Salar de Uyuni (three day trip)

Sitting in Uyuni, drinking a beer, going through photos of the past three days.

First, let me set up the contrast of the fact that Uyuni is literally the worst town I have visited in South America. There's one main strip of over-priced restaurants and hostels, a ton of travel agencies all offering the same exact thing, and some fountains that I have yet to see flowing. But that's just the town. Ben (my temporary travel buddy) and I arrived and went to an Internet cafe to do some research on the best travel agency. We found our top three: 1) Red Planet 2) Quechua Connections 3) Oasis Tours. The first two were full, so we went with Oasis. Set to leave at 10:30 the next morning.

We arrived and were in a Land Rover with two Chilean guys, one German girl, and one Brazilian girl. I love the international mixes you find in popular tourism trips.

We first left for the salt flats--they were INCREDIBLE. Miles and miles of pure white salt as far as the eye could see in every direction. We spent about 45 minutes taking fun photos; because of the pure white ground you lose all depth in pictures and can take lots of fun pictures with people meters away that make them look like tiny people. We also visited some of the flooded parts. The flooded salt gives a perfect mirror effect!! We also got to see the hotel built completely out of salt. It was strange walking on a surface that looked so similar to snow and yet had a soft, squishy feeling unlike anything else.
The flooded parts were interesting because it felt like warm water, but the minute you remove your feet a salty white crust forms over your skin.

After the flats, we visited a train cemetery, where old Bolivian cargo trains were laid to rest.

We continued on to our hostel for the night. A villa style complex in a town with only 800 inhabitants. All were either hostel owners or farmers. On the way we drove through a storm. Needless to say it was both nerve-wracking and exhilarating to watch lightning striking all around us. None ever hit us thankfully.

The next day we first visited the valley of rocks. It was insane!

Day 1! (Kind of)

Well I'm officially moved into my new house! I'll be calling this place home for the next month.
I admit I was a bit nervous leaving the comfort of my nice hostel to move in with a family. I had no idea what kind of house or people to expect. I'm definitely quite happy with how things turned out!

It's a really nice apartment on one a street that's very close to one of the main streets. It's about a fifteen minute walk from the Zona Turistica (that has the touristy restaurants and shopping and stuff like that). I have a huge room with a two full sized beds (one of which would normally be occupied by another volunteer if there was one) and a dresser, a closet, a big entertainment center furniture piece (I describe it like that because it lacks the actual entertainment, it's just the wood), and a desk. The apartment is well decorated and seems quite modern.

The family includes Gonzalo; the father, who I'm guessing is in his fifties; and Carma, the mother, probably about the same age. They have two kids both in their late twenties and in graduate school. Both kids live at home, but I have yet to meet them.

Week 1- Infectology Hospital de los Niños

Ok, journal in hand, lets review:

I'm officially finished with my first week of medical placement here in La Paz, Bolivia.
I spent it working with Dra. Maria Salete Queiroz Tejerina in the Infectology department of the Hospital de los Niños.


First let's talk about the hospital. The hospital is the largest children's hospital in Bolivia and serves as the "rule maker" of sorts for standardizing medical practices for all other children's clinics and hospital in Bolivia. That being said, it was still far below the standards of the American hospitals I was used to. For example, private rooms are not thing. All rooms are shared and contain multiple beds. There is one main waiting room in the front entrance, and the hospital itself has four floors with ten departments in total, I think. They have computers and properly document everything as common medical practices dictates. They have a pharmacy, a lab, and a sufficient staff of doctors and nurses and residents. There are far less luxuries in terms of equipment. For example

Week 1 summary - Daily Life

I am absolutely enthralled with the experience I am having working in medicine here in La Paz.
That being said, La Paz is, to me, almost too modern. It's great for living and working in, but I'm not getting the crazy cultural contrast I got in Cuzco. But it's because of this that I thinking I'm also getting a much better exposure to medical practices.
And I think that's complimented by my being without other volunteers here. I love it because I get completely private attention from the doctors and directors and everyone, but it can definitely get a boring without another volunteer in the house.
This host family situation is alright. I find myself a bit jealous of people's stories of great host families who teach them how to cook and are very accommodating. My one meal a day, restrictions on going out, and lack of Internet leave a bit to be desired...

But it's by no means ruining my experience here in La Paz, just not the host family experience I envisioned. I joined a La Paz couchsurfing group and have met friends through there as they travel through the city.

I found an awesome bar near my house called Diesel Nacional that's decorated to look more like an old mechanics shop.

Also, there's my favorite thing in the city. The market food. Market food is always my favorite and is usually the first thing I try when I visit a new city.

Week 2 - Hospital de los Niños, Oncology and Surgery

In the past week, I have learned so much about medicine, compassion, culture, and myself.
I spent the past week in both the Oncology ward and in Surgery.

Monday, Tuesday, and Wednesday I spent only in Oncology. There was so much to learn about the different types of cancer and associated treatments. I did some research myself over the weekend before to try to familiarize myself beforehand. There were about nine children in total over the few days I spent there.
Most of them had Leukemia, so I learned a lot about the course and treatment of that cancer. One had a tumor in the upper portion of his right cheek, although the scans revealed that it penetrated far back into his head. There was one boy with Leukemia in grave condition due to the presence of another infection, Sepsis.

All of the children had one parent by their bedside.
There was one moment that was hard, and that was when the mom of the boy with the facial tumor saw the scans and just how large the tumor was. She cried pretty hard for a while and it was difficult to stand and observe.

Worlds Most Dangerous Road / La Senda Verde / Coroico

This past weekend I visited the World's Most Dangerous Road! It's a mountain biking trail and one of the most popular attractions near la Paz. I went with a company called Adrenalin Barro Biking. I only paid 500Bs which is cheaper than some of the really popular tourist companies. However I heard about some of my friends visiting some sort of monkey reserve at the bottom, so I told the lady at the tour agency I wanted to see them. And she told me the only way was to either spend the night in the nearby town of Coroico and return in the morning, or stay in a treehouse at the animal reserve. Obviously a ridiculous question. Treehouse it was.

So I left early Saturday morning for the biking trip. SO FUN!!! It was my first time mountain biking and I was surprised at how easy it was to navigate the road. The first section is paved and it was freezing cold and foggy and I was wet and frozen and flying down a road and loving it all. Then you reach the unpaved deadly road part and we had gorgeous sunshine in one of the most gorgeous valleys I've seen. The road is full of breathtaking views and lots of fun times. We end at some luxury hotel a few thousand meters down in the valley and eat lunch and take a shower.
The bus then dropped me off at La Senda Verde animal reserve.

Best experience of my life.

Weekend Update

Today I met up with two couch surfers and the three of us took a mini bus out to Valle de la Luna, an absolutely incredible work of nature out in the Zona Sur!

Definitely worth checking out!

I also tried Aji de Lengua (or spicy cow tongue), a delicious traditional dish in Bolivia.

Week 3 - Centro de Salud - Adolescent Pregnancy

I spent my third week here in La Paz working with Dra. Santivañez in the Centro de Salud in Alto Miraflores, a poor neighborhood in the outskirts of La Paz.
Centros de Salud are first level clinics, which means they have consultations, can give shots, but can't do surgery or have inpatients. The same as an American doctors office.
Dra. Santivañez is a specialist in adescrnt medicine at one of these clinics in a poor neighborhood of La Paz. She is well recognized in her field! She was one of three contributing authors to the book of diagnostics for the Bolivian public health insurance manual for mothers and children (SUMI). She is often asked to contribute to studies, attend conferences, and give opinions. More than that though she is a very amiable and funny person to work with.

Week 4 - Hospital de los Andes - Infant medicine

I spent my fourth and final week in La Paz working with Dra. Cecilia Uribe at her consultation in the Hospital de los Andes in El Alto.
First let me fill you in correctly:
I was supposed to work with a Dra. Gutierrez at the Hospital de los Andes during my final week here, but on Sunday, my medical director, Dra. Uribe texted me telling me that Dra. Gutierrez wouldn't be in so I should go back to Hospital de los Niños.
So I did. I went back and found Dra. Cruz, an incredibly nice maxillofacial surgeon I had been with when I was in the surgical room in my second week. I asked her if there was anything to see in surgery, and she said no, but I was welcome to come with her on her rounds!

This was an incredible experience because as she is a specialist and surgeon, we got to go to all of the departments to offer inter consultation on the difficult cases. We started in oncology and looked at some solid tumors and talked about surgery options. Then we went to Gastroenterology and saw a boy born without eyes, a cleft palate, all of his organs reversed (eg, heart on right side), scoliosis, severe malnourishment, and anemia. It was a heartbreaking case.

Vacation Week - Potosi and Sucre

This past week, I was in between my two programs. I finished my program in La Paz and had ten days to get to the southern-most city of Tarija. I decided to spend the time visiting the cities Potosi and Sucre.
Potosi is the ancient mining town. The Spanish first discovered massive amounts of silver in the mountains in Potosi, and the mines are still active today!

I left La Paz on a Friday night to arrive in Potosi on Saturday morning. When I arrived I checked into my hostel, Koala Den, and made friends with some other people in the dorm right away. They told me they were going on a tour of the mines that morning. I decided to join. So within an hour I was in protective clothes, boots, helmet and headlamp, and off to the mines!

They were awesome! We actually crawled through levels of the mine, rode around in an actual mine cart, and hung out with some miners who were working there, drinking some 96% miners whiskey and all.

Week 1 - Centro de Salud Nestor Paz

My first week in Tarija!

First thing, I absolutely love this city. It's warm and so friendly. It's much smaller than la Paz, so it's very common to run into people you know.

I spent my first week working in the clinic of Dra. Amanda Delgadillo. She works in a neighborhood here in the outskirts of Tarija. It has a relatively poor patient population and offers basic services such as consultation, vaccinations, dentistry, and a minor inpatient room if people need to stay to let stitches heal.

Dra. Delgadillo is a super nice doctor and the whole clinic in general has such a welcoming, family vibe. All of the nurses were hilarious and always joking about the "pretty new student." We all had coffee and snacks after the work day together and I really felt like I was a part of the clinic.

The one downside to this week was that Dra. Delgadillo already had a student in the final stages of her internship about to enter residency. Because of this, I felt like I was really an unnecessary third wheel in her clinic. She is a general medical doctor, so we had cases ranging from pregnant women, to a man with tuberculosis, and a lot of sore throats. The coolest parts of the week were the occasional moments I spent working with the doctor in the laboratory looking at fluid samples and diagnosing different parasites!

On Friday, I accompanied two of the interns on their community work. It was a lot of fun! It was National Children's Day, so we walked around farmland to different houses asking if they had young children and distributing nutritional supplements to help kids get their vitamins.

Overall, the week was rather low-key, but a super friendly environment to be working in!

Week 2 - Hospital Obrero - Internal Medicine

For a very interesting ward in the second largest hospital in the district of Tarija, this was by far my most boring week.

I realized here what an immense difference in my experience the personality of the doctor I'm working with makes.

I spent my time here working with Dr. Victor Vilcaez.

Monday was Tarija's anniversary, so no one worked. So my first day was on Tuesday, and I arrived at the hospital at 7am. In Internal Medicine I asked if Dr. Vilcaez was there and they said not yet. After about twenty minutes I asked again and they said Oh yeah, he's in that room. I introduced myself but he told me to wait and then came out and said we were going to do rounds.

As per usual, rounds consist of the residents taking the doctors around to all of the patients and explaining their case and any recent developments. They're always the hardest for me to understand because the Spanish is so fast and mumbled.