Sunday, April 22, 2012

Goodbye Bolivia

This was my last night in La Paz.  I have spent today sharing time with some great friends and family that I've gotten to know and love over just my short time here.   I'm so thankful for the HOPE team that is working so diligently and full of the Spirit of God to bring people to Him.  Their goal is to love the people of this city - the poor and the rich, the children in the orphanages, the taxi drivers, those who know Christ and those who don't, the doctors, nurses, hospital staff at Arco Iris - so that they may see God and glorify Him.  They are giving their hearts and being strengthened by God daily.  I'm also blessed by the friendships I've made here, both in and out of the hospital.  Many have been asking me about the one big thing that I've liked the most about La Paz.  I'd have to say it's the people I've met and the relationships I now have.  There are many needs here and many opportunities for any and all of us to serve.

To wrap up a few things on my last blog from Bolivia (unless something crazy happens at the airport tomorrow!), I now have experienced Bolivian karaoke, have taken every form of public transportation in the city, have walked from one end of the city to the other, have tasted a saltena (like a handheld steak pot pie), had a Bolivian doughnut, drank the best limeade in town, and climbed up a mountain next to the President's guarded house to get to the bridge that connects the city so we could cross on foot.  All of this was done under supervision of course, with the help and guidance (and encouragement!) of my two good friends... and carrying a plastic sack of mega popcorns so that I can bring them home for someone special (starts with a T-h) to taste. 

The people are great, but I can't say that I like the food here.  Some of the best food I had was cooked by my friends for dinner both on Easter and tonight, and it wasn't Bolivian!  Tonight we had tacos, chili, rice, beans, chips, and salsa.  Yum!  I can't wait to have a pizza again, to be honest.  I'm sure I'll have interesting stories from the airport tomorrow morning where Bolivian time will again be in action as I wait in line.  More to come...


Thursday, April 19, 2012

Life (and Food) can be Tough

It's been a few days since my last blog - apologies!  Since Monday, many things have happened.  First, I successfully traversed the mini bus system to my home on my own, a thirty minute drive for 2.30 Bolivianos (less than 50 cents).  Second, I met a friend from church at a place called Dumbo's (yes, the Disney Dumbo, picture and all) which is actually a really good place for dessert.  We had an awesome chocolate almond cake with a funny lemonade and milk mixture that was just ok for me.  The people here that I've met are amazing, really.  Good, caring people.  On Wednesday I gave a presentation via powerpoint (in Spanish - wow!) about a case from UNC Hospital to a group of 30 attendings and interns at Hospital Arco Iris.  It went well, thankfully! 

This week I've been going to the clinics during the morning to see how outpatient pediatrics works here.  This morning, BT set in again, but all was well and I still got to see quite a few patients. Apparently, first thing in the morning (7am), people start waiting in the halls of the hospital clinics for the office to open so they can be first in line to ask for an appointment for that day. If the appointments fill up, they're off to the ER to be seen.  Children under 5 have free health care through an insurance called SUMI, but over that age, it's all out of pocket.  I've seen lots of drug reps going in and out giving away samples to doctors, then seen the samples go right into the hands of single moms with three kids who barely could afford the trip to the hospital. 

I've been reminded recently about how different life is for people here- and how "tough" things can be.  Take first, the scenario above with the waiting room.  Imagine you're an Aymara lady with your bowler hat and long braids.  You've carried your baby on your back from your neighborhood in El Alto (on the mountain, a 30 minute overall trip, bus plus walk) because she's sick and you need to see a doctor.  You've heard about Arco Iris having good pediatricians.  There are only adult doctors in El Alto, plus most of the public doctors are on strike right now and refuse to see patients (true statement).  You successfully get your baby to the hospital (oh yeah, with your 3 other small children at your side), then you take a number and sit...and wait...for 3 hours.  Your child is actually quite sick and needs labs and radiology studies.  If your child is over 5, you pay out of pocket, up front.  You take the order to the lab, pay them, and they do the labwork.  You then take your order for the xray, pay for it, and then are expected to return and pick up the results, then make another appointment with the doctor to review the results the next day.  That means that you have to come right back in less than 24 hours.  You are relieved that, if she has to be admitted to the hospital, you don't have to pay, because the hospital covers the cost.  Life is tough for you.

Yesterday afternoon I called the doctor in charge of ambulances to ask if I could go to a prison or school to see some kids with them.  We went to an elementary school in a poorer part of town where the children had dirty faces and fingers (like many children, I know), as well as wet clothes.  It's been raining a lot here, almost every afternoon.  It made me sad to pat each kiddo on the leg as they moved through and feel a wet pant leg, then notice that their sweaters were wet, too.  They looked at me with their sweet faces and smiled, many with teeth that were decayed, brown, or missing from cavities.  Tough life for some tough kids.

On to a lighter topic which I've seemingly enjoyed this entire trip: food.     

Chicharron (aka "pork cracklings") was ordered as take out for a birthday celebration for one of the attendings today.  This is supposedly a treat for all Bolivians.  I was reminded of my previous encounter with this thoughts went to....
this picture of what my lunch looked like from last week.  Yep, appetizing I know.  You may be wondering what you're seeing above.  Those smaller yellow things are corn or hominy(?).  The ones from my previous blog (where my friend was cutting off the tips before she ate them) were like these, but even bigger.  The black things are small freeze dried potatoes that can last FOREVER and are super popular here called chuno (with a tilde over the n).  The brown things on top are pork.  This is often served, as is every other dish I've ever eaten here with....
Bolivian hot sauce.  So today, the treat for all the interns and docs were take out boxes of the plate above.  I tried the pork again, thinking it may be better the second time.  These things are not able to be cut with a knife - only with teeth, and they still don't work that well.  Five minutes after taking my first bite, I swallowed.  Enough for me! 

Another common food here, which I attempted to drink today, is juice in a bag.  I've seen people drinking juice from the corner of plastic bags multiple times, but today was the first time I attempted it myself.  It took me 10 minutes to tear the plastic corner off of the bag so I could start to drink it, then when I tried, it spilt of course, on my shirt.  Bags are actually used for TONS of things here.  Take out food is placed on a plate which is pre-wrapped around the bottom with a bag, then when done serving the plate, pulled up and tied together so you have a big food bag to carry out.  Oatmeal and milk are served in bags tied together around little straws which stick out the top.  A lady and her husband sell this every morning at the front of the hospital, making some Bolivianos and saving the environment at the same time!
Yep - tough meat, tough juice bags, tough Bolivians.  Gotta love 'em. 

Monday, April 16, 2012

Bolivian time

All is well in Bolivia, including my digestive system (for those of you interested!).  Today was a not-so-interesting day that reminded me of a common topic here that I haven't yet discussed: Bolivian time (BT).  You may be thinking to yourself, "Does that mean that time is somehow different in Bolivia than it is here in the U.S.?"  The answer is yes, absolutely.  That is, the people perceive time differently.  It actually does still go by at the same rate.

I was thinking of this and other deep thoughts today as I sat in the front of an ambulance, watching the people and cars on the street in front of the hospital...waiting.  I was scheduled to go with the ambulance to the women's prison and then to a school later in the day to do check ups and administer medicines.  I'm told to be at the ambulances at 8:00am so we can leave around 8:15 to 8:30.  At 9:30am, we left the hospital.  This was no big deal because, hey, we were starting the day!  Yay!  However, somehow I missed that we had to drop off some important paperwork at the boy's orphanage instead, then return to the hospital for medicine supplies before actually going to the prison.  No big deal, right? 

It depends...  Bolivian time (BT) set in and a few minutes waiting became an hour.  We left the orphanage and went back to get the medicines at 10:45am.  I sat again in the ambulance outside of the hospital waiting on the doctor I'm working with to return.  [Insert Bolivian time]  At 12:30pm he returned with medicines, saying that not only could we not go to the prison because of time spent with the errand of the paperwork at the orphanage, but that we didn't have the needed medicines to go to the school this afternoon.  Bummer!  Someone must have gotten stuck in BT and not picked up the right meds! 

As a "gringo" (or foreigner) here, I and the rest of our team from the U.S. have been forced to accept this new way of seeing the world.   Phrases now have different meanings.   "I'm on my way" may mean, "I'll be there in the next 2 hours."   "Yes, we will meet you at the entrance at 7pm" means "Yes, we will meet you at the entrance at some point tonight."  Even scheduled professional events such as the one I attended with my friend last Saturday night (Selected songs and dances from the TV show Glee) do not start on time. Not even close. ("Show starts at 7:30pm" = doors open at 8:10pm and show starts at 8:25pm.)   Some things start on time despite BT: the movies (more or less) and restaurant reservations...I think.  Also, the church services start pretty close to on time, which I think is important.  (We should at least be on time for God!) 

I suppose at times, BT can be a breath of fresh air, especially when you don't want to rush around and have no time schedule in particular.  Plus, it's important to appreciate other cultures unlike our own.  Because of Bolivian time, people here are (and must be) more patient....well, unless you're in a taxi in a traffic jam.  

There were redeeming qualities of my time spent in the ambulance, stuck in Bolivian time: 1. a chocolate croissant, 2. a lot of great conversation with the driver and a new friend, 3. practicing my Spanish, 4. sunshine (when stepping out of the ambulance), 5. lunch (that's now 2 food items), 6. getting home early to finish my presentation for Wednesday (yay!), and last but not least, 7. a lesson in patience.  Thankfully, during my hours of sitting, my mind wanted to become frustrated and sad because I missed my chance to see things on my last Monday with the ambulances, but I tried to renew my mind.  This verse popped into my head: "The fruits of the Spirit are love (for those in BT), joy (despite frustration), peace (when you want to be angry), patience (enough said!), kindness (to those who made me enter BT), goodness (always), faithfulness (when I'm disappointed), gentleness (when I'd rather be harsh) and self-control (to keep my mouth shut if I have nothing good to say!).  Against such things there is no law." Galatians 5:22.

Friday, April 13, 2012

If it's going to happen....

Who knew that corn could be SO big?!?!  That's what I thought to myself when I saw the cafeteria worker pile up some large yellow things with a red, oily sauce on my plate.  I had asked my friend earlier, "Are those shrimp?" (in Spanish of course) and I got a big laugh in return.  "No!  Es maiz!(corn)".  On top of the corn went some yuca (potato like food) and then some super tough, greasy and salty pork.  This pork was not to be cut - it was to be torn with the teeth and chewed...for a while.  I went ahead and tried the food, as I only have one option in the cafe each day and I didn't bring my peanut butter sandwich today.  I decided that the corn was a good thing to focus on, so I proceeded to eat multiple kernels (each about 1 inch in diameter).  I noticed my friend to my right.  She was cutting off the ends of each kernel before eating them, leaving the small gray colored tips on her plate.  I then became curious.  "So, what are you doing?" I asked.  Then, my friend, who knows that I am the girl from the U.S. who asks everyday about what the food is in order to assess it fully before eating it, tells me that those parts of the kernels give her diarrhea....

Tonight I planned to go with two other girls from North Carolina to a Korean restaurant that we were told was the best in La Paz.  We made our way to the center of the city and found ourselves speaking Spanish to a Bolivian waitress about Korean barbecue while sitting next to Chinese businessmen.  We first had appetizers of sesame flavored spinach-like leaves, green beans, and spicy cabbage.  Then I shared the barbecue (which cooked on an electric skillet like thing in front of us) with my friends.  It actually was great.  I took a big piece of lettuce (that appeared recently washed, though this is a big risk for me right now) and packed it full of sticky white rice, added some sauce, then piled on the beef and bell peppers.  I wrapped it all up and ate it, with a smile on my face!  It was good!  I basked in the goodness of lettuce at that moment, hoping that it wouldn't come back to bite me.

I've made it thus far without digestive problems thanks to my careful choosing of foods, I think.  Last week I slowly branched out to trying any safe-appearing foods for lunch at the hospital.  However....

If it's going to happen, it will happen in the next 24 hours. 

Wednesday, April 11, 2012

Adventure in an Ambulance

I spent most of Monday inside of an ambulance.

Here in Bolivia, ambulances go to schools to do check ups for the children.  In the morning, we examined almost 100 children while sitting on a small bench inside of an ambulance with each child moving through in assembly line form.  First, they were weighed and their heights were measured.  Then they saw either me or Dr. Carlos, the attending doctor I was following.  I asked them their name and if anything hurt.  If so, I asked about medicines that they were taking and many times we dispensed a box of vitamins, a few Tylenol pills, mucolytics, etc....all based on what a 5 year old reported (No parents involved).  One worried 5 year old asked me, "Am I ok, doctora?", to which I laughed and told her that she was.  Then she scooted down the stretcher in front of the dentist who put fluoride on her poor cavity-filled teeth.  One thing's for sure - these children have LOTS of deep, terrible cavities.  Only 1 of the 90+ kids we saw had none. 

Later that day, I found myself in the back of an ambulance taking care of an older man who needed to be transported to his home in Copacabana.  This trip is a 3 hour drive from La Paz.  The ambulance staff from Arco Iris was asked to help with the transport, as he was under hospice care and desired to be in his own home.  I thought I was going along only for the ride.  Little did I know that I would be in the BACK of the ambulance, attempting to keep things from falling and tubes from flying out of this man, while suctioning his nasogastric secretions every 30 minutes and keeping his head straight on the stretcher. 

We left La Paz with sirens screaming and lights flashing, weaving in and out of trucks and cars, going up and down hills, around curves....over bumps....  I can't describe this well enough.  I tried so hard not to throw up...and thankfully was successful.  We weaved up into El Alto, which has to be one of the dirtiest cities I've ever seen.  People, cars, dogs, fumes, children, and trucks were everywhere!  We dodged people and cars while racing over speedbump after speedbump (they use these here I think in leiu of stopsigns...they're brutal!).    I thought to myself, "Never in a million years would I have imagined myself in this situation!"   Finally we got to flat ground, and the view opened up into this picture below - the beautiful Andes.

The next best part of the trip came when we arrived to Tiquini (I think?).  This town is split into two parts by Lake Titicaca, which is a huge lake on the border of Peru and Bolivia.  The road we were on dead ended at the lake and a big flat boat with large wooden planks awaited us (see below).  As I wondered what was happening, I noticed other vehicles on these things, moving across the lake.  Next thing I knew, we drove onto the boat (carefully), and 2 men grabbed very long wooden sticks to push us off of land.  Then one of the men cranked up what looked like a speed boat motor and we slowly inched across the lake.  The man below in the picture has been doing this job for almost 50 years.  The second picture is the view from the middle of the journey across the lake. 

With gastric secretions on my ungloved hands and a patient who was breathing harder with an almost empty oxygen tank, we successfully made it to Copacabana.  We pulled up to the house and carried him inside, only to find that in a few minutes after being home, he would pass away.  Sadly, we said goodbye to the family and went to the "tourist" area for dinner.  I had trout with potatoes and rice (of course, the carb duo of Bolivia).  We then grabbed some pasancalles (HUGE popcorns that are chewy and sweet - que bueno!) and made our trek back to La Paz.  We almost missed the ferry back across the lake!  It closes at 9pm, and we arrived at 9:20 - thank goodness for Bolivian time!  (Bolivian time = at least 20 minutes late).  After hours of sitting sideways, listening to Flamenco music, eating huge popcorns, and being stopped and questioned by police (standard procedure on the roads - no worries!), we made it back home to Calacoto (my neighborhood). 

What a day!

Tuesday, April 10, 2012

La Via de La Cruz

This means the Way of the Cross or the Walk of the Cross.  On Good Friday, La Via de La Cruz is a Catholic tradition that many people attend from different churches/districts across the city of La Paz and across Bolivia.  There were 20 or more different walks in La Paz on Friday.  My friends from here were invited by a couple who comes to their marriage class through the church, so I went along as well. 

We started in the middle of the street in a neighborhood called MiraFlores (note: middle class neighborhood).  I first noticed a large group of people (above), four of which were carrying a casket with a mannequin inside with blood stains meant to represent Jesus.  They also carried, further back in the crowd, a figure that represented Mary (who wore purple, but had a blue poncho when it started to rain).  The people in the streets walked from station to station, 14 in total, down the street.  Traffic was stopped for this procession.  Certain store owners asked that their store fronts be used for the walk (see below).  At these store fronts, the owners usually decorated, and the Jesus and Mary figures were placed on a table while the priest read verses and led prayers.   The procession in total lasted about 3 hours.   

How interesting are the different traditions in different cultures!  I know many Catholics in the U.S. do something similar to this in churches across the country for Good Friday. 

Saturday, April 7, 2012

Changing Lives with Taxi Drives

Taxis are the way that we get around here in La Paz.  I have spent most of my taxi rides with my brothers and sisters from the church in North Carolina who are now here working with HOPE (an International project started by the church) and who are helping spread the news of Jesus to the people here in multiple ways.  These ways include working directly with the church and its disciples here in La Paz, with leading Bible studies/marriage classes, with working with the orphans and children who live on the streets, taking taxi rides.  I've gotten to know Raul, Bernandino, Gabrielo, and many other drivers during my short time here thanks to my friends who initiate conversations with these men.  During many rides, we just chat about the city or how our Spanish is not great.  Others involve more personal conversations about family and God.  Many of the men have thanked us at the end of the ride, and even asked more about our faith.  The point is to love like Jesus did so that they may come to know Him.

Orphans and street children have been supported here in La Paz by Foundation Arco Iris (Rainbow Foundation) which was founded in 1994 by a priest from Germany named Padre Jose.  The main goal of the foundation is to help the children in La Paz, many of whom are homeless and who have no caregivers, left to live on the streets.  Arco Iris therefore started many social projects (an orphanage for girls and boys, homes for teen mothers and their children, "pass through" houses for teens who abuse drugs and children on the streets) as well as a hospital (Hospital Arco Iris).  The objectives of the hospital were first to be the "sanitary prevention and rehabilitation" of all of these children, as well as "basic health training" according to their website.  Currenly I'm working in this hospital.  It continues to serve children from the city and has traveling clinics for prisons where children must live with their parents if the parents are put into jail.  There's no such thing as foster homes here (I've asked), just adoption, which occurs rarely.   

The first time I went to the orphanage (called Ninas de Obrajes or Girls of the neighborhood Obrajes), I rode in - you guessed it - a taxi with other ladies from the church.  We brought with us 2 big bags full of games, cards, and suckers for the girls.  As we pulled up the stony, steep hill, I wondered what this orphanage would be like.  We were allowed in through the gate and were met by group after group of excited girls running towards the lady from my church and her daughter who have been here for 7 months and have become like a mother and sister to these girls.  They were so excited to have our time and attention.  The girls range in age from 5 to 18.  After 15 years of age, Arco Iris helps find jobs for the girls so that, when 18 years old, they can transition out to a job and find a place of their own.  Children here go to school either in the morning OR in the afternoon with a lunch break.  The older teen girls will attend school in the morning, for instance, and work in the evenings.  I've made friends with 4 of the teen girls who now think I'm a good way I think!  We talk about music and food - they make jokes with me about funny Spanish words, and we all laugh together.

I've only gotten to go to Ninas (the orphanage) a couple of times so far, but these times have made a huge impact on me.  I've spent much of my time with one girl who I'll call Valerie.  On my first visit, she wouldn't speak, but played games with me and showed me how to make bracelets.  She is new to the orphanage and says very little to anyone.  She's 12 years old.   The next day I returned and spent most of my time with her again.  She opened up about her life, how her parents died when she was young, and she has a grandmother and aunts and uncles that she hasn't seen in over 1 year.  She's unsure where they live now.  She has no other family, and has been moved to this orphanage recently.  I remember her face when she said, "They didn't want me".

HOPE's goal and our goal as a group of Christians here is to love kids like Valerie.  We are doing our best to also love the teens who are abusing drugs, the moms who are attempting to get out of their lives of prostitution, the children of these moms, and the staff and workers who work so hard to keep these organizations running.  We love them by providing their needs (food, clothes, health), by helping them find ways out of their situation by giving eduation and providing job opportunities, by being their friends and family they never had, and by telling them the truth about why this is important - because Jesus did it.  They, just like everyone, need to know. 

My apologies for finally sharing with you all the important things about this trip.