Blog #2: Our First Week in the Hospital

Buenos Tardes. This is going to be a short post as we are just about to get on a bus to travel to Torotoro National Park in a few minutes. Furthermore, this post will be written in much less literary splendor than Jude's previous one, so please lower your expectations before reading on.

Our first week in the city has been absolutely amazing. The weather continues to live up to its expectations, and I feel that we have successfully learned how to take advantages of some of what Cochabamba has to offer including restaurants, markets, nightlife, etc. We have now spent four days shadowing different physicians at Hospital Viedma, and all of us are having a blast.

I have spent most of my time with a pediatric endocrinologist named Doctora Rodriguez in part because she is fluent in English. The patient population that Dra. Rodriquez has seen in just four days has made my hospital experience so far very exciting. Iodine deficiency is very common in Bolivia, so hypothyroidism has been a very common finding. Furthermore, I have gotten some exposure to patients with Grave's disease, metabolic acidosis due to Coca leaf tea (an unfortunately common folk remedy for babies with diarrhea), and congenital adrenal hyperplasia due to an enzyme deficiency. I have come to realize that the doctors here rely a lot more on physical diagnosis tests, as the laboratory diagnostic testing is not quite available to the level that we have it in the states.

I have spent my remaining time with a 5th year medical student, which are what everyone calls interns here in Bolivia. Vladimir is an intern currently rotating on the pediatric internal medicine ward, the pediatric emergency department, and the neonatology ward. Currently Vlady is just about to finish up a 36 hour shift at the hospital. These long hour shifts are the norm for the interns, and I was shocked to learn that he sometimes will only have a few 15 minute breaks while working these long hours. Vladimir is also covering for one of his buddies 36 hour shifts this weekend, which means that he will be working another 36 hour shift after he gets 2-3 hours of rest in between. I am very glad that medical school in the U.S. is not quite this intense. It has also been very exciting following Vladimir around the hospital, and I have gotten to see many devastatingly sick babies with diseases such as dengue fever, HIV, and whooping cough.

Jude has spent the week with Dr. Romero, a plastic surgeon who works in the Children's burn clinic. She has seen many different surgeries so far, and I'm sure she will blog about her experiences very soon. This week was Kiandra's first experience watching a surgery, and has now been exposed to several types including an orthopedic surgery, a hysterectomy, and cesarian section. Alix P. has spent most of her time on the OB wards, witnessing several births and surgeries as well.

We will be sure to update the blog with our experiences at Torotoro National Park after this weekend. Take care and thanks for stopping by.

Alex W.

Blog #1: Arrival in Cochabamba

I am happy to create the first entry for our group of 4 as we embark on our much anticipated rotation here in Cochabamba, Bolivia.  Having been here for all of 8 hours (2 of which were just spent on a post lunch siesta, a wonderful Bolivian tradition) this entry is more a tale of our journey from Charleston, SC to Cochabamba, a snapshot of my first impressions towards the experience, and the recent development of a new language I call Spitanglish.

I'll start out by saying that these past two weeks have been a sheer whirlwind of activity.  Preparing for this trip in the midst of studying for our last exams as first year medical students at MUSC has been a test, and truthfully everything didn't come together until the day before our departure.  It certainly wouldn't have been possible without the guidance of our trips predecessors, Matt, Colin, and Meg.  Luckily, we did get it together.  And made our plane to Cochabamba..... barely.

Our trip began with a 10 hour drive from Charleston to Miami, where we were greeted with the warm hospitality of one of my dearest friends of many years, Alex Fulton (yes, a third Alex).  Alex F. drove us all over Miami, ensuring that we all made it to our flights on time.  Our experience in Miami is for another day, but I would like to highlight what happened when Alex W. and I were dropped off for our flight.

Coming off of a high from the fun times and mojitos we had had in Miami, Alex and I felt like we were on top of the world.  We had made it to the airport.  We were about to check our fancy new backpacking packs.  Nothing could stop us, and we were home free to passively sit on our non-stop red eye flight and let the airplane gods magically transport us to our destination while we reveled in what awesome travelers we are.  Obviously, this is not what happened.

We approached the kiosk and the smirky airline guy asked for our paperwork.  I handed it all over, very proud of myself for keeping all of it straight in a green binder that I kept in my carry on.

"Um, excuse me, miss but where is your 4x4 photo?"

"er.... what are you talking about? My passport? Or, one of the 10 photocopies I printed off of my passport?"

"No... its for your VISA??  I can't let you on this plane without it.  You see?"

And then he had me get back behind his little podium and look at his computer screen, where there blinking at me was "required: 4x4 printed passport photo".  We definitely didn't have it, and following this heart dropping discovery ensued a flurry of Alex and I pleading and trying to compromise with this man and his supervisor, and coming to grips with the fact that without these pictures we were doomed.

The supervisor scribbled down the address of the closest Wallgreens and said,

"Yeah, you have a half hour till we can't let you on this plane.  You gotta get a taxi and try to get these passport photos."

In disbelief and anger that we actually had to do this, but scared to death knowing that we had to leave right in that moment to try to salvage what little hope there was for us to make our flight, we sprinted away from the kiosk with our bags flailing around us, stuffed ourselves into a cab, and I THINK we said this to the driver:

"Quick!  To the nearest Wallgreens, and make haste, for time is of the essence!!!"

Anyway, at that point there was nothing else we could do but hope this Wallgreen's wasn't in the middle of nowhere.  Alex and I tried to calm down, but our sympathetic nervous systems were firing with a fury I had never known before.

When we got to the Wallgreen's, somehow luck shined upon us and we were immediately helped by the most gentile woman I have ever met.  She took both our pictures with a knowing smile (obviously we weren't the first frantic 20-somethings to need passport photos at 10 pm) and then made fun of mine for how bad my hair looked.  In fact, she didn't even charge us for that picture because it was so terrible.

Our faithful cab driver was outside Wallgreen's with the meter running, and he drove us back to the airport.  We didn't yet know our fate... we were arriving for round 2 at the kiosk but 45 minutes early for our international flight.

And we made it.

The photos that almost cost Alex W. and I our trip to Bolivia.   Don't be fooled by those smiles.  We were freaking out.

After that, it was pretty smooth sailing.  When we got to La Paz at 5 AM and went through immigration, Alex W. actually lost the passport photo we had spent all that ridiculous stress getting.  To which the immigration officer responded, "Oh its ok.  You don't need that" (thanks American Airlines).  Moral of the story for future MS4BCIers: get the passport photo.  Even if just in case.

The La Paz airport is the highest altitude airport in the world, at over 13,000 ft.  We were warned repeatedly of altitude sickness.  Alix, Kiandra, and I were fine, but at one point Alex W.  looked over at me and said 

"Hey, do you feel ok?  I feel sweaty and sick and like I'm going to pass out."

I quickly used my Spitanglish to ask the flight attendant for coca tea and water, and Alex W. felt a lot better.  So yeah, altitude sickness is no joke.

Mountain visible on the plane from La Paz to Cochabamba.

When our flight from La Paz to Cochabamba landed, Alix, Alex, Kiandra and I were greeted by two of our contacts, Barb and Dean.  They picked us up in their white 1974 defender.  Alex climbed on the roof of the car to hoist all of our bags on top.

Barb and Dean immediately began to tell us about the extremely high tensions and political unrest we had just walked into in Bolivia.  I'm still not 100% sure exactly whats going on, but basically the government cut pensions for most of the people in the city.  Here is a short article I found highlighting the problem:

http://www.usatoday.com/story/news/world/2013/05/16/bolivias-morales-protests/2192637/

They told us that things hadn't been this bad in Bolivia since the water privatization fiasco of the early 2000s.  If you are curious about that, here is a good article.  This event basically set the political landscape seen in Bolivia today.  

http://www.citizen.org/documents/Bolivia_(PDF).PDF

We have yet to see any protests in the streets, and Barb and Dean ensured us that by simply avoiding any street blockades we will be perfectly fine.  I'm sure we will continue to blog about this issue as time goes on.

Since our arrival yesterday, we have been able to check out the city a bit and today took a taxi to Laguna Argostura, which is about 30 minutes away.  I would rank this lake as one of the top 10 weirdest places I have ever been... but it was really pretty, and we had a great time.  We are hypothesizing that the lake was created by a manmade dam that you can walk across.  I quickly nicknamed that bridge, "The Bridge of 1000 Wasps".  It weirdly had tons of wasps that were swarming around us as we crossed.  I think it was Kiandra's favorite thing, and I have a feeling she will be returning many times to walk across that bridge.

The Bridge of 1000 Wasps, as seen from our boat.

A strange pirate ship yard jutting into Laguna Argostura.

We walked around the lake along this abandoned railroad track, and took a 20 minute boat ride on the water.  After that, we ate dinner in a restaurant with a beautiful view of the lake.  My meal was called "Pique Macho" or something of the sort, and all I knew was that it had beef.  Lucky for me, it had beef, filleted hotdogs, onions, and french fries all in a great big pile... it was more than I could have hoped for.

Alex W. enjoying a fine cerveza on the Laguna.

Our living situation is wonderful, as our host mother, Juana, is the sweetest woman alive.  She speaks no English, and I have been barely getting by communicating with her in Spitanglish.  She has already made us numerous delicious comidas Bolivianas tradicionales, including empanadas, chicken soup, and Api, a yogurt-esque breakfast drink made from purple corn.  I am really looking forward to getting to know her better the rest of this trip.

View of Cochabamba from the apartment.

We are by no means roughing it here in Cochabamba.  We are staying in a very nice apartment, with hot water and comfy beds, and obviously, internet.  Cochabamba itself is a beautiful city at around 8000 ft, and it sits within a valley giving it a mild climate (its nickname is the "City of Eternal Spring") and great landscape.  In fact, it sort of reminds me of the landscape of Boulder, CO. At the street level, there is pollution, lots of stray dogs, and definitely a dichotomy of extreme poverty and wealth, as one sees in many South American cities.

Tomorrow is our first day in the hospital, and I think we are all very excited.  Our next blog updates will surely include more of the medical aspect of the trip.

Judy

Beautiful view of Cochabamba.

Rotation Number 1, Summer 2013

We've just had our farewells for our first rotation of four students from MUSC going down to Cochabamba to work at Hospital Viedma.  They are well prepared to have a meaningful and productive experience in Bolivia, sharpening their clinical skills, learning about global health issues specific to Bolivia, and embracing a new culture.  Check back here regularly for more updates from the team as they experience it.  For now, a few introductions:

My name is Judy Staub from Wilmington, NC and I am a rising second year medical student at MUSC. I got my BS in Biology from UNC in 2010. I'm a snowboarding fanatic, a lover of the outdoors, and travel as much as possible. Although I have no idea what kind of doctor I want to be, I hope to incorporate global health and wilderness medicine into whatever I do.

My name is Kiandra Scott and I am from Charleston, SC. My hobbies include dancing and singing. I attended Clemson University with a degree in Microbiology/Biomedicine. In the future I hope to work in global health as a pediatric cardiologist or cardiothoracic surgeon.

My name is Alix Pommerenke and I am a rising second year medical student from Greenville, SC. I graduated with a degree in Biological Science from Clemson University in 2010. During my time off before med school I did some volunteer work in Nairobi, Kenya and worked as a research coordinator in Charleston, SC. Some of my interests include hiking, reading, traveling and spending time with friends and family.

My name is Alex Wharton and I graduated from Clemson University in 2012 with a degree in biochemistry. As of right now I am most interested in pursuing a career in surgery. In my spare time I enjoy playing golf, tennis, squash, soccer, and guitar. I am really looking forward to expanding my understanding of a different culture this summer in Bolivia.