Rough cut of pictures!

I finally figured out how to get pics up! I know, I'm a little slow. I apologize about the roughness of the slide show. I have to come home and fix up the slide show. This is only the pics from my 1st week in Bolivia. When I get home I'll add more, and captions too!

The home stretch

So, my adventures are almost over. I still have 4 days left in Sydney, but as you probably noticed, I haven't been on the internet as often. Mostly because it's pretty expensive here! I've enjoyed my time in Sydney. I could live here. It's a great city. Except the US dollar is worth crap, so everything is expensive! Last night I went to see a Shakespeare play at the Sydney Opera House. During the intermission, I enjoyed a nice glass of white wine and looked up at the opera house. I couldn't believe that I was here. It was one of those dejavu moments. I've been to the beach again. The weather's been great. Lots of surfers and big waves. I've eaten a lot of fish as well. They have great ice cream here. We watched the Queen Victoria and the QE2 port in Sydney harbor. A big deal here, it was on the news for days! Who new? I thought it was fun to try and pick out the passengers in the crowd. Usually they were the old british ones, fancypants! We are hoping to head out to the blue mountains this weekend before the long plane ride home, back to the cold!

The longest airplane ride in the world!

So, I made it! No DVT yet either! My flight out of Bolivia was delayed 1 hour because the fuel pump was broken (very reassuring when you are already loaded on the plane and about to take off when they tell you the fuel pump is broken!). Anyway, I made it to Miami with only 1 hour to spare. I ran through imigration and customs, rechecked my bag and ran across the airport just in time to catch the next flight. After 7 hours on the first flight, 6 hours on the next flight and 14 hours on the flight to Sydney I made it. I don't recommend that anyone fly that much ever. I don't normally get motion sickness, but man, I was feeling it. When I got off the plane, I felt dizzy, like I was still moving! But luckily, I was now in Sydney which is gorgeous! The weather is perfect! Sorry people in Chicago, I know it's been a sucky February, but right now in sydney its mid 70's to 80's and sunny. Absolutely perfect. There's palm trees here. I thought we would be too far from the equator for that! Anyway, we've walked around circular quay where all the ferries take off, by the harbor bridge and opera house. We ate dinner the first night in Darling Harbor, and yes, we did go by the real world house (come on, it's me, I had to take a pic of it!). It's actually pretty dumpy in person. It's in a great area. Yesterday, we went to Bondi beach on the Pacific. Got a little burned, not bad. Watched the surfers. The food has been great, love the fish. We had some fantastic ice cream and took ferry rides around the harbor last night. I'm loving this so far. Wish I could stay. Don't they have semesters abroad for residents? Wouldn't that be great!

Goodbye to Bolivia

So, I'm about to leave Bolivia for Sydney. I know I've run behind in my blogging. It's been hard to have time to sit down and write about things. This past weekend after coming home from clinic late Saturday night, we departed for Samipata on Sunday morning. Samipata is a small village set in the green mountains at the end of the Andes Mountains. The scenary was gorgeous. I felt like I was in Switzerland, only hotter. We stayed at this beautiful hostel owned by a Dutch couple, Peter and Margarite. They built the hostel surrounded by beautiful gardens. They also run a small cafe, where every dish you order is freshly picked from their garden. Delicious! After a day of breathtaking scenary, and after a long 3 hour taxi drive to arrive in Smaipata (5 people squeezed into an old beat up station wagon), we relaxed and enjoyed ourselves. The next morning, we took a 2 hour breakfast. It was brillant, eating out in the garden. Afterwards we went to see pre-Incan ruins. The car ride there was an adventure that I couldn't really handle! We again climbed 5 people into an old beat-up station wagon and attempted to drive up a single dirt path that was really rocky. Our driver seemed to enjoy driving on the very edge, were there was no guard rail to protect against steep drop offs. At crucial points, the engine would cluth out and we would slide backwards. Finally, at the steepest point, I no longer could handle it and shouted "I'm done" and got out of the car and walked the rest. The ruins were quite a hike, but the ruins themselves looked like some weird petrified space ship.


After our excitement, we went to a waterfall to go swimming. We had a picnic lunch packed by our hostel. Afterwards, we headed back to Santa Cruz. This morning we went on rounds at the public hospital. It just always amazes me there. I saw 2 patients on ventilators on the floor, not on any monitors. Their vents are the oldest vents I've ever seen. They only have 2 modes , CMV or IDV. But everyone's vent settings were the same, whether they weren't breathing over, or if they were breathing 50 BPM. Weird. They also assume that everyone has dengue and treat accordingly, and if it turns out they are wrong, oh well. Not the greatest examples. Today was scorching hot. It was oppressively hot. I'm glad to get a break. It will be a long flight, but I'm looking forward to Sydney!

Breathtaking and breathless La Paz!

So, another adventure started this past weekend. I flew to La Paz with 2 of the medical students and the other attending. La Paz is the capitol of Bolivia, and I think is the highest capitol in the world at 14,000 feet. We had decided to fly the national airlines, aerosur. I had trouble getting my credit card accepted, so had to book through a travel agent (which is an important detail later on in this post!). So we thought our flight headed out at 8:30. Turns out that airlines schedules here are just loose suggestions. People show up for the flight about 5 minutes before scheduled take off. They also can´t fill their planes with people because the engines can´t handle the weight! Anyway, we finally arrived after midnight in La Paz. Because the airport is so high up, the runway needs to be extra long, 5km, because it takes planes longer to stop because the air is thin. It also takes a really long time to get enough wind speed to take off. Therefore, when I finally left La Paz, our take-off terrified me because you are speeding down the runway for 3 times the normal amount of time, and you barely lift off!

Anyway, La Paz is absolutely breathtaking! The whole city is built into a crater in the Andes mountains. I loved it! When I stepped off the plane, I wasn´t sure if I was going to feel altitude sickness right away. Luckily I started taking diamox (great stuff) and didn´t get sick at all. I was huffing and puffing much more than normal! Anyway, we made our way to the hostel, the world´s highest microbrew. Unfortunately, they were no longer serving beer by the time we got there :( The next morning we got up early and headed to the buses to Copacabana on Lake Titicaca. The public bus took 5 hours, but the scenary was breathtakingly beautiful! Mountains, Lakes, and rural Bolivia. It makes me really regret some times living in a really flat city!



In Copacabana on the edge of Lake Titicaca we found a nice hotel and explored the town. There was probably more gringos there than I´ve seen the entire trip! Most were German, man, those people get around! Ï´ve seen German tourists in every third world country that I´ve worked in, including Ghana Africa! Anyway, after enjoying the afternoon in Copacabana, (carnivale was still going on), we settled in. The following morning we headed out on a boat to Isla del Sol, an old Incan site. The boat ride took 1.5 hours, then we had only 1 hour on the island and had to return! It was fine with me, the boat ride was more beautiful. I got really burned on my face and arms, though! I forgot, it was cooler, but we were closer to the sun!



Next we headed back to La Paz. I loved La Paz. It was like being in a completely different country than Santa Cruz. The indiginous are closer to their roots. The women wear shawls, skirts, derby hats and carry their children on their backs. We walked around at some of the markets, including a witches market which sold really weird stuff like llama fetuses. Next we went down to the cosmopolitan area, which was like any other city. We visited the museum of contemparary art. To our surprise, all of the art was for sale, and affordably on sale. I fell in love with a painting of La Paz and bought it! I got a certificate of authenticity and everything!

We were suppose to leave that night. When we arrived at the airport, we found out that my flight supposedly left the day before, even though we had confirmed with the airlines. It was a whole debacle. There was moments when I thought that I was going to be staying by myself in La Paz, knowing very little spanish. Turns out the one of the students stayed with me. We flew back the next morning and made our way out to clinic, very late! I hope to get some pictures up so everyone can see how breathtaking it was, but time is tight now. I leave for Sydney next Wednesday. We plan on heading to Samipato this weekend, it is a dutch settlement in the middle of Bolivia. Should be interesting!

Palacios, to many people in a small space!

It seems like ages since my last post. I don´t even know where I left off! Last Tuesday carnivale finished off. There was more gringo paint being thrown. We were drenched and covered in thick paint. Most of the paint has come off by now, but there still a bit left on my skin! We watched a movie, 27 dresses. It was in English, but subtitles in spanish, which was really interesting. I think I picked up a few new vocab words during the show!

Wednesday we headed out to the clinic. There was 12 of us headed to a house made for 6. Needless to say, space was tight! The road finally had dried out and we could make the extra half hour drive down a very bumpy dirt road. The clinic is pretty remote. I really felt cut off from the world out there, I was probably the most cut off that I´ll ever be. There was tons of bugs! But the stars were beautiful. The land around the house and clinic have a bunch of horses. They would come right up to the clinic door.

The first day, everyone split up. I headed out to one of the remote villages with a couple other doctors. The village was cute, but poor. We saw patients on someone´s front porch. Our waiting room was their front lawn. In that village, it was mostly young women and children. I saw some interesting stuff, though. Diagnosed a kid with pericarditis without an EKG. Since there are so many internist down here, I decided to just bang right through all of the kids. It was fun. But trying to decide who gets the amoxicillin and liquid tylenol when we only have 2 bottles was not fun! Afterwards we all gathered at the house for chicken curry and divided up the rooms/beds. I luckily ended up in a bedroom with 2 beds and a total of 3 girls. We pushed the beds together and slept pretty comfortably 3 across. In the other room, there was 2 bunk beds and 4 people, but apparantly, one person snores like no other so I was glad not to be in that room. Our bosses slept on the couch and on a spare mattress in the kitchen. 2 boys had to sleep in the clinic, which I imagine was pretty buggy!

The next morning we split up again. We headed out to another village that was pretty remote, but large. We saw a lot of people there at a ¨"hostel", if you could even call it that. Again, I tried to stick to the kiddies! Lots of rashes around here. I bunch I didn´t even know what I was looking at. There was one old guy with a raging STD. He was 68. Good for him.

Anyhow, the third day we all stayed at the clinic all day. The clinic is really nice. It´s big and spacious and like a full functioning clinic. There´s a room for eye exams, dental, and gyne. I saw lots of patients, but the one that sticks out was an 8 year old girl with some bony abnormalities from birth and severe scoliosis. At home she would have surgery on her back. We´re going to try and convince someone to come and do surgery on this girl. That night, half of the people left because they were flying home. I finally felt like we could breathe again. We found out that a cat had given birth under one of the bunk beds, and there was much excitement in pulling her out and looking at the kittens.

Today we saw a few patients in clinic and headed home. Since the main driver had left with the others the day before, I had to drive us home because I was the only one who knew how to drive stick shift. Unfortunately it had been raining all day. The road was really muddy and slippery, but I´m proud to say that we didn´t get stuck once. I drove the whole 2 hours back to Santa Cruz, even though all of the drivers are crazy. On the way back we saw a lady get on the back of a motorcycle in the rain carrying a cake, right out in the open, not even in a box. Everyone here is crazy. Right now I´m getting ready to head off to La Paz. I hope that I don´t get altitude sickness, the capitol is 14,000 feet up there.

Trying to add photos!!

I've been at this for hours! I've been trying to add pics from the trip, but I have no idea if it got linked! If the pictures go through, so of them are still bad because I'm just getting used to the camera.

Anyway, lots happens everyday and I fall behind in blogging. Time here seems endless! It makes a big difference not having distractions like phones and TV. We also are only working 4 days a week. I'm not used to so much time! When we returned from our rural adventure, I took a long wonderful shower. I felt so dirty from the hostel. That evening we went to eat dinner at Casa del Cambo, a traditional Bolivian restaurant. It would be equivalent to a fancy restaurant at home, but our entire meal with appetizers wine, beer, and dinner was $10 each. The restaurant itself was akin to Fogo de Chao, with the waiters all dressed up. They did have a cheesy background keyboard singer throwing out a mix between traditional bolivian music and cheesy 80's songs.

Saturday, my boss for this month and her husband arrived. That evening, Sharon (the canadian social worker), took usto a Bolivian baptism. She had befriended a Bolivian family during her last visit and they had asked her to serve as Godmother. We arrived at the church super early. But it was nice, different than at home. Only the mother and godparents were there for each of the families. Sharon was Godmother to 2 year old Jose Eduardo. A 3 year old girl named Sharon was also getting baptised. Afterward, we made our way to the family's house for the party. Their house was humble. They had set the party up in the front yard with the chickens and dogs. The BBQ pit was made with a chain linked fence. But the amount of food they bought must have cost them a years worth of salary (actually, I think Sharon bought a bunch of it). They were so excited to have the Americans at their party. The food was delicious, even though I knew that I would probably pay for it later! We played soccer with the kids. Later in the evening there was lots of dancing. It was great.

Sunday, we finally made it to a carnavale party. So, they had warned us to wear clothes that we wouldn't mind getting wet and dirty. I was thinking that we were going to this family's house and that maybe they would throw a few water balloons at us. Oh no, this is a city wide water balloon fight! Everyone from the very young to the very old get into it. We arrived at our host's aunt and uncle's house. After greeting everyone, his aunt, who is about 70 years old, walks over to a bucket of water, takes it and dumps it over our head! After that, it all broke loose! There's strategy involved. There is also lots of dye involved. I was drenched from head to toe and also covered in paint! If a gringo attempts to walk down the street, you are just pelted with dyed water, foam, waterballoon, hoses. There's so much coming at you that you can't tell where it's coming from! Everyone's is into it, I loved it!

When we came back to the house, a whole bunch more people arrived. Yuna, the 1st year NW student left and so did Sharon, the canadian SW. Now there is an OB attending from Wright state that brought a resident and a student. There is also a 4th year student from UCSF who has been traveling around central america and is staying for a month. There is an attending from UC Davis, and a college student who will be staying for 5 months as a volunteer! We are packed into the house now! It's still a lot of fun hearing of everyone's story!

Jugo, clinica, y more

So, the party ended and the real work began on Wednesday. We traveled about 2 hours north of Santa Cruz to rural lands to work in the clinic. Unfortunately, the clinic we normally would have worked at was impossible to reach, as the road has been washed away during the rainy season. They are working on repairs and hopefully this week we'll make it up there. We set up clinic at Arboleta, an outpost about 20 minutes from where we would have had clinic. The building was simple, cement bleakly painted a green color that nobody would ever choose. There are 3 rooms with psuedo desks and chairs and "examining" tables or beds. We saw patients there wednesday, thursday, and friday. It really wasn't bad and felt good to finally really get to work, which is the whole purpose for coming down here in the first place! We are able to treat people with some medications that we have on hand, simple stuff like BP meds (diuretics, beta-blockers, and aceis), amoxicillin and bactrim only for antibiotics! Some antiparestics and antifungals. Then some simple stuff like tylenol and ibuprofen.

So this week it was just the 3 students and myself. Each day we also had a Bolivian doctor there as well. I sent 2 patients to the hospital this week. One woman had just been discharged after staying about a week and being treated for a UTI. She was dehydrated yet again, and looked terrible. Another man actually was receiving dialysis twice a week, and came to clinic with a blood pressure in the 70's/50's with tachycardia and fevers. I've seen some heart disease, DM, lots of arthritis, and one rheumatoid arthritis. The kids mostly had "beechos" which is there term for worms, parasites, etc. All in all it was similar to other trips I've taken in the past, but I felt that these patients had more continuity and follow up. And I could actually order tests on them if necessary. The saddest moment was when I saw this older man, who had sustained a large burn injury on the back of his leg about 1.5 years ago. It was still open and quite large, but fairly clean. I was trying to explain how he should dress the wound every day when I found out he couldn't afford soap. That sucks! We bought him some soap.

We stayed out at a small town near the outpost, at a village called Buena Vista. It was very cute. Every town has a plaza which is the focal point of the town. The plaza is like a park, with lots of trees, bushes, flowers, and also lots of benches. In the evenings, everyone comes here to hang out, talk, etc. It's really nice. Buena Vista had a nice plaza, surrounded by a church built in 1690. They are famous for their jugo or juice. It was delicious, a combo of orange, passion fruit, strawberry and other stuff. It was great. Our hostel, on the other hand, was bare bone basic. It cost $2 a night, and was worth only $2 a night. Pretty much we were camping outside. The outside toilets broke after 1 day. The showers had those electric shower heads that I hate, with lots of wires sticking out. I'm always freaked out that I'll get electrocuted! All in all, wasn't that bad, and not too many bugs except for a gigantic cockroach the size of my foot!

On Friday night we made our way back to Santa Cruz. Carnavale is going on from Saturday to Wednesday morning. Basically, it sounds like a large city wide water balloon fight with drinking and dancing! We'll see! Also, a couple people left the house and a whole boatload of people arrived, from Wright State, UCSF, and Loyola. Where are all these people going to fit! More on carnavale and hopefully pictures in the next post!