27 February, 2010

Ok, so I am exhausting all of my international travel for 2010 in the first two months. I didn't really intend for it to happen this way, but it did, so I am trying to make the most of the fact that I am taking a lot of cool trips – Peru, South Africa, Bolivia -and trying to forget about the fact that I am not getting paid vacation and thus will be very poor when I go back to real life.

I felt like I had just stepped off the plane returning from South Africa when I got on the flight(s) to Bolivia, as it was literally just two weeks later. After my harrowing and extended journey back from S. Africa I felt a bit like I never wanted to travel again, but here I was, at the airport at 6 in the morning with a big bag of veterinary supplies that exceeded the American Airlines weight limit.

The trip was unremarkable, devoid of significant delays, and generally not nearly as long as my most recent adventure, as I arrived in La Paz a short 22 hours after leaving Portland. I have concluded that if nothing else works out in my life, I can at least take heart that no matter where I go in this world, I will reliably be followed by lots of sick people, screaming children, and flocks of mosquitoes. It seems not matter where I fly, I am invariably sitting next to, in front of, or behind both someone who is coughing up a lung and someone else with a screaming child (or two). And then, when I arrive at my destination, I am horded by mosquitoes. This trip was no different. The Miami-La Paz leg of the flight I was seated behind a family traveling with FOUR children under six, and next to a young man from Japan who was reading his Bolivia tour book in Japanese. This was quite entertaining for me to watch because of course they turn the pages "backwards" and they read right to left instead of left to right, plus the whole book was filled with symbols (their letters) instead of the letters I am used to. He was trying to fill out the reams of Bolivian customs forms with his Japanese guidebook, as apparently he spoke neither English or Spanish (that's ok, I don't speak a lick of Japanese). He borrowed my pen and then coughed all over it before he gave it back.

We arrived in La Paz (which is located at 4100 meters - 12,500 feet above sea level) at 7am Saturday morning. I did ok with the high altitude in Peru last December, but yesterday was not a good day for me in La Paz as far as breathing goes. Thank goodness I had nothing to do all day but wait for the rest of the vet group to arrive at 7pm. I slept a lot, and then went to lunch with one of the local Bolivian vets who is helping with the teaching clinic, Alberto. We drove what seemed like 100 miles in his 1978 (I asked him!) Nissan with doors slightly thicker than a piece of tinfoil through a smog-choked, traffic-chaos city (although not as bad as Lima) to a restaurant called "Pollo Copacabana," which is essentially the local version of Kentucky Fried Chicken. It was ok as fried chicken goes, and it was nice of Alberto to take me there for lunch, and he obviously thought it was a pretty special place, as we must have driven past at least 2300 other restaurants on the way to get there.

After lunch we visited an ATM around the corner so I could get my own collection of "Bolivianos," the local currency, and what happens? In true Flacke-travel fashion, the ATM ate my card, but fortunately not until after it had given me about $100 US worth of Bolivian money. But the bank was closed, so we could not retrieve the card, so we promptly went to a local international calling kiosk from which I called my bank in the US and cancelled my ATM card. Although $100 US equivalent of Bolivianos might go a long way here, I have to pay for my food and drink every day as well as taxi rides to and from the clinic, so I am not sure how long it's going to last. Susan, the director of the trip, has assured me she won't let me starve if it comes to that.

After returning to the hotel (another 2 hour drive later) I slept until the rest of the group arrived, and then all 8 of us piled into a few taxis and drove to the home of a local family. Someone in the family, I am still not sure who, is one of the Bolivian vets at the clinic where we will be teaching, and her husband was having a birthday. His entire extended family, which numbered in the 30's at my last count, was at this birthday dinner, and we had to kiss on the cheek every person as they arrived and left, according to traditional Bolivian custom. The food was amazing traditional food, home cooked and so savory and tasty. It was very kind of these people to invite us to their home, and it was very interesting to see a traditional Bolivian birthday party, but wow what a LONG night!! We arrived at 8pm, we sat around and talked in broken English and Spanish, we drank a bunch of the local grape brandy called singani (apparently great cure for an altitude-induced splitting headache), and we did not eat a lick of food until 11pm. We had birthday cake just after midnight. Then we finally had to excuse ourselves as we were falling over with exhaustion and altitude sickness, and headed back to the hotel in a zombie-like state.

And that was all for my first day here, more to follow as clinic preparations get underway...

1 March, 2010

I have come to the conclusion that most (if not all) Latin American cities are a collection of litter, street dogs, chaos, traffic, smog and diesel exhaust, sirens wailing, whistles blowing, horns honking, people yelling, music blaring, the smell of meat cooking and hair burning, a hint of raw sewer mixed with cigarette smoke and fresh paint. I am almost used to the traffic now; this morning during our 1 and 1/2 hour drive from the hotel to the clinic at the Public University of El Alto (which is a mere 10 miles away) we almost had an accident about 5 times, we nearly ran over a dozen different people, and we hit so many potholes my kidneys are now floating free in my abdomen. But somehow, it all seemed routine. That worries me a bit.

The traffic police this morning were dressed like zebras. Literally, they were wearing head to toe zebra outfits complete with black and white stripes and mane, and they were waving traffic signs that said "go" or "stop" depending on the situation. I guess this is a new Bolivian Police Force strategy - dress in a very attention-getting manner and more people are likely to notice you, not run you over, and maybe obey the traffic "laws" if you are lucky. The mini-bus taxis here add new life to the line from the Jimmy Buffet song "a tin can packed like sardines, with bananas piled on top."

La Paz has the highest percentage of indigenous people of any large Latin American city, with over 80% of the population being Aymara (in addition to being the highest capitol city in the world). These people are very striking and beautiful, with dark skin, pensive expressions, long black hair, and always carrying loads of various ridiculously heavy items on their backs wrapped in colorful cloth. There are traditionally dressed women all around, wearing their cultural bright Aymara skirts and wraps and the black bowler hats that are so common in this part of Bolivia. It is very interesting to see.

This particular RAVS (Remote Area Veterinary Services) teaching clinic consists of four vets and two vet techs from the USA and 8 local Bolivian veterinarians (from the faculty at the university) as well as a handful of veterinary students. Today was our first day, so we basically spent the day setting up the clinic and meeting everyone. La Universidad Publica de El Alto (UPEA) is one of four veterinary schools in La Paz and the only public school. The faculty is very happy to have us here, as they apparently told us today in a meeting in the Dean's office of which I understood only about 25% of what was said. The six of us set up the clinic, for which all of the supplies were brought with us from the USA, and that took about 4 hours. While setting up we all were feeling rather nauseated and dizzy from the altitude and the restroom situation (please refer to next paragraph), and so we decided to measure our blood oxygen level using our pulse oximeter anesthesia monitoring machines. A normal pulse ox measurement of a healthy awake animal or person is about 99 to 100%. Ours were consistently reading about 83% to 88% due to lack of oxygen in the air. No wonder we felt like crap. Please refer to our newly composed "America's Top 40" winning hit, lyrics sung to the tune of the 1980's Foreigner hit "Hot Blooded:"

Light headed!
Check it and see
I've got a pulse ox
Of 83!

Light headed!
What can it be?
it's a wonder
I can even breathe...

No matter where you go, there is the token brown, shaggy, matted street dog, usually with a pronounced limp or a missing patch of hair or a seeping wound or some other chronic ailment. It takes a lot to look away and not have it break your heart. Those of us in the "western" world are so lucky to have what we do. This university is only 10 years old, and yet the plaster is crumbling, the paint is peeling, the windows are broken, the floor tiles are cracked, and the classrooms don't have enough seats for the students. The bathrooms are frightening, with layers of urine and fecal material on the floor, piles of used tampons and sanitary napkins on the ground surrounding the toilet, no toilet paper or toilet seats, and a smell that will permeate your very being and make you want to vomit no matter how hard you try to hold your breath. And that is what they are used to, they don't even think twice. So next time you use your clean toilet with a toilet seat and toilet paper and there isn't human excrement on the floor, and there isn't a shaggy starving dog with a broken leg outside your shack you call a home, take a moment to be thankful.

On the way home from dinner tonight we passed a techno-rave party going on upstairs in some building, complete with drunk people in clown costumes hanging out of the windows beckoning us to join them. If we had not been so tired, and if a week-long intense teaching clinic were not upon us tomorrow at 7 am, we might have considered it.

5 March 2010

Sorry it's been a few days since my last update, we have been extremely busy at the teaching clinic, leaving the hotel at 6:15 am every day and sometimes not returning until almost midnight (like last night). It has been a TON of work, but a lot of fun, and very rewarding to see how grateful and appreciative the local veterinarians and veterinary students are to receive our help and training. It is a bit scary what is (or isn't) taught in most veterinary school in Latin America. Since most of the people reading this are not in the vet field, I will not discuss the details as they will likely be very boring and not make any sense. However, I can summarize by saying things are very different here, both culturally and educationally, and some of the things the vets are (or aren't) taught in school are absolutely frightening.

The amazing thing is that all the clinic participants were SO eager to learn and so happy we were here to help them improve their skills. The first three days we worked with 8 veterinarians (mostly professors from the various vet schools around the country) and the second two days, including today, we worked with 8 veterinary students from the Universidad Publica de El Alto. The veterinary students were like sponges, wanting to learn all they could from us and asking so many great questions.

I will admit, however, that it is very difficult to teach someone how to do a surgery or diagnose an illness when you cannot communicate with them. In fact, I would describe it as quite frustrating, as you are standing there doing a dog spay and the person you are working with has no idea what you are trying to tell them to do or not to do. We had a few bilingual Bolivians who helped a lot, and my broken Spanish somehow got me through without killing anyone (canine, feline, or human). I made up a few new phrases, including "I slept like a foot" instead of the more common expression "I slept like a rock," and then I asked one of the students "how many fish does your dog have?" instead of "how old is your dog?"

Last night the Bolivian crew took us to a thank you dinner in downtown El Alto, which is teeming mass of chaos and humanity. As we walked (shoved our way through the crowd would actually be a better description) to the restaurant, which was located in what I would describe as the most busy, crowded, and insane place I have ever been in my life, we were almost hit by a bus, we were struggling not to trip and fall over all the street vendors selling everything imaginable from watches to donuts to dehydrated llama fetuses, and we had to hold on to each other so as to not be permanently be swept away into the crowd, never to be seen again. It really was like something from a movie, except more insane and more real as the oppressive sights, sounds, and smells were all right there. And then it was your typical Latin American meal that lasts hours upon hours, leaving us all ready to drop dead from exhaustion when we returned to the hotel at almost midnight after fighting our way through the biggest traffic jam on the planet.

We had to sneak a dog into the hotel last night, as she had a severe complication after her spay surgery and was bleeding internally. We put her in a duffel bag and then three or four of us created a distraction at the front desk as someone else sneaked by with the bag and onto the elevator. Then as we were tending to her in one of our hotel rooms, another client from earlier in the day randomly showed up with her dog who was bleeding from her surgery incision (how did she know in what hotel we were staying?). So then the hotel room turned into a mini-ICU at midnight with bandages being applied and IV fluids hanging from the towel rack and such; it was quite entertaining, but not conducive to sleeping much at all.

Today one of the students brought a two month old cria (baby alpaca) to the clinic to have us fix an umbilical hernia. OH MY GOODNESS it was the cutest thing EVER (except for a baby hippo, of course, but there aren't many of those in Bolivia). It was only two months old and was so soft you just wanted to cuddle it to death. But instead we treated it, and at the end of the day when we were all sitting around discussing the pros and cons of the week with the teachers and students, the cria came and sat down on the floor in the middle of all of us and was looking so cute we could hardly focus. It is also likely that we could hardly focus because of six straight 12 to 16 hour days of non-stop veterinary work, brain-numbing rapid-fire Spanish conversations all around us, hypoglycemia from not eating much, altitude sickness, and emphysema from all the diesel exhaust.

Tomorrow we disassemble and clean everything up and put an entire veterinary clinic into six action packers (travel boxes) which will all be carried back to the USA with the various group members. Everyone then leaves the next day except for myself and Susan, the trip leader, as we are staying an extra two days to do some sight-seeing around La Paz. Every time I come on one of these trips I ask myself "why am I putting myself through this on my vacation time when I could be sitting on a beach somewhere sipping a gin and tonic instead?" But then I am always reminded of why when I see how rewarding it all is, how the local people are so appreciative and incredibly friendly, and how something so seemingly insignificant as a week-long veterinary teaching clinic can really make a big difference in the lives of those we are helping (human and animal).

9 March 2010

The last few days in Bolivia were designed for rest and relaxation, and actually had the potential to be restful and relaxing as my body finally seemed to have adjusted to the altitude by cranking out billions more red blood cells. However, before we could rest and relax, we first had to go through the most insane traffic experience ever. I thought the one the night before had topped my list of all time worst traffic experiences, but little did I know what was to come.

During the week there apparently had been a transportation strike going on protesting a new law – if you get caught driving drunk you lose your license forever, no exceptions. Not that most of the people on the road in Bolivia have a drivers license to begin with, so I am not sure that law would actually affect too many people, but anyway, because of the strike apparently the roads were much less busy than normal (this was when traffic was already unbearable). Saturday night this was not the case, and to make the situation even more of a disaster, it was also the 20 year anniversary of the city of El Alto, where the clinic was located. On the way back to the hotel in La Paz Saturday night, it took us over 2 hours to go less than 8 miles. If your math skills are up to par, that equals a speedy FOUR miles per hour on average! We spent several 20-minute increments sitting perfectly still, engine off, surrounded by hordes of people making their way through the streets, busses and cars and minivans and every type of vehicle imaginable, just sitting.

Since that was the last night of the clinic, we were supposed to have a big dinner with the entire Bolivian group of students and vets. Instead we got back so late that we sat on the floor of the hallway in the hotel and ate cold take-out pizza (because of afore-mentioned traffic, by the time the pizza arrived it was cold). But many adventures were still to come:

1. Tiahuanaco Ruins

   

   These structures were about as underwhelming as ancient ruins can be. Plus it rained the whole time we were there, and as ancient ruins tend to be, this place was located outdoors, so we were also very cold and wet. The guide spoke very little English, there was no photography allowed (although the fact that there is no record of this trip may not be such a bad thing), and the restaurant where we were supposed to eat lunch had run out of food. That about sums that up.

   The two choices for the day of the ruins trip were a) the ruins or b) a 5-hour mountain bike ride down the world's most dangerous road (it's actually called that) from above La Paz at 4800m down to Coroico at 1200m elevation. The mountain bike option was chosen by two other group members who described it as "awesome" and "thrilling" and "a once in a life-time experience." It is a dirt road that hugs the edge of a cliff that tumbles thousands of meters into a very profoundly deep abyss. People have been known to die on this mountain bike ride. Although the ruins were a bit boring, at least I returned alive. Fortunately, so did Melina and Eric.

2. La Paz

   

   I did have half a day just to explore the city, walk around a bit, and do some shopping. I managed to get caught in not one, but two political rallies on the street after I was told the last thing you want to do in Bolivia is end up in a political rally. I do know that La Paz is one of the most well-armed cities I have ever visited. There are more police officers per square mile than there are Starbucks Coffees in Seattle, all carrying automatic weapons, handguns, grenades, and wearing bullet proof vests, making me think that war was going to break out at any moment the whole time I was there. I did eat a very yummy ice cream from a street vendor and managed not to get lost or run over on my 5-hour stroll through downtown. I passed about 50 places called "Tienda microsnak." Tienda means store, but what exactly is a microsnak? A peanut? One potato chip? I also saw lots of Bolivianos wearing American T-shirts displaying various interesting slogans and pictures. My favorite was a plain black shirt that said nothing more than "Git R Done!"

3. Lake Titicaca and Copacabana

   Her name was Lola, she was a showgirl...

   

   The day Susan and I went on this trip the weather was gorgeous, amazing, beautiful, and perfect, in contrast to the last time I went to Lake Titicaca, on the Peru side in December 2009, when I almost died as our boat was caught in a hail/rain/thunderstorm on the lake. About halfway between La Paz and Copacabana (town on the lake) the bridge was out, so the bus had to forge the fortunately not so deep river to get to the other side. Then about 2/3 of the way we had to cross a narrow part of the lake on a ferry; people went in small boats that hold about 25, busses and cars went on bigger ferries that took much longer to cross. I was told the reason vehicles and people cross separately is that it is not safe for the ferries to carry the vehicles with people in them. I know the real reason is so that the tourists can be forced shop on both sides of the crossing at the 28,430 curio stands along the shore. Someone should really tell the Bolivian Ministry of Transportation about the concept of a bridge.

   When I booked the tour I was told the 100 km stretch from La Paz to Copacabana would take three hours. It took five; this is a testament to the state of Bolivia's roads. At least our average speed on this trip was 20 km/hr and not FOUR! When we did finally arrive around lunchtime, we had a quick tour of the beautiful white cathedral in the center of town, and then ate the driest, most boring sandwich ever for lunch at "Café Copacabana" (which claimed on its sign to have the best food in town – I am concerned for the locals if what we ate was truly the best food). Then we took an hour open-top boat trip to Isla del Sol; what an absolutely beautiful trip! The lake was such a deep, clear blue and the sunlight was glinting and sparkling off the water, and the snow-capped Cordillera Real mountains surrounding the shoreline were reflecting on the surface. It was fairy-tale like, as was our hike up and across Isla del Sol to an ancient ruin site (are there non-ancient ruins somewhere?). Isla del Sol means "island of the sun" and it is believed among the Aymara and Quechua people that this is the place the sun was born. It was still going strong the day of our trip, and although I was wise enough the slather myself completely in sunscreen, I somehow missed the tops of my hands.

   

   The bus ride home took place entirely in the dark after a stunning sunset over the lake. It was only 4 hours home (less traffic!) but still made for a very long but incredibly rewarding and amazing day.

4. Chacaltaya and Valley of the Moon

   

   The last day I was there I went on a tour to Chacaltaya, a mountain peak in the Cordillera Real (of the Andes) at 5495m elevation (16,300 ft). The tour consisted of a German couple who looked like they had never heard of a product called sunscreen, a Norwegian girl traveling on her own, two Brazilian girls and five Brazilian guys, three French guys, and me. One of the French guys was sitting next to me on the bus and since he spoke no English and my 8th grade French is now limited to a few words, we conversed in Spanish, which was interesting to say the least. It helped that he was really good-looking, that encouraged me to keep trying to talk to him. He told me a story about being on a bus in southern Bolivia a few days before that collided with a truckload of cattle (at least that's what I think he said).

   

   We drove to our destination on the world's most rickety bus along a dirt road (a rock road, really) that switch-backed up the mountainside with small boulders tumbling into the valleys (WAY DOWN) below as they were kicked up from the wheels of the bus spinning around the tight corners. I then realized I really hadn't missed the world's most dangerous road experience at all. I also realized I would much rather have been on a mountain bike than in a 1957-model bus over which I had no control whatsoever. But once again, no one died, and we parked at the trailhead at 5300 meters with a 1.5 km hike in front of us. The elevation gain during that hike was a "mere" 195 meters, but as far as my cardiovascular system was concerned, it might as well have been 19,500 meters. All those extra La Paz red blood cells could do nothing for me at this altitude, and it took me almost an hour to walk to the summit. The good news is that all the other healthy, energetic, strapping young people on my tour didn't make it much faster than I did. The views at the top cannot even be described, it was so beautiful and clear and you could see what seemed like a million miles - Illimani volcano at 6800m, Huayni Potosi at 6080m, Lake Titicaca in the distance, and the tallest mountain in Bolivia (the name of which escapes me now) about 300 km to the south. I would that say it took my breath away, but it was already too late. I even got to see an Andean condor on the wing!

5. Traveling back to Oregon

   The trip back was not nearly as prolonged and harrowing as the trip back from South Africa last month, but it was filled with its share of delays, completely packed flights, missed connections (referred to by American Airlines as a "disconnect"), missing luggage, and stress. When I arrived at the La Paz airport at 4am (to catch my 7am flight to Miami) there was no one there, it was dark and quiet, and the American Airlines ticket counter was closed. The porter who helped me with my luggage retrieved the baggage cart out of a bush by the airport entrance. The departure lounge had about 50 seats for 250 people waiting for the flight. The woman in the duty free store was creepy and followed me around as I looked at stuff. I was happy to get home.

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