come).

The most surreal part of the trip happened as we were leaving our hotel – I was carrying my bags out to the taxi driver, and a tall guy in the lobby stopped me and said “Natalie?” I was a bit confused, and said “No, Nadine, wait…how do I know you?” And then he introduced himself as the “Anti-Chris,” a Canadian guy who had read and commented on my blog. (I’ve also run into 4 other Uchicago students randomly in every city I have been to, small world.) I was stunned, and awkwardly asked him how he was enjoying his stay, if he had recognized me from the picture, etc. (If he reads this again I’m sure he can attest to how surreal of an experience it was.) As we conversed about the lack of tourist information about Bolivia (beyond the Lonely Planet Guide), I had the idea to write some mini-reviews of the restaurants, hotels, and sights that I have visited while I’ve been here…so I guess I’ll be working on that for the next few days.

But honestly, what a surreal, ridiculous experience!

Sucre, Capital Plena

2007-08-29T13:07:00.000-04:00

(I was in Sucre from August 19th to August 21st.)

I arrived in Sucre from Potosí after a 3 hour taxi ride in which our driver used both lanes of traffic to round the corners at 120km/h in a speed zone of 40km/h. About halfway through the ride, as I was attempting to sleep in order to avoid constantly worrying for my life, a burning smell began wafting through the taxi. Our driver pulled over to check the brakes, which were obviously burning at this point, and then told us “Everything is fine, no worries.”

The next morning I headed off to Tarabuco, a small Quechua town about 3 hours outside of Sucre famous for its textiles. The bus ride there gave us beautiful views of the countryside, stark mountains and valleys with a few cacti here and there, an incredibly blue sky contrasted against the reds, oranges, and yellows of the terrain. The town itself was pretty ordinary, and while the textiles were certainly beautiful, I was a bit disappointed that I had seen most of the merchandise previously in La Paz. I got bored walking around, and a bit annoyed by the less-than-passive sales techniques of the vendors (“Mamaciiiiita, por favor…”) I wandered to the edges of the town, past the tourist-friendly parts, to see the mountains and the countryside. It was incredibly rural, with a bit of farmland, some animals sleeping peacefully. I saw few farmers dressed in traditional textiles herding a line of pigs, and I saw a few women taking a break in the shade of a large tree. It was such a relief to get away from the bustle of the inner markets.

Back in Sucre, I was a bit disappointed by how many museums and churches were closed, contrary to the indicated hours of operation. The city is filled with gorgeous white buildings, which gives it a very peaceful air (even if some of the buildings are a bit dirty.) I got a chance to see the Textile Museum, which had a beautiful array of weavings and explanations of the traditions, and also the convent La Recoleta perched on top of a hill, affording a gorgeous view of the city. While I was waiting to buy my entrance ticket into the convent, I saw a woman sitting in the office – it took me several minutes to realize that the skin hanging off of her face was not because she was old, but rather because she was so thin (and yet she was still carrying a heavy load on her back.) I could see the ribs protruding from her chest, and as I looked down at her legs I realized that her calves were thinner than her knees.

Later that day I sat down in the main plaza to take a break, and was immediately approached by an outgoing shoe-shine boy who wanted to polish my beat up converse. I politely declined the offer, but started chatting with him about his life…he was 12 years old, he claimed that he was in school, and his parents lived in the countryside. After about 5 minutes I found myself surrounded by a group of about 5 shoeshine boys, all trying to get me to buy them food or give them money. Unfortunately the original boy wandering away, and I was left to fend off the others, who weren’t nearly as charming. I kept telling them “No, it is not my responsibility to buy you food or give you money.” Part of my really wanted to indulge them, but I knew that it would just reinforce annoying behavior, and more than anything it would continue the wrong kind of relationship that locals have with tourists. Eventually I had to get up and leave because they would not leave my alone.

I think the most interesting part of Sucre for me was seeing the signs everywhere that were protesting about the capital. In contrast to the “La Sede No Se Mueve” signs in La Paz, everywhere in Sucre there were signs saying “Si, La Sede Se Mueve” or “Sucre Capital Plena.” The signs were even more visible there – in people’s windows and on cars – and there was even a car driving around the main plaza playing a propaganda song. There were also students who had tied themselves to the main building as part of a hunger strike. From my understanding, the controversy over the capital has economic and cultural components. I don't have a firm understanding of the controversy, so I can direct you to this article.

So now I am just milling around La Paz, waiting for my parents to arrive tomorrow evening. I’m eager to see their reception of Bolivia – at first it was such an alienating, foreign place to me, but now I feel so comfortable here. I’m also eager to practice my skills as family tour guide, because my parents don’t speak a bit of Spanish. Should be interesting…

The Most Terrifying Experience of My Life

2007-08-27T13:55:00.000-04:00

After visiting several churches, convents, and the Casa de la Moneda (the museum that details the refinement and use of the silver mined in Cerro Rico, the silver mine that fueled the wealth of the Spanish empire in the colonial era,) the next day I decided to go on a tour of one of the cooperative mines that still functions inside Cerro Rico. When I walked into the tour office the guides (all ex-miners) were chatting in Quechua, and it took me a while to realize that their second language is Spanish. Our first stop was to get our protective clothing, which consisted of bright orange rubber pants, a rubber jacket (held shut with well-used Velcro), rubber boots, a bandana for the face, and a hat with an attachment for a lamp. I was one of the four tourists who opted to take the tour in Spanish, because I figured that the guides would give more details in a language they were more comfortable with (and the rest of the people were annoying British and Irish tourists, so I needed to get away).

Our guide Rolando took us to the Miner’s Market to check out the supplies that the miners take inside the mountain – Bolivian dynamite, fertilizer soaked in diesel fuel (to augment the capacity of the dynamite), coca leaves, soda, 96% sugar cane alcohol. After milling around the market and buying “gifts” for the miners, we went to one of the “ingenios” (silver refineries) to see how they grind up the rock and then purify the minerals with a variety of noxious chemicals. Traveling to the mine entrance (4200 meters) in a severely underpowered bus, I was extremely glad that I had opted to be in the smaller, Spanish speaking group - I heard one of the British girls say “I didn’t buy coca for the miners because I just didn’t have enough money…” I pretty much wanted to smack her for being so ignorant of the mining conditions and the poverty.

I wish that I had been able to take better pictures inside the mine, because I don’t think that anything I say can possibly describe the experience (but here I go anyway.) As we went into the entrance, trying to stay out of the way of the workers manually pushing huge mine cars of ore down the rickety tracks, I was thinking to myself “this isn’t so bad, I can handle this, all I have to do is duck down a bit.” Sure, I was hitting my head every 5 minutes on the ceiling, but I was able to breathe and I didn’t feel the least bit claustrophobic (as I had been warned at the beginning). Our guide turned to our group, asked us if we wanted to go on a “small adventure,” and we nodded in consensus. He brought us over to a 2x2’ hole about 5 feet up in the wall, and motioned for our group (made of me and three very tall, very athletic men) to follow him. I went right after him, and when I had stepped into a small, dark hole I started to have panic attacks. My heart was racing, I was having a hard time breathing, and every part of my body was screaming “GET OUT WHILE YOU STILL CAN!” I watched Rolando climb through a hole about was wide as my hips, and I told him “I don’t think I can do this, I’m very afraid.” He looked at me and told me not to worry. At that point I decided that what scares you probably makes you stronger in the end, so I put beside all my fears and started crawling through the incredibly claustrophobic areas.

After about 15 minutes of climbing up and down passageways (at one point I had to shimmy on my back, the ceiling about 3” from my face, and then down a vertical hole), we came to our first group of 5 miners working a small hollow, surrounded by deposits of gold, silver, and lead. We talked to them for a while about their work, their age (one man was 17, looked about 30, and had been working the mine with his dad since he was 14). They had been in the mine for over 24 hours, sleeping, eating, and working. We offered them a few gifts, including the alcohol (which was an awkward experience, certainly meant to bridge the cultural gap, but in reality it had no such effect.) The mixed the alcohol with a bit of soda, and then offered it to our group in a small cup made out of the top of a plastic bottle. We had to offer a little bit to Pachamama, the goddess of the earth, and to the Tio, the evil spirit of the mine, by pouring a tiny bit on the ground. Luckily for me our offerings were quite big, because the stuff we were drinking was quite strong.

As we climbed deeper and deeper into the mine, it became harder to breathe because of the incredible amount of dust in the air. All of the work was done manually, with a hammer and pick, and there were no ventilation systems. When we were on the third level, the heat and feeling of claustrophobia became almost unbearable, and I had to take the bandanna off of my face because I couldn’t bear the feeling of something constricting my breathing, even if it was moderately filtering silicone particles out of my face. After seeing the areas where they lift the ore from the lower levels to the top level to be taken out of the mine, our guide decided to take us back up to the surface. We scurried up a long, nearly vertical shaft for about 20 minutes, and when we finally emerged from the mine, I was thanking the higher ups that I was alive and able to pull air into my lungs. By the end I was glad that I had been chewing on a large wad of coca the entire time, because the combination of altitude and lack of air left me feeling dizzy and exhausted. We were the last group to emerge from the mine, after crawling around for about 2.5 hours (and boy did I feel it in my legs the next day.)

I'm incredibly glad that I went on the tour, but it was the most terrifying and exhilarating experience of my life. Looking back, it's one of those things that you appreciate afterwards, but while it is happening it is horrible. I can't imagine how those miners can work down there, and I now have a tremendous amount of respect for the miners and their way of life. I suppose it also gave me a greater appreciation for the lack of communication that exists between tourists and manual laborers in Bolivia, because in the end our lives are completely different. There is no way I can begin to understand what a miner's life is like.

Potosí, Faded Glory

2007-08-27T13:54:00.000-04:00

(I was in Potosí from August 16 to August 18th.)

The bus ride from Cochabamba to Potosí (10ish hours) was quite tranquil, even though I have a hard time sleeping on bus camas. As I was getting settled, I became quite annoyed by someone pushing repeatedly on my seat. Usually I try to let those kinds of things go, but after about 5 minutes (I was also trying to write) I stood up and turned around to lecture my bus-mate. Turns out an adorable little girl was squirming on her mothers lap, and as I started asking her not to push on my chair, por favor, I started to melt at her toothless smile and giggling. We ended up chatting for a bit, as she told me she was 5 years old by holding her hand up to my face, and then when I told her how old I was, she asked me “How many hands is that? Show me!” She proudly told me she was “from the campo!” and then as I tried to go back to my writing, she tapped my head a few times and eventually grabbed my nose between her chubby little fingers. As the night wore on and I tried to recline in my seat, I heard her say “You are going to squish me!” I felt kind of bad, as she was laying on top of her mothers lap and it was bound to be uncomfortable, but by that time I was dead tired and need to relax.

My experience with Bolivian children, in general, has been amazing. Aside from the looking at me like I’m an alien, they are incredibly outgoing and friendly. They also have a fascination with being photographed, which is such a change from every other photography experience I have had here. In Cochabamba when I was photographing a museum, a group of school children literally jumped on me, eager to be photographed. It’s so nice, such a relief, that they aren’t yet influenced by the cultural issues that surround photography here. Instead, sheer joy and excitement at seeing a weird machine that can take pictures.

I arrived in a very cold (after Cochabamba) Potosí at about 6:30 in the morning, just as the sun was starting to come up over the mountains. I left my luggage at the bus terminal (not without a bit of fear for its safety) and proceeded to walk towards what I thought was the city center. I ended up going down the wrong side of the hill and getting a fantastic view of the shacks speckled on the red-brown hillsides. Also turns out that I was wandering around arguably the poorest part of the city, so as soon as I realized that there were not beautiful colonial buildings in the near vicinity, I hailed a taxi and went to the city center.

Once I was in the right area, I started wandering down the narrow, cobblestone streets gazing at the beautiful, colorful colonial buildings and the grand churches. At that hour the city was perfectly deserted, and there was none of the dizzying traffic of Cochabamba or La Paz. I found my way over to a tranquil little café to have breakfast, and was a bit startled when I emerged to find the city alive with taxis and people advertising the days papers. Of all of the cities that I have visited thus far, Potosí is by far my favorite – it has preserved a charm that makes it feel miles away from any other part of civilization. Perhaps it’s the altitude, the serene setting among the mountains, the sheer visibility of past glory. But I haven’t felt so peaceful or intrigued by any other place that I have been in Bolivia.

Cochabamba Heat and Urkupiña

2007-08-24T14:59:00.001-04:00

(I was in Cochambamba from August 12th to August 15th.)

Traveling by bus from La Paz to Cochabamba was an interesting experience, not only because I was seated in the only section of the bus with two crying babies, but also because it was my first real view of the vast expanses of the country between cities. Leaving El Alto I had a terrific view of the Altiplano—the small dirt-colored mountains with shacks scattered here and there, the endless dead looking fields. As we got closer to Cochabamba the climate became noticeably warmer, and the flatness gave way to larger mountains and valleys speckled with small bushes and cacti, a few flowers here and there. The variety of socioeconomic classes traveling by bus was also astounding…there was a collection of tourists, businessmen, and campesinos.

When we got to Cochabamba I left my luggage at the station (not without worrying for its safety, even in the “guarantee” of left luggage), and went off to find an internet café. I ended up stripped off several layers of clothing (a shirt, my socks) in the café, causing several people to look at me with the “what the devil is that gringa doing?” expression. But I’ve gotten used to the colder climate in La Paz, so at that point I was pretty much drenched in sweat and I didn’t care how weird it looked.

After Anna (I was in Cochabamba to visit her) got out of her classes, she took me to her house in the suburbs of the city, a pleasant little middle-class barrio full of fenced in houses and flowering trees. Señora Ellie, Anna’s host mother, is an adorable little woman who lives with her extended family and multitude of pets. After I set my things down in Anna’s room we sat down for dinner. While Anna had told me about the ridiculous amount of food Señora Ellie piles onto her plate and expects her to eat every night, I was not really prepared for the sight of my plate – a platter of white porcelain piled about 3 inches high with chuño cooked in peanut sauce and a reddish potato stew served over a bed of potatoes. Balanced meal, right?

The next day we wandered around the town, which seemed surprisingly similar to La Paz, much more so than Sucre or Potosi. There is certainly a warmer climate, which means that there is more vegetation and flowers and color, and there is also a distinct lack of hills. I also noticed that the cholitas have a very distinct method of dress – because the indigenous culture here is mostly quechua, the women wear shorter polleras (skirts), sombrero-like hats (instead of bowler hats), and more colorful textile clothing. And yet the buildings, the bustle, and the general dirtiness of the city felt very familiar to me. It really annoyed me, however, when a man approached Anna and me on the street and warned us “You have to watch out, you have to be careful, those people are looking at you and it’s dangerous to be here!” If you look at all like a tourist, you elicit such a strange range of reactions here in Bolivia. But the assumption that you are helpless (specifically women) and that you have no idea what you are doing drives me crazy.

On Tuesday we headed off to Urkupiña, the folkloric festival for the Cochabamba department. It’s held in Quillacollo, which has a similar relationship to the main part of the city as El Alto does to La Paz, and drew in a large crowd of not only city-dwellers, but also campesinos. After wandering around for 20 minutes, guided by a very vague and hand-drawn map, we finally found our seats. The dancers, accompanied by local musicians, danced down the streets surrounded on each side by cheering crowds of people. The colors of the costumes, along with the energy of the dancers, was incredible – depending on what dance and what part of the country, the costumes were full of sequences, ruffles, feathers, traditional textiles, elaborate masks. The parade, I guess you could call it, was so much more alive (even with the horribly out of tune Bolivian bands) than any celebration in the United States.

By 6:00 the entire crowd was drunk, and by nightfall people was singing and dancing in the streets, now heaped with piles of beer cans and food wrappers. I had no idea how to do any of the dances, but because I was standing along the side moving to the beat and one of the only gringos in the area, I was repeatedly dragged into the crowd to join the dancers. There were, of course, the fair number of sketchy and drunk men, but thankfully Anna and I were able to avoid any issues. It was tremendously liberating that people were excited to see foreigners participating (in contrast to the usual mistrust and hostility). It’s sad to me that it seems like flowing alcohol is a necessary prerequisite for cultural mixing, but it’s still thrilling that people were friendly, and came up to us asking “Where are you from!?” and “How do you like Bolivia?!” All of the revelry was of course accompanied by the “look at that fool of a gringo dancing” and the customary “make the gringo drink” (people would come by and demand that you take a sip of their beer, and if you refused they would look at you with a confused and offended expression), but I have never felt so part of Bolivian culture. In all my time in La Paz, I have never been able to break down that barrier, and I have never been so filled with energy. The color of my skin, the difference in my education…in the moment that I was attempting (rather badly) to dance tinku in the street, none of it mattered.

At the end of the night the crowd was quite out of hand, and the streets were so filled that the dances were unable to proceed. We left at about 11:00 when they were performing dance #56 of 80. The night had been generally quite good-spirited, but after Anna’s camera had been stolen and another tourist’s bag had been slit open, we decided that the atmosphere was decidedly a bit more dangerous. The next morning Anna and I recounted our adventures to Señora Ellie, and as I explained my perception of Bolivian men and their wandering hands, Señora Ellie’s reaction was priceless: she told us that we had to “kick them where it hurts,” complete with a demonstration and high pitched squeals and giggling.

Picture Slideshow

2007-08-23T16:27:00.000-04:00

Now that my time here is (sadly) coming to an end, here's a slideshow of some of the photo highlights, enjoy.

It Wouldn't Be a Bolivian Experience Without a Blockade

2007-08-22T16:46:00.001-04:00

I have finally come back in La Paz after traipsing around the country for more or less a week and half. It feels good to be back at home base, although I’m dead tired because I spent 24 hours trying to get from Sucre to La Paz due to the good old, classic Bolivian blockade.

I left Sucre at about 6:00pm last night on a 12 hour bus ride to La Paz. The ride in bus camas ( as they call the buses that recline to more or less a 45-degree angle and have more leg room) are generally pretty tranquil, but I find it a bit hard to sleep in the cramped quarters. I had a pleasant surprise when I awoke to something small hitting my chest with a thud, and realized that someone had vaulted a gum ball through the air and onto my chest. The gum ended up tangled in my headphones and also in the ends of my hair (I had to cut it out with a swiss army knife.) I wanted to yell out a serious of Spanish and American swears, but as it was about 12:30am and most of the bus was fast asleep, I decided to just let it go.

At about 2:00am we stopped at the side of the road, and at the time I though we were ahead of schedule or taking a break. At 6:30am, when the sun came up, the bus was still parked at the side of the road, and from what I could tell without my contacts in – we were in the middle of nowhere a good hour and half before we were schedule to arrive in La Paz. After the man in the seat in front of me stuck his head out the window, he announced to the bus that we were, in fact, stuck in a blockade, and that there were “hartas flotas” (a ton of buses) in a row. A few people decided to try their luck at walking, but my seat-mate (a nice Bolivian man studying tourism) and I decided to wait it out a little while to see what would happen. Our bus driver managed to drive down the wrong side of the road a good half a mile, but when we realized that we weren’t going anywhere further, we joined a group of quechua men and started trekking down the road.

At the head of the blockade, which I would guess was about a mile long, we could see a group of people parading across the road. To avoid confrontation we hiked over a small hill (I was carrying about 50 pounds worth of luggage and gifts) and then made our way back over to the road, only to see that there was a definite shortage of taxis or minibuses transporting people away from the blockade. After hiking down the road for about an hour (the view was gorgeous, the sun was just starting to come over the hills), we finally ran into a taxi driver who piled six very grateful people into his rather decrepit car and took us to the center of Challapata…only to find that there was another, larger blockade.

My amigo and I set off walking again for another half our or so, this time past an even longer line of flotas and transport trucks. We walked past the main protest area, filled with miners from the Oruro area, who gave me a lot of funny looks because I was not only the only gringa around, but I was also walking with a Bolivian man. (According to http://www.abi.bo/index.php?i=noticias_texto&j=20070822104411, the miners were protesting the suspension of mining due to the danger of water contamination.) Eventually we saw a flota that was turning itself around to go back to Oruro, and after it made its way across the dirt and salt ground (the town is close to some salt flats), we squeezed our way onto the bus (after literally fighting the crowd of 150 people). Luckily there were quite a few empty seats, and by the end even the aisles were crammed with people.

So from Challapata to Oruro (3 hours), and then Oruro to La Paz (3 more hours), my amigo and I managed to make it back to the city only about 8 hours after we had been scheduled to arrive. But like I said, my time in Bolivia wouldn’t have been complete without a blockade.

Sucre

2007-08-20T18:01:00.000-04:00

The white city. They aren´t kidding.

(The students who have tied themselves to the building in the picture are protesting about the location of the capital, if you remember back to the Cabildo and the “La Sede No Se Mueve” signs. Here it reads “Si, La Sede Se Mueve.”)

(Capilla de la Virgen Guadalupe.)

(Inside of a church.)

(And another church.)

(And another…)

(Convento Santa Teresa.)

(Textiles for sale at the Museo de Textiles ASUR.)

(Courtyard of one of the many Universities.)

(View from the top of Iglesia La Merced.)

(Courtyard of the hostal where I am staying.)

Tarabuco

2007-08-20T17:19:00.000-04:00

(The outskirts of Sucre, on the way to Tarabuco, a pueblito famed for its textiles.)

(The baskets are full of strips of llama meat drying the sun. The finished product is called charque, and it’s like a very flavourful and lean version of beef jerky.)

(Wandering around the market.)

(Most of the textiles are made from alpaca wool, and they generally sell from between $2 and $20.)

(Wandering around the outskirts of the town.)

Tour of the Mines in Cerro Rico

2007-08-19T16:52:00.000-04:00

(Walking through the miner’s section of town on our way to get outfitted with mining gear.)

(Miner’s market.)

(Visit to the mineral refineries called Ingenios. This particular machine is grinding up the rocks into pebbles.)

(Machines mixing rock paste with lovely chemicals like arsenic.)

(Silver sediment on my hand, after washing the soot that came out of the chemical baths with water.)

(View of Cerro Rico.)

(View of the Miner’s Barrio and below.)

(The Little Bus that Could.)

(Miner’s house.)

(More or less at the entrance of the mine, in the small but informative museum.)

(My guide Rolando sitting in one of the larger holes we crawled through.)

(The fuzziness of the picture is from all of the soot that was in the air.)

(Me and Rolando, hanging out in the mines…sigh.)

(Finally able to breath again, Rolando holding a dynamine bomb of Bolivian nitroglycerine, fertilizer, and diesel.)

(The dynamite bombs exploding on the hillside.)

Potosi

2007-08-19T16:26:00.000-04:00

(Right outside of the bus terminal, after arriving on an overnight sleeper from Cochabamba at 6:30 in the morning.)

(Café Cultural, the peaceful and sunny spot where I had breakfast.)

(Main plaza that holds the Cathedral, the Cabildo, and the Casa de Moneda.)

(Cathedral, under repair and sadly closed to the public.)

(Wandering around the city.)

(Iglesia de la Merced.)

(View from the top of the Iglesia.)

(The mountain Cerro Rico is in the distance, which contains the still operational mines.)

(Intricate façade of an observatory tower.)

(Inside of a random building.)

(Convento Santa Teresa.)

(Altar inside the convent.)

(View of the mountain Cerro Rico.)

(Famous building Arcos de Cobija.)

(Street festival in front of the Casa de Moneda.)

(Interior of the Casa de Moneda.)

(The walls are apparently 3 feet thick.)

(Giant cogs used to shape and polish silver bars.)

(The room where they refined the silver and melted it in giant ovens. The ceiling is black from soot.)

(Statue in the Miner’s square.)

(Iglesia Jerusalem.)

(Koala Den, my hotel.)

(The daughter of the owner…adorable.)

(Calle Quijarro and the Pasaje de las Siete Vueltas, an area near my hotel famed for its narrow colonial streets.)

Centro Cultural Simon Patiño

2007-08-19T16:11:00.001-04:00

(Anna!)

(Front office.)

(Gardens.)

(Beautiful turn of the century house.)

(Bolivian kids!)

Urkupiña

2007-08-19T15:53:00.000-04:00

This a folkloric festival held in Quillacollo, a province on the outskirts of Cochabamba that seems to have a similar relationship to the city center as El Alto does in La Paz. The festival is held in honor of the Virgen María de Urkupiña, and people from all over the Cochabamba department come to participate in the singing and dances. These dances are performed by various indigenous youth groups that are usually affiliated with schools.

(Dancing during the day, while everyone was still on moderately good behavior…)

(Dancing at night, when the crowd was drunk and things started to get a bit crazy.)

Cochabamba

2007-08-19T15:37:00.000-04:00

(A pueblito that we stopped at along the way from La Paz to Cochabamba.)

(Anna´s host family´s house in a neighborhood about 20 minutes outside of the city center.)

(The barrio where Anna studies and lives.)

(Central square in Cochabamba.)

(The main cathedral in the center square.)

(One of the women begging outside of the entrance.)

(Wandering around the city center.)

(The Cancha, a very busy and sprawling indoor market.)

(Another plaza close to the Prado in Cochabamba.)

Good Night and Good Luck

2007-08-12T19:34:00.000-04:00

I´ve decided to wrap up my time working at the hospitals, and being in La Paz for that matter, and travel around the country. Alas, this means an end to my medical adventures, but I´m hoping to fill the rest of the space in this blog with a lot of pictures and quirky stories as I trek through Cochabamba, Sucre, and Potosi for the next two weeks or so. I´m very much excited to travel, because in reality I haven´t been more than an hour outside of La Paz for the last two months. Some highlights are going to be Tarabuco, a town outside of Sucre that has a wonderful Sunday market full of colorful textiles and artesania, and also the mines in Potosi, which are (I think) some of the largest in the world and also supplied Europe with the majority of its silver in the colonial days.

So, tomorrow I can look forward to the 8 hour bus ride to Cochabamba, and then who knows...

The Bolivian Spa Experience

2007-08-12T13:26:00.000-04:00

The other night we went out to a “highly recommended” spa for a relaxing, well-deserved massage. They’re so cheap here, about $10 for 45 minutes, that it’s almost a sin not to pamper yourself every now and then.

I came in pretty sore, still recovering from typhoid, and was looking forward to the experience. There were three of us there - I decided to go last, and after an hour of near-napping in the lobby, they finally told me to come in and undress. While I’m not so comfortable with nudity, for the sake of a good massage I can deal with it, but this was too much – I was given a disposable white cloth diaper to wear in the place of underwear.

As I was walking over to the shower, I was shocked to see my friend Andy sitting in a wooden box, completely enclosed by a green tarp surrounding his neck, only his mud-covered face sticking out of the top. After I got over the shock of this Bolivian version of a steam bath, I took a 30 minute trip to the unbearably hot sauna, which featured me opening the door every 5 minutes to let in cold air. After another shower, Andy and I swapped places, and I had some personal time with the steam bath. It took me about 15 minutes to realize that the moisture dripping down my body was not in fact water, but my own sweat. I’m sure that anyone who actually likes hot things would have enjoyed the experience – it was relaxing for the muscles, and the box was filled with nice smelling herbs. For me the highlight was having the tarp lifted and being sprayed down with spine-chillingly cold water every 5 minutes.

From there I spent another 30 minutes in the now slightly cooler sauna, and then I was escorted to what I thought was the actually massage part of the deal. They had me lay down on a bed, sandwiched between two heavy blankets, on top of a vibrating mat that was rather uncomfortable (and something like the massage chairs they sell at the Sharper Image.) Next I was slathered – from head to toe – with gobs of “all natural, aloe-based” moisturizer. After ten minutes of being “moisturized,” they told me “listo” (done), and that was that. Later on I heard that my two other friends had their pressure points beaten by a stick by the head masseuse, just to make sure they left feeling relaxed.

So, two and half hours later, I left the establishment feeling very sticky, uncomfortable, and a lot more stressed out than when I went in. But despite my mal humor afterwards, I have to say, it was a pretty hilarious experience. I’m actually a bit sad that I wasn’t beaten with a stick, more for the humor than the therapeutic value. But no, I will not be going back to experience the “energizing waters of Lake Titicaca” or the “chocolate bath.” I think not…

Go eat your chuño...and french fries.

2007-08-09T16:57:00.000-04:00

In my efforts to kick myself back into shape before the fall frisbee season, I’ve joined the gym on the corner of my street. It’s pretty basic, with some rather old and worn looking weight machines, but the real reason I signed up was to go to spinning and some of the aerobic classes that they offer in the evenings. Last night I had my first experience in a Step class, where I proved myself to be the token white girl who had no rhythm…at least for the first half of the class. I joined the group a bit late, and then spent the next 30 minutes admiring the male teacher’s hips swaying to the blasting techno music. He was going through everything so fast that I kept tripping over my feet, and sometimes over the wooden step (it was rather unstable and flipped over a few times), until I finally figured out how to move and started enjoying the movement. Finally, I could feel the workout, which probably would have been easy at sea level, but at altitude left me feeling tired and exhilarated.

Today I made a journey to a different hospital called Juan XXIII located very, very high in the city. Due to its proximity to El Alto, the hospital sees a lot of very poor patients (even more so than the Hospital de Clínicas) with very grave conditions, a lot of time because the people wait until their conditions are very serious before they seek medical treatment. My goal in visiting this hospital was to talk to a Pneumologist about her experience with tuberculosis, and in particular how poor nutrition affects susceptibility to TB infection. I got to see a 20 year old girl with military tuberculosis, the most severe form of the disease where the bacteria spread from a lesion and infect all of the tissue and organs in your body. I also heard a 78 year old aymara woman cringe at the though of putting an IV in her neck, as she asked “Why are the doctors trying to hurt me?” She didn’t understand that the procedure was necessary for her health, and seemed to instead view it as a form of torture.

The doctora was quite overbearing in the way she interacted with the patients and the staff (she openly castigated the interns, in front of 20 people, about their medical ignorance), but it was a great opportunity to get one perspective on tuberculosis in Bolivia. I have always attributed the problem of poor nutrition to a combination of traditional food (which consists of chuño, freeze-dried potato, corn, potatoes, bread, and rice) and poverty, but the doctora asserted that the influence of western fast food practices has had a monumental effect. The traditional food that grows in Bolivia is actually quite diverse and healthy, like quinoa and fruits and vegetables, but according to the doctora, people have turned to French fries and fried chicken as the primary food because it is cheap and fast. So while “Bolivia tiene todo” (Bolivia has everything), the diet is all carbohydrate and lacks vitamins and minerals. Furthermore, the doctora seemed to think that coca chewing, especially in the lowlands, leads to poor nutrition, which leads to tuberculosis susceptibility. Coca gives you more energy and suppresses appetitive, so that people don’t feel the need to eat as often.

Her opinions raise a lot of questions and doubts in my mind. There are so many doctors here who look down upon indigenous practices, and who also criticize western medicine. While there is some merit to both of these viewpoints, I find myself in a weird position as someone who is trying to learn about aymara culture with an open mind, and as someone who is also part of an obviously problematic but nonetheless effective culture of western medicine.

I was left wondering about her blaming poor nutrition on coca consumption – she didn’t seem to consider that there are reasons that people need to consume coca, like lack of resources to buy food. Furthermore, as I think about how the poor nutrition in the campo is derived from fast food, and also as I think about the food that is actually native to the Altiplano (i.e. not fruits and vegetables). It made me start to think about the fast-food industry in the United States, not in the sense that it is responsible for obvious health problems like obesity, diabetes, and heart problems, but also in the possibility that it is making people more susceptible to infectious disease. I honestly don’t know that much about this field of study, but it’s something that I would definitely like to look into, for its obvious relation to what I am seeing in Bolivia. People here just aren’t overweight and unhealthy in the same way as the United States.

It seemed like this doctora had quite a bit of a grudge against the United States and “western ways.” Most strikingly, when I was talking about the correlation between AIDS and TB in Bolivia, something that I have witnessed repeatedly in the Hospital de Clínicas, she interrupted me and said, “AIDS, no, that’s in your country.” Everyone in the room burst out laughing at the point, but I think I was the only one thinking how ridiculous her statement was. When we were talking about protein, as well, and I mentioned that I was vegetarian, she looked at me incredulously and said “But you have to eat meat,” as if there was absolutely no other way to live. I explained to her that the meat in the United States is less than appetizing, and she scoffed and turned to her patient and said “There they inject cows with all sorts of hormones so that they grow big and fat.” While it is a true statement, the accusatory tone of her voice made me realize how her vision of the world and culture was truly uninformed.

First Interview

2007-08-08T12:58:00.000-04:00

One of the main reasons I originally came to Bolivia this summer, other than to work on my Spanish, was to set up an affiliation to pursue a Fullbright Grant. Having made my way into the Hospital, the basic of the grant (other than the actual writing) are well on their way. I'm planning on doing a project on the communication, or lack thereof, between patients and doctors, and how this affects both the perception and efficacy of medical care. I was imagining that it would consist of interviewing the patients and doctors, but today I realized that I have never actually tried to conduct an interview. (talking to patients doesn't count). So , I wrote down some preliminary questions, found the friendliest and most bored looking patient, and went at it.

The patient who I decided to interview, a 56 year-old woman who lives in one of the higher, more indigenous neighborhoods of the city (actually near where I used to live), was surprisingly eager to talk to me. I'm always a little taken aback by the variety of responses here, ranging from cordial and obliging to standoffish and downright rude. As far as the content of the interview went, I'd put my comprehension at about 50%, not because my Spanish is terrible, but more because the woman had a very thick Aymaran accent. "Dieciséis" (16) came out as "Diesei", and the ends and beginnings of her words were blended together.

It also took me a while to figure out the right questions. I began by asking her about her illness, about her family, about her general experience in the hospital, and then I moved onto more specific questions about her interactions with the doctors. She spoke highly of the care she had received in the Pabelon Italiano, but finally she began to talk about how some of the doctors in the other parts of the Hospital had mistreated her. At the end of the interview I thanked her, started to shake her hand, and then realized that a kiss on the cheek (the Bolivian way of greeting people) would be more appropriate. Seeing the smile on her face, the enthusiasm as she gripped me hand and wished me good luck, made the whole thing worthwhile.

I walked away surprised that she was so appreciative of the care she had received, but also with a better understanding of the variety in medical care in the Hospital de Clinicas. I don't suppose that it will be hard to actually conduct the interviews, but more to figure out the right questions to ask and the right areas to ask them in. But then again, variety is the spice of life, eh?

Market Prices

2007-08-07T11:50:00.000-04:00

I love the markets here in La Paz - the color, the variety, the shouting vendors, the smell - all of it. For me it's the most definitive experience of being in Latin America, and I lament the fact that we have almost nothing of the sort in the United States. Life in the streets makes things so much more interesting.

While I make it a point to wander the street markets, especially the ones beyond Sagarnaga, at least once a week, I do most of my shopping at the supermarket (Hipermaxi) near my house. It has nothing to do with the convenience of it being two blocks away, and more to do with the fact that things actually have price tags. In the markets, none of the prices are displayed, and it's expected that you don't take the first price for granted, and that you haggle for a little. For a La Paz native who knows the average price of fruits and vegetables, shopping in the market is great - you get extremely ripe and fresh produce for dirt cheap. But when I walk around the markets and ask prices, they take one look at my blonde hair and pale skin, and jack the price up 5Bs.

I know that 5Bs is nothing for an American, about $.50. But yet I still take offense to the change in price, and more than offense, it deeply bothers me. It's a complicated issue, really, that provides a bit of an ethical dilemma...and perhaps that's why I chose to go to the local supermarket and avoid thinking about it altogether. I understand that the extra money is not a burden to my bank account, and more than anything I know that the money is going to people who need it and will put it to a good use. I also understand that it is a fact that I am from the outside, and that I am intruding into a different society and economy. But at the same time, what gives them the right to treat me differently, and to judge as an outsider when I live down the street and when I am trying hard to learn about culture and practices?

It happened the other night when I was buying flour and sugar for a cake. I know the casera overcharged me, because I've seen the prices in the supermarket. Instead of being inspired by the energy of the market, I came away annoyed and upset. I hate that.

It's basically the same issue with photography, and it boils down to a long, hard history of foreign relations. I wish I didn't have to inherit that legacy. I wish I didn't feel better going to the Hipermaxi, because ultimately it's not stimulating the local economy in nearly as productive a way. But I refuse to contribute to the idea that it's okay to more-or-less trick foreigners into paying a higher price. Doesn't it make sense that if the people are demanding an end to racism and discrimination, that they stop practicing it themselves?

Oy, it's all so complicated that it just makes my head hurt.

Paceña: Es Cerveza

2007-08-06T10:36:00.000-04:00

Anna, my dear old porchmate, is visiting from Cochabamba for the weekend. She´s been studying Spanish in a school down there, and also doing some research in political movements for her BA, but she made the 8 hour busride down here to see the best and the brightest of La Paz. Actually, our main goal for the weekend was to go up to the 16 de Julio Feria (street fair) in El Alto and see the "Luca Libre," the fighting cholitas. It´s like the WWF, but with hardy Aymara women dressed in polleras (skirts) and hats, beating the living daylights out of each other. This article is in Spanish, but has some interesting photos of the fights.

We weren´t sure what time the attraction began, so we took a bus to El Alto early in the morning (10:00, on a Sunday it´s early) to try to buy tickets and scope out the venue. After wandering around looking for the "Multifuncional" where the "cholitas pelean", we found the building, a pink and rundown looking warehouse. Turns out the fighting wasn´t until 3:30, so we spent the next 5 hours wandering around the fair, walking ourselves to death. In the end, we didn´t actually get to see the Lucha Libre - we were dead tired by the time the fighting was scheduled to start, and of course being on Bolivian time, the doors weren´t even open at 4:00. Furthermore, neither of us wanted to watch and wince through the opening event, Bolivian wrestlers dressed in tacky spandex...

The highlight of the day, however, happened right after lunch as Anna and I were wandering around in search of a sprite for me. I was holding her beer, Paceña of course, as she was trying to take a few pictures of the canyon, when a cholita woman selling a few polleras started mumbling "You´re going to get drunk with that beer." At first I thought she was telling us not to take a picture, but then I realized she thought we were getting drunk at the Feria. I explained to her "It´s okay, it´s the only beer we have, really, all day," but she shook her head and said "No, one leads to another." Eventually, as I stood there trying to defend my sobriety and honor, she warmed up to the sight of two gringa tourists and started asking us how we liked La Paz, El Alto, the Feria. The mistrust turned to amusement, and as we walked away she was smiling a big toothless grin.

PIctures of the Hospital

2007-08-04T16:06:00.001-04:00

I tried my first salteña today. I’ve been meaning to try this La Paz staple for quite a while, and today I finally decided to go visit the place down the street that has vegetarian ones on weekends. Salteñas are pastry shells typically filled with meat, vegetables, and eggs in a flavorful juice/sauce. It was quite tasty - the outer pastry shell was a bit sweet, and the inside was a mix of potatoes, corn, carrots, and a few other vegetables in a spicy, curried, gravy-like sauce.

Also, I finally got over my fear of taking pictures in the Hospital de Clínicas, so now I can finally give people a glimpse of the conditions I've been working in and observing. Unfortunately I couldn't get a picture of any of the orphanage-style wards, the large rooms with the rows of beds. The ward that I did photo, the Pabellon Italiano where I am "stationed" right now, is the nicest area of the hospital that I've seen thus far, so base your judgments upon that.

[The Hospital Militar, where I work with the dermatologist. It’s located just up the hill from the Hospital de Clínicas.]

[Avenida Saavedra, where all of the Hospitals and Medical Institutions are located.]

[Main entrance to the Hospital de Clínicas, which is usually open and packed with people in the mornings.]

[The main area, which is a large open courtyard bordered by the buildings that hold some of the main Unidades, like Traumatologia and Patologia.]

[A new building under construction.]

[The interior of the Pabelon Italiano.]

[The Claudias’ room.]

[This rather stoic looking patient kindly let me take his picture. He was sitting in the sunlight, calmly staring out the window. Something about his demeanor was very regal, and it touched me.]

[The front of the Pabelon Italiano.]

[Patients and family catching some fresh air.]

[The Hospital del Niño.]

[The area where I used to work, which holds Dermatología, Infectologia, and Mental Health.]

[The Hospital de La Mujer, which has pregnant women and neonatal care.]

[Outside of Emergencias.]

[Miraflores, the neighborhood around the Hospitals.]

[The Puente de Las Americas, the bridge that I take every day to get to and from work.]

[View from the bridge. That’s someone’s house…]

But I hate white shoes

2007-08-03T16:28:00.000-04:00

I returned to the Hospital de Clinicas for the first time in over a week today, and was greeted with a lot of “Whoah, were did you disappear to?” It was good to be back – it gives me a sense of purpose in life down here – although my stomach does flutter every time I walk into the ward and smell the sickness.

Today I got my first glimpse of a surgery, although a minor one, on a 75 year old woman with cervical cancer (apparently there is a high incidence of cervical cancer caused by HPV in Bolivia). She has a large tumor pushing on her urinary tract such that she can’t urinate (it had been 15 days), so I watched as they put some sort of catheter into her kidneys to help her “urinate”. We brought the woman over to the imaging unit, where they had her lay down on her stomach as they used an ultrasound to view her kidneys. There was no protective paper on the bed, and the woman was lying there with her pants around her ankles, her feet resting on a folded cardboard box. I watched, rather stunned, as the room filled with all sorts of medical students, as the poor woman sat there without any friends or family to comfort her. The doctors were wearing gloves, but no scrubs or facemasks, and of course the rest of us were without proper medical attire as well. My naive, childhood vision that all doctors are perfect and will automatically make me well has certainly been replaced by a more skeptical appreciation of medical staff.

They cleaned her back with iodine, and then proceeded to put a catheter through her back. The process seemed so crude to me – they used the ultrasound to see if they were “in” her kidney, while a bit of urine mixed with blood from the tube dripped onto (and possibly into) the area around the wound. It scares me a bit that when I asked the intern why they used the chemicals they do for curaciones, her reply was “It’s what we have around here,” with no hint that she knew that the methods they use are quite bad for tissue healing and health.

At the end of the procedure the attending doctor finally noticed that there were students standing around, and he asked the doctor I was standing with who I was and what I was doing there. After a brief introduction as a biology student from Chicago, the doctor looked me up and down and, in front of all of the people in the room, started to talk about how all attendees in the hospital should wear white shoes and white pants – focusing on my black converse and khaki pants. Not referring directly to me, he talked about how patients needed to see people in the hospital looking professional, and how even though “this is a third world hospital, we still have our idiosyncrasies.” And before I could really grasp what was happening, he told me “Avoir” (why in French?), and then I found myself waiting outside.

In the month and a half that I’ve been at this hospital, I have NEVER been castigated for my clothing, much less in public. I’m not really sure what he was trying to accomplish, but I have a feeling this is another case of prejudice against foreigners, which could have happened for any number of reasons. In my experience, most people are happy to see a foreigner working as a volunteer in a poor hospital, and the white lab coat ensures that I blend in more than well enough. I know that some people look at me and automatically assume that I’m a western doctor who thinks she can just barge in, prance around, and insert all-knowing remarks once in a while. While part of that statement is certainly true, minus the comments and the prancing, it’s that same assumption that bothered me so much at the Cabildo in El Alto. I understand is a complicated mix of history and race relations, but I still get worked up that people are so quick to judge.

I'm Famous!

2007-08-01T13:24:00.000-04:00

Just kidding. I'm only excited that I was quoted/referred to on another website, check it out here:

http://www.globalvoicesonline.org/2007/07/24/bolivia-historic-rally-in-la-paz-provides-opportunity-for-journalism-20/

Other than that, not much going on here. I've been distracting myself by reading a pirated online version of the new Harry Potter book - I feel bad, but I couldn't get my hands on the real thing, and I couldn't wait any longer.

Intestinal Discomfort

2007-07-30T14:31:00.000-04:00

The typical symptoms of Typhoid Fever, according to the CDC, are high fever, stomach pains, and loss of appetite. Aside from moderate stomach pains a few days in the past week, I didn’t really have any of the above indications, but lo and behold, I have Typhoid.

I’ll spare you the moaning and whining about the condition – it suffices to say that I reluctantly decided to go see a doctor today after being nudged by my roommate (who ironically had Typhoid about 3 weeks ago) and parents. I showed up, he looked at my tongue – which is apparently a bit yellow and a good indication of a bacterial infection – and then poked my stomach for a while. 30 minutes later, after a blood test, diagnosis confirmed. I have to go on Ciprofloxacin for 8 days, and I was told not to eat a relatively long list of foods because they will “upset my stomach.” I have to say, some of the items on the list seem awfully random - in addition to no fried foods and alcohol, I’m not supposed to touch peanuts, white bread, avocado, or unpeeled tomatoes. Huh?

More than learning that I have a weird bacterial infection that no one gets in the United States (as my friend Liz pointed out, “You have an Oregon Trail disease! And not a lame one like a broken arm.”), it was interesting to see the incredible contrast between healthcare in this private clinic in the Zona Sur and the Hospital de Clinicas. The difference begins upon walking in – unlike the dark, dirty, undecorated rooms in the Hospital, the waiting room in the “Trauma Klinik” had a formal, glass-fronted reception desk, artwork on the walls, colorful clean couches, and even an elevator.

Beyond the appearances, the treatment was much more informative and personal (obviously) than anything I had seen at the Hospital. The doctor asked me for a full history of my symptoms, which seems to be rare here, and then proceeded to discuss the actually pathology of the infection during the exam. Contrast that with the “get ‘em in, get ‘em out” methodology at the Hospital de Clinicas. Everything was also very fast – I called the doctor on his cellphone this morning to make an appointment, and 2 hours later I was in the exam room. I also had a blood test right after my exam, and the results were ready not 30 minutes later. In the Hospital de Clinicas, doctors evaluate patients for an external consult only when they are in bad shape, and then they often have to wait an entire day before they are seen.

What is most striking to me, however, is the informal way paperwork is done around here. After the exam, the doctor wrote me a prescription on a non-descript piece of paper, and then he gave me a handwritten bill right then and there, cash-only. And there was the same sort of informal system for the laboratory work.

As I was sitting in the clinic, I couldn’t help think to myself about to what level patients are informed of their conditions and tests here. In the Hospital de Clinicas, as I’ve mentioned before, there is a complete lack of communication between doctors and patients. But on the other hand, all of the papers, exam areas, and testing facilities are so visible that if people knew what they were looking at, they could easily get some sort of idea. In this clinic, there was a bit more privacy, but the testing equipment was in the same room as, and in plain eyesight, the room where they took my blood. And in the end, the doctor sat down with me and went over the data, number by number, so that I could actually view the process of making a diagnosis. Then think of the United States, where the exam rooms are completely separate from any of the diagnostic equipment, and patients are supposedly more informed by their doctors, but yet have to rely on hearing the words from a medical professionals mouth instead of viewing actual numbers or data.

In the end, is communication actually that much better in the United States, and how does this communication affect the quality of medical care? And can I only say this because I have had a rigorous education that has not only exposed me to biology and medicine, but has also taught me to question my surroundings?

Concert Part II

2007-07-29T14:48:00.000-04:00

The concert was a real riot: the goth-metal-rock venue was located in a community center that usually plays folk music. I arrived a bit early and, as usual, was the only gringo in the place, and the few black-clad people sitting there gave me a look like “What are you doing here?” I ran into a few familiar faces, notably my former roommate Evan, and as we watched the Metallica and Apocalyptica music videos they were playing before the show, I myself was thinking “What am I doing here?”

When the band got on stage, the lead singers were decked out in black corsets, skirts, and commando boots. They played a lot of screaming cover songs, and while my friend Karim looked a bit stiff, the other singer had her curly black hair whipping and her hands writhing through the air (it was a bit cliché). When the next group went onstage I just about lost it – it took me a double take to figure out that the lead singer was, in fact, a man…he had long, straight hair and was wearing a skin-tight full-length strapless pleather dress. To complete the ensemble, he had painted his face white and his eye sockets black, and he was playing a huge white double bass in a rather phallic fashion. I applaud the groups for their enthusiasm, but in a venue with not more than 50 people, it was kind of comedic.

After Evan and I couldn’t bear it anymore, we headed out to my new favorite place in La Paz – it’s a bar/lounge called “Adam’s Rib”, situated in an unmarked, white house at the end of a very, very steep street in Sopocachi. From the outside it looks like a ordinary place, but when you go, after you’re personally greeted by the jolly owner, you’re overwhelmed by the sheer amount of kitsch. Every room in the house has been converted into a makeshift lounge that is decorated with colorful odds and ends that should look tacky, but in combination give the place a charming and unusual feel. We ran into another friend, Dado (who happens to be the AP photographer for La Paz), and ended up chatting until 3:30am, while the resident Siamese cat wandered in and out of the rooms meowing.

Yesterday, on our way up to buy a few DVDs from the electronics market, I paid a visit to my former landlady, Doña Emma, who owns one of the tiendas in the witches market. I brought my 5 gringo friends into the back of her store, which is dark and dusty but filled with thousands of interesting things, where she had us participate in an Aymara misa/ritual. She had a small bowl in the middle of the floor filled with leaves and some sort of liquid, which she lit on fire to form a flaming bowl of incense (which is great for me, being afraid of fire and all). Chanting in a mixture of Aymara and English, she had us sprinkle sand and then some flammable powder on the bowl. After we “washed” or faces and bodies with the flames, we then had to walk over the foot-high flame three times.

During the ceremony she offered us coca leaves, which is chewed along with a burned quinoa paste. As my first time chewing coca (you don’t actually chew it like gum, more let it sit between your back teeth), it was actually quite pleasant – the juices are a bit sweet and have a numbing effect on your mouth. I suppose this weekend in general was a first for coca experiences - at “Adam’s Rib I also tried a coca-infused rum mixed with lemon and some sugary substance. (I’ve also seen fish with coca-cream sauce and coca flour).

Bolivian Goth-Rock, Ye-uh

2007-07-27T14:34:00.000-04:00

Well, I had my first experience with all-out food poisoning here, which was lovely. I spent some time curled up on the floor wanting to die, but all seems to be well now (fingers crossed).

My good friend Karim, a La Paz native, has a rock band named Libellula that is going to going to be putting on a show tonight at a club in Miraflores. It's pretty hilarious (I mean that it an endearing and admiring sort of way) - it's a group of middle-aged women who all love classic rock bands like Guns N' Roses, Led Zeppelin, The Cure, etc., and they play covers of hard-core, goth-rock music. I think many of them are involved in video productions in La Paz, so they made a music video (complete with a "Making of" documentary). It was filmed in the Valley de La Luna, and all of them are wearing dark red lipstick, heavy black eye-makeup, corsets, and black leather boot. Amazing.

During my first week here, Karim invited me to a dinner at the drummer's house, where I had a Bolivian version of Lasagna and was introduced to the chicas of the band. They sat around in her living room, chain-smoking, eating, and singing along to Matchbox 20. The word to describe it here is "chistoso", which roughly means funny but has more of an endearing, joking connotation.

I was originally going to play violin with them for one or two songs, but that sort of fell through when I sat in on one of their rehearsals (in a tiny, tiny room with the amps blaring and the drums blasting), and realized that my poor little violin would be completely overwhelmed by their sound. So I guess I'll have to put my dreams of being a goth-rock violinist on hold for the time being, and settle for watching their show. More to come later...

Everybody Dies

2007-07-25T13:09:00.000-04:00

Patient #10 - Female, 52 Years
Diagnosis: renal insufficiency secondary to sepsis, chronic gastroenteritis, hydroelectric disequilibrium, moderate anemia

As I was waiting for the interns to finish their morning paperwork (there’s a flurry of activity as they rush to finish the clinical evolutions from the past day and distribute all of the charts and relevant materials to the beds), I was wandering around the ward looking at the patients and trying to figure out how to occupy my time. I glanced at the woman in bed #10, and I saw her on her back with her mouth open, not really moving. I thought to myself "Hmmmm, she doesn’t look so good, in fact she sort of looks dead...no, it can’t be, they’re keeping an eye on her." And I continued on my merry way.

10 minutes later I came back to the ward, and the woman was on the floor surrounded by several doctors and nurses. Her mouth was still wide open, exposing all of her teeth, as the doctors took turns trying to resuscitate her by pumping her chest. There was no machine keeping track of her heart, there was no defibrillator, and there wasn’t an oxygen mask ready at hand. Everything seemed rather haphazard. They spent more than 15 minutes trying to bring her back when I was standing there thinking "She’s dead, I saw her like that more than 20 minutes ago. " There were a lot of thoughts rushing through my head, but I couldn't help but wonder if I could have prevented her death if I had said something earlier? Is it even my job to be keeping track of that, and shouldn’t someone have been keeping a closer eye on her?

As I was standing there watching them pump her chest, her limp body moving back and forth, they asked me to help... my immediate, panicked reply was ¨I can’t, I don’t know how.¨ While it was partly true, I think I was also afraid to get close to a dead body. All of my experiences thus far have involved some degree of separation from sickness and death, and that was so real and so accessible. After I said that I was mad at myself for turning down the first opportunity to help someone hands-on. Why did I do that?

When they realized they couldn’t bring her back, they wrapped her up in a sheet, leaving half of her face with its wide eyes and open mouth still showing, and they left her lying on the floor for another 20 minutes while they went to look for a dolly to take her away. They finally wheeled one out of the back, placed her on it, and then left it in the corridor outside of the interns´ room while they called the family and cleaned up her bed. The poor girl who was sharing her habitation was sitting in a chair next to the desk, hugging a raggedy stuffed animal. I asked her if she was okay, and she said yes...and explained how one moment the woman was breathing, and then she just stopped.

I’m surprised that I’m not more disturbed by this. Even though this is the first time I have ever seen a dead person, more than horrified, I was fascinated by the process of trying to bring her back. The only explanation I can find for how I feel is that I didn’t see her dying, and that she seemed so dead to me during the whole ordeal that I could file it away nicely in my brain as something that had ceased to be human.

Following the Interns

2007-07-24T12:04:00.001-04:00

I went to work yesterday to talk to Dr. Revollo, the head of the Unidad de Infectologia, to receive an official introduction to the new interns in the unit. To my surprise, he suggested that I go find the two Claudias in their new section - a combination of Cardiology, Nephrology, and Gastroenterology - because it would interesting to see different types of patients. I tracked the building down all the way on the other side of the Hospital campus, only to find that in contrast to the complete lack of privacy and security in Infectologia, this area had a locked front gate controlling access to the wards. After waiting at the gate for a few minutes I flagged down one of the Claudias, who then introduced me to one of the Jefe's, a very cold and intimidating man compared to the jolly and "chistoso" (funny) Dr. Revollo. After a bit of explaining, and more due to the fact that I have white skin and blond hair, he told me that I was allowed to follow them around, but that I had absolutely "no responsibilities".

This area of the Hospital is completely different from the Unidad de Infectologia. The building gets a lot more light, which not only makes the wards warmer, but also gives them the allusion of being cleaner. Instead of dormitory-style beds, there are partitions separating every two patients, and the blankets on the beds are actually embroidered with the hospital logo. There is a reception desk with a centralized location (at least nominally) for the patient charts and paperwork. In general, there is much more of a flurry of activity - more nurses, more doctors, and much fewer visitors. It's kind of ironic that access to the patients with heart and kidney problems is strictly controlled, while access to tuberculosis and AIDS patients is not.

My day itself was kind of boring, because I ended up following Claudia #1 around while she filled out paperwork and accompanied the Jefe's on rotations. This is especially hard because the doctors rattle off a string of clinical indications that I have never heard of...but at least I was inspired to go home and look up things like renal tuberculosis, uremia, and congestive heart failure.

On a completely unrelated note, I have a few yummy recipes to share...of course with slight modifications. Saturday night I made tortilla soup (with corn added in), and also zesty quinoa (with apples and zuchinni because I couldn't find sundried tomatoes.) Also, last night we had avocado enchiladas with a mexican chili sauce and sprinkled with cheese. The tortillas were a bit mushy because we didn't fry them before baking them, so if you don't mind extra oil I would recommend that. Serve them with black beans, rice, salad, and a nice glass of red wine.

Journey to the Outskirts

2007-07-22T18:07:00.000-04:00

Today my friend Rossana took me for a ride in her car (no taxis or minibuses, what a treat) to see the outskirts of La Paz. We didn’t go as far as the areas that are considered the “campo,” where I’ve heard that the poverty and landscapes are truly shocking, but we did drive about an hour outside of the city proper, quite far enough for me to be stunned by the landscapes. On the road that winds down from Sopocachi you pass through the various “barrios” of the Zona Sur, and then as you head past Mallasa and the Valle de la Luna the road starts to get a little bit worn, with increasing numbers of potholes and sections of gravel.

The lower areas afford a better glimpse of the surrounding mountains and hills, and they are unlike any rock formation I have ever seen. Here’s my geeky geologist side surfacing: the bright red, orange, and pink stones (as you can sort-of see from the pictures of the Valle de la Luna) jut into the dazzlingly blue sky in ragged formations of what looks like sandstone. There are houses and little tiendas dotting the sides of the road, perched alongside crumbling rock formations that look like they are made of rough cement. It’s some bizarre mix of desert and barren forests - as the road winds up and down the hills, on one side you have cacti and on the other patches of bright green growing alongside the numerous streams. Some of the hills remind me the badlands of the Southwestern United States or of the weird Hoodoo rock formations in Southern Alberta. But here everything is so much more dramatic. It’s unfortunate that I didn’t have my camera, because my words just can’t do it justice.

Rossana took me to a really great restaurant along the side of the road, which I suppose serves a mixture of “comida típica” and more international entrees. The restaurant itself was an enclosed courtyard, which provided a respite from the dusty road, and as we sat down we were immediately served what looked like a tiny glass of orange juice, but turned out to be something like a Bolivian version of a screwdriver, de gratis. I’ve taken to ordering fish at Bolivian restaurants because being a vegetarian means eating overcooked pasta, French fries, or a salad that has a good chance of making you sick. I ordered the “Trucha a la diabla,” trout from Lake Titicaca in a spicy tomato sauce served with French fries, “arroz chino” (white rice), and salad. The trout, which is a Bolivian specialty, was delicious and tasted surprisingly like salmon (it had the pink color and all). Rossana ordered a typical dish that turned out to be a huge hunk of roasted pork (about 1/ 2 the size of a football) perched on top of sweet potato, an ear of “chuño” (corn), and a roasted plantain…with a salad on the side. I have never seen so much food in my life for $4.50.

On the way back Rossana gave me a tour of the distinct parts of the Zona Sur, which gave me more of an understanding of quite how different the suburbs are form the rest of the city, or say, El Alto. Even more so than the houses I talked about and photographed in Obrajes (where USAID is located), the houses in the more isolated parts of the Zona Sur are huge and stunningly beautiful. While some of them appear to be copies of the ugly modern architecture in the suburbs of the United States, others are colorful and full of character. Every now and then we would catch a whiff of the rivers, open sewage systems, running alongside these ritzy neighborhoods. The terrain is so much more exposed than in the city – you can actually see the jutting cliffs and how the houses have (for the most part) been made to adapt to the ups and downs of the land.

But the Zona Sur really bothers me, not so much because it is a deliberate display of wealth (the people have lighter skin, wear fashionable clothing, and their own sets of stores), but more so because it is an obvious attempt to be separate from the rest of the city. I became almost angry when I saw the Colegio Alemán and the Club Alemán. It’s a very pretty compound - it has patches of green grass, a pool, and beautiful buildings – but more than anything it seemed like a snobby attempt to be isolated from the vibrant culture of La Paz. I suppose I don’t understand what people are thinking when they build a replica of a German institution and when they work so hard to defeat the natural beauty of the land…when the whole point of being a foreigner in a country like Bolivia is (or should be) cultural exchange. After seeing this, I have a better understanding of the signs like “The rich are crying…” that I saw at the Cabildo in El Alto.

The Cabildo in El Alto

2007-07-20T17:27:00.001-04:00

Everything is closed today. The city is even more deserted than it was on the 16th of July, La Paz Independence Day, because today is the Cabildo, the meeting held in El Alto to protest the possibly movement of the seat of the government (administrative capital) from La Paz to Sucre. The hospital was eerily quiet - the Claudias and a few nurses were the only people I could find – and there were no mini-buses sputtering up and down the streets. Because it seemed like the whole city was in El Alto, Alison (my roommate) and I decided to head up to the Cabildo to check out the scene. The speeches were scheduled to start at 1:00, but because people from all over the Department of La Paz (which includes La Paz, El Alto, Lake Titicaca, and the neighboring mountains) had come to the meeting, the streets in and around El Alto were completely packed as early as 11:00, making it very hard to get near the action.

We found a trustworthy taxi to take us up the “back way,” which instead of the highway-like Autopista is a set of narrow and mostly cobblestone streets that wind through the heights of Sopocachi Alto. It’s actually the same route that the taxi used to take me from the El Alto airport to the city center when I first arrived, and the trip was just as stunning in the daylight. The taxi took us as close as he could get to the center of the Ceja, the center area of the Cabildo, and we (surprisingly) only had to walk about 5 blocks until we were fully immersed in the horde of people gathered around the platform and cheering on the speakers.

It was a fascinating experience being in the middle of not only a political, but also a cultural rally. Situating the administrative capital in La Paz, with its location in the Andes and with it’s heavily Aymara population, is symbolic of the political and cultural importance of the indigenous people. After the election of Evo Morales, who is the country’s first Aymara president, for the first time in the history of Bolivia the indigenous people (who only received voting and land-owning rights in the 1950s) seem to have representation and recognition in the government. Also, the decision to hold the Cabildo in El Alto is meaningful because La Paz’s sister city is considered the indigenous capital of Bolivia, further emphasizing the importance of the indigenous community. If the administrative capital were moved to Sucre, which is in the south of the country, I think many people in La Paz and El Alto feel that the newfound appreciation of indigenous rights and culture would disappear.

[People cheering as a helicopter, possibly with Evo Morales in it, flew by]

[“In Defense of the Department of La Paz: The Seat of the Government Will Not Be Moved”]

[Flag of the Aymara Nation]

[“The Rich Also Cry: They Can’t Govern Us Anymore”]

Being one of only two white people walking through the streets of a completely indigenous community, I sensed an interesting mixture of curiosity and also hostility. People all around me were looking at me with such scrutiny that it was impossible not to feel subconscious. Some people would shyly smile, while others would snidely call us “gringas” under their breath. When one woman saw me with my camera, she grabbed my arm and started to yell at me in Aymara (I think that some indigenous people believe that cameras and photography can steal their soul). When we were sandwiched in the middle of the crowd, most of the people were paying more attention to us, trying to figure out what we were doing holding Bolivian flags in the middle of the Cabildo, than they were to the political speakers.

I know that these people have an incredibly history of oppression, but it really bothers me that foreigners are consistently treated with such hostility. I guess I just don't understand how there can be such malice when we are clearly there to appreciate the politics and indigenous presence of the country.

The Cost of Medical Care

2007-07-19T16:03:00.000-04:00

I found out today that my interns, the Claudias, are moving to another unit tomorrow after a 20 day stay in the Unidad de Infectoligia. At first I was quite worried, thinking "How am I going to deal with this, the reason I enjoy work right now is because I like the two girls so much, oy oy oy..." But I've adopted a "this is the way things work" attitude in my time here, since the decision about whether I follow the chicas to their next assignment or stay in my current unit is out of my hands. It's just that it's hard to have to build a relationship with two new interns, especially after I was just getting close to these two. Oh well.

Today I was asking Claudia #1 a little bit about how the healthcare system works. As I've been stressing over and over again, the Hospital de Clinicas treats the poorer people in the system, and it functions as a sort of social welfare system. This is reflected both in the cost and quality of treatment. Apparently, if patients do not have "seguro" (insurance) it costs them *ba dum ching* 20Bs per day to be interned in the ward. For those not familiar with the conversion, that's about $2.5 a day. I know that the cost required of patients does not amount to the cost spent on a patient, but I was doing a bit of research, and the cost per patient per day in U.S. hospital is more than $1000 a day, on average, and for patients with bedsores it is more than $2000. I can't find the cost per patient per day for the Bolivia hospitals, but I can guess that it's around $50 a day. (This website indicates the cost per patient per day in countries such as Tanzania, Kenya, and India is less than $20 a day.)

Also, today when I stopped in for a brief chat with Dr. Revollo, he said his usual "Ohhhh Nadine, deliciosa!" and then followed it immediately with "Did you eat some seafood with garlic last night? I can smell it!" I had to stop and think for a minute, and then remembered that I'd made and eaten roasted garlic. Embarrassed, I told him "Yes, but I brushed my teeth?" He just smiled and said "It's in the blood."

The Socioeconomics of Healthcare

2007-07-18T19:19:00.000-04:00

Now that I've been working long enough at both the Hospital de Clinicas and the Hospital Militar to get over the initial shock value and start to observe interesting things about the patients, I've begun to realize quite how different the two institutions are. Both are governmental institutions (not private), but there are a few key differences. The Hospital de Clinicas treats the poorest patients in La Paz and El Alto, and it seems that most patients (understandably) use it as a last resort for medical treatment...which also means that most of the illnesses are quite grave by the time they are treated. The Hospital Militar, in contrast, is open to members of the military and their extended families.

Most strikingly is how differently the patients dress in each institution. In the Hospital de Clinicas the people dress in the “indigenous style” (forgive my crudeness, I don’t know how else to describe it) – the women wear the clothing typical of cholitas, and the men wear simple pants and sweaters. There is no makeup, and things are often worn, stained, or torn. In addition, people bring their snacks or chores (the sister of one patient brings her knitting every day) to the waiting room. In the Hospital Militar, the women wear paint suits and makeup, and they dye their hair, while the men wear nice suits or military uniforms and have shiny leather shoes. Interestingly, the Spanish is also a lot easier to understand in the Hospital Militar, probably because it has less of an Aymaran accent.

It’s kind of interesting to think about how in one place I’m seeing a woman with peritoneal (abdominal) tuberculosis, while in the other I’m seeing a little boy who has a wart on his hand. I’m sure there are areas of the Hospital Militar with more serious infections, but compared to the Hospital de Clinicas it feels like a walk in the park. For example, today a mother brought in her 6 year old boy who had some sort of viral warts or pox in the interior of his bottom, and for treatment (they’re contagious I think) they had to be removed one-by-one with a pair of tweezers. This involved having the boy lay down on his stomach with his pants pulled down as the nurse attempted to anesthetize his bottom. His mother was telling him that it wouldn’t hurt at all, but as soon as he felt that needle, he started crying, screaming, and clenching the muscles in his bottom. “Tengo miedo de las agudas, quiero ir a casa AHORA!” (I’m afraid of needles, I want to go home NOW!) I felt genuinely sorry for him, because until recently I’ve had a mortal fear of needles (along with fire), and I always hated when doctors would tell me that the needle wouldn’t hurt when it was always extremely unpleasant. But at the same time, the situation was inherently funny – here were the nurses wrestling with this little boy’s clenched but muscles while his mother told him to stop crying. I didn’t know whether to cry from sympathy or burst out laughing.

I find it hard to take an episode like that seriously after treating infected bedsores.

Jail Cell for Rent

2007-07-17T16:24:00.000-04:00

Treating that patient from the La Paz jail the other day made me realize that I haven't had the chance to talk about how fascinating the jail system is here. The main jail is called San Pedro, and the BBC did an excellent photojournalism piece on the place not too long ago. Unfortunately my knowledge is pretty limited because it isn’t easily accessibly to foreigners (there are no tours) and because, thankfully, I don’t know anyone who has lived in the jail.

[The Plaza outside of the Jail]

[Family members lined up outside of the main entrance]

[San Pedro Church]

Before I lived in Sopocachi I used to walk by the jail almost every day without realizing it because the area is so well integrated into the rest of La Paz. The building is pretty unremarkable other than the fact that it has no windows, but more striking is the complete absence of extra security precautions. There are no barbed wire fences or control towers, and the only policemen are those stationed right at the front door. Interestingly, most of the street vendors seem to cater to the “jail crowd” and sell significantly more hard alcohol and drinks, as opposed to fresh fruits and vegetables.

The way I understand it (and I’m sure the BBC article explains it much better), is that people go into the jail and are expected to not only pay for their living space, but also all of their provisions. The cells range in cost and quality, and prisoners sometimes resort to bringing their families (especially children) to live with them inside the prison. I don't think there's a security system, so people have to work within the jail to pay for their cell space. I don't understand how prisoners are prevented from escaping to roam the streets.

So just like everything else in Bolivia, the government doesn’t seem to have the resources (or the desire) to provide supplies/services for incarceration. It’s interesting when you think about how much money the United States spends on both medical care for the underprivileged, and on keeping large portions of the urban poor in jails. In addition to wondering how anyone can possibly recover in the Hospital de Clinicas, I’ve been surprised by how much these doctors can do for patients with so little supplies (and for such little cost). I’ve also begun to wonder if there’s some balance point between spending very little on patients and keeping them in the hospital for a long time because they don’t recover, and spending more money and speeding up recovery time. It would be an interesting study…if only La Paz had any sort of data collection system for these things.

Copa America and Curaciones

2007-07-16T13:13:00.000-04:00

Yesterday, as I mentioned before, was both the Independence Day of La Paz and the finals for the Copa America - the soccer tournament that is basically the Latin American World Cup. Soccer is a huge deal in Latin America, kind of like Football is in the US, so you can only imagine how excited people get about this tournament. The whole point of soccer (for me at least) is that you go watch it with a bunch of fans and be there for the collective experience, so I headed out to the nearby coffee shop. The finals were Brasil vs. Argentina, and while Argentina was favored to win, I decided to cheer for Brasil because I feel that they’ve represented the spirit of Latin American soccer for a very long time. The whole place was filled with Argentinians, chain smoking their cigarettes and looking arrogant, but I found myself in a corner with a tiny group of very loud, very energetic Brasilians. Brasil finished with a pretty definitive 3-0 win, so while our crowd was making merry and being obnoxious in the corner, the rest of the coffee shop was giving us dirty looks and taking long, annoyed drags from their cigarettes.

Today, despite it being a very important holiday, I decided that I would go into work at the Hospital to see if I could be of any help. On my way over this morning this city was markedly deserted. None of the usual shops are open, and the traffic has been reduced to about half. When I got to the hospital it too was deserted – only a handful of doctors were there, and there were no patients or students wandering around the corridors. Due to the low volume of hospital traffic, the two Claudias actually had time to do their “curaciones” (treatments) early in the day, so for the first time I was able to watch the actual process involved in treating and dressing wounds.

I almost ended up going home because we couldn’t find an extra face mask and hair net (I was not about to deal with sick patients without them), but I ended up borrowing one from Claudia #2, complete with makeup stains (they re-use them here). The majority of the cases currently in the ward are infected bedsores, which while interesting from a medical and immunological point of view, are quite disturbing. The first patient we treated, a 60 year old woman with both a mental and physical disability, was quite the introduction. The patients in the nearby beds had to leave the room because of the apparent smell (I was breathing through my mouth) of this woman’s two bedsores on her back and hips, the smaller of the two (about 3” in diameter and exposing her hip bone) which was infected and oozing a nice grayish liquid. Although I don’t like the sight of blood, I would say that I have a pretty strong stomach for these things after several years of working with animals in my lab…but I was this close to running to the bathroom to vomit after the sight of her wounds. The only way I could stand being there was by forgetting that this woman was a living, breathing human being, which presents quite a quandary for me after my critique of how the doctors here treat these people more or less like animals. But now that I actually have experience with treating patients, I can say that this is the only way I can handle medicine, by putting up some sort of mental block.

The actually procedure of treating these patients involves wiping down the wounds with an antibiotic, the hydrogen peroxide, and then iodine (no anesthetics are used to ameliorate the pain). While the tools in the US come individually wrapped in plastic and are discarded after a single use, these tools come in burlap sacks in a sort of “kit”, along with the cotton, the gauze, and the tray for pouring the treatment liquids (I just hope it’s all been sterilized). I’m not so familiar with the procedure for treating bed sores in the US, but I can tell you that when the interns used a minimal amount of clear packing tape to secure the gauze, my head started to explode. I couldn’t stop thinking, How does anyone leave this place alive?

All in all I got to help out with 6 patients, most of them with bedsores. One man is actually a prisoner from the city jail (a car thief, so I’ve heard), and he’s there because he was (apparently) playing soccer, received a small injury on his leg, and then winded up with an infection that ate away at all of the skin from his ankle to his upper thigh and left the muscle exposed. So while one leg is wrapped entirely in gauze, the other is tied to the bed with a chain…as if he’s going anywhere, anyway. I also had the delightful experience of treating the 15 year old boy with cerebral palsy, which isn’t so bad because of his wounds, but because of the piercing screams he lets out every time we try to move him. This poor child is so pathetically thin and incontinent, and he moves like a lizard, waving his cross-eyed head back and forth as he reaches his arms out to grip his legs or my hand.

Now that I’ve been there for a few days, and now that I’ve proven that I’m there to get my hands dirty, a few of the nurses and patients have started to warm up to me. They’ve stopped going “oh my, there’s a gringa” and started to ask me questions like “Why exactly are you here?” I had a bit of a shock when the attending nurse asked me “So, what do you think of that guy who’s in the government in the US?” As I started talking about how I despise President Bush (she couldn’t remember his name) and how I think the War in Iraq is a disaster, just to make sure she was following along I asked her if she knew about the War, and he reply was “A little bit, I’ve heard of it.” That was when I realized that an awareness of International News is basically non-existent here. It’s a different world, in every respect.

Hike to the Cemetary

2007-07-15T13:03:00.000-04:00

I’ve been feeling a bit restless for the past few days, so I decided that I would take a hike today from my apartment in Sopocachi, which sits at the far south-east end of the city, to the Cemeterio of La Paz, which is at the opposite north-end of the Prado. On my way there I passed through the food section of the upper markets, which was even more crowded than usual because today is the 15th of Julio, the day before the “Independence Day” of La Paz.

There were also quite a few fiestas in the street, and one group was especially endearing – I heard drums and trumpets blasting from about two blocks away, and when I wandered towards the music saw a group of people dancing, singing, and laughing as taxis and buses rolled by.

After huffing my way up quite a few steep streets, I finally found the cemetery (I could literally feel the change in altitude). Amidst the bustling markets and street vendors, not to mention the smell of fried and roasted meat that is even quite enticing for a vegetarian, the cemetery was a large and fenced-in, and was surprisingly filled with trees and greenery. In comparison to the cement, cobblestones, and trash in the streets, it’s quite shocking to see a little oasis in the middle of a rather poor area.

The La Paz cemetery differs from those in the United States in several ways, but most markedly by the fact that people are not buried underground, but instead stacked vertically in building-like structures, as many as 10 “people” high. Instead of stone gravestones, each person has a little glass enclosure where their family members place fresh flowers, mementos, etc. There was so much greenery and fresh flowers that I didn’t feel like I was walking through a cemetery – instead of the somber, creepiness of American cemeteries, it had a festive and peaceful ambience that was almost akin to a sculpture garden.

[Flower market across the street from the cemetery]

Valle de La Luna

2007-07-14T17:38:00.000-04:00

Today I decided to venture out of the city to see some famous rock formations called the Valle de La Luna and its accompanying town Mallasa. The Lonely Planet guidebook gives a brief description on how to get there, either by hired taxi for 50+Bs or a minibus for 2.50Bs, which I opted for. After about a 20 minute wait I found a minibus going that far into the county, and it was actually quite a comfortable 30-minute ride. We first drove through Obrajes and Calocota, the two components of the Zona Sur which I had explored briefly in the past, and then crossed the Rio Choqueyapu, the foaming orange river that runs underneath La Paz and dumps out further into the valley. The filthy river is used as an open sewer, and while it’s kept underground in the more populous highlands, in the lowlands it is used, despite its contents of sewage and chemicals, for the irrigation of the crops that make their way back to the city – thus my avoidance of unpeeled fresh fruits and veggies. Once we had crossed the river, the road turned into a rough cobblestoned path that wove through the smaller, further out villages. While the poverty and aridness of the terrain no longer shocks me, it was very strange to see crude brick, windowless houses within twenty feet of huge, elaborate fenced-in mansions. The juxtaposition of the poverty and the wealth is so blatant and shocking.

Although I was a bit confused about when to get off the minibus, I managed to find the place because (contrary to typical Bolivian fashion) it did have a relatively large sign marking it as a tourist destination. The Valle de La Luna was every bit as surreal and wonderful as the guide-book suggested – it was a large, fenced-in area with a narrow trail winding through the rugged, sandy rock formations. The terrain is actually quite desert-like, and it’s considerably warmer because of the pounding sunlight and the lower altitude. There was even a bit of grass speckled in with the numerous cacti jutting out of the sides of cliffs and the occasional flowering bush. The view from some of the higher points was breathtaking, and afforded a view of the mountains, the valley, and even bits of the Zona Sur.

[A view of the roads near the entrance]

To complete the serenity of the Valle de La Luna, two men were standing on top of the rocks playing wooden flutes and chirangos (traditional Andean instruments that look like mini-guitars). The sound projected all the way across the hiking area, and it made the experience simply perfect. I complemented the guy on his music afterwards, and although he tried to sell me a flute, he did show me how it worked and how he could play 3 octaves with only 8 stops/holes.

[Chirango player perched on the rocks]

The whole trail took about an hour and half because I was taking so many goddamn pictures, and afterwards I decided to trek down to the accompanying village, Mallasa, to find something to eat. I skipped the Zoo because I’ve heard that the animals are quite depressing, and instead found a hole-in-the-wall joint selling nothing more than ice-cream and cheese empanadas – my first experience with these delicious pastries of La Paz.

[The town of Mallasa]

Family Values

2007-07-13T18:25:00.001-04:00

I haven’t done much of anything today – I’ve allowed myself to have Fridays as my day off from work, so I’ve pretty much been sitting around, practicing my violin, and eating. This is actually really hard for me, because I constantly feel the need to be moving around and seeing things and “feeling productive.” But no, today I made myself be a couch potato, damn it. There’s actually a really great Vegetarian buffet 2 minutes from my house that I tried for the first time today. A full meal without meat is a rare commodity in La Paz, but it was quite tasty, and for 20Bs (about $2.5), I’d say I’ll definitely be visiting again. It’s just a shame that I’m at work during the typical “almuerzo” hours because I miss out on a lot of the lovely set-lunch menus and experiences.

Last night I gave my friend Vivi another violin lesson at her house up in Miraflores. Like most of my 30-something Bolivian friends, she lives with her mom, dad, sister, and grandparents. The family here seems to be a much more powerful force. Unless children get married (and even sometimes if they do), they continue to live in the same house with their entire family. Contrast that with the typical route for kids in the US: go to college and live with a bunch of friends hundreds of miles from your family. I shamelessly admit that part of my decision to go to Chicago had to do (initially) with its distance from my home, just like most college kids go through the “get me the hell away from here” impulse. But now that I’m living in a culture which values the family unit above the individual, I’m amazed and appalled that children are encouraged to leave the nest at such an early age, and moreover that they are encouraged to never come back.

Doesn’t it make sense from both an economic and a social perspective that single adults should live with their families? In addition to pooling resources, there’s also something inherently comforting about being with your relatives. While the family without a doubt comes with a fair amount of bickering, it also comes with an unconditional love that friends can never truly provide. More than anything, it’s just nice to see that my Bolivian friends have maintained such close relationships with their families, and I think it shows in the general level of happiness. People around here (for the most part) work what we would consider “crappy jobs” and have a much “lower standard of living”, and yet from what I’ve seen there’s a certain sense of content and tranquility that is totally absent from American culture. I fully admit that this is a combination of factors ranging from religion (Catholicism vs. Protestantism), proximity to nature, and lack of the western “work ethic”. In general, Latin American culture seems to have much more of a focus on the importance of social interactions, which makes North American culture feel disjointed and isolating.

I guess what I am trying to say is that after seeing this particular aspect of Andean (and I suppose Latin American) culture, I have begun to reconsider how my family will fit into my plans for the future. While I want to do things for myself, like travel and pursue international job prospects, I also want to be able to see my family on a weekly or even daily basis. Maybe even more than want it, I think I need it. Yes, we fight, we argue, and we get snippy with each other, but in the end I can’t think of anything that I’d rather be doing right now than eating dinner with my mom, my dad, and my two dogs.

The Power of the White Coat

2007-07-12T17:37:00.000-04:00

Now that I’ve finally established a (sort of) regular work schedule, which involves going to the Unidad de Infectología in the Hospital de Clínicas in the morning and then going to the Dermatología office in the Hospital Militar in the afternoon, I find myself dead tired. I’m not even working a full 8 hour day, but I realized that this is my body’s way of telling me that it’s working overtime trying to understand so much Spanish, much less medical terminology. At the moment I feel like my Spanish (accent, vocabulary, grammar, you name it) has actually gotten worse, and I find myself pretty confused about what’s going on more or less half of the time. But I’m hoping I’m in one of those moments where things get really jumbled and confusing before they make a giant leap forward.

I had been warned that some of the doctor’s can treat the patients, who are mostly aymaran and from El Alto like complete crap, but luckily Dr. Revollo and the two Claudia’s don’t fall into this trend. However, upon bringing some of the patients to other doctors for consultations, I really started to get a sense of how much of a problem discrimination and disinformation can be. During the mornings the hospital is filled with patients and the families of patients wandering down the open-air corridors or sitting in waiting rooms, and it seems like no one really knows what is going on. The doctors fail to tell the patients why they are being taken to x building, why they need a consult, what the diagnosis of the consult is, or how their medicine will help them get better. How can they blame these people for failing to take the full course of their medications when they are constantly left in a state of confusion?

Yesterday a new patient with pulmonary tuberculosis was admitted to the ward – he was so sick that he couldn’t swallow a pill, much less speak. They had this frail, pathetic man walk from the Infectología unit to his throat consult, supported by two family members on each side, so weak that he had to stop halfway to sit down and catch his breath. Once he was in the exam, the doctor sprayed an anesthetic in his throat that hurt him so much that he started to gag, drool, and cry. The doctor examined him, as the man visibly cringed, tears welling in his eyes, and then without saying a word more than “tilt your head back and open up” the doctor started talking to Claudia #2 about the diagnosis (laryngitis as a complication of TB) and the treatment. The man was left sitting there, silent and dejected, his head practically hanging between his knees. I reached out, touched his arm, and said “está bien” (it’s okay) - with that tiny gesture, for the first time he seemed to relax and smile just a little bit. Come on doctors, is that so hard?

Most of what I’m doing now involves paperwork—reading charts, watching other people read and write in charts, bringing the charts to different areas of the hospital. It’s hard to believe how incredibly decentralized this hospital is. You have to personally walk each individual “consulto external” sheet and it’s accompanying patient to the distinct units, and then you have to wait in person while the patient is seen, so that you can then bring the patient back with the appropriate paperwork. I honestly have no idea how they keep track of everything here – when we went to the test results office, it was filled with piles and piles of papers spilling out of cabinets onto the floors and shelves, in no apparent system of organization. While I didn’t come here to experience the joys of medical paperwork, I have no doubt that once I’m more familiar with the basics of the system, and once I develop more of a relationship with the patients (since most of them are there for at least a week) that things will get a lot more interesting. Hell, I guess they already are.

Everyone in this hospital, especially the little children, look at me as if I’m some sort of alien.
Just because I am Caucasian and I wear a white coat (which as I mentioned earlier, I bought on the street, which means anyone can buy one), patients and families refer to me “doctora” and ask me for medical advice. I am completely (in every sense of that word) unqualified to give any recommendation, and yet people try to ask me about their medical conditions and take every word that I say as truth. A tuberculosis patient in our ward was asking Claudia #2 about a toothache – she wanted to know if the pain from her wisdom teeth could spread to her throat and make her sick again. Claudia kept telling her no, I don’t think so, really, but it was only until I said that I didn’t think so either that she really started to believe us. She looked at me with the penetrating stare, and without questioning what I said, she started to nod. That sort of power really makes me scared.

Every time I walk in there I have to overcome the urge to escape, not only because I can see the sickness, but also because of the smell, a gut-wrenching combination of sickness, dirty bed linens, and stale food. Today another TB patient came in, and I actually got the chance to see them reading his X-Ray (which showed dense clouds of white in his lungs) and also diagnosing him with renal insufficiency. He was clearly quite sick, talking with a rasping voice and coughing every now and then. What really disturbed me, however, was as he was describing that he had been coughing blood, one of his relatives opened up the drawer of his bedside table and held up a plastic cup filled with bloody sputum. And while I was thinking “Oh my god, someone please throw that away,” the 15 year old boy with cerebral palsy and bedsore was screaming and crying as the nurses tried to change his sheets and re-dress his wounds.

Day #1 in the Unidad de Infectologia

2007-07-10T19:08:00.000-04:00

First of all, here are a few pictures to show the crazy weather we’ve had in the last few days. The white background isn’t because I have a crappy digital camera, but rather is the clouds that were sitting in the valley and causing a perpetual drizzle. It’s stopped raining now, but I’m a little sad that I no longer see the lady on the corner sporting her bowler hat wrapped in a plastic bag.

I guess I should also mention that I moved – to Sopocachi, actually, the neighborhood that I’ve mentioned in the past. The decision was a combination of factors, but was mostly because my future but not anymore roommate decided to come to La Paz later than expected, and I was quite tired of living alone. I suppose I should also mention that the new apartment is gorgeous, probably nicer than my apartment in Chicago, and is also about a 10 minute walk to the main part of the Prado. I feel more comfortable in every respect…except for the fact that we have an empleada (the La-Paz term for a maid). Doña Rosa is a lovely lady who comes every morning for a few hours to make breakfast, clean, do laundry, and cook lunch. This is extremely weird for me. I’m usually up around 7:30, a bit before she arrives, so I usually make my own breakfast and leave before I see her in action. But I haven’t at all gotten used to the fact that someone is cleaning my dirty dishes, making my bed every day, and addressing me habitually as “señorita.”

I’ve officially started working at the hospital. IIt was still dark out and bitterly cold (about 25 degrees), so much that my toes started to go numb, when I arrived at 6:45 to make the rounds with the two interns and Dr. Revollo. I found the Claudias in their room, which is located not 20 feet for the ward, as they were getting out of their queen sized bed (which practically fills the space) and watching TV. At 7:00 we met up with the doctor, who seemed very surprised to see me there so early, and proceeded to check in with all 20 or so of the patients. The ward is divided into two large rooms, one for women and one for men, with all of the patients in side-by-side numbered beds (picture an orphanage). As we walked around I began to develop a genuine admiration for Dr. Revollo because he treats these patients not with the usual medical indifference, but rather as if they are living, thinking, and feeling human beings. He’s this 60 year old man with wiry gray hair that sticks up from his forehead in an Einstein-esque fashion, and as he moved from bed to bed he was laughing and joking with each patient. He radiates a light-heartedness that I believe these sick people desperately need in order to put up with the misery of their surroundings.

I was a bit overwhelmed by all of the medical terminology that was being thrown at me, so I decided that it would be a better use of my time to read the case histories of each patient and then come back the next day with a more informed idea of what was going on. While the Claudias were off at a seminar, I sat down with the pile of metal files, conveniently labeled with each bed number at the top. First of all, when I first asked the presiding nurse if I could read the files, she told me “Sure…for two minutes.” I was a bit taken aback by the randomness of her response, which she justified by saying “I don’t know who you are, you could be anyone.” So after I dropped Dr. Revollo’s name, she immediately warmed up to me, handed over the files, and exclaimed, “Well, how rude that he didn’t introduce me!” So while I familiarized myself with the terminology for pulmonary tuberculosis, hepatitis A, bedsores, and Karposi’s sarcoma, patient #5, the 39 year old alcoholic with pneumonia and gastroenteritis, shuffled up and down the ward in his bare feet, wearing only a bathrobe and a hat.

Hospital Take Two

2007-07-09T18:39:00.000-04:00

First of all, I just want to say that the weather for the past few days has been crazy. We’ve had a combination of rain, hail, and even snow, which has left La Paz in a perpetual cloud of dense white fog. I am beginning to wonder if buying a pair of Converse Allstars before coming here was such a good idea – the rain leaves the cobblestone streets so slick that I quite literally can’t walk uphill in some places.

And today…after getting over my fear of returning to the Hospital de Clínicas, I met up with Dr. Guillermo, the guy who has been helping me out and putting me into contact with other people. After the customary kiss-on-the-cheek greeting, he walked me all the way across the hospital to the department of Infectología, where I was introduced to yet another older, director-type gentleman. Luckily this guy, Dr. Revollo, wasn’t nearly as scary as the “jefe” – he sat me down and immediately started joking around. “Oh que bonita, un ‘blondie’ no?” After a brief introduction (thankfully done by Dr. Guillermo, who is quite superior at describing who I am and what I want to do), he introduced me to two interns who work in the unit, Claudia #1 and Claudia #2, no joke. This time I made sure to ask rather extensively about the kinds of things they did, and Claudia #1 explained to me that they had a patient with tuberculosis, one with gastroenteritis, one with necrosis, and one with a sarcoma in his head (did I get that right?) Right up my alley with infectious diseases.

Immediately, there are two things that struck me as fascinating. In the middle of the room there was a nurse, dressed in the 50’s style white apron and little hat, cooking food in steaming pots and pans and giving it to other nurses to serve to the patients. Also, the perpetual lack of supplies leaves people at a real loss here – basic medical supplies like bandages and syringes are not at all included in hospital care, and instead doctors send the families of patients to local pharmacies with a list of supplies. If the supplies are too expensive, the patients go without the treatment. As I told the Claudias that I would be more than happy to write asking for medical supplies, Claudia #1 pointed to a young boy who has a form of tuberculosis that has spread to his intestines (I think?), and shaking her head, she told me that even though the young boy has a family, they never come to see him. The reality for many patients here is that their families cannot afford to take care of them, so they are often brought to hospitals, abandoned, and left to die.

So…who knows how this is going to turn out, but I’m more optimistic that it will be a better fit, in particular because it will be more of a personal interaction.

But that’s not all. I’ve made contact with a doctora who works in the dermatology section of the Hospital Militar, and while this isn’t the discipline I find most interesting, I decided it was worth a shot. Since she seemed nice, and since I was only going to be working with her 6 hours a week, I thought I could at least use it as a starting point. But working with her today was actually fascinating. You would think that dermatology would just be a lot of mother bringing in their adolescent girls with bad acne, but in reality it’s much more based in pathology. While there were the cases of pimples and dry skin, there was also the case of a woman with a huge cancerous lesion on the side of her nose which had been growing for more than a year (!). However, the most interesting part of the case was that she was actually terminally ill with colon cancer, but none of her family members wanted to break the news to her. She only knew that she had stomach pains, and Doctora Gúzman later explained to me that her families reluctance to explain her condition to her came from the fact that people here go crazy when they find out they have cancer.

There were also several cases of leishmaniasis, a parasite transmitted from a sandfly that leaves nasty looking skin lesions. Since most of the patients in this particular hospital are from the military, and are therefore often stationed in the campo, they are exposed to all sorts of nasty tropical bugs, leishmaniasis included. However, the most interesting case was a young soldier who presented with general inflammation of the skin on his arms and legs. Turns out the cause of this inflammation is probably a general allergic reaction…to three simultaneous parasitic infections (giardia and two different types of entamoeba). What makes his case fascinating is that his bloodwork shows a complete lack of eosinophils, which are the innate immune cells that are the frontline of defense against parasite infections. So either there was a problem with the blood test, or this young man has a rare genetic defect with his immune system. Doctora Gúzman ordered his bloodwork to be redone, so I eagerly await the results…

Two hours later, after we had seen 15 or so patients, the doctora led me up to the fifth floor to see the hospital’s catholic mass. It wasn’t located in a real room, but more like an open space filled with a few sets of plastic waiting room chairs and a priest standing in front of a metal hospital table covered with a tablecloth. I’m not usually a fan of religious ceremonies, especially if they are in so-called “public institutions,” but there was something quite moving about the solidarity of the people—patients and doctors alike—gathered there. Even though I lack a religious sentiment, I could appreciate the scene of the priest reciting mass to the crowd of mostly young military boys, patients from the nearby ward, with a spectacular view of the Andes out of the window.

It's not Miss America?

2007-07-08T14:08:00.000-04:00

I hate the Miss America pageant - I saw it a few times when I was little, mostly at family gatherings - while at age 7 a lot of ridiculously done-up women prancing around in bikinis saying they want to stop world hunger is entertaining, now that I have some perspective on what these things entail, they make me question what the world is coming to. These women are supposed to represent “American culture,” right? What a joke.

In La Paz, they have “Miss Cholita Paceña”. A little explanation of the terms might help. A “cholita” is one of the women that I’ve described briefly before – they are indigenous women who wear bowler hats, shawls, long braids, and very elaborate skirts. “Paceña” is the word that refers to people native to La Paz – if you think about the etymology it makes sense as a derivative of “Paz”, because it’s basically like saying “Chicagoan” or “New Yorker”. Instead of being judged on a bikini, a formal gown, whatever, these women are being judged on their traditional chola clothing, their participation in the local markets, and their knowledge of the history of La Paz and the Aymara language.

For those of you who read Spanish, the article is here http://www.eldiario.net/noticias/nt070706/5_01nal.php, and for those of you who don’t, I’m going to translate some of (what I think are) the highlights.

They choose contestants for the contest “Cholita Paceña 2007.”

“19 cholitas were registered to participate in the election, the same that will represent the distinct markets and public and private institutions located in the district...there will be the participation of three musical groups, a Folklore Ballet and a fashion show of cholitas that will display beautiful mantas (shawls), polleras (skirts), and hats made by artisans.”

“Cholitas of age 18 to 22 are able to participate in the event, they ought to be residents of their neighborhood, gremailes (artisans?), trabajadoras de hogar (workers of the home), and representatives of the markets, joined locales and associations of the macro-districts.
The participants ought to present themselves in the clothing typical of the Chola Paceña (skirt, shawl and hat), furthermore they ought to have general knowledge about the anniversary of La Paz and knowledge of the aymara language.”

“The subalcaldía Max Paredes will carry out the Second Contest of Student Bands and Plato Típico (Typical Foods)…All the vendors of the markets, popular eateries and others related to this activity are able to enroll…For this year the participants will be able to present, optionally, any of the three following dishes: sajta according to the variety, chairo paceño and fricasé (I don’t know what those are.)”

Make your cake and eat it too.

2007-07-08T10:50:00.000-04:00

Last night I held my first ever dinner party in La Paz…and also had my first experience using my kitchen for anything more than making hot water or toasting bread. Initially I had a really hard time figuring out what to cook, because not only am I unfamiliar with the common ingredients around here, but also my apartment here, in comparison to the one in Chicago, has only the bare bones of cookware. While I have everything I could possible want and need in Chicago (garlic press, food processor, lasagna trays), this place has a baking tray, a frying pan, a big soup pot, a smaller pot…and that’s about it. Even after I had finished cooking, I realized that I only had enough forks and plates for about 4 people, not to mention that we didn’t have enough cups, so I had to ask my friend Karim to bring over extra place settings…sigh.

Anyway, after perusing the commercial supermarket (called Hipermaxi, which caries a lot more foreign goods compared to the little stalls where most people buy their food), I decided that I would make carrot-ginger soup, polenta pie (with queso fresco and parmesan instead of mozarrella), and brownies. The adventure began when I realized that the supermarkets around here don’t sell measuring cups…so for all of the ingredients which required some sort of measurements, I was going to have to eyeball things. Luckily the proportions for the soup and the polenta aren’t so critical, but for baking, especially at high altitude, it’s kind of essential to get the right proportions. I ended up modifying the instructions which came on the back of the semi-sweet chocolate I bought, which had all of the measurements in grams: I threw in a bit more chocolate and butter than the recipe called for, an extra egg, roughly a mug-full of what I thought was flour (it was sitting in my pantry, and while it looked like flour, the end result was a lot chewier than I expected), some sugar, a large spoonful of vanilla, a couple pinchfulls of salt, and (this is the part that killed me) a small spoonful of baking powder. I was hoping that the extra egg and baking powder would compensate for the difference in altitude, but the end result was poofy and didn’t taste very much like chocolate.

I suppose that the lack of measuring cups was complicated by the fact that the oven actually had no indication of temperature. Lighting the stove or the oven here is actually quite an ordeal for me – I hate fire, and there is not pilot light, so in order to get it going you have to take a match or a lighter, turn on the gas, and hope that you don’t burn yourself. When I first got here I was incapable of using a lighter, so I immediately went out and bought one of the long gas-grill lighters that let’s you be a comfortable 9 inches away from the flame. When I was baking the polenta and the brownies, I had to reach inside the oven to light it, and then I had to keep an eye on the food every 5 minutes to make sure it was cooking at more or less the right temperature. When I was almost don’t cooking, actually, my long lighter crapped out on me, so in order to get the burnings going I had to resort to lighting a long piece of paper on fire from the flame already going at the bottom of the oven – fun for someone who hates fire.

All and all, I would give the food a 5/10 and the experience a 10/10. The soup was excellent, the bread I bought to go with it not so much, the polenta was good but needed more cheese, and the brownies, while everyone really seemed to like them, were pretty tasteless and weird. Compounded by altitude, measuring, and ingredients, it’s also hard to keep food here warm because there is not heating in the houses, so that certainly doesn’t help when you’re serving soup or something that is supposed to have melted cheese. While it stressed me out to cook (I made a point to make it different from the local cuisine) and have people over an apartment that is so much more bare and unattractive than my usually living space, it felt good to have a bunch of local Bolivia people hanging out in my living room, drinking soft drinks and wine, and eating my rather mediocre food.

Perhaps to highlight the strangeness of the night for me, there was a thunderstorm at about 10:30 at night, complete with lightening, pounding rain, and hail. While it rains a lot in the summer in Bolivia, in the winter (now) it’s very rare to have such a storm. It was short – it only lasted 30 minutes - but as I heard the hail pounding on the tin roof, instead of being all alone there were actually people sitting and laughing in my living room, and that made all the difference.

"No! Es Feo!"

2007-07-07T18:39:00.000-04:00

Since I have extensively explored the southern side of the Prado, I decided yesterday that I would explore the northern side, which includes Plaza Murillo and the older "colonial" part of the city. There's not much interesting to say, so I'll just let you gaze at the pictures...

[Plaza Murillo]

So the following photo have an interesting story: A couple of years ago the government forces and the city police had a showdown of sorts…it was described to me as being surreally similar to an old western shootout, with each faction lined up on either side of the square, shooting at each other. The holes in the side of the building are the remnants of the shots fired. Cool, eh?

[Colonial Center]

[Okay, I’m sorry, I had to take a bit of an artsy photo]

The following photos are of Calle Jaen, a spectacular street that I really should have discovered sooner. It’s really narrow, cobblestones, and all the buildings are painted different bright colors. This is also where a lot of the state museums and newer bars are located.

[Wandering out of Calle Jaen and more towards the Prado]

[San Francisco Plaza and church]

The following pictures are of the Sagarnaga area and the Witches Market, which is right up the street from the San Francisco Plaza. While it is a pretty touristy area, I have to admit that the textiles that they sell there are spectacular.

Right after taking this photo I got yelled at by one of the vendors. She asked me to see my camera, and then proceeded to shake her head and say “Que feo, que feo!”, which basically means “How horrible!”

[I snuck in a shot when she wasn’t looking…]

[Coca Museum]

The things I hear from my bedroom

2007-07-06T11:09:00.000-04:00

This morning, while writing a flurry of emails to organizations and people involved in public health, I have heard:

- about 10 gunshots
- what sounded like a dog attacking a person...lots of growls, howling, and a woman and child screaming
- my landlady yelling to her daughter "Innnnneeeeezzzzzz"
- two cats playing on the roof next door
- the customary mini-buses yelling their destinations "HositalObrero-AvendiaArce-PlazadelEstudiante-SanPedrooooo"

In the past week, I have also heard:

- what sounded like a dog getting run over
- kids playing tag up and down my central staircase
- domestic violence, although i tried to pretend that i couldn't hear the drunk man yelling at his wife
- spanish covers of "Dust in the Wind" and other classic hits blaring out the next door window

Soon it will be time to get out and walk around for a little while, I think.

The First Violin Lesson

2007-07-05T21:35:00.000-04:00

My buena amiga Karim, who I mentioned a little while back, brought me to her friend’s house for dinner last week for a La Paz version of lasagna. Itwas a strong group of middle-class working women, a few of which also happen to be in a hard-core rock band called Libellula (which is hilarious and fascinating in itself, more on that in a later post). I may actually get the chance to be their violinist - when I first met Karim and told her that I played the violin, she also mentioned that she was in a music group, and I jumped at the chance to meet more people and play a bit of non-classical music. So anyway, I was hanging out with these women at their house, feeling a bit out of place, when I started chatting with Vivi, a really fun and energetic woman…who also mentioned that she owns her grandfather’s old violin. Eager to meet people (anyone, really), I offered to give her lessons, so we exchanged contact info. I’m sure she walked away thinking that I was a nice young gringa, but that I would probably never contact her.

Well…I emailed her a few days back, and tonight she came over to my apartment for a lesson. Before she came over I was thinking to myself: “Nadine, how do you start from scratch with something that feels like it’s my third (and wooden) arm?” I’ve been playing for so long and it’s so natural to me that I had to literally sit myself down and think about how to present the violin to someone who doesn't know what a chin rest or vibratto is. I hadn’t really decided how to give the instrument its proper introduction, but as soon as she took her violin out of its case, I started remembering my first year or so of playing, and with it all of the little tricks and tips that my teacher had used. While it made me happy to show her how to tune the instrument, how to hold it, and how to use the bow correctly, the best part, far and way, was seeing the look of surprise on her face when she realized that could make a sound all on her own. And yes, it did inflate my ego a little bit when Vivi told me that I was a great teacher, but my sense of pride came mostly from knowing that I could (potentially) bring someone into “the world of the violin,” as she called it.

I’ve always said that if I were to save one thing in a house fire, it would be my violin, but this is perhaps the first time in my life that I’ve truly known how important it is to me. I honestly don’t know what I would do without it here in La Paz. It’s like an automatic stress reliever - hearing the echoes of my slightly unpolished rendition of a Bach sonata reminds me of home, but mostly it brings me to a place where no one and nothing can touch me, not even the intense pangs of homesickness that I feel every now and then.

When she asked me if she could pay me, which is of course ridiculous, I got a little flustered and shushed her. So I told her, instead, that she could bring me a nice bottle of wine Bolivian wine, and also that she could show me around her favorite parts of the city. So on Saturday we’re going to wander through Miraflores, exploring the part of the city that I don’t really know yet. So even if this whole public health-volunteering deal is a bust, at least I've got my violin.

On Internet and Feeling Old

2007-07-04T23:41:00.000-04:00

The internet access in my apartment, sadly, is one of the most important things in my life in La Paz right now. It’s been caput for the last few days, and I’ve been in a bit of a frenzy, more anxious and sad, if you will. It’s not even that I end up using the darn thing all that often, it’s just important that I feel connected to the part of the world that I know best in some way, even if it does involve a lot of electronics and binary code. I finally got sick of using the oh-so-slow connections at the local internet cafes, and I decided to give the service provider a call and see if I could get it fixed. After calling the company 3 times and explaining to them over and over again where I live (my Spanish accent becomes very forced when I’m nervous), they finally sent someone over to check it out. Turns out the other night when I blew a circuit breaker I messed up the settings in the modem, so the technician played around with my computer for about an hour and fixed it. I feel that this marks a turning point in my ability to navigate this city – I can now communicate with Bolivian customer service, que bueno.

Having sat around my house for 3 hours, waiting for the people to fix my internet, I decided that a night out on the town didn’t sound like such a bad idea. I walked up and down the Prado, and then met a friend for dinner/drinks at a nice little lounge restaurant. I’ve discovered that altitude really does have an effect on tolerance - let’s just say I was “happy” on two glasses of wine spaced out over 3 hours. Also, a guy who looks like Spike from Buffy the Vampire Slayer (picture bleach blonde spiky hair) tried to pick me up with a poem written on a page ripped out of an E. E. Cummings book. While he gets points for creativity, I’ll let you judge the quality of the work…here it is for your reading pleasure:

“Relentless sky, river of crystal, rain of life, tease the sick, cure the rotten, flow of light, carriage of old red hair, beast of a deranged, and happy lives, cream of prosperity, seed of wealth and sand, crop over the machine, dance with the naked, destroy all cannon (word?), live with cracked walls and heavenly cockroaches spinning heads of mad holy magicians, into a path of thick forests and orgies with an abundance of wine and taste of sweat, bleak- scorn, bliss, laughter of chaotic disasters all in a beautiful mess.”

After dinner I met up with some other friends who had invited me to go to a “bolinche”, which I think is the word here for dance club/bar. It was already pretty late at that point, but I was really curious to see what a club might be like on the Wednesday night of school vacation. After wandering around Sopocachi in the freezing weather, we finally came to the place. It was supposedly “full of people”, but when we got inside there was a very disappointing lack of people dancing to the blaring techno. But after a while they started playing reggaeton, and my little group of five girls started to dance (as fun as sitting on a couch can be) while everyone else, which at that point was primarily 18 year old boys, sat around and stared at the wall. I have never felt so old in my life. Contrast a classy dinner with a club full teenagers…and then I get really confused when I remember that most of them are around my age.

So to that, add getting told that I couldn’t volunteer for a Spanish NGO, and talking to a dermatologist in the Hospital Militar, and that was my day. Also, I think I may have had a minor, minor, minor reaction to some “queso del campo” (farmer’s cheese, which tastes a bit like feta but is more salty and more rubbery) that I bought on the street the other day, but nothing that could keep me down (clearly).

First day (or not) of work

2007-07-03T07:57:00.000-04:00

By the title of this post I'm sure that you can already guess that my first day of "work" was a bit of a bust. I shouldn’t have assumed that I (or any place I was working for) was going to get it right the first time, but there goes my naivety again. I guess I had idealized the experience because I had absolutely no idea what it would be like, so when no one handed me something on a silver plate (of course), I momentarily lost the feeling of stability that I’ve built, finally, as I’ve become accustomed to this city and people.

They had told me to arrive at 8:00am around an office – of course no one was there until about 8:30, so I spent a while wandered around the outdoor buildings looking for the doctors I had met. I finally decided to sit down and wait by the “jefe’s” office, and at about 8:45 he rolled in with his baby on his hip and gave me a “So why aren’t you ready?” look. I threw my lab coat over my jacket (it was about 25 degrees yesterday morning), and then without saying much of anything he shooed me into a room full of about 20 residents and nurses. My only introduction was a whispered “This is a biology student from the United States,” and then I was left on my own as everyone in the room eyed me cautiously and then proceeded to completely ignore me. There were several sick beds and it looked like there was a doctor making rounds as students presented the cases, but I couldn’t see the doctor or the patients, I couldn’t hear what anyone was saying, or much less understand the medical terminology in Spanish. Even if it had been in English, I think I would have been incredibly lost.

From the beginning my mind was screaming “What am I doing here…GET OUT!” – not so much in reaction to the patients, but rather to the lack of any personal contact or interest whatsoever. After about 20 minutes I decided I had had enough – I ran into the “jefe” and explained to him that I was confused, and he told me “Oh, I thought you would observe the cases and take down the ones you thought were most interesting.” Obviously there was a breakdown in communication, because I haven’t been exposed to medicine like this before, and I was really hoping for one-on-one contact with a doctor. I decided to go find the original doctor, but he was either not there or busy. At that point I was faced with a really hard decision of a) stay and be confused and unhappy but maybe find something eventually or b) get out and come back tomorrow while you think of and look at other options. Obviously I chose the latter.

Where to go from here. I would be lying if I didn’t say that right afterwards I almost asked for a plane ticket home. In all honesty I question whether I’m actually cut out to deal with this sort of work, whether I can match the analytical tendencies of my brain with something more social. I’m lacking everything that I rely on to get my by in the US – communication skills, a structured project, guidance – and here people don’t give a crap whether you have this and that award, a high GPA, or that you’re going to a great school in Chicago. (Where is that again?) I'm not sure I have the personal skills to prove my worth without all of that, nor the patience to wait things out and try over and over again when it isn’t a perfect fit.

But there’s definitely something inside of me that won’t let me give up. While I’m certainly thinking about the “investment” of flying here (the money, taking a haitus from my lab work, the nightly anxiety attacks that I'm giving to my parents), I’m also thinking "Sheesh, I’ve never done anything like this..." And I want to prove to myself that I CAN. Thus this crazy, solitary adventure that is simultaneously building me up and tearing me down.

So I guess the conclusion is (for all of you who have seen Finding Nemo) “Just keep swimming, just keep swimming…”

The Fair of El Alto

2007-07-02T07:33:00.001-04:00

My new La Paz-ian friend Karim took me up to "La Feria de El Alto" - I’ve felt overwhelmed walking through the Upper Markets in the city, but this fair makes them all seem tiny in comparison. I met her on the San Francisco Plaza and we jumped into a mini-bus that was headed up the Auto-Pista, a long and narrow highway that winds around the Paceña beer factory and a huge forest of Eucalyptus trees on the climb up to El Alto. After a 20 minute ride, the mini-bus let us off at the side of the street and we climbed an incredibly steep set of mud stairs to get to the main altiplano fair ground, passing all sorts of vendors perched on the hillside. I was literally about to fall to the ground after about 30 stairs - the change in altitude was unmistakable, my ears were popping and I had the same, strange headache as when I first came to La Paz.

We started out on what Karim described as “the poor side”, which was filled with hundreds of ramshackle tents selling all sorts of goods from used bathrobes to naked Barbie dolls. We wove our way through the crowds in search of a hat for me (I was stupid enough to think that sunscreen alone would protect my skin from the blinding rays on the altiplano, no such luck) and a jacket for Karim. I ended up buying a black cowboy hat, which prompted several young kids to say “Un vacquero!” (A cowboy) as I walked by.

On our way to “the rich side” we passed by a central plaza, actually the area where cars are sold, that had a giant statue in the middle. There was also a sort of steep concrete structure that a bunch of kids has converted into a slide, which looked awesome, and if I were younger I would have joined in.

We continued walking around the fair for about three hours, passing through the areas that sold clothing, bags, shoes, car parts, you name it. I bought a brand new fleece for $4, a barely used computer bag for $1.50, and the cowboy hat was about $1. The amount of used clothing is unbelievable –huge bags of it come in from the US (I guess from places like Good Will) and are sold in the street markets here. Apparently they have been trying to pass a law for some years that, in an attempt to develop the Bolivian clothing industry, would stop the importation of foreign clothing, but I think that “law” has been in place for quite some time with no changes being made.

[The main drag in El Alto]

Far and away, the food continues to leave the biggest impression on me. There are people on the streets selling dough balls, pineapple slices, a drink made from water and dried peaches, and there are also tents selling fruit juices, fried sardine-like fish, chunks of meat, and potato-corn soups. Karim was on a mission to have me try some of her favorite “comida de la calle” (street food), which left me feeling a bit terrified, especially after seeing the giant vats used to cook who knows what kind of meat. But I did end up trying a food called “pesque”, which is basically a quinoa mash served with milk and “queso del campo” (farmers cheese), and it was very tasty, although I was convinced I was going to get food poisoning afterwards (I didn’t).

The air was a bit hazy in the morning, but in the afternoon as we were coming back down the sky was a perfectly clear hue of baby blue. Looking out for a view of the entire canyon full of the brick houses and curving roads was one of the most incredible sights I have ever seen in my life.

[Illimani]

We also had to cross a footbridge and climb down a very steep hillside to get back to the minibuses.

Me Speaky English

2007-07-01T08:59:00.001-04:00

The other day I was waiting for my friend Karim and her son on the Plaza San Francisco, a beautiful colonial church set smack in front of the busiest, most congested area of the Prado. As I was sitting on the front steps watching the foreigners, the traffic, the shoeshine boys carrying their black boxes and wearing their black face-masks, I noticed a group of 4 teenagers approaching me. I was pretty convinced that they were going to try to rob me, and as they asked me, hesitantly, if I spoke English, I instinctively clutched my bag closer to my body and gave a noncommittal reply and tried to look away like I do when street vendors ask me to buy candy or fruit. But as soon as they heard me speak English, they excitedly huddled in a circle around me, whipped out a tape recorder, and asked me if they could do an interview for a school project. I was still thinking “huh?”, but as soon as I saw them reading off of questions they had scribbled onto a notebook, I started to relax a little bit. It turns out they needed to interview people so that their teacher could analyze it, and I ended up talking with them for about 20 minutes, on the steps of the Plaza, as everyone else looked on curiously and eavesdropped. .

Them: “Which is your fav-or-ite city?”
Me: “Here, in Bolivia?”
Them: “Yes.”
Me: “Well, La Paz”
Them: “Ohhhh!!! …why?”
Me: “Um…I guess I like the Andes?”

And I conveniently left out that I hadn’t really visited any other place in Bolivia…yet. They really seemed fascinated when I started to talk (slowly) about the differences between La Paz and Chicago. One girl, clearly very bright, kept trying to ask me extra questions that she didn’t quite know how to formulate, so with a combination of English and Spanish I was able understand what she wanted me to say.

At the end of my “interview”, I asked them if they’d had a lot of trouble finding other people to talk with – turns out they had only successfully found one other person who spoke English and German, and no Spanish – which makes a lot of sense to me because, as I tried to explain to them, most people were probably suspicious of a group of four kids wandering around and asking questions like that. It’s really heartbreaking to me that my first impulse when I saw these kids was to protect my belongings and hope that I didn’t get robbed. I felt sort of horrible afterwards, because they were friendly and so clearly trying hard to make a connection with foreigners, which is actually quite rare here. I find myself behaving with such a delicate balance of respectful appreciation (and distance) and also wariness, and I hate that more often than not the distrust takes over

Mini-Bus Etiquette

2007-06-29T09:40:00.001-04:00

The thing that I continue to find most fascinating about this city is the transportation system. I now feel quite confident about my ability to take the crazy mini-buses to almost anywhere I need to go in this city, so I figured I would enlighten you all with my take on what they’re like and how people use them.

So the mini-bus is basically a long van (think school field trip) rearranged to hold as many as 16 or more people. I’ve seen a whole host of brands ranging from Subaru to Ford, but I’m pretty sure these vehicles are nothing like when they were originally manufactured. They are usually pretty plain looking on the outside, and they advertise their destinations with printed cards in the front window, usually abbreviations of the more popular roads and plazas in the city. The routes are never totally set because these buses are not controlled by the government, as far as I can tell, and are instead managed by a driver in the front and another person in the back, who is usually yelling out destinations at light speed through a sliding Plexiglas window.

People flag down the mini-buses like a taxi and jump through the sliding door, while the minibus often starts driving away with the door still open. Sometimes there’s an occasional “buenos dias” (good day), as people climb to the back, flipping down one of the third seats (which is basically like a fold-down chair) in a row if they need to. I’ve seen “interior decorating” ranging from faux-leather to plush leopard print, but above all these things just speak of relentless use. The person hanging out in the back asks “Los que han subido, pasaijes por favor”, (those who have climbed aboard, fares please), and people scrounge around in their change purses for the 1B ($0.15, for a shorter trip) or 1.50B ($0.25, for a longer trip) fare. Ever since I’ve stopped having a cold, I feel like my nose has been assaulted by the range of smells in the city, especially sitting in close quarters with all sorts of working class people (wealthier citizens take radio taxis).

When someone is ready to get off, they usually say “Voy a bajar” (I am going to get down) or “A la esquina” (at the corner), which is sometimes, but not always, followed by a “Por favor” (thanks). The person in the back yells to the driver “Se va a bajar adelante” (A person is getting off ahead), and the min-bus screeches to a halt while the person hurriedly gets off. Then the bus goes sputtering off into the line of traffic, often leaving behind a thick black cloud of diesel smoke, as the manual transmission goes grinding and lurching up one steep street after another.

It took me a while to get used to the min-bus lingo, if you will, because the translation doesn’t make sense directly into English. There are all sorts of interesting ways people interact with one another on these things, and I swear it’s like its own social space. I remember the first time I got on I felt the need to make room for people at every stop and to help with the door. Perhaps my favorite moment thus far was when a rather plump lady at the back was getting off, requiring a young woman to get out and make way for her, and as she got down she laughingly apologized “Soy demasiado gordita, señora!” (I'm too fat, m'am!)

I have a job?

2007-06-28T13:47:00.000-04:00

So today my mission was to go check out the Hospital de Clínicas, the main hospital that services La Paz. The healthcare system here is a bit different from in the US - what I’ve gathered so far is that people far and away prefer to use local neighborhood clinics not only because they are less costly, but also because they often have better service and supplies. The main hospital, apparently, is a place that people avoid due to poor sanitation and hygiene (think using dirty needles and syringes), and it has been said to me that I should "avoid it at all costs," if you can imagine.

When I got there, the block was absolutely filled with people because the area holds not only the Hospital de Clinicas, but also a medical school, the Hospital de Mujeres, and what appears to be the police/army training grounds. As I wandered in, I was struck by the complete lack of security, and for that matter any sort of central administrative office. Instead, there were patients wandering around an open courtyard style place with lots of sunlight and open corridors. Although it was nice to break away from the sterile atmosphere of the hospitals in the US, I was a bit disturbed by the smell (was it urine?), the lack of sterile space, and the chaos.

In reality, I was there because I have been emailing back and forth with a doctor who worked with the spouse of a fellow UofC grad student. There was no central directory of offices, because there just see to be waiting rooms and procedure areas, not personal spaces. After asking a few people if they knew him, I finally found someone who did, and was directed over to the endocrinology area. After peeking my head into a room with doctors, notebooks in arms, wandering around dormitory-style beds (picture an orphanage and that’s probably about right), I found the doctor standing outside in the courtyard, standing in the sunlight talking with a young woman. He was a bit younger than I expected, and as we started chatting for a while, I realized that he thought I was a doctor...whoops. I had no desire to have to pose as someone who had been medically trained (although I probably could have gotten away with it), so I quickly explained to him that I was a biology student, although I omitted the part about being 20 and an undergraduate (having lab experience basically makes me a grad student, right?). He seemed to think that there were plenty of opportunities to do basic things, like be an observer or even help in the infectious diseases unit, and then he took me over to meet his supervisor, who may or may not be the head of surgery or the head of the hospital (not sure?).

I found my way into a small office area in the main building, where I encountered a middle aged man (the director, we’ll call him) in a nice suit, smoking a cigarette. He motioned for me to sit down, and he settled into the chair opposite me, leaning back and occasionally taking long drags on his cigarette. He started asking me about what it was that I wanted to do, what was my background, how long was I here for, and as we were talking, I noticed that I had developed an audience of about 4 extra doctors, including the original doctor who I had come to see. They all looked interested and a bit perplexed, maybe even a bit amused by my presence. Eventually, he offered that I could start work on Monday on an 8:00am-2:00pm schedule. I’m not sure exactly what I am going to be doing, other than that I am going to be following along some of the work in infectious diseases (tuberculosis, malaria, yellow fever), and perhaps shadowing a doctor, taking notes, developing a small epidemiological project. On my way out, the doctor recommended that I “desayunas bien”, aka eat a hearty breakfast because I should expect a long day…I rather like the sound of that.

It’s unclear what I’ve gotten myself into, other than a glimpse into the heart of public health issues hear in La Paz. Yes, of course I’m a bit nervous that I’m going to be spending a lot of time around very sick people, but I think that this could be a rare opportunity to not only help care for patients (without an M.D.), but also to truly understand the situation of healthcare here. I guess it all started to hit me when they told me that I had to go buy a doctor’s coat. I was a bit confused as to where this might be possible, but then they told me to just walk towards the school…and there would be some people selling them in the street. I found a little stand run by two chola women who were selling doctor’s coats, scrubs, cloth face mask…and latex gloves. By the pair. Oh boy, here we go…

A long entry to fit a suitably long day

2007-06-27T22:36:00.000-04:00

I just had the pleasure of watching Pirates of the Caribbean 3 in a theater on El Prado in downtown La Paz. So, other than the movie being far too long, it was really interesting seeing an English film with Spanish subtitles, mostly because my eyes kept wandering down to the translations to see if I could understand them, and to see if the subtitles seemed correct (yes they did). But other than that, it was a pretty normal theater, and it was nice to escape the TV commercials that have become the standard "pre-entertainment" at the American cinemas. (I might get myself in trouble here if I keep using the word "American" to refer to the United States, whoops.)

This morning I had perhaps the most defining moment in my time in La Paz. I was on one of the crazy mini-buses headed towards one of the two destinations I'm familiar with, and as a chola woman sat down next to me, I felt something fall by my side. Turns out her watch had fallen off of her wrist, and after I picked it up for her, she held her arm out (which was surprisingly frail, the layered clothing makes these women seem overweight when they aren't at all) and I helped her put her watch back on. I had a hard time understanding her Spanish, but we didn't even need words to communicate. Her whole mannerism changed after she saw my willingness to help her. This is perhaps the first time that I've felt any sort of access or connection to the indigenous community here, and I hope to continue gaining insight into this culture about which I clearly know nothing.

Earlier in the day I made it down to the nearest area of the Zona Sur (finally) called Obra to pay a surprise visit to USAID/Bolivia. It was so obvious that the building was associated with the US government, as it was the only place for blocks that had an extensive security checkpoint. I don't think they understood that I wasn't asking for a job there, but rather for information about volunteer work for some of the organizations they support. So while my visit was basically pointless, it did give me the chance to wander around the neighborhood.

The houses here, as was described to me, are certainly much larger, much further apart, and have these distinctive high walls surrounding them. I don't know if I would classify it as a typical American suburb, but it certainly does have a different feel from downtown La Paz. Also, as you can see from the pictures, the mountains are even more visible than in the thick of the city. Wandering around downtown, sometimes it's easy to forget that you're in the middle of the Andes, but here, no.

As much as the area is pretty, honestly...it reminded me of some of the suburbs of Florida, apart from the fantastic view, of course.

Please note how almost every car on this street is an SUV...blech.

I spent the rest of the day wandering around Sopocachi and El Prado (I think I spent something ridiculous like 8 straight hours walking.) I was on an epic quest to find a bookstore, which ended up in my wandering back and forth across town from one closed store to the other. Who would have thought that it would be so hard to find a bookstore (that isn't for little kids and doesn't exclusively carry religious literature) in the area where most of the foreigners live?

[Calle 20 de Octubre]

[funky building]

[La Universidad San Francisco de Asís]

[Plaza Eduardo Abaroa]

[Gorgeous house in Sopocachi, right off 20 de Octubre]

[Surreal car dealership]

Anyway, I finally made it back to the store where I first bought my map, and I ended up buying a great book (in Spanish of course) of short stories by a Bolivian author, Oscar Cerruto. I've never heard of him, but I always find the genre of "fantástico e imaginario" interesting, so I look forward to filling some of my more bored afternoons puzzling over Mr. Cerruto's work. I also picked up "Los largartos terribles" by Isaac Asimov, obviously a translation, which should be...fun.

On my way back towards a coffee house called Cafe Terraza, which is basically the ritzy hangout for foreigners and wealthier Bolivians, I also caught a glimpse of a demonstration/parade/protest by the Miner's Union in the Plaza del Estudiante, which basically caused a huge traffic jam in the area. As you can see in the pictures, it was interesting to see the fully outfitted police (or soldiers) standing by, ready to intervene.

Well...if you made it to the end of this entry, I apologize that I crammed so much into one space. I did a lot of walking and seeing today, so yeah, that's what happens when I'm alone and have a camera :)

A quick lesson on the layout of La Paz

2007-06-25T23:27:00.000-04:00

So I’ve fallen in love with the area of town called “Sopocachi”. It’s a bit different from where I live (okay, a lot), in that it’s definitely a place with more money and more foreigners. You can see it on the streets as you’re walking - much more of a diverse crowd (aka not everyone looks of Andean origin), more stores that cater to “western tastes,” like a French fusion restaurant, a furniture store, and lots of internet cafes. But mostly it’s that the buildings are more colorful and there are a few trees spattered here and there. It's a toss up for me on where I think the "right" place to live would be - I know that where I live now is closer to the heart of La Paz (if you will), as it houses a mostly indigenous, working class population. But as a new arrival (not to mention the fact that I'm pretty much on my own in a neighborhood that is foreign in every aspect), I feel more comfortable in a more western, comfortable environment. On the upside, living where I am now is like a crash course in La Paz life...get on the mini-bus, yell when you need to get off, don't get hit by a car crossing the street, hail a radio taxi and repeat, "yes, Cruce Villa Copacabana" four times, just to make sure.

But this area Sopocachi: apparently it was built towards the beginning of the 20th century to house the growing population of richer people and foreigners, who now live in the suburban area called the “zona sur”, which is fascinating in and of itself. While Sopocachi appears to be a normal, if not a bit ritzy Bolivian neighborhood, the Zona Sur is apparently modeled after the American Suburb – it’s cut off from the rest of the city, and filled with huge single-family mansions, gated and surrounded by gardens, that often include an array of chola servants. It has its own supermarkets, people get around by driving SUVs, you name it. How interesting (ironic?) is it that the richer people of Bolivia model their homes after the middle-class American dream of the 1950s?

Today I wandered around a place referred to as the “mercado negro” and perhaps the “mercado chino” (okay, I’m still not familiar enough with the city to know the difference between street market areas). It’s a zig-zag of streets holding a sprawling market of stalls and indoor areas crammed with anything (seriously) you could ever think to buy. It’s actually separated spatially by the different types of goods that are sold, for example clothing vs. electronics vs. paper goods vs. household items. The “mercado chino”, which I think is just one part of this giant market area, is basically a black market selling all manners of stolen goods that some poor tourists were unfortunate enough to lose. I’d love to take pictures of the place, but something tells me that if I whipped out my camera and played the part of the obvious tourist, I would end up leaving the market with a lot less values then when I came. It’s a fascinating place, definitely a bit off the main drag, and once my Spanish is a bit more manageable I intend to go back and bargain for some important things...like a space heater. Hace mucho frio por aqui.

Push those second thoughts out of your head

2007-06-25T09:47:00.000-04:00

This is perhaps a bit harder than I thought it would be. Last night I blew a circuit breaker in my apartment and lost the internet, causing me to effectively lose contact with my entire world. While I was stressing out about the power in my apartment (I didn't realize until this morning that the breaker is right outside my door, damn), all of my neighbors were having fiestas and getting drunk and making merry with their family and friends. I guess at that point I realized just how lonely it can be living in a foreign country all by yourself. I feel a bit lost in this city...I'm not really comfortable with anything yet.

But honestly, what was I expecting? This isn't supposed to be easy - if I had wanted that, I would have stayed in Chicago working in a lab, playing frisbee, doing everything that I'm used to and comfortable doing. I guess I sort of realized that I can't just sit around all day (not that I have been, I'm still sick with this goddamn cold) and be afraid of the world (because in reality I am) and expect to accomplish anything. So I sent out a flurry of emails hoping to start in on this volunteer business as soon as possible. As much as I enjoy gazing at the Andes from my window, it's time for something a bit different.

And speaking of gazing and mountains, here is the view from my balcony:

¿Cómo está el pescado?

2007-06-23T21:46:00.000-04:00

I went to the house of the aunt of my friend Alejandra Taborga today, who plays frisbee with me at the UofC and is originally from Bolivia. I’ve been trying to network as much as possible here (and get some practice hablando en español), but it’s been a bit hard because I’m still adjusting to the altitude (check this out: my pulse in Chicago is más o menos 60, and my pulse here is 95!), and now I’ve come down with a mild version of the flu. Honestly, it’s hard to tell what is what, because all of the pollution from the sputtering taxis and mini-buses makes it hard to breath…but anyway, I’ve been really excited to meet her and her two sons, so when she offered to cook me lunch today I jumped at the chance. I got a bit lost on my way over, had a bit of an adventure, and finally found my way over to her nice yellow apartment building in Sopocachi (the south of the city). I had sent her an email saying I was vegetarian ("Perdón, no quiero ofenderte, pero soy vegetariana"), and as we were discussing lunch, she said she was going to cook me rice, fried potatoes, a salad of tomato and avocado...and some fish. Oh...

I knew that this was going to happen sooner or later, because here it’s basically unheard of to not eat meat, it’s such an integral part of the culture. When you say you're a vegetarian, unless you make it clear that you're allergic to meat, they think that you eat chicken and fish. I think she could see I was looking a bit tired, so she presented me with a huge hunk of fried fish on my plate. Honestly, I’d been walking around all day and I hadn’t really eaten anything in about 20 hours, so I just dove in and started eating it. Having not eaten meat for about 2.5 years now, this marks a pretty big event in my career as a vegetarian. But en realidad, I really, really liked it, era muy rico. I don’t exactly think that I’ll go out and buy myself a fillet of fish or order meat in a restaurant, and I suppose I should wait until I’ve been given a bloody llama steak before I say more, but I don’t think this will be so bad.

First day wandering the streets of Nuestra Señora de La Paz

2007-06-22T17:46:00.000-04:00

This morning I woke up on my own rather early with a bit of a headache from the altitude. The evening was pretty chilly - it gets down to about 30/35 and there's no heat. I was comfortable in a sleeping bag under two alpaca blankets, and I had to submerge my entire head in my sleeping bag. And not five minutes after I'd gotten dressed, the landlady started banging on the door - apparently the last girl who lived here didn't pay the phone bill so the line got cut off, and Doña Emma ushered Ben and I over to the office, which was closed, and told me to take care of it. She's a bit of a menacing woman, as she kind of just yells at you when she wants something done, but she's also quite endearing.

After a brief breakfast (I still don’t have much of an appetite from this altitude business, which I'm feeling a bit more now...) I headed out to the city center with Ben. He had to buy a ticket to Cochabamba to go photograph and Aymara ritual (called a tinku), so I found an ATM in the bus terminal and spent about 5 minutes trying to figure out the conversion from Dollars to Bolivianos...I want to blame it on the altitude, but I could just be really pathetic at mental math. Then we walked down El Prado, the main street in the city center, and headed over past the Plaza San Francisco and on to the area around what is sometimes referred to as the "witches market" - the area where a lot of indigenous people sell their goods in artesanías, and also where my landlady happens to keep her shop. The guidebooks say it's known for selling all sorts of weird stuff, but it actually seems like a pretty normal, if not colorful, area of the city.

[La Plaza San Francisco]

We decided we were hungry, so Ben took me to the only place he could think of that had anything vegetarian, this place on Calle Linares (in the Mercado de Hechería) called "Angel Colonial", tucked away in a little courtyard between some of the shops.

[El Angel Colonial]

Ben had to go get read for his travels, so I decided I would wander around the city for a while and try to get my bearings. I started off walking around the Calle Sagárnaga area, which is more touristy (although it's quite a relative thing in Bolivia...) and then headed north to explore some of the less touristy markets in the area filled with mostly indigenous people. The streets are dotted with tiny stands selling fruits and vegetables, grains I’ve never seen before, and even raw fish. One of the more intriguing sights are the indigenous women called Cholas, who wear skirts, alpaca textile shawls, have long braids, and wear a bowler hat. It’s a bit of a cultural taboo to photograph them, so unfortunately I don’t have any pictures…yet.

[Calle Sagárnaga]

[Random street market]

After a while I decided I needed a better map, and as I wanted to explore a bit more of the city center I started walking down El Prado, the main street in the center of La Paz. It has the same tiny tiendas lining the streets, but it's also lined with more glitzy, modern shops that reminded me a bit too much of the U.S. and Europe. When I came across a Burger King and a car dealership, it made me sort of mad that those places were starting to come into such a unique city (although I still haven't seen a McDonalds).

[El Prado]

[Crazy traffic of downtown]

However, I did come across a pretty hilarious Pizza shop. When you look at the picture, make sure you read the small print that says “Chicago Pan Pizza”…even in Bolivia!

[Pizza Shop on El Prado]

I veered off the main drag on my quest to find a good map, and as I was walking by what I think was the Oficina del Vice-Presidente, I ran into a demonstration. It was actually very low-key, three groups of people standing around, occasionally raising their voices. When I was about half a block down the street, a few people started firing blanks into the air, but I was surprised that there was not at all a sense of violent tension.

[Protesters]

Using my new-found map, I decided that I wanted to try to walk back to my place from the center of the city rather than take a bus, which took me down further down El Prado. Maybe it's because I'm a little bit afraid of the mini-buses, which smell like burning oil, advertise where they go with block-letter signs on their windshields, and have people yelling destinations and price out the window. But even after the cultural shock, I think the most striking thing about La Paz for me, so far, is that you only have to walk one or two blocks in any direction to catch a breathtaking view of the canyon walls and the mountains.

[View of the hills from El Prado]

[Mountain?]

After seeing the view of the mountain (I have no idea which mountain it is) I veered off onto the Av. del Poeta that ran down by the city’s official park. Seeing lots of kids playing soccer on little fenced in hard-courts made me want to join them really badly. I though I was well on my way towards my place, having walked around for about 3 hours straight by then, when I came to my supposed road and realized that it a) didn’t have a sidewalk and b) didn’t really go where I needed it to go. At that point, I was feeling a bit lost (not really, just confused…), and combined with my complete lack of a desire to backtrack uphill for about an hour and walk back to my place for another hour, I hailed a cab and somehow found my way home. It's nice knowing that even though I completely filled the "tourist with a camera" role, I have my own keys to an apartment and I'm beginning to catch on to this places ways (mini-buses, I will conquer you!)

The Arrival…

2007-06-21T23:51:00.000-04:00

8:30 flight from Washington, DC to Miami, then a 1:15 connection from Miami to La Paz, Bolivia. Due to unforeseen travel circumstances, I had to change my travel itinerary and got bumped up to first class/business class. It was definitely a strange experience being pampered – having extra leg room, a warm and moist towlette, and getting free wine (a Chilean red, very good). I felt like I didn’t really belong (because I certainly wouldn’t have paid several thousand extra dollars for this). I really realized how out of place I felt when some passengers from the economy class needed to put their luggage in the first/business class area and the flight attendant got mad at them, saying “These people paid for this space, I’m sorry!” And then the flight attendant turned to me, after I offered to move around my luggage around, and she said “No, really this is your space, you paid for it.” And then I just got uncomfortable and looked out my window, avoiding the stares of the unhappy people.

The scenery from my window was gorgeous, and I kept wishing there was a better way to take pictures of it. As we were passing over what I think was the badlands of Brasil, I kept thinking of La Guerra al Fin del Mundo and The Backlands from my Vargas Llosa class this year (books about Brasil), and I had the urge to call Kelly (my teacher) up and talk with her about the geography. There was also a nice little bug that somehow got caught between the two window panes, so we hung out and commented on the view.

When I got to the airport I was really nervous and anxious, which resulted in my not really understanding the customs guy when he was telling me to push the button on the metal detector. I also remembered to go to the currency exchange only after I’d found a taxi to take me to La Paz, which was kind of embarrassing and caused a bit of a scene (not a big one, just enough to make me feel like an idiot). But driving through El Alto was an amazing sight – roughly paved roads, random traffic patterns (in fact I haven’t seen a single stop sign or traffic light in Bolivia thus far), dogs and people wandering everywhere, couples making out on the streets. And then the drive into La Paz was breathtaking. As the taxi drove down possibly the steepest road that I have ever seen, I looked into the canyon and saw the entire city illuminated against the night sky. There were little houses perched (rather precariously) all over the hillsides, and all along the sides of the street there were tiny stalls, literally holes in the wall, selling food and drinks.

I gave the tax driver the directions to the store of the landlady, and we finally came to the road. I was a bit confused as to where it was, when suddenly this little old aymara woman was poking her head into my taxi. I started asking her if she was, in fact, Doña Emma, and just she rushed me into her store (after I quickly paid the taxi driver) and told me to sit down in the back. She proceeded to have my count some invitations she is selling for the festival this weekend, and then she rushed me back into the street and into another taxi. I was having a bit of trouble understanding her Spanish, so I wasn’t really sure where we were going (although I hoped to the apartment). We finally got there, and I met Ben, a really nice guy from London (who actually plays Frisbee!) and was shooed up to the apartment. It’s not in the location I thought it was, but that’s a good thing. I don’t know exactly what I expected it to be like, but it’s definitely really nice - big, clean, has some character, lots of windows.

[my room]

[bathroom]

[living room]

[kitchen]

And now I’m sitting in my new apartment – I hooked up the internet and sat down to have some té de coca (which tastes like really grassy green tea). I think I’m too excited to be here to even think about trying to fall asleep. I haven’t really felt the effects of the altitude yet, although it’s hard to separate out the Sudafed (which makes me feel like I’m having an anxiety attack), the tiredness, and the fact that I’m at 12,500 feet. There are a lot of noises in the neighborhood, but even though I’m a light sleeper I expect that I’ll sleep like a rock.

And now…the time has come, the walrus said, to talk of many things: Of shoes, and ships, and sealing-wax, of cabbages and kings…

Adventures at the Passport Agency

2007-06-19T10:12:00.000-04:00

Countdown: two days until I leave. Having rearranged my flight time, oh, 4 or so times, I'm now leaving Thursday morning and flying into La Paz (El Alto) in the evening. Estoy superemocionada. As of now, I have everything that I need for my trip except the most important thing: my passport.

The infamous passport,
creeping out of the shadows.

Having applied roughly 12 weeks ago, which they claim is the maximum time it takes to get your passport, I decided to head over to the office in person. They say that "If you are traveling in two weeks or less, please schedule an appointment with our automated, 24-hour system", but of course you can never get through to make an appointment because "due to the high volume of calls, all of the lines are busy." Beep, hang-up, fin. So on Monday I showed up office at 7:15 (it opens at 8:00), ready to camp out in front until someone would see me, and ended up waiting in a 200 person line for four hours before I saw someone (and it actually wasn't so bad because I had my computer with me.) When I finally saw a "supervisor", she informed me that my application was in New Hampshire and nowhere near to being ready, and that I would need 1) a new set of photos and 2) my birth certificate in order to re-apply at that time...neither of which I had. I went back today at 6:15 in the morning (and only waited 3 hours this time) with all of the necessary documents, and hopefully I can go pick it up in a few hours.

In my short stay in DC, I've been pretty astounded at the number of Spanish speakers here - I'm not sure if there are actually more people that speak the language, or if the city is just more integrated than Chicago - probably the latter, given Chicago's geography of sort of segregated ethnic neighborhoods. But everywhere I go I hear tons of people talking in Spanish in a whole bunch of different dialects. Although I feel a bit bad when I blatantly eves-drop, it's still fun to try to make out what they're saying (and I almost feel like I've been inculcated into a privileged world. ) At the passport agency today I was fortunate enough to be in line with a woman from Peru , and as I started asking her about her travels, we started speaking in Spanish (which was great practice and a lot of fun), and we ended up talking for more than an hour. Turns out she works in a cafeteria at one of the local schools, and her husband (an American) works for the FDA as a maintenance person (and he gets to clean the animal facility, which somehow involves playing with monkeys...) They met when he was putting up shelves in the laundry room of her sister's building, and apparently they hit it off right from the start. Que bueno.

Post edit: I did actually get my passport later that day, after waiting in line for another two hours, bringing the total time spent at the passport agency to somewhere in the vicinity of 10 hours. This system is clearly functioning and awesome.

Penelope Cruz Actually Does Have Talent!

2007-06-18T10:44:00.000-04:00

With my desire to practice Spanish before I leave, I decided that I would try watching the Almodovar flick Volver...without subtitles...which was an experience.

Given my ability to understand most of my Spanish-speaking teachers and friends at the UofC, I was hoping that I wouldn't have too much trouble following the film. But about 2 minutes into it, I realized that the accents of the Spanish actors/actresses are almost completely unintelligible to me. I pick up every other word, so that basically, while I can understand what they are talking about, I end up missing a lot of the key plot twists. Which for an Almodovar film poses a bit of a problem.

It didn't surprise me that it was a great film, as I've really enjoyed his other films like La Mala Educación and Todo Sobre Mi Madre. But I was really surprised that Penelope Cruz actually did quite a phenomenal job. I've pretty much despised her in any American film where she's been talking in English, because she has this nasal, high-pitched, girly voice that really gets on my nerves. But in Volver her voice was a deeper pitch and had a lot more emotion. A pleasant surprise, for sure, although my inability to understand the film, on the other hand, was not.

Oh well, that's why I'm going to Bolivia anyway, right?