The colourful Ps Nestor Hugo

Day 17- Nestor Hugo and the Evangelical Fair

There was very little for us to do in the hospital today after rounds. Tiffany and I sat in on the gastroenterologist's weekly sermon to the people in the waiting room. We didnt have Leticia with us and consequently have no idea what it was about.

After the sermon the hospital's pastor excitedly greeted us and beckoned us to come see his office. Ps Nestor Hugo is one of the most colourful and amusing character's I have met so far. He is a constant bubble of excitement. He does everything with 250% of his being. This is hilarious to watch! He often looks like he could explode with enthusiasm. He is a little intense, but a pleasure to be around. He is very interested in everything you have to say and is a very sweet, generous man. Nestor Hugo would be in his 60's and often dresses in one block colour. Once he came dressed in a green suit. This coupled with his unexhaustive enthusiasm made him appear very leprachaunish. Another time he dressed all in black and with his hairstyle of an era gone by looked just like an old latino Danny from Greece. 

Nestor Hugo loves to practice his english with you. This is very difficult because his pronounciation and phrasing of words often evokes giggling. Every word is spoken suddenly and loudly, he often pronounces a word 4 different ways before settling on one that he feels most comfortable with. He phrases his english very awkwardly and substitutes with spanish when he gets stressed. I appreciate his efforts and he actually is doing very well. And of course who am I to judge with such basic spanish skills but it is very amusing...
For example, one day a very stressed Nestor Hugo appeared at the door of the guest house. After greeting Leta very enthusiastically he exclaimed with despair "I have an accident in my pants!" Leta was most shocked, what was she meant to do about an "accident" in a grown man's pants. Where was she going to get a pair of men's underwear and pants from, and how was she going to help him without embarrassing him further. As she was calculating how to deal with this delicate situation Nestor Hugo began motioning to a tear in his pants- the "accident". Leta was most relieved when she realised that this man didn't need a change of underwear after all and she was only required to fetch him a needle and thread. 

If there is one thing Nestor Hugo likes more than practicing his english on you its talking about his relatives in Australia. We were dragged into his room. He generously filled our hands with lollies and biscuits and began questioning us about Australia. He dug out photos his Australian nephews and nieces, pulled a clock in the shape of Australia off the wall and made us point things out and made us test him on his pronounciation of Australian animals. Finally he asked us to tell him something he could pray for, for us. He also asked if we might pray for him. There in his office he fervently prayed for us in spanish with his 250% effort. He made Leticia write down our requests in spanish so that he could continue to pray for us. It was very kind of him and I am grateful to have such a faithful servant praying for us here in Bolivia.

That afternoon, we made our way to the Evangelical Fair. We took a trufi to Quillacolla to catch a bus that would take us to the Fair. As the Trufi bumped along the hospital's street a large  funeral procession of villagers dressed in black filled the road before us. They made their way along the road following a herse covered in flowers. They were accompanied by a brass band that played a hauntingly solemn tune. They mourned over the passing of a lady only 50 years of age. She had been in an accident and had died of easily preventable complications. It was very sad to see the tears in the men's eyes and hear the harrowing cries of the women. Stuck in a Trufi that stood in their way I felt so out of place intruding on their sorrow.

The bus ride to the city was the most thrilling Bolivian travel experience yet. The bus driver seemed to be on a mission to kill us all. He did not slow down for bumps and hit each one with enough force that we lifted off our seats. He did not slow down around corners and we were thrown form one side of the bus to the other. He nearly ripped a door off another car. Children screamed and jumped out of the way as he tore down streets in the city. We all tumbled around in the bus so much that we felt sick.

The evangelical fair was a display of churches and christian aid organisations in Cochabamba. The hospital was sending the ambulance to set up a first aid station but it still hadn't showed. The fair was at a convention centre and was a series of stalls displaying their service. It was very difficult for Tiffany and I because there was so much that required translation. It was not very exciting and we were ready to go in no time. The ambulance turned up 3 hours late. We found out that they had been in a car accident and had to take the other person involved to the hospital. We got a ride home in the back of the ambulance listening to Pablo sing love songs in spanish.

House of Love Baby Orphanage

Day 16 -Casa de Amor (House of Love)

Today we did the early morning rounds at the hospital with the assistance of an intern. Dayana took us around the hospital after the rounds and explained each patient to us slowly and clearly. This was a huge success! Finally we understood the patient's diagnosis and management.
Interns in South America are still in their final year of medicine. They work shifts for little or no pay. If you attended a private school you pay the hospital to allow you to do your internship there. They are some of the hardest working people in the hospital system and they do it for free.
Dayana is from Peru and studied in Bolivia because it is so much cheaper. When she has finished her internship she hopes to go to spain to do her specialty. She is lovely and I would really like the opportunity to get to know her better. Of course the language barrier is difficult but I feel most comfortable practicing my spanish with her.

After rounds we set out for the Casa de Amor with two interns from the hospital. Casa de Amor stands for House of Love. It is an orphanage for babies and young children. It was started by Hospitals of Hope but has since branched out on its own. It is run by a young girl from the USA. She was only 23 when she started it and it has been running for 6 years. How incredible to come to foreign country at that age and start something like this!

The house was hectic to say the least! There are approximately 20 children there from premature newborns to 3 year olds. Many of the children are multiples who's parents are unable to take care for them. Some of the children come from abusive families. One little girl is the daughter of siblings, her mother was raped by her brother. Another girl was blind because of an "accident" or infection that went untreated as a baby, she was also sexually abused by a family member. She is not even 3 years old. She was new to the house and was extremely malnourished. She is way behind in her developmental milestones and it only just learning to walk now, which is a difficult task even with the ability of sight.

The volunteers at the house are angels. There job is so demanding and stressful yet they do it with such joy. We were there for lunch time. Can you imagine feeding over 20 babies and toddlers at once? It was a marvelous mess! Many of the children develop quickly as they need to be able to function independently in this environment. Others who do not adapt so well or arrive when they are very young develop more slowly because they do not get stimulated as much as children living with parents. It was very sad to see some of the premmies left in rockers for hours just because they didnt have enough hands to hold them. We did our best to give kids the attention and love that they crave from adults. Many of the older children just long for your time and attention. We each took turns at holding the babies and hope that we made a bit of difference to the work load for the house volunteers.

When we arrived there were children on swings, children on tricycles, a set of triplets in 3 identical prams, 5 volunteers were nursing babies and more children rushed toward the entrance to greet us. It was overwhelming!
We set up the clinic and had small child after small child handed to us. We examined ears, eyes, mouths, hands and feet. We listened to hearts and lungs, felt tummies, weighed and measured and changed nappies! It was unlike any other children's clinic I had ever done before. Children's health is based around a child's observed development by parents, their family history and birth history. It is so important to have the parent there to fill in all the history details that a child cannot tell you. However, these kids have no parents. We had to do a lot of guess work.

This is such an incredible place to visit. It was very challenging. To hear about such horrific stories and consider the consequences for these little ones. We are so privelidged to have been born in a country like Australia. We are so fortunate to have a government that supports children in these circumstances. It made me question...what am I going to do with this privelidge and fortune? What are you going to do?

Dr Romer's antics

Day 15- American pop-culture has a lot to answer for

Doctors in Bolivia are not paid very much at all. Specialists may receive as little as $1000 per month. Per year that is just less than $2000US a year! This is even less than students receive on Centrelink in Australia!!! Consequently many Bolivian doctors leave Bolivia to work elsewhere. Obviously the economy is poorer here and they have more money relative to other Bolivian's. However, in comparison to the world's economy it is dismal. A year's work couldn't even buy our return tickets to Sth America!

Dr Romer is one of these doctors. He is also the medical director at Hospitals of Hope and works nights at the largest hospital in Cochabamba, Viedma Hospital. He happily shared with us this information and was interested to hear about the differences in Australia. He nearly had a heart attack when he heard what a specialist with his qualifications earns in one year; approx $250 000AUS. I felt awful! How unfair it is! It is these circumstances that lead to the phenomenon "Brain Drain" (professionals leaving their country for financal reasons). While this is a terrible situation for third world countries what alternative do they have. What are 1st world countries doing about it?
So next time you hear someone complaining about seeing a foreign doctor consider this...consider what circumstances they have come from. Rant finished! Thankyou for listening...


Today Dr Romer wanted to take us and show us Viedma Hospital. He had hoped that we would be able to see a surgery there. So we piled into his car and began the frightening journey to Viedma. Dr Romer is a 'colourful' driver, this coupled with the dangerous Bolivian roads made for a 'edge-of-your-seat' type trip to the hospital.


Dr Romer is a real character. He is one of the most warm, welcoming people we have met and he is great fun! He has a terrific sense of humour and is an incredible doctor. He seems to enjoy our company and I always look forward to anything we get to do with him. He speaks spanish and 3 other indigenous languages! However, he cannot speak english very well but is eager to learn (his 5th language! I cant even get a second one down lol). The extent of his english skills are based on video games, movies and songs. This makes for some hilarious trips!


For example, he would say when he was ready to leave " OK, Lets go!...Fight!" Lol This he had picked up from WWF. Occasionally, when the car had gone quiet he would yell "Destroy!" or start singing a BonJovi song! He shared that 10 years ago he was a big fan of BonJovi and had his haircut. Jokingly Tiff asked "Did you have the earring too?" To our dismay he replied "Yes, but mine was clip on!" Hilarious!!!
Out of nowhere he asked Leticia "Como se dice (How do you say) I am your father!" in english. A fan of star wars?? He loved madagascar and would break out every few minutes into "I like to move it, move it! I like to move it, move it!" You have to imagine all of this said very awkwardly and slowly in a spanish accent. We all had tears in our eyes we had laughed so much.


Finally he started talking about politics and saying that he wanted to "Destroy" all these minority groups. We had noted that some Bolivians can be quite racist despite the government having strong laws against racist so we couldn't tell if he was joking or not. We couldnt believe this lovely man would be so racist. He started to say "Destroy, destroy" over and over and mimed having a machine gun!! Repeating what he obviously seen in a movie. Leticia sounding horrified said "Dr Romer! You shouldn't say things like that!" But he just kept going. We looked around at eachother and started to get the giggles coz it was so random and outrageously racist. Dr Romer burst out laughing..."Haha you believed me!! What a good joke. " I have never been so relieved that someone was joking in all my life! I was starting to think we were trapped in the car with a crazy!


After an hours trip into the city centre we finally got to the hospital. Dr Romer couldn't find anyone he knew so within 15mins we left again. This is typical bolivian antics. He could have called ahead and discovered that no one was there. I think tho that he secretly just wanted to show off his english to us gringas. 
On the way home we stopped for coke at a little shop. Here we discussed how things were different here. Leticia brought up how our blonde hair gets so much attention. Dr Romer expressed how rare it was. Leticia translated how my dad had wanted me to dye my hair. Dr Romer exclaimed "Oh don't do that blonde is beautiful!" in spanish, then launched into "Pretty woman walking down the street..." Lol! We would have been wierded out if it wasn't Dr Romer.
So we were off again laughing all the way at Dr Romer's limited pop-culture english. On the way home we passed a crash and Dr Romer said "oh bad." Then blurted out "Superman!" He is so random. He sung english love songs all the way home..."Where do you go, my lovely..." we tried very hard to suppress our giggling.


For dinner Leta made real american chilli and corn bread. I love that we get to experience all these foods! I loved the chilli but had always thought corn bread would be savoury and was shocked when I found it tasted like pumpkin scones. We are effectively having a Nth American/Sth American experience here in Bolivia.

Medicine and Markets

Day 14- A busy ED and a bustling market
Today Leta tried to come and help Leticia translate morning rounds at the hospital. It didnt really work. The doctors mumble and speak too fast when they present. I always think that if they were marking someone on their presentation and did it like they did they would get a big fat fail! Its frustrating as it really inhibits how much we can get involved.

ED was very interesting today. At home Mondays are always the busiest as everyone rushes in after a weekend of being unwell. Apparently, this phenomenon is universal. The ED was full of patients when we arrived. 
Our first patient was an elderly quechuan woman. The quechua people are one of indigenous people groups of this area. They speak their own language that is entirely different to spanish. Luckily many medical professionals in this area are taught quechua. Many people in this area may also be part quechuan and have basic understanding of their language and culture passed down from family members. This old woman was delirious and crying out for her mother in her native tongue. She was very distressed and was kicking and punching doctors. In no time it was found that she had a very low blood sugar and this was amended. With an infusion of glucose the transformation was instantaneous and she settled and calmly fell asleep.

Our next patient was a 3 year old boy who had recently had an operation to seperate his fused fingers. He was presenting for redressing. Due to his age a simple procedure like this requires sedation. A 3 year old is not going to let you anywhere near his sore hands. The boy was given ketamine and was lulled into an an awake stupor. It is used mostly in kids as it is safe and easy to use for light sedation in these minor type procedures. It has also been the object of abuse. It can give you some very interesting hallucinations. While the drug is acting kids are pain-free and unaware of what is happening but they're eyes can be open and they appear to be awake. Its wierd!

We also saw a sigmoidoscopy be performed on a man with an obstruction post a bowel operation. This is not an appropriate platform  from which to explain what this procedure entails. This man was in a tremendous amount of pain and discomfort. This was very unsettling to watch. In Australia, the patient's comfort is always a priority. Here not so much so; time, resources and cost all make pain management slightly lower on the scale. I had to leave the room as it was too difficult to see the man in this pain and literally made me feel sick. Leticia who has not had much exposure to medical procedures and this is certainly was not a good place to start. He had terrible scarring and what seemed like a prolapse and the nature of this procedure means that there is poop everywhere. This poor girls initiation to the world of medicine was quite shocking and left her feeling nauseous and looking green!

Today Tiffany and I  went to the market in Vinto with Leta to buy fresh fruit and vegetables. The market is made of many men and woman clambering over eachother to sell you their fresh produce. Sometimes they may have mounds of tomatoes, potatoes, oranges etc. Others may have a small selection that is the produce of a tiny veggie patch. It was so interesting to see all the produce and the way it is sold. Cereals, pastas, flour, sugar, spices etc are sold from big sacks.
It is set out on a large plot of rocky dirt. Ladies from Anocaraire had beautiful flowers laid out on the ground. The market is surrounded by rubbish that has been discarded without a thought. Sheep graze in the nearby mounds of rubbish. Stands selling the hats worn by the women in traditional dress are situated next to a young girl selling chicks from a crowded box of fluffy, chirping, scrambling babies. Tiff very nearly bought one of these extremely unflattering hats in the endeavour to embrace the culture. I wanted a chick but didnt know how Australian customs would feel about that.

When we got home we went about the fruit and veg disinfecting process that follows every visit to the market. That night I cooked curry. So good to have some food that I would normally have at home. The girls really enjoyed it too. Has been nice here having someone cook for you but I miss cooking too.
While I have been blogging I found this blog that is a cooking blog for 20-somethings...seemed pretty cool. For anyone who is interested here's the link...http://www.biggirlssmallkitchen.com/

Thoughtful Strangers

I am so grateful for the kindness of strangers. The many people who thoughtfully warned us about protecting our bags and cameras in the crowd. The kindness of those who stop us when we are lost and set us safely back on the correct path. The man who leant us his phone and translated for us when we were struggling with the language barrier and were pressured by the clock. The lovely lady who saw us standing confused and distressed in a crowd of angry people and translated for us putting our minds at rest. These people are God's answer to our prayers. They are a reminder that he is watching over us and has many faithful servants to keep us safe. How blessed we are to have such an almighty travel companion guiding us along the true path.

Spanish Sunday

Day 13- Hillsong en espanol

Many of the staff at the hospital are christians. The other girls have had the job of politely accepting invitations to all the churches. It seems everyone wants to show off their gringa friends to their congregation. Today we went to one of the doctor's churches. This church was really close by. It was in Vinto, the rural suburb on the outskirts of the city that hospital was in.

The doctor had arranged for the ambulance guys to pick us up and drop us at church. At 930am we were prematurely ready and eagerly awaiting our 'emergency' lift. At 1030am we were still waiting. We decided to opt for the reliable transport via Trufi and started the 20min journey to the church (it was lucky that we were so close).
Despite being an hour late when we arrived we were greeted by ushers at the door. Bolivian time is an unusual concept. Basically you arrive to things at your earliest convenience, even if that isn't so early and even if people are waiting to meet you. So today we fit right in!

The church was huge. It was much like calvary in style. The church was pastored by an American couple who had been in Bolivia 28 years! The praise and worship was just wrapping up when we arrived. For the next hour the congregation prayed for different parts of the city and individuals who were leaving the city or leaving for missions. It was nice to be a part of this prayer...but made for a very long service. Bolivians apparently only do church long lol. More praise and worship followed which was almost all HILLSONG! Then finally the sermon. This is a great chance to practice spanish. The girls translate the sermon for us but we also can work on piecing bits together ourselves. Christianese is a whole new language in itself when you translate the terms to spanish!

Hillsong is huge over here! We are always proudly declaring "these guys are Australian!". I think its amazing that one of Australia's most successful exports is almost totally unheard of by the general population. Tiff and I were completely puzzled as to why the songs were in Spanish but sounded just like the guys from Hillsong. We discovered they they have all learnt how to sing the songs in espanol! This is a massive feat because so much of spanish is how you pronounce vowels. You have to learn pronunciation of every word, you cant just read it off the paper with a mexican accent lol. Additionally they have to change words of the songs slightly so that it translates correctly. 
Check out dios puede salvar which literally translates as god can save (mighty to save) dubbed in spanish by reuben morgan... http://www.youtube.com/watch?v=sbCoWYAMbkY&feature=related

You can even buy these at their website. Tiff has already bought and downloaded one.

That night we had one of the staff members from the hospital stay with us. She was doing a surprise visit to the hospital and ambulance service to ensure everyone on shift was awake and active. It was really nice to have some Bolivian company in our home. She spoke very slowly to us which made her easier to understand. She filled us in on some Bolivian geography and culture. We laughed over the difference in culture between, north america, sth america and australia. Helen was also amused by our accents.

La Concha & Kid Washing : )

Day 12- Saturday shopping & Washing

Whenever we go anywhere we must take a Trufi to Quillacollo, the bustling suburb nearest to Vinto. Here we can catch Trufi, Bus or Taxi into the city. Quillacollo's busy centre surrounds a park. On one side street venders sell peeled oranges, hotdogs, traditional bolivian dishes, nuts, toys, remote controls...you name it! The venders children play in the gutters filled with rubbish by the stalls. Baby's lie sleeping in the wheelbarrows of oranges. Young street boys help the trufi drivers in exchange for one boliviano by shouting advertisements of route's and available seats. On the other side is a busy market of fresh fruit and vegetables piled into great big sacks. The women selling the produce shout their best prices and shove the best of their produce in your path. 

This morning the park was full of the Bolivian military. In Bolivia, the police additionally are part of the military. They carry great big guns! Some are younger than me I am sure and there are a surprising number of women in the military here. They seemed to be fishing for recruitments and had a number of displays set up at the base of the statue of Bolivia's historical saviour Bolivar.


We piled onto a bus headed for the city. Half way through a journey a man jumped onto the bus in traditional costume and began serenading us with the mini guitar and pan flutes. He played with great enthusiasm and energy traditional Bolivian music. When he finished everyone on the bus clapped, the man took a collection, then jumped off the bus and went in search of his next audience. 

Some of Tiffany's La Concha Purchases

The bus weaved through smaller and smaller streets and the city began to rise around us. Many streets were so narrow that the bus only just evaded scraping along buildings and collecting parked cars. Eventually more light began to break through the canopy of buildings and the street broadened and opened out onto a expansive market- La Concha. 

La Concha is the biggest open air market in Cochabamba. It is busy with sights and sounds. Everything imaginable is for sale here at ridiculous prices. One US dollar is equal to 7 bolivianos. One long aisle is filled with tiny cubbyhole shops selling beautiful traditional fabrics, carved instruments, delicately detailed bags and journals. Another aisle is filled with fresh produce, grains and cereals. All over you can buy cheap clothing displayed by some of the most horrifying manequins I have ever seen. These dummys belong in a horror film. Each one is more frightening than the next. We stopped at a tiny cafe amidst all the stalls for a refreshing drink. Four gringas attracted the attention of a number of venders who would not take no for an answer. A young boy appeared at our side begging for food. We made a habit of taking food to give to beggars we encountered along our travels. Many crippled elderly and children wandered the market begging for money and food. It is overwhelming to see such suffering! You want to empty your pockets and give them everything you have but then what will you do for the next one, and the person after that and that little girl?



Hot and bothered after traipsing through countless aisles of clothing, toys, dvds and other assorted items...including a tarantula; we decided to retire to a nearby coffee shop. It was so sweet to have a clean, delicious coffee in the quiet cafe.

 

Our next stop was Cochabamba's main town square. The square is a beautiful park, an oasis in the dirty, bleak city. The park is filled with the purple flowering jacarandas. The garden beds adorned by blooming flowers and the cities seemingly only functioning water fountain creates the calming sound of flowing water. Elderly couples sit on the park benches reading the paper and having their shoes shined. Mum's try and organise their excited, squealing children. The park itself is surrounded by nineteenth century buildings that are supported by pillars, forming arched arcades.
This park was the setting for the afternoon's kid washing...yes kid washing.

Each Saturday afternoon the christian aid organisations join forces to complete one of the most difficult missions known to man...kid washing! Street children gather in the park ready to have their hair washed and to receive a new set of clothes. Warm clean water is trucked in and tents are set up for bathing stations. Children 8 years and under are bathed and the older kids just have their hair washed. Prepared for battles we armed ourselves with soap, shampoo and towels. However, these kids new the drill and within 30mins we had washed about 50 children. They sat patiently as we soaped, scrubbed, rinsed and dried. Dry and in a fresh set of clothes they were chattier and happier than ever. Little girls came in every direction to have you brush and style their hair and a little boy quietly sneaked onto my lap as I tended to his sister tangled matt of hair. 
This has been the highlight of my trip so far. So many beautiful kids stuck in terrible circumstances they cant control yet they giggle and play as if they don't have a care in the world. It was very humbling to be serving these kids in such a simple way. You often feel helpless when faced with poverty and homelessness. However, this was on simple act we could do that made these little kids lives just a bit more bearable.

Salpancho

 After kid washing we headed to a well-loved Bolivian franchise known as Dumbo's. There we ate our fill of Bolivian dishes-Salpancho and Pique Macho. Bolivian food is a truck drivers dream! Mostly deep fried and covered in gravy. Salpancho is an odd layering of rice, meat pattie, salsa and an egg. It is not my favourite to say the least! 

On the way to the restaurant, we passed a mother sitting on the footpath flanked by two sleeping toddlers and cradling a baby in her arms. She was begging for money...Here I was on my way to have a great big feed at a restaurant and she couldn't feed her three little ones. Ah back to feeling helpless and hypocritical!