Don’t Go Chasing Waterfalls

Since my last post I have gotten out of the city and explored some waterfalls. Hence the title I chose for this post. I wanted to say do go chasing waterfalls, because they are beautiful and a nice reward after a hard hike, but that is not how the song goes. Of course, our waterfall adventures were not without challenges. Last Monday afternoon, my Spanish teacher was out of town so I had the afternoon free. My friends (Elise, Madeline and Hannah) invited me to go to a nearby waterfall with them. We took a minibus to Calama, a rural town outside of Tarija. There we were told by a driver that the waterfall we planned to walk to was super far away. We would have had to come in the early morning to get there and back before dark. Whoops. We were going to give up and just walk down the path for a bit but the driver, kind and helpful like many of the Bolivian strangers I have come across, told us about another waterfall that was much closer and offered to take us to the entrance. He didn’t even charge us for the ride. Thanks for saving us from a disappointing afternoon, driver! We walked about 45 minutes before reaching the waterfall and lagoon below it. Gorgeous! I only wish it was a bit warmer. After taking one climbing lesson in La Paz, I now think of myself as an experienced climber and challenged myself to scale the rock wall along the lagoon to make it to the waterfall. As you can see in the photos below, I did it! It was incredibly difficult and scary but also rewarding. I avoided getting in the chilly water on the way there, but ironically ended up walking back through water up to my waist on the way back. No regrets though.

The second waterfall, or more of a collection of waterfalls, was called Coimata. I went there Sunday with Elise, Madeline, and Andre. Andre is a new student in my program that arrived last week. He is a medical student at Drexel University in Philadelphia, but is originally from Cleveland. So he's pretty upset about the NBA finals. Go Warriors! We walked along the river, seeing little waterfalls along the way, until we made it to the two big waterfalls at the end of the hike. There we had a picnic lunch, enjoying bread with avocado, cheese and tomato. We bought the food at Mercado Central, one of my favorite places in this city. Its a 3 story indoor market that was just finished being built this January. It looks like a mall inside, very modern architecture, complete with escalators and elevators. The first floor has women selling fresh fruits and vegetables, cheese, meats, a place you can get fresh juice, bread and lots of little pastries. On the second floor you can sit down for lunch and have some typical Bolivian foods at one of the dozen little kitchens. Pico and I have lunch their every once in a while.

I borrowed this sign from Andre, who is taking pictures with it in
different places for his mom's birthday. My mom's birthday was Thursday
for those of you who didn't know. Shoutout to Patty. Love you Mom!

Here in Tarija I am rotating at a different health center each week. A week ago I was at Hospital San Juan de Dios. Tarija only has one tertiary hospital, and many health centers or primary clinics. The hospital has specialties, unlike the health centers which usually have only pediatricians, gynecologists and general physicians. I was placed with the internal medicine pulmonologist, a doctor who specializes in the health of adult's lungs. Since I had been in Hospital de Niño in La Paz, I had some expectations of what the week would be like. I assumed that I would have trouble understanding what was going on with the patients because of all of the medical terminology. I was right for some of the days. When I was following a group of doctors and students on rounds I rarely understood what was going on with the patient. However, I also spent two days rotating with the internal medicine physical therapist. For me, these days were much more engaging and interesting. She does a lot of work with patients that are in hospitalized for respiratory infections. I learned how pushing on a patient's rib cage in a certain way can help them use more of their lung capacity.

This past week I was at a rural health center called Hospital San Lorenzo. Even though it is called a hospital, it is a primary care center. It is one of the few 24 hour health centers in the area, they deliver babies and they also have a small laboratory. I spent each day in the consulting office of the gynecologist. The majority of her patients are pregnant women, many under the age of 20. Pregnant women are supposed to come monthly for prenatal check ups. The government started something called El Bono Juana Azarday, a small monetary incentive for women who go to their prenatal and postnatal check ups. I learned how to feel for the curve of the baby's back so that I knew where I should place the Dopler to listen for the fetal heart beat. Something else I saw a lot of were PAP or Papanicolaou tests. This is a test to detect pre-cancerous and cancerous cells in the cervix and women are supposed to get the test every year. In the US, it is recommended to get this test every 3 years. This difference is because the incidence of cervical cancer in Bolivia is much higher than in the US. Not many Bolivian women actually get the test every year and some forget to come and get their test results.

Hospital San Lorenzo

I started taking ceramics classes at a place here called Casa Creart. Casa Creart is a really awesome center that offers classes in pretty much all types of art— drawing, music, sculpting, mosaics, cooking and more. There are beautiful murals inside and outside of the building done by artists from all different countries. I am focusing on alfarería, or pottery that is made on a turn table. Fernanda, my teacher made it look so easy when she showed me how to work with clay on the turn table. It's not easy. I struggled a lot at first but since have made a couple pretty good pieces.

Time for Wine

Me and Hannah with the various wines 
sold at Campos de Solano

It has been quite a busy week. It was complete with two birthday celebrations, lots of wine, learning about Chagas disease, and starting a new volunteering opportunity.

I'll start with La Ruta de Vino last weekend. Hannah and I were lucky to be with a really friendly and lively group. There was our guide, Wildo, a Bolivian couple who now lives in Washington DC, and a Venezuelan couple with their 2 year old daughter. In Tarija there are both industrial wineries and artisanal wineries. We visited two of each. Our first visit was Campos de Solano, where we each enjoyed a glass of Merlot and a variety of cheese and hams. At the second stop we all had "chuflay", a cocktail made with ginger ale, Singani, and a slice of lime. Singani is a liquor distilled from grapes and is only produced in Bolivia. The last two stops were the artisanal wineries where we had some super sweet wines that I am convinced had added sugar. My favorite stop was the artisanal winery Casa Vieja. The main building there was constructed 408 years ago during colonial times. The tradition there is to try many wines as a group, but sharing wine glasses. My group and some other tourists stood in a semi circle and we passed around glass after glass taking small sips of each of the 10 variations of wine. The last woman in line had to finish the wine left over in the glass every time. It was really fun but obviously not the most hygienic activity. After the tour we said goodbye to our guide but my group stuck together for lunch where I paid way too much for a pork dish that was mostly fat. It is called Cerdo a la Cruz. They like their fatty meat here. Anyway, overall the wine tour was a success. I made friends with the couples in my group, drank some wine, and learned a lot about the wine making process.

Our ham and cheeses, bread sticks, and soon to be filled wine glasses

A selfie with Hannah and the huge fermentation tanks

The machine that filled bottles with Singani was pretty cool to watch.

My wine tour group with our chulfays in hand

One of my artsy vineyard photos

We stopped and took some photos at
this beautiful canyon. It was too windy
 to stay long.

Some of the wine bottles dressed up and
ready to party, at the artisanal
winery called Las Duelas 

The patio of Casa Vieja. It was so precious.

Hannah was first in line to try the wines. All of the glasses
 lined up to her right were passed around our circle to share.

On Sunday it was Pico's birthday. To remind you all, Pico is my host dad. We celebrated a little at his girlfriend's apartment. She made the beautiful dessert in the picture: homemade lemony ice cream with strawberries arranged decoratively on top.

In the afternoons I am now going to Spanish class every other day because I have started volunteering at EdyFu, short for Education and Future. The center supports kids living in poverty who have received little schooling, are victims of abuse or have to work to make money for their family. There is a cafeteria, a school support center and a shelter for girls in situations of physical, sexual and psychological violence. They also have a sponsor system where sponsors, mostly people in Europe, pay monthly for a child's school supplies. I have been helping kids with their homework, mostly math and language. The kids are all very caring and sweet but they also get distracted easily so its been a challenge keeping them on task. I am excited to continue volunteering there and getting to know more of the kids.

I was at a different clinic this week called Plataforma Chagas. Tarija is a high risk area for Chagas, a vector borne disease. Vector borne essentially means that it is transmitted by a bite of some kind of bug. In the case of Chagas, the vinchuca is the vector. The vinchuca often has the parasite that causes Chagas in its intestines. When a vinchuca bites a person, it also leaves feces near the site of feeding. Its feces contain the parasite, called Trypanosoma cruzi. When the person scratches the site, it allows the parasite to enters the bloodstream through small openings in the skin caused by the scratching. Chagas patients rarely show symptoms until many years after infection, when they enter the chronic phase of the disease. Over time the parasite can cause damage to the heart and digestive system. Chagas can also be transmitted from mother to child, although the risk is said to be less than 10 percent. In all high risk areas in Bolivia for Chagas, pregnant women must get tested for Chagas. If they have Chagas their babies must be tested at birth and periodically after to rule out the disease. If a baby does have Chagas however, treating them before they are a year old guarantees a cure.

At Plataforma Chagas they test people for Chagas, diagnose and treat patients. I spent one day in the lab and my other days in the consult offices of two different doctors. The treatment given to adults kills most of the parasite and is meant to stop the progression of the disease to avoid cardiac and digestive problems that can cause death. The treatment is 2 months long and often causes mild to severe side effects. For this reason, it is important that patients taking the treatment come in every couple weeks to see the doctors at the clinic. Most patients I saw either already had treatment and were coming in for their yearly check up, or were getting their test results back, and it seems like most were positive for Chagas. The doctors did many electrocardiograms, measuring the electrical activity of the heart to see how far the disease had advanced. Dr. Alejandro taught me where to put the electrodes on patients chests and how to use the machine. On the last day, I did 3 or 4 electrocardiograms on my own. Being in the clinic, I got a glimpse of how prevalent this disease is in Tarija and learned the importance of diagnosing and treating it before it advances.

If you are curious and want to learn more about Chagas, I suggest visiting this website:
http://www.infochagas.org/en/que-es

The life cycle of a vinchuca

My Spanish teacher asked me this week if I wanted to come to an event called Time for Wine, hosted by a local wine company called Aranjuez. It was 5 courses and a different wine paired with each plate. The food and the wine was delicious. I was there with my teacher Carolina, her husband, Hannah and another student Madeline who is actually also from California. I also got a haircut this week! I stopped at a random peluquería that I passed on my way home from the clinic. The day I got it cut I realized one side was significantly longer than the other so I went back the next day and she fixed it. In the end it was much shorter than I anticipated but I am loving it. Hope you guys are fans of the short hair look too.

Me with my wine and tiny little cheesecake for dessert.

One day there were various tents set up in the main Plaza like this one,
selling plants and clothes and jewelry. I liked all the labels for the plants so
 I asked the owner if I could take a photo.

Even though I am currently the only student in my program, I still managed to make friends! I met three girls through my Spanish teacher and we have hung out every once in a while over the past couple weeks. Hannah I already introduced but the other two girls, Elise and Madeline are currently staying in a cute little apartment together. Elise is Canadian and Madeline is from California but the two met in Colombia and decided to be roommates here in Tarija. On Saturday we celebrated Elise's birthday with a delicious brunch and some mimosas. He is not pictured but Moises, the owner of the tea house that we like to go to, also attended. I always love a good brunch and it was a relaxing to spend time with some new friends and get to speak English for a change... although I love practicing my Spanish too :). Later at night we continued the celebration and danced for a few hours at a discoteca called Blue Parrot.

Me, Hannah, Elise, and Madeline. Crazy but wonderful coincidence that
2 Canadians and 2 Californians all ended up in this small Bolivian city.

The food for brunch was incredible. Elise cooked a spinach and
cheese strata and potatoes. We also had a delicious fruit salad,
mimosas and some pastries. I ate way too much.

I walked through the huge Saturday market that had everything: clothes, toys,
flowers, produce, grains, and more. I bought a rose for Pico's girlfriend Nelida for
Mother's Day, which is today in Bolivia. Pico and I joined her, her daughter, son
and grandson at their apartment today for a nice lunch of paella.

¡Chau La Paz! Buenos Dias Tarija

I have just finished up my first week in Tarija, a peaceful city in the south of Bolivia famous for its wineries. On top of that the people here are notorious for how slowly and relaxed they speak, which has been great for my understanding and practicing Spanish. First, however I want to back up to my last days in La Paz.

Friday at Virgen Niña in physical therapy there were only a couple patients because there was a school wide meeting the kids had to attend in their classes. Therefore, I spent my time there hanging out with all of the physical therapy students, a few of which I had gotten really close with. For my goodbye they had made jello and bought cookies. I hate jello but I tried a little anyway. Saúl, my closest friend there, gave a little goodbye speech saying how much they had enjoyed getting to know me, were grateful for my help, and wished me the best for my time in Tarija and future career. All of the students and the main physical therapist had signed a handmade card for me and attached the center’s prayer card. I was touched and thanked them all for welcoming me, teaching me, and being patient with my Spanish. I made cards and bought chocolate for two of the students, Saúl and Jhosy, Dra. Stefanie and the physical therapist, Lila. They all made me feel so at home and I will miss them as well as the kids in the class I helped in and those that came to physical therapy frequently.

A selfie with my PT student friends on my last day

I made sure to have a salteña and api before I left Saturday afternoon. I also spent some time with Olga and put photos I printed of Alison and I and Elisa up on her fridge. Olga was a wonderful Bolivian mom. She cared for us like we were her own daughters and cooked us delicious meals during which we always had something to talk about.

Now begins my journey to Tarija. The flight is only about an hour and a half from La Paz to Tarija. I started my book by a Bolivian author, The Matter of Desire. From the airport, I was taken to my home stay, with Pico. He has another name but everyone calls him by his nickname, Pico. At his house it’s just the two of us so I have my own room and the kitchen has a beautiful skylight. He is divorced but has a girlfriend who I met on my second day here. Her name is Nélida and she is very sweet, letting me know that she’s there for whatever I need. She also has two kids and a grandson. On Sunday, Pico, Nélida and I ate at an outdoor fish market of sorts. Nélida and I shared a whole grilled fish and Pico had a his fried. These fish come from the river and are cooked fresh there at the market. They are pretty huge but so moist and delicious. ¡Muy rica! Pico has a morning routine that I have now become a part of. He makes fresh squeezed orange juice and carrot juice at breakfast time for the two of us. On my first day we went to the Saturday outdoor market to buy the fruit for the week. I have learned that Pico knows a lot of people here. He’s lived here all is his life so everywhere we go he sees someone he knows. We have been eating out for lunch this week, I think because he’s not a big fan of cooking. But I have been able to try some Bolivian dishes-- most of which are different variations of meat, egg, tomato, potato, and rice.

This guy was hard at work cooking huge fish on the grill

Nélida and I split this big guy. You have to be very careful of all of the tiny bones.

My lunch today, a Bolivian dish called Silpancho.
A beef filet served with rice, fried potatoes, salsa and an egg.

This week I was at Centro de Salud Villa Avaroa, one of the primary care clinics here in Tarija. There are many of these clinics but only one third level hospital in the city. In Bolivia there are primary, secondary and tertiary level health centers. To my understanding these categories are based on the services they offer and availability of resources and specialties. The building of the clinic is very new and nice. The facility and services available were a huge contrast to the clinic in El Alto I spent time in. I spent half my time with the pediatrician  and the other half with a gynecologist. I won't bore you all with everything I did and learned but I'll share a few things. With Dra. Estella, I learned that babies should be crawling by about 8 months and she discouraged parents from putting their baby in an "andador", or baby walker. A better alternative is to put them on their bellies to encouraging crawling. From Dra. Leyda, I learned that Bolivia requires that sex workers, or prostitutes, are required to go to their gynecologist every 15 days. Each visit they get tested for sexually transmitted infections and have to get a negative test and a doctor's signature to go back to work. If their tests are positive they receive free treatment and can't go back to working until they get a negative test result. I haven't yet researched it but I doubt we have any support like this for prostitutes in the US. Something to think about!

In the afternoons, each day of the week I have Spanish class with my wonderful teacher Carolina. The classes are one on one, tailored to my abilities, and interactive. This week we focused on subjunctive, went to the market, and explored the Archeology and Paleontology museum. Through her I connected with a Canadian college student, Hannah, who is traveling by herself. I joined her and some guys from her hostel to go salsa dancing at a nearby Irish pub one night this week. I think I deserve most improved dancer for the night. I got much better at moving my hips and shoulders to the music. Hannah was already a pretty great salsa dancer. We also booked a tour together of the famous Ruta del Vino, the wine route. We will go tomorrow morning but I will save that for my next blog post.

I loved all of the colors of the fruits at the market. We also walked through
the not so pretty meat market, but I didn't want my readers to have to see
the pig carcases and cow heads.

A replica of a Megatherium, basically a prehistoric giant sloth.
I was trying for a creative pose.

A few last remarks about Tarija. I am currently the only student in my program, so you would think it would be lonely. But honestly I have absolutely loved exploring the city, journalling in the many beautiful plazas, each with trees, fountains and different statues. I walked to one of the miradors, or viewpoints, to see the city from above. I already found a great salteña place. I tried a new food called a cuñape, one baked and one fried. Cuñapes are like tiny savory cakes made with cheese and flour. They are yummy and have a nice chewy texture. My go to wifi spot is Tetería Shadi. A cafe/tea house owned my a man named Moises who has lived in many different Latin American countries. His tetería has art and games from various countries and the menu lists probably 50 types of teas. I  took a Zumba class on my own here. The first was free but it was a blast so I will be paying to take more this month. Everywhere I go here I like to chat with store owners and waiters. Everyone has been so friendly and warm. The smaller town feel, warm weather, and tranquil environment here is pretty great.

One of the many plazas that I like to relax in.

Mirador de Loma de San Juan

The view of the city from the mirador

Cuñapes! The left is fried, the right is baked.

Casa Dorada- a famous building which has a museum that I still need to visit

A pretty mural I saw walking home today. The women are making salteñas.

There are zebras here too! I caught them in a photo shoot.

This is just a cool photo and a good representation of what
most of the streets look like, except for those in the city center 
which have many more shops and markets.

Twenty-Fun (21)

So much has happened since I last posted. I turned 21 in a foreign country, bought an alpaca sweater, saw Cholita wrestling, ate lots of humintas, biked the death road in Coroico and saw monkeys!

Here in Bolivia, May 1st is international workers day. Kids have school off and many adults have work off. So on my birthday I didn’t go to Virgen Niña or have Spanish class. I slept in, had salteñas and maracuya (passion fruit) juice for brunch and went on a nice walk to show Elisa around the city. We walked to the witches market where I bought myself a birthday gift- an alpaca fur sweater which women here sell in countless colors and patterns. We had a little celebration at home in the afternoon with Olga, Clark, his Bolivian friend Carola, Elisa and me. Carola was very sweet and gave me a Ceibo dark chocolate bar, a Bolivian brand of chocolate that I love. We enjoyed tacos with fresh guacamole and finished with quinoa cake. Everyone sang happy birthday in English and then Spanish. I was told to make 3 wishes. Right after I blew out the candle, Olga pushed my face into the cake! Elisa had warned me about this Latin American tradition but I forgot in the moment and was caught by surprise. We danced a little salsa to end the party. At night, Elisa and I went to a little pub that looked like a train inside called Diesel Nacional where I ordered a margarita. I felt like I needed to order a drink on my 21st :)

Enjoying my margarita on my 21st in my new sweater (chompa)

Last week I spent time in physical therapy and a classroom with kids with autism. I love getting to see the same kids and learning about the different physical therapy exercises for kids with cerebral palsy, autism and other disabilities. I have also befriended the PT residents and get to practice my Spanish with them each day. I attended a conference on HIV at a nearby hospital with Elisa and one of the doctors that helps run our program. I learned that the greatest number of reported HIV cases in El Alto were people ages 15 to 24. This is not surprising considering the high prevalence of adolescent pregnancies in El Alto. It is now the norm for pregnant women to get tested for HIV but there is still a huge gap in terms of testing men, who have positive tests more frequently than women in El Alto.

Api with a little pastry with cheese.
But now I prefer my api with a huminta

Elisa introduced me to one of my new favorite things to eat here: humintas. To my understanding, humintas are made of corn, cheese, butter, sugar and anise, wrapped in a corn husk and either steamed or baked. I also have been ordering api, a warm drink made from purple corn, lemon, cinnamon sugar and water. It’s the best warm night time meal. We also went and watched cholita wrestling last week. A cholita is the name for indigenous Aymaran and Quechuan women. They dress traditionally in multilayered skirts (la pollera), a shawl (la manta) and a bowler hat. Years ago, the women started a wrestling show as a feminist movement to show that they had strength and the ability to make a living without men, who were historically abusive to the cholita women. The show is all pre rehearsed and planned out. No one gets hurt even though it seemed like it would hurt to get flipped over onto the mat! The show was entertaining and the cholitas were talented actresses and wrestlers.

This weekend Elisa and I went to Coroico in the Yungas. It is located about 2-3 hours away from La Paz.  To get there, we took a packed minibus Saturday morning. We stayed at Hostel Chawi, with a beautiful garden and terrace that had a view of the mountains. We were definitely the only guests which allowed us to have the bathrooms and terrace to ourselves. For lunch we ate at Carla’s Garden Pub, popular among tourists for its cold beers, hammocks, WiFi and good food. I enjoyed my Haurni beer with honey and a savory crepe while we listened to a traveling artist from Colombia sing a Beatles' song for us. After lunch we took a bus to one of the waterfalls. Some Bolivians chose to swim in the water but we opted out, not knowing what kind of bugs or bacteria we would be exposed to. Next we explored the town a little and went on a walk to Villa Bonita, a cute little spot where we had some ice cream. We continued down the path taking in the views, seeing various butterflies, birds, beautiful vacation homes and resorts with pools. Because of its tropical climate and proximity to La Paz, Coroico is a popular vacation spot among city dwelling Bolivians. Eventually we turned back because we were confronted by an aggressive dog and didn’t want to be attacked. Elisa prefers cats so she was pretty freaked out. I was too but I had my rock in hand in case he advanced. We escaped him and walked back to town where we ate pizza for dinner at a tiny Italian restaurant. We chatted with one of the owners, Daniel, and watched the hummingbird that had made a home in the light fixture that resembled a birds nest.

Taken from our terrace. On the right is the city of Coroico.

The view from the doorway of our room

Another picture of the gorgeous view from our terrace

Part of Hostel Chawi

The cool walkway down to Carla's Garden Pub

Happy jenny because she has her beer with honey

Elisa and I in front of Cascada la Jalancha 

Villa Bonita-super cute and colorful, plus yummy ice cream

Obligatory selfie on our walk

Some friendly dogs in the sun (not the one that almost attacked us)

One of the many beautiful resorts that we saw on our walk

Day 2 in Coroico I biked down La Calle del Muerte while my guide, Victor, drove behind me. Being the only one on the tour had its perks. I went at my own pace and Victor stopped whenever I needed a rest or wanted to take a photo. I loved seeing the waterfalls on the way down. The views were nice too but were diminished by the heavy fog. I don't think I had the best type of bike for how bumpy the path was so by the end my arms and hands were screaming with pain from vibrations through the handles. Victor dropped me off at Sende Verde, a animal refuge center, where Elisa and I got a tour in Spanish. We saw tons of animals but my favorites were the capybara, the coati, the toucans and the monkeys. What was unique was that the monkeys were outside of the cages, allowed to roam free but stayed in the area for the food and companionship with the other monkeys. Meanwhile we, the humans, were in cages watching them. After an hour at the center, we took a minibus home during which I was fairly stressed due to the combined risks: darkness, fog, stick shift van, narrow roads, and sketchy drivers.

 This was taken while I sat in the main plaza, where local kids were running around
playing the night before. In the morning things were more quiet.

Ready to take on Death Road

I passed tons of waterfalls on the way down

When I finally got out of the fog and saw the view on my bike ride

Capy the capybara and her buddy Bambi the deer

This coati climbed into this man's lap!

Obviously, this is a toucan. My favorite bird :)

A tapir-- weird looking animal

A curious little howler monkey

Walking through the human cage

This weekend 3 new undergraduate students arrived from University of Georgia. Elisa and I showed them around El Mercado de las Brujas yesterday afternoon. I am in the middle of my last week here in La Paz. I am spending my mornings in Virgen Niña, splitting my time between physical therapy and the classroom. I love the kids and the staff at this center and will be sad to leave. At the same time, I am looking forward to moving to Tarija, a much smaller and warmer town in the south of Bolivia. My house mom now, Olga, is originally from Tarija and keeps telling me they have great wine.

Thank you for reading and as usual I would love to read comments and questions :)