2007 Bolivian Mission Journal

February 14, 2007

We begin another year on Valentine’s Day. This is always the longest day of the mission. I finished a few last minute tasks and left for the airport at about 11:30 AM. I will arrive in Montero, Bolivia about midday tomorrow. A full 24 hours of travel.

I am excited about this year’s mission. There are several new faces, and their excitement always gets me in the right spirit. Letty Power and her daughter, Rachel, are fluent in Spanish. Letty was raised in Mexico and Rachel spent last year in Chile as a Rotary exchange student. They are presently planning the Taco Dinner which will be held at the recreation park on March 2nd. That is our last fundraiser for this fiscal year. When we get back we will begin fundraising again for next year. Both Rachel and her mother are very excited to go to Montero, but they don’t arrive until April. Accompanying them will be three other students, Josh Hendricks, who has been on the mission three times before, Katelin Cochran-Smith and J. T. Schandolph from Scaly Mountain. This is J. T.’s first trip out of the country. Our special member in the last group is Linsey Wisdom of The Highlander Newspaper who will be doing several stories about the mission for the paper.

Fred and Martha Rodenbeck have become regulars on the mission. Fred does his dental work and teaches dentistry at several schools in Santa Cruz. Martha works from dawn to midnight doing her evangelical skits which have become famous in Montero. Her helpers will be Mary Yoder and Eugenia Green. Eugenia is a native Spanish speaker also, and has been invaluable to our mission over the years. This is her 9th trip with the group. Mary is Polish and survived both the Nazis and the Russian invasion. She enjoys speaking Polish with several of the nuns at the girl’s orphanage who came from Poland during the Soviet rule when freedom of religion was stifled.

Nancy and Michelle Main will return for the second time after a lapse of several years. Their job will be the setting up of a microfinance project involving several of the groups we have worked with before, a church, Dios Es Amor, and the Etta Turner Center. This project will teach women to develop a business plan and a budget to enable them to borrow small sums of money, e.g. $100. This will be paid back over a period of time and that money can be loaned to other women. A small loan of this nature can transform a woman from an employee, earning less than $1 a day to an independent business person making her own decisions and keeping the money she earns. Many of these women will be able to afford to buy the fruits and vegetables they sell, or buy a sewing machine and fabric to make clothes or accessories. If they can earn one or two dollars a day, they will be successful in this country where an average family lives on $300 a year.

Joanna, my wife will join me with Steve Hott, our master builder, and Wayne Clark, who works three jobs to be able to spend his vacation in Bolivia. I love this kind of dedication.
Joanna couldn’t come with me due to unfinished work on the Playhouse Trip and delay in finding a place for the Antique Show, a big fundraiser for the Highlands Playhouse, to be held in September. I look forward to her arrival.

Twelve students will join us again from the Honors College at the University of Mississippi. They will experience the hospitals, the foster home and building houses. It is always fun to interact with these smart, energetic young people. This is the third year this group has joined us. One of the graduates from this group will be coming from Harvard Medical School where he received a scholarship last year. I hope his experience in Bolivia was influential in his receiving that scholarship. His advisor is Paul Farmer, MD who is quite well known for his mission work in Haiti and Africa.

Work details this year will involve the groups in finishing the second foster home for the older boys, 12 and older, the prison ministry, our evangelical work, building houses, medical and dental clinics, work in the hospitals, and the microfinance project. I am going early to help the Rotary Club distribute the 280 wheelchairs we sent to the area last month through a worldwide Rotary program. I will be joined by a group of Rotarians from Washington State. The date for beginning to distribute the chairs is February 24, but there needs to be a lot of work done to determine who gets a chair before that date. Everyone who donated $100 to the Wheel Chair Foundation will get a photo of their recipient receiving their chair. These chairs were made in China and are specially made for dirt roads. There has been so much rain this year that they need to be able to float.

I am especially interested in seeing how the new government, the president is the first indigenous Indian to hold that position, affects our mission. Our goals are the same, to help the poor and disaffected. If he can get rid of some of the graft that has made governing practically impossible in the past, he will be seen as successful. Unfortunately, he is a friend of Hugo Chavez and Fidel Castro and has made many un-American remarks that make a few of us a bit uneasy. There has always been an enmity between the lowland people of the tropics and the mountain folk. In the past all the commerce was done in the mountains. The tropics were mostly uninhabitable due to malaria and other diseases. Now, with improvements in mosquito control, the tropics control the commerce and the flow of money. Unfortunately, the taxes still flow to the mountains, and the money doesn’t come back. To those of us who live in Highlands and Cashiers, this is a familiar story. Evo Morales, the president, is from the mountains, and he recently sent a governor to Santa Cruz, the largest tropical province, who is from a mountain tribe. This was not well received. I pray there will be peace.

This is a busy schedule, and new projects always attract our attention, and sometimes make us shift our attention and funds to other areas. That is the challenge and the joy of this mission. I hope to be able to tell you in the daily journal about our successes, and with God’s help, I will.

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Friday, February 16, 2007

As expected, the longest day was just that. I spent the morning unpacking and putting my computer and other electronic equipment together. I keep a printer and a transformer here in a big box with work gloves and sun hats and other things we have accumulated over the years. The Pinocho, our hotel, is kind to store this for me. Next, I set out to get new cell phone cards and a new chip. The chips that control the phone number and the account need to be changed if they are not used over a six month period. Obviously, we can’t use the same one year after year. That cost about $35 for the two phones that the group will use this year. I went to the supermarket to buy some batteries and lunch meat for the meals that will not be supplied by the Hotel Pinocho. When larger groups come, they will furnish lunch and dinner. In the meantime, I will have to make due. I really don’t mind having just a sandwich for lunch considering all the food I get when I am invited to friends homes for dinner and occasionally lunch.

I ate lunch at the home of Dr. Patzi. He is one of my best friends here. Every day, the whole family has lunch together. There are two daughters and their husbands, including one grandchild, and their son, his wife and their two children. It is also the grandson’s birthday, and two cakes have been bought by mistake. One was eaten after lunch and the other will be used for his party in the evening, after the Rotary meeting tonight. A typical meal includes soup, and then a main course, usually chicken, beef or both. There are several vegetable side dishes to complete the meal and then the dessert. Everyone seems to be so happy to be together. I am sure there would be less peace if the family didn’t get along, but I think the togetherness shown here in Bolivia is now missing in the United States. When I was young, my whole family lived within a one hour’s drive from one another. Now all my relatives live in Colorado, California, Tennessee, or Arkansas. We almost never see one another, even on Christmas or Thanksgiving when we used to always be together. Here the family is very important and I will give an example of how this works later in today’s message.

After lunch I went down the street to see the home of Jamie Weathers who is adopting two children from the foster home. She has spent two years doing this and today she finalized the adoption, and now must begin the visa process. That will take another three months. She had to become a Bolivian resident to complete the adoption, thus the four room house she rents for $180 a month. This is actually a quite large house for a single family. There is a patio, a kitchen, a living room and two bedrooms, plus a bathroom.
She gave me something to eat as she is becoming very Bolivian. You need to offer something to eat or drink to everyone who visits. After Jamie’s house I went to the house of Herman who also lives within a block of Dr. Patzi. As it was raining hard, I drove to each of these houses. It has been raining for the past two months and the water has no where to go.

Herman is just recovering from dengue fever, a mosquito borne viral disease that can be very serious, especially in people who are not very healthy initially. Herman is the richest man I know in Bolivia and he is healthy. He was very ill requiring IV’s and bed rest for four days. He looks to be on the mend today, and he will try to come to Rotary tonight. There is really no treatment for this malady and, unfortunately, no vaccine. Perhaps, if this disease were common in the US one might be developed. I was brought a plate of cake, and offered a drink. I took water, with ice. The water was bottled but the ice was made from water from the faucet. Oh, well! Maybe I am getting used to the water after all these years. Still, one needs to be careful.

I returned to the room at the Pinocho and read and rested a bit before the meeting tonight. The meeting was held at the home of Dr. Plata who is the gynecologist and does the prison clinic every Saturday morning. After our stories in the newspaper this past summer two people donated $500 to pay for a year’s worth of medicines for the jail. Now the doctor can buy more medicines or make the funds last for two years. We are the only support the jail has, receiving no money from the government for medical care. The Rotary Club has a huge covered area and this is being used for constructing the floats for Carnival that begins tomorrow. Thus, the meeting is being held at the future Rotary president’s home. The dinner was similar to the lunch with a different kind of soup and chicken for the main course, followed by cake for dessert again. Many of the Etta Turner volunteers, including an uncle of Etta, and Etta’s mother were in attendance as were some of the Rotarians from the Washington (state) club. They are involved with the wheel chair project that will commence next week. I will explain about the Etta Turner Center later.

Following the meeting I went to the birthday party of Dr. Patzi’s son, Jorge. It was 10PM and the party was just beginning. I had a few glasses of beer with my friends and left before the food was served, most likely at 11:30, having had a long day and eaten enough for one day. There were many children there who would not sleep until after midnight. This is common in Latin America. I slept well.

Today I went to the Etta Turner Project. Etta, as you know if you have read this journal before, was an exchange student who was killed in a bus accident when the exchange students went on a tour of the area around Potosi in the southern mountains of Bolivia. Her mother, with the help of several Rotary Clubs in the US, turned a tragedy into a wonderful project that feeds children and teaches their families how to cook healthy and inexpensive  meals and also gives classes in labor skills. Today several of the workers would spend the morning at a family complex teaching the families how to cook Soya beans into several different inexpensive and healthy dishes. We drove to the house, only a few blocks away in the rain and mud. Fearing we would get stuck in the muddy road, we parked and walked through the mud, finally arriving at the home. The complex had four bedrooms, one each for the four relatives living there, all having their own cooking range and a refrigerator and two beds for an average of five persons. There was a larger kitchen outside covered by corrugated metal sheets. This was where the cooking demonstration took place. The rain was coming down in various degrees from a hard rain to a light drizzle, and the dirt floor in the kitchen was turning into mud with all the human activity. A twelve year old girl was the most attentive student, and actually earned enough money selling tortillas she made to buy a blender for her mother. We cooked the Soya beans in boiling water twice, throwing out the water, but, after that, nothing would be wasted even the water used to boil the beans. We made a paste from the beans, using the blender and the water from the last water bath. We squeezed the water out of the paste using a towel and that liquid would be used to make jell-o, a Soya drink, and a milk substitute. The paste would be mixed with vegetables and made into vegetable “hamburgers.” At the same time, other Soya beans were boiling with vegetables to make soup. Chicken parts were added, none of which we would eat. The legs and heads were the only parts I could recognize. The claws and the beak were cut off by the 12 year old girl and those were the only parts discarded, although I suspect the dog would eat those. They complained that the food prices were up significantly due to the rain. Farmers cannot get the goods to market even if they can be harvested. Before we could be invited to lunch and not wanting to be inconsiderate, Mort, a Rotarian from Washington, and I left to go to the market, the mercado. The mercado was not very busy, although there seemed to be plenty of fruits and vegetables available. They were probably too expensive for the average person to buy. I wanted to buy some boots as the ones I have only cover the shoes, and the water and mud is much deeper than that today.

I went to the foster home with great difficulty getting there even with four wheel drive. Something has to be done to this road. We spent many hours of back breaking work fixing this road last year. The small drainage canal that runs along the foster home road is nearly at the top of its banks and I was told that it has been over the banks at times. I had to park far from the home and walk through ankle deep water to get to the home. The boys were eating lunch and were a bit subdued. I saw them last night so my visit was not a surprise. With difficulty I made it to the carpentry shop where business is poor due to the price of the wood and the scarcity of this commodity. Only two of the workers from last year are still there, but there is a full group of workers. The cook at the home has not been able to get to work for nearly two months. That is bad for Irma, the house mother, who now has to cook in addition to her other duties, and the cook, who is not earning any money. The garden is a lake and weeds are everywhere. There will be no crops for the boys to eat. The farm is a source of food, and a learning experience for the boys. There is no playing outside and that is probably the reason the boys are down. They did sing a few songs to us and then we left to eat lunch and rest. The rain is really causing a lot of trouble with disease and economically. I don’t know what will happen if it continues.

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Sunday, February 18, 2007

The rain has continued here as it has since December. In all the ten years I have come to this place during the rainy season, I have never seen anything like this. I made it out to the foster home two days ago and it is a microcosm of the problems that affect the whole area. The road which was bad last year was nearly impassable. The drainage creek was nearly at the level of the road, and I was told it has been over the road at times. Normally this is a dirty sewage ditch with hardly a flow of water even when it rains. On approaching the foster home compound, the normally well maintained farm was in weeds and even the hardy yucca plants had died. I could not go to the new house for the older boys due to the water that covered the garden that occupies three quarters of the grounds. Normally they would be harvesting corn, beans, tomatoes, potatoes and yucca at this time. Not only are they not in harvest, but there is little likelihood that a new crop will be planted anytime soon. Therefore, they will have nothing to harvest in three to four months. For our home this is not a catastrophe, as we pay for the food, and the farm is more for educating the children than a source of food, but it still helps keep the cost of feeding the children down. For the average farmer, this is a disaster. In the market, there is little food as compared to usual and the price is higher. Most of the common laborers cannot work or even get to their jobs. The big road to Cochabamba has been washed out in three locations. Most of the fruit and vegetables come from Cochabamba and conversely, the meat and chicken comes from this area. There is no chicken in Cochabamba and chicken is the main protein in the diet of most poor people. I think this is the main difference between the third world and our world. When disaster strikes, we have the ability to cope better, although a tragedy like Katrina stretched our ability to cope to the maximum. Disease caused by mosquitoes will become rampant when the sun ever does come out and it gets hot. The only saving grace, for me at least, is the cool temperature. It has been in the 70’s all the days I have been here. Normally it would be in the 90’s to 105 degrees.

This is Carnival season, and most of the parades have been cancelled due to the rain. Some families make most of their yearly income from the Carnival sales. If they don’t make the money this week, they will be in financial trouble the rest of the year. One of our projects this year is the microfinance program and I fear people will get the loans and use the money just to live. Then they will never be able to pay back the loan and keep the program going. These are going to be very interesting times, and our mission is going to be more important than ever this year. I think this country is going to need a lot of help to get through this troubled time. Even my more affluent friends here are feeling the pinch. The doctors are not getting paid, and the farmers see their crops rotting and the produce they do gather in can’t get to market. I pray the rain will soon end, but there is no sign that it will.

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Tuesday, February 20, 2007

Well, prayers are answered! The rain stopped as we went to the parade of the Collas. Joanna and I went to this parade three years ago and it was fantastic, especially compared to the Camba, the tropical version. The latter was slow and unorganized while the former was well run and featured the folk dances typical to the mountain areas. I was very disappointed as in only three years the parade had degenerated into the same sort of affair as the lowland parade. It was slow, late and the dancing was done mostly by children. We were sprayed by ink and the groups could not dance for being sprayed by foam that is sold by vendors. No wonder the adults don’t want to dance in their costumes that can cost more than a house. The Carnival I went to last year ruined my enjoyment of these parades, not that I liked them all that much before. There are just too many drunken people and too much noise and mud. It is traditional to throw water on Sunday, paint on Monday and mud on Tuesday. My car got all three yesterday. I will get it washed tomorrow when there will not be any more mud thrown on the car on purpose. The mud from the roads is enough. I spent the last two days with my boys in the foster home. That is really what I enjoy, and I think they enjoy my presence as well. They call me “Papa John.” Some are speaking English fairly well, having had special lessons for three years now. Since the rain stopped, there are some high places on the property that can now be mowed. Due to the amount of time it has been since this was done, machetes needed to be used. Later the ground will be tilled by a machine and then the seeds can be planted. It is hard to believe that this area was a shallow lake just a few days age. The road getting here, on the other hand, is still terrible. The ruts are so deep that the wheels get stuck in the ruts and the ride is very uncomfortable as the car is thrown back and forth. I am sure this is not good for either the car or its inhabitants. The only good thing is that there is no fear of getting stuck, unless the chassis of the car would get hung up because the ruts were so deep. They have filled the ruts at the foster home with bricks where I got stuck yesterday. It is like a paved road if you can stay on the bricks, which is not easy.

The boys played football until I know they were tired, but this is the first time they have been able to play on the field for over two months. The sun came out and the temperature rose into the 80’s, but that is still cool for Bolivia in February. Soon the mosquitoes will hatch and that will be another problem. There was so much rain and it was so cold the even the mosquitoes couldn’t hatch. I was bitten for the first time today. The daytime mosquitoes are not supposed to carry diseases, but how do they know that?

I brought some kits to make projects on the mini lathe I brought last year. It was my plan that the boys could make things for us to sell and the money would go to their college fund. Last year we made pens and pencils. The pens were good but the pencils were harder to make and they didn’t work very well. I have cork screws and letter openers this year, in addition to pens. Since I have not made any of the new items before, I stole away into the carpentry shop during siesta and made one of each of the letter openers and the cork screw. First I had to rewire the lathe as someone had disabled it. I don’t know if that was done on purpose to keep the workers from using it, or they just didn’t know how to reset the circuit breaker that was tripped. The surge protector I bought last year also didn’t work, and the power is very erratic. Finally I was able to make a corkscrew out of scrap mahogany that was just lying on the floor by a table saw, and a letter opener out of a soft wood called guaycan (Pronounced y- a-can) which was left over from our projects last year. These were very easy to make and assemble and the boys will enjoy doing this later in the visit. If they are careful, making these is very safe, and they will learn some valuable lessons in carpentry and in marketing and sales, in addition to providing money for their college fund.

Tomorrow I will be able to get some real work done, although eating at Rotarian’s homes every night during carnival has brought me some feedback about our projects. I talked to the president and vice-president last week, and they obviously talked to other members of the club and the projects have been bounced around enough to begin to see how they will function. The recipients of the houses have been chosen, and the people that will work on the microfinance have also been identified. There is even a bank in Santa Cruz, run by women, which may be interested in helping us. I am very encouraged by this. Also the Etta Turner Center people are all here and ready to get involved as they train people for home work and that type of person is our main target for the project. The wheelchair project is very well organized from the highest levels at Rotary International, so my concerns in that regard were groundless. Each of the 280 chairs comes with a certificate with a number on it and a camera. The cameras are sent back to the US where they are developed, and the Rotary then has a record of the donor of the chair, the name of the recipient, and where it was given out. Each donor will receive a photo of the chair he/she gave. I bought a new camera just to do the same thing. Oh, well! The one I had last year got hit by a water balloon during Carnival in Oruro and the flash has never been reliable since. The next group comes on Saturday, the day of the wheel chair project, and I was able to find someone else to pick them up at the airport. Slowly, I guess I did get some work done during Carnival!

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February 22, 2007

The rain has held off for five days at this point and things have returned to “normal” for the most part. Many roads are still impassable especially in Pando and Beni, more rural areas in the northern lowland of Bolivia that are difficult to enter in the best of times. Photos are finally being published from those areas in the newspaper and the pictures are graphic and horrible. Many cattle drowned and I am sure people as well. Islands of high ground are inhabited by cattle, all of whom will starve to death. We are lucky to be here. The city is fumigating every night to kill mosquitoes before they get bad. So far, I have seen very few of them. The hospital is full of patients with dengue, but I have not seen any malaria.

I have spent the last few days organizing the work teams that will arrive on Saturday. The wheelchair distribution is also on Saturday so I had to arrange for others to pick up the next group. As the whole group coming has been here before, it was easy to find volunteers to pick them up. I will visit the clinic where Fred will work beginning Monday to be sure everything is ready, and then I have been invited to go fishing. That should be interesting with all the rain, although the drainage ditch near the foster home is now at the normal level. That stream has become by barometer for the water level.

Yesterday, I worked with the children to make pens. They made two nice ones with my help. Today I left them on their own to see how they would do. I was not surprised to find that both pens were a disaster. There was little that was correct, but even in failure, they learned a lot and both pens worked even if they looked funny. The boys promised that the pens tomorrow would be better. Some of what they do is perfect. Soon I hope they will have the whole process down to the same perfection so the pens and other wooden articles can be sold for their education. They assembled the good pens in the presence of two Rotarians from Washington State, who bought them immediately. More money for their educational fund and a lesson in commerce also. If you do good work, you make money.

I have been eating lunch at the home and today the same two Rotarians ate with me. One, Mathew Paul, is from Holland, and his family took in Jews during the war. His story would be another Anne Frank diary if he chose to write it. One of the survivors is now a professor in a university in Israel. His story had a nicer ending than Anne’s. It is always interesting to meet people here. There are so many stories to tell. We went to the girl’s orphanage while the boys did their pens and gave some presents there. We have several sponsors of children at the little girl’s orphanage and everyone likes to visit this place as it is a Shangri La in the midst of the chaotic market right outside. The girls were making a kind of cookie that the Polish nuns taught them to make many years ago when they were the only sisters here. Now nearly all the Poles are gone but one of their legacies is these cookies. If you have ever been to Eastern Europe, you have probably eaten this kind of cookie before. They are long and thin and are very rough on top and not very sweet, which is just the way I like cookies. The small cooks have changed the recipe a bit to their own liking, but the basic cookie is still the same. We never know what our legacy will be, but this one will still be around many years from now.

Last night we had our final meeting to be sure the paper work was satisfactory before the wheelchairs are distributed. Of the 280 chairs we have available, the Rotary Club and the social workers have located 231 recipients that have a social worker’s report, a doctor’s consent and live in the area that is served by this project. Another crate of 280 chairs is being distributed by a club in Santa Cruz. There was a lot of work done by the local club and the local social workers. This is an excellent opportunity for these workers to actually accomplish something that can be measured, seen and felt. This kind of opportunity does not come around often. I am excited and these workers and the Rotarians must be ecstatic. The head of the group of social workers is blind, so she knows what it is like to have a disability in a third world country. There are no special efforts by the government or any other agency to help people with handicaps. Basically the families are on their own.

The Rotary meeting was like all the others except there were six visiting members and the staff from the Etta Turner Center. All are welcome here, without cost. We charge $12 for visitors and every other club that I have visited, in the US or abroad, charged for the meal. They are missing an opportunity to make a little money here, but hospitality is always a main concern here and always has been. Charging for a meal might ruin the feeling of hospitality that pervades this place. There were the usual introductions and then the reading of the minutes from the last meeting. We only do that at the board meetings to expedite the regular meetings. There is no rush here. Then all the correspondence from the last week was read. Because of the wheelchair project, there was plenty. Then we went to eat. Each week is a different member’s responsibility. There is quite a variety in the food from week to week, but today’s selection was chicken cooked in a mushroom sauce, pot roast, rice, potatoes, tomatoes, and a meringue cake that was delicious. The cakes in general here are more moist, heavier, and taste better to me than cake in the US. Of course, all these are made from scratch. There are five Rotarians from Washington State here for the wheelchair project, which made me feel bad because I am the only person from our clubs that donated money to this project. The Cashiers club and both of the Highlands clubs were involved. Furthermore, this is the seventh crate of chairs the clubs in Washington have donated. This is one of their main projects. All clubs have different goals, which are nice, but this is a great project. I was proud that we had been able to help with this crate, but now I see what could have been done. Maybe next year we can do more. We took out one chair just to have a look at it and took a lot of pictures. Saturday there will be many photos taken, to be sure.

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Friday February 23, 2007

Last night the men with whom I was to go fishing told me the river was so far away that they planned to go there for three days. I told them it would have been nice to know this before but I could not go due to the wheel chair project, which was the reason I came so early to Bolivia in the first place. Therefore, I have basically a free day to catch up on things. I had plans to meet Dr. Dardo Chavez, the head of the Cruz Roja and Villa Cochabamba clinics, in the morning and I did that after getting some Slim Fast for one of the Rotarians who got sick the second day here and has not been able to eat since. I thought he might have a bacterial gastroenteritis as he got sick too fast for it to be a virus, but where he got it, I do not know. He is an experienced traveler. At any rate, he was admitted to the hospital later in the day while I was out. With some IV’s he should be better tomorrow. The clinics Dardo runs are managed well. He maintains the equipment and is a good boss, but he makes people work. Most of his employees are the same as they were ten years ago when I first came. That makes a good team. The clinic we visited today is the one in which Dr. Rodenbeck will work on Monday, the Cruz Roja or Red Cross. Everything is ready for his arrival tomorrow and I should not have been surprised by that fact. He will still spend the better half of Sunday setting up.

Following the clinic visit, I went to the foster home to lance an abscess on a boy’s eyelid. I had bought some anesthetic and some eye medicine which were quite expensive here, but the abscess was just below the eye lid so none of those medicines would be helpful. I washed it up and lanced it with a large needle, with little discomfort. If you cut the white area in the middle of the boil, there is generally little or no pain, except for the feeling that one will have pain. That, I can’t make go away. This was over in a few seconds and I proceeded to try to show another boy how to make a pen. Oliver is very competitive, which is good in a way, but he is no match for Nestor, who made a pen yesterday. I try to keep these two apart. Nestor is good at most everything and really doesn’t care. He scores more goals than Oliver playing football and that really makes Oliver mad. One day I hope they will work together on the same team, but right now they are rivals. Nestor made a really bad pen yesterday and I am sure Oliver wants to make one better. He is a quick learner but he, like the other boys, has trouble with certain aspects of the lathe. With my close supervision he made a very good pen, but when I left for a little while, he fell back into the same mistakes as before. I learned from yesterday to not leave for a really long time, so we were able to correct things before the project was beyond help. After he and the rest of the boys went to school, (they only go for four hours a day), I left to do a few chores and see another patient who had a really bad fungal infection. On the way I passed one of the largest sink holes I have ever seen. Two or three cars could have fallen in and not been found. The problems related to the rain are only now being addressed and the sink holes are just the most obvious result of too much rain. I have been here 10 years and never saw anything like these sinkholes. After buying a few things we need for the pen project, I went home to rest and write this missive. Tonight I will play tennis again. The guys that went fishing probably didn’t catch any anyway.

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Saturday, February 24, 2007

Today was one of those days that make one proud to be a missionary and a Rotarian. After much planning we finally had the day of the distribution of the chairs. Hundreds of people were present as I arrived late having made a hospital call to one of the Rotarians from Washington, Jack Frisk. He was the leader of the wheelchair group from his club that sent five Rotarians here to help distribute the chairs. He had also been to Trinidad and South Africa to do this before. The day was hot and the recipients may not have been out of their homes for months or even years, but the protocol called for speeches and a few folk dances, which, in my opinion, took way too long. Also, dancing in front of people that only wish they could walk, perhaps, is not the best therapy for the wheelchair recipients. Many of the older women were fanning themselves, and many in the group could not help themselves. In the two locations in which we distributed wheelchairs, there were three boys with spina bifida, a condition of the lower spine where the spinal cord is exposed in the uterus and irreversibly damaged by the amniotic fluid in the mother’s womb. This is usually accompanied by hydrocephalus, or water on the brain. Two of the boy’s heads were huge, but one boy had a mild case and was able to walk with a walker, and refused the wheelchair. I was proud of him and he will be better in the long run using the muscles he can use for as long as he can. Most of the recipients were very grateful, but only a few cried when they got their chair. Bolivians are generally very emotional people and I was surprised by the apparent lack of emotion today. Still, no one left in their chair without heartfelt gratitude, thanking all of us for our help. Not including the cost of freight, these 280 wheel chairs cost about $50,000. However, money is not the reason for the thanks. The caregivers and the handicapped both benefit today. Also, as is the case almost everywhere, there is a kind of discrimination against the handicapped here that may be more pervasive due to the physical environment of most of these people. It just isn’t that easy to get around, even if you have no handicap. In the mud last week, none of these chairs would be any good outside the home and if the home had a mud floor they wouldn’t even be useful inside.

It was amazing to see the variety of the maladies today. Many were just old and probably had Alzheimer’s. There are no homes for the elderly here and everyone is cared for by family or relatives. This is another example of the strong family unit that exists here. They may not have much but they have love. A few had amputations, several of both legs, and a few had strokes, but most of the crippled people had polio. Thankfully the youngest was about 14 years old, as polio was last eradicated in Bolivia just before I came for the first time in 1998. Rotary has also been involved with the largest polio immunization program in the world. Polio still exists in only a few locations in the world and these places are involved with tribal strife and war that makes immunizing the least able to care for themselves very difficult. Most people in the US, especially those born after 1957 have never seen a case of polio. There were many reasons to be thankful today. I am thankful to be able to be here, to be a Rotarian, and to be from Highlands, NC where the generosity of the people in our area has made the mission to Bolivia possible.

Martha and Fred Rodenbeck arrived today and along with Eugenia Green and Mary Yoder they will begin the evangelical and dental missions on Monday. I will be attending the hospital rounds and trying to see where we can be more helpful there. Last year the hospital said they didn’t need any more equipment. I was glad to hear that but this place will always need help. It gets very little help from the government.

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Monday, February 26, 2007

Yesterday we finished, I thought, the wheelchair project by going to Warnes, a town to the south of Montero. This town has a lot of industry but few residents. I think there are several large land owners that keep the land available for home owners to a minimum. At any rate there were 35 people who needed these chairs and the fact that there was no Rotary Club in Warnes to help plan for the event did show as the preparation for the distribution was lacking. In their behalf, the room used was small compared to the Rotary Club in Montero but the process was chaotic to say the least. There was not enough room to hold all the boxes of the chairs so many were left in the truck until needed. There must have been some planning as the number of the chairs and the sizes eventually came out correctly with only four chairs left over. The last recipient was home bound and we delivered the chair to her house which was across the street and around the corner. She was a stroke victim 79 years old. The people getting chairs were generally different. Most were older people with strokes. A few were amputees and there were a few children who obviously had birth defects or developmental problems. I don’t think any were victims of polio as compared to the day before. Perhaps the small population and the age of the people made polio less common in Warnes. There was a woman there from the first who had a wheelchair from a previous distribution. At home she would be called a “bag lady” using her chair to carry things in and using the handles as a walker. She would have a grocery cart back home. She was always in the way and wouldn’t move and was, more or less, ignored by the workers. At the end, everyone just left without saying anything to her. Just like the homeless back in the states, the people have learned to ignore this kind of person. I suspect she wanted to turn her chair in for a new model.

Following the event, I wanted to return to the Pinocho for lunch, having told the owners to expect us at 1PM, but the organizers of the distribution asked us to stay for “just a little food.” I knew what that meant but my efforts to return to Montero went for naught. We were taken to a restaurant in Warnes where we had a full meal taking over two hours to complete. Food has a special relationship expressing thanks for efforts given on behalf of ones friends. This has been apparent to me since I first came to Bolivia. Every home we ever went to in order to give aid gave us water, food, or refreshment which could not be refused. On returning to the Pinocho I expressed my sorrow that they had prepared food that was not eaten. We told the cook staff to take the night off as we would eat at a restaurant in the evening. I was invited to the fraternity across the street to celebrate the last day of Carnival. I thought it was over on Tuesday, but here festivals last much too long. Being the last day, everyone was soaking wet after being hit by water balloons and a hose. I was dressed nicely having just returned from Warnes but the rest of the men knew what was in store and were dressed more casually and prepared to get wet, which they did as did I. Also there was more food. I politely ate just a little, and returned to the Pinocho to gather the others for dinner. Most of our group had been invited to various locations for dinner, and the rest of us left to find a restaurant, giving the staff at the Pinocho a rest. Unfortunately, due to the Carnival, all the restaurants were closed. I would have been happy to skip dinner but the owner of the Pinocho said that they would prepare dinner for us. I felt awful about this as we hadn’t shown up for lunch and then, after being told to rest this evening, they wanted to give us dinner. Again, Teresa, the owner’s wife, said she would only make us a little food, but as I also expected, it was a full dinner. Much of the food was probably left over from lunch, but it was an effort we appreciated very much. I have never left a tip before after a meal here at the Pinocho, but we did this night.

On Monday morning the dental team went to the Cruz Roja and Mort, a podiatrist with the Washington group, and I went to the general hospital for rounds. There were several patients with dengue and a couple young people with kidney stones and a gall bladder patient. The most interesting patient was a man in a coma. He would respond to pain by a grimace in the face, but had no other movement of his trunk or extremities. All the doctors did painful things to him with the same reaction. I don’t know if they thought their stimulation would do something different from the ones before, but it began to cause me pain. He had a cough, with a normal chest ray, elevated white blood cell count, and a fever. I thought he needed a spinal tap, to rule out meningitis, but the most likely cause of his strange neurological symptoms was probably lack of oxygen to his brain caused by drinking too much during the Carnival. He may improve with time. Here there are no other tests available so there is little else they can do but wait.

After rounds I talked with the hospital administrator about the state of the hospital. The doctors and nurse have not been paid since December. Why they don’t complain with protests and other forms of nonviolent acts is beyond me. They had to close the intensive care unit as it was just too expensive to keep it functioning. Later I did examine the equipment and it was still in good shape and well maintained. The head nurse had the only key to the room and she was responsible for the care and stocking of the various mobile carts. She is very capable and competent. I trust her with the equipment and I was told the unit would reopen as soon as the money was paid to the hospital. Mort and I went to the emergency room where he treated a girl with an ingrown toe nail. Not major surgery, but many doctors really don’t know how to treat minor problems like this. He cut and I cauterized the skin. We then went to the delivery rooms and found the fetal monitors we brought last year were being used. The fact that they were being utilized made me feel good also. The hospital itself was in horrible shape. The ceiling in the halls had fallen in several areas and looked terrible. There seemed to be no urgency to fixing the problem. This, too, was apparently due to the excessive rains. I don’t know how any of the patients could possibly feel secure getting care in a hospital with the roof falling in.

Following lunch the Rotarians here from Washington and I went to Santa Cruz to shop and eat dinner. This was the only time they could see another part of Bolivia. Having had a busy day we were happy to see the Pinocho and get a good night’s sleep. Another day of heat and no rain. It has not rained since this group of Rotarians came last week. If it begins to rain when they leave, we may have to ask them to return.

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Tuesday, February 27, 2007

The days just keep getting better. I took Jack Frisk to the foster home as he was the only Rotarian from Washington who had not seen it before. Jack was in charge of the wheelchair project but he got sick right after arriving and spent the night in hospital. He has been afraid to go anywhere since, but he is now feeling back to normal and he was happy to visit the home. We arrived in the middle of the English lesson and we participated with the children. Then we took two of the older kids to the carpentry shop to complete a few more pens. Every day they get better. If I can teach three boys to do these well, they can teach the others. When we returned to the house the computer classes were in session. Jack, who is an educator, suggested that we change the mode of teaching as the boys have been taught computer two and a half years and they are still doing the basics, not doing hands on work. With some of the boys being 14 years old, they should be fluent in computer by now. The teacher tries to teach the whole group at the same time and that is impossible. I will have to speak to him.

Following the morning we left for lunch and ate some exotic animal meats. Armadillo, wild pig and another animal I don’t know. They all tasted about the same and none tasted like chicken. They were a bit tough and tasted more like pork. As soon as we finished lunch Mort and I went to the Etta Turner Center and had a makeshift medical clinic. He was scheduled to see foot problems and the first two patients did have orthopedic problems but none related to the foot. One had a fractured femur, the upper leg bone, which healed poorly and was short. He also had knee problems and couldn’t straighten his leg. He would need major orthopedic surgery to repair his leg. In the meantime, he tied a rope around the foot so he could raise it to be able to walk. A young boy came in with a poorly healed elbow fracture, but he could do everything he wanted to do with the arm so there was nothing to do for him. After the news got out that there was a free clinic, fifty people came in to see the two of us. I cut the visits off at 40 or we would have been there still. Most of the children were affected by the creeping eruption, a parasite disease of the skin. This worm gets into the skin from animal feces in the soil, but humans are not the usual host so the worm just winds around near where it enters the skin. We freeze the worm with carbon dioxide but here there is no such treatment. I saw at least five times as many of these cases in four hours than I have ever seen in my life before. There is a medicine for this but I don’t think any of these people can afford it. It eventually goes away as the worm dies, not being in the right host for the usual life cycle, but it can be very uncomfortable while it is still alive. Some had the outbreak on their feet, but some also had it on their buttocks and a baby had it on her back, having been laid on the mud on her back. I think the muddy conditions are the reason for this outbreak. Even with shoes on, the mud with the parasites can come in contact with the skin allowing the parasite to enter the skin. Most of the other cases were dengue or something like dengue. All were not that ill and we had lots of Tylenol to distribute so they were lucky to get free medicine. I have arranged to buy several thousand antibiotic pills tomorrow. That purchase will dent the miscellaneous account another $700.

I was called at the end of the clinic to go to a meeting at the sugar hospital. They had apparently called to arrange the meeting and left a message at the Pinocho. Unfortunately, I received the message when I got back from the meeting. Due to the poor weather, the sugar company has not been able to work as the cane cannot get to market. Consequently, they don’t have the money to replace the ultrasound machine they had for 20 years and now doesn’t work. The model they want costs about $18,000. I don’t know how much money they think we have, but I told them we couldn’t even think about helping them until next year, and I really don’t think we can spend that kind of money in one place that benefits only a small group of people who actually have insurance. They did mention that they are contracted to take care of our foster home children. I think we can help with the purchase of a new machine, but we will not pay the whole amount.

I got back just in time to eat dinner and then I got a call to see if Dr. Fred and I wanted to play tennis. Even with the setting of the sun, the temperature was still in the 90’s and the humidity was high. A few bats showed up for the first time this year. Usually when we play tennis we have to deal with the bats flying around the lights at night. There have been very few insects of any kind since they have been spraying for mosquitoes. I suppose the bird population will suffer in a few years due to the continued use of DDT which can be used in poor countries even with the ban elsewhere in the world. I don’t agree with the use, but I am grateful for the lack of insects.

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Wednesday, February 28, 2007

The last of the Washington Rotarians left this morning leaving the Pinocho housing only the five members of our group. The wheelchair project was a great success and it is continuing to go on to smaller towns that have been isolated by the rain and couldn’t come to the distributions when they were planned. It should be interesting to visit these places later, as they are the most remote and poorest of all the places we have donated the chairs. What a wonderful group of people these men were and several have mentioned that they would like to join our group next year and even bring their wives. They were surely impressed with the congeniality and comfort of the hotel and that has to be a big concern when coming to a third world country. This place is never what people imagine it to be before one visits. I certainly hope to see some of these people again and I will keep in contact by e-mail at least.

The anesthelogist from the hospital, Dr. Barba, came by to pick up the computer we bought for him to complete his project to document all the teams of volunteers that work in Montero. This will include the visitors and the local persons as well. He wanted a new video camera and a computer but he got a refurbished computer and a less expensive camera than he wanted, but these will do the job. His DVD is unlikely to be that professional at any rate. I kept the camera as mine doesn’t work and we need to make a DVD for our micro-finance project. Nancy and Michelle Main arrive on Saturday and that will be their main project. Also the plans for the house we will build are being drawn up. This will be a main focus for the Mississippi group when they come on March 11. We are beginning to get really busy.

I spent the morning purchasing medicines for the medical clinics. I will need special medicines for the creeping eruption, ivermectin, which costs about a dollar a pill, but one pill is the entire course, so it is easy and economical. Common antibiotics like amoxicillin and erythromycin are cheap, but those only came in blister packs which are more expensive, but they will be easier to dispense and keep dry, especially in the areas I intend to go. My calling cards were ready but I forgot to put my e-mail address on them. It cost $10 to have another 100 made, the smallest amount they will make. I don’t want to give my e-mail out to everyone anyway so it is good that I have two cards. The rest of the morning was spent making another airline reservation for a teacher, Henry DeGrazia, who is coming to see if this would be a good place to bring a group of students this summer from his private school in Atlanta. One never knows how the mission will grow. I got another e-mail from one of the Ole Miss grads who will be in his fourth year of medical school next year and he wants to come for his elective quarter and work in the hospitals and clinics. I am taking the microscope to the Cruz Rojas lab to refresh my memory on parasite testing. They will see more parasites in one day than our hospital will see in ten years. The same can be said for TB, although I did diagnose a case of malaria in Highlands and I have yet to see a case of that here in Montero. I am also waiting to get my truck back. One of the back tires had a 4 inch crack so I bought a new one to replace it. When they changed the tire, they found the brakes were bad and needed to be changed. Then they saw that the suspension needed repairs. No car except the very new ones has a good suspension here. I think they knew they had a “rich” gringo in their midst, but I always like to help Dardo keep his vehicle in good shape, as I really appreciate his giving it to me for the two months that I am here. Being mobile is a real benefit and many of the taxis just can’t get to the foster home when it rains.

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Thursday, March 01, 2007

March always comes at you so fast due to the short month of February. I still don’t know why February is so short when they could take a day off two months that have 31 and then most of the months would have 30 days. I guess they would have to make up a new song replacing the “30 days has September, April, June and November…

I spent the morning taking pictures of Dr. Rodenbeck who usually gets left out of my journal because we are always working at the same time in different places. He does such fine work here, both providing care to the poor and teaching, even at the dental universities in Santa Cruz. I am very proud to have him working with our group. Finally the lab called and told me they had five samples to check for parasites. Of the five, three were positive. Two have the eggs of the common long white worm, ascaris and one had the hook worm, ancylostoma. A form of this worm, the cat and dog ancylostoma causes the creeping eruption, cutaneous larva migrans. I thought the preparation of the slides would be difficult but the process was very simple. No stains or anything else was needed except for some stool and a drop of saline. This exam will be easy to perform in the country if the microscope can get enough light without using electricity. I am looking forward to going to the campo, the country, as the people here in Montero have access to medical care if they so choose to be seen. Of course, the parasites will return if clean water is not found and the habit of walking around without shoes is not changed. All of the parasites enter the body through the skin except for amebas, pin worms and giardia. Giardia is the only parasite commonly found in the US and certainly exists in the mountains of North Carolina. Cutaneous larva migrans is found in Florida and other tropical beaches where dogs and other animals are free to roam.

Following the learning cession at the clinic I went out to see the property where we will build the house. Having learned about the rain and the devastation of the roads while I was still in Highlands, I decided that we would try to find a family that needed a house right in the town of Montero. The secretary of the Rotary Club has been working at the club for 21 years and presently earns $1000 per year. From this salary she supports her aging parents and four children of her sister who died several years ago. She has always been a great help to me, and is more valuable to the Rotary Club here than they know. She sometimes works 14 hours a day, and often is called upon to work on Sundays, as she did a few days ago with the wheelchair project. Saturday morning is also a normal workday. No one in Highlands would work this many hours per week even for a normal wage. She will need a bathroom, kitchen, bedroom and a living room with the house costing about $5000. This is a bigger house than we normally build but I am happy to help this hard working woman out.

I set up my clinic hours at the Cruz Roja and brought three minor surgery trays in to be sterilized and also brought about 100 packs of suture. I have two suitcases of suture material that will arrive with the following groups. That should supply the area for a year or more. I had read an article about a patient who died because the family could not afford a pack of suture and that will not happen here. No one should die for lack of such a simple thing.
I spent the afternoon planning the micro-finance meeting to be held on Monday at lunch, and then met with a man who would like to be the English teacher. We spoke almost totally in Spanish, and when I spoke in English, I was sure he didn’t understand. He had certificates from several schools indicating that he received excellent marks, but the proof is in the pronunciation of our words. He didn’t pass my grade. Tonight we will discuss the house building project, the teacher’s contract for music and computer, the micro-finance, and the schedule of events for the further distribution of the wheelchairs. I thought that project was done, but there are about 100 more to give away. I need to know when these distributions will occur. One of these events is tomorrow afternoon. That I do know!

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Friday, March 02, 2007

We did have a very good meeting last night, lasting only 30 minutes as I thought we were to go to dinner at 8:00PM. There were four groups of meetings at different Rotarian’s homes. Later I found that my dinner began at 9 but all the others started at 8. The plans for the home we were to build were initiated, and the contracts reviewed. Money for the projects was budgeted and a meeting time for the micro-finance was set for Monday at lunch at the Pinocho. Following the meeting I walked to Dr. Patzi’s house where our group of Rotarians would discuss the upcoming events and come to some conclusions. Three other groups would do the same at other locations. We call this a club assembly, but we break up into four groups after lunch and discuss the four different club service areas. Apparently the other groups talked about the same things as we did. The big project on the horizon is a child care center and clinic in a growing but underserved part of the city. This is actually near where the Etta Turner Center is located. Since none of the other persons from our group could understand what was being said except Eugenia Green, who had no idea what the project was about, they were quite bored. At least at my group, the discussion was limited by the fact that we talked before the dinner, while they discussed the project after dinner at the other three sites. We all arrived back home at about midnight. While at dinner, Nancy Main called and said that she had missed her flight. I am so glad that I have the cell phone that can be called from anywhere; otherwise we would have been wasting our time at the airport as we did a few years ago when the Ole Miss group got stranded in Chicago due to snow. I still don’t understand how the cheapest flight from Mississippi to Miami went through Chicago. Fortunately, a new flight from Miami to Bolivia just started on March first and they will be on the ground at Santa Cruz tomorrow night at 11:45PM, so they will be only 14 hours late. Before you never knew if you could get another flight for a few days as the planes are usually full. They were very lucky!

Friday morning I did some visits to different areas trying to set up the meeting of the micro-finance and trucking people to their work locations. I went to the Villa Cochabamba clinic hoping to see Dardo who consented to pick up the Mains as it is quite late at night and I will be in Santa Cruz celebrating the birthday of a friend. I wrote some letters in Spanish and English to help with the customs as the last group was held up for not having a letter explaining the use of the things in their baggage. I have never seen the need for such a letter before and I went through customs without a single question. I guess it is just luck. Dr. Dardo was there at the clinic and he happened to be in the store room and I needed a few things for the stool for parasites tests we were planning to do tomorrow. He had the slides and the cover slips, and a glucometer for the strips that were given to me to bring here without the machine in which they work.  I knew they had about a hundred of the glucometers that use this kind of strip so I didn’t bring one. They brought out all the supplies I needed in about a minute. Now we are ready for tomorrow’s visit to the country to have a makeshift medical clinic. After lunch I went to the Internet café to be sure there were no other changes in plans and to check if the ticket I purchased for the teacher in Atlanta arrived (which it had) and I readied myself for a trip to Santa Cruz to celebrate the birthday. Birthdays here are quite a celebration, at least for the well to do. Some of the younger children of the poor do not even know their birthday.

I went to Buena Vista to distribute the wheelchairs there and on the way we passed the town of Portachuelo to see if the X-ray machine we had sent 14 months ago had cleared customs. The hospital administrator, a doctor and the head nurse just happened to be there. What a coincidence! We talked with the mayor and the rest to see what was needed and what we could do to expedite, if that is the right word after more than a year, the situation. It seems that they still don’t have the right papers but they thought $300 might grease the right wheels. I can’t understand why the government would keep such a valuable piece of equipment in storage for lack of anything. If the government had provided this kind of machine to the hospital, we would not have needed to do so for them. One would think they would be grateful and do all in their power the help the machine get to the hospital to help their own people. I wondered how many people had died because this machine was not in use. Also I feared that the equipment, if not cared for properly, might not work at this point. It was obvious to me that no one had done anything about this matter for some time and I was glad we had come to reignite the flame. They need someone to call every day until something is done and if it is only $300 that is needed I will gladly pay. We went on to the next town which was Buena Vista, which is well named. It is in the foot hills of the Andes and overlooks a valley with the mountains in the back ground. It is, indeed, a beautiful view. As we get farther away from the bigger cities, the crippled people seem to have greater disabilities. There were polio victims, amputees, children with cerebral palsy and brain damaged kids who were probably normal before they had some sort of diarrhea disease. I have seen this kind of child before. With no diagnostic equipment, the doctors have to treat by the seat of their pants, and these patients are the unfortunate result. The host of the birthday party was my driver to assure I arrived at the party on time, but I was glad I had come to this event. I got to speak this time and I told the people present that they should not tell us “Thank you,” but we should be thanking them for the opportunity for us to serve them. After all, Rotary is a service organization. This type of work is our duty. This group of people moved me more than all the others so far. We still have several more places to go before we are done distributing all the chairs.

In Santa Cruz, the party included all the brothers and sisters of the husband but none of the wife’s relatives other than her children and grandchildren. They were all there and very well behaved. The youngest grandson said, “Grandma, this is the best dinner in the whole world.” We were in an interesting restaurant featuring meat in the Brazilian style, serving all the grilled meats on skewers and the meat just keeps coming and coming. This kind of restaurant is very popular here and it is becoming popular in the bigger cities of the US. It is not the place to eat if one is trying to keep his cholesterol down. There are all different cuts of beef, kidney, stomach (tripe), udder, pork loin, and chicken hearts. There may have been a few more and having tried all of these before, I felt good about refusing several of the local delicacies. Actually the chicken hearts are one of my favorites.

We began our trip to Montero and it was just the right time to see if Nancy and Michelle Main had arrived as we came to the airport. We got into the terminal just as they came out of the customs area having had a wonderful flight with many open seats and practically none of the usual customs people to give everyone a hard time. You are allowed to bring in $1000 worth of things and our baggage always has less than that. Our carry on baggage is a different story… We arrived at the Pinocho at about 12:30 AM and I know the Mains were happy to be back home, having been here four years ago, but their hearts never left.

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Sunday, March 04, 2007

This was one of those blessed weekends that makes you sure there really is a God, and he led us all the way. We had breakfast Saturday morning at eight and we were to leave at 9 AM. Following breakfast I went to the pharmacy as the pharmacist promised that all the medicines I had ordered would be ready. She had said the same on Wednesday, Thursday, and Friday but I had faith that all the medicines would be there today and my faith was not displaced. Five boxes of medicines richer and $700 less wealthy, I returned to the hotel to pick up the rest of the group. It had rained quite a lot in the night and there was some concern about the state of the road we would have to take to get to Santa Martha. The main road was fine, but then we turned onto a dirt road, and I knew the rest of the trip would be an adventure. The road was wide and farms of sugar cane lined the path, but the road itself was a sea of mud. With four wheel drive we did quite well but our windshield was so muddy I could hardly see. When we approached a truck that was stuck I knew we were in trouble. The taxi that had led the way got stuck, but was able to get by the truck and the mud with the help of several of the men working with the truck. I thought I could get through on the other side of the road, but I got caught in a deep rut, and the mud in the middle, between the ruts was so high that it lifted the wheels up enough to be useless. With some cut tree branches, we were able to lever the truck backwards until we were able to dig a channel around the ruts to let me escape. I was able to get to the other side of the bad place and we finally got to our destination and set up our clinic in a school house. The man in charge of the school just happened to be there even on a Saturday. Perhaps he actually lives there. They did have electricity and we had a strong cell signal for the phone which I found both comforting and confusing. I don’t always get a good signal in the town of Montero. However, the cell phone wouldn’t work even though we had a great signal.

We all prayed there would be no more rain or we might have to spend the night here. Unannounced and unplanned, it came to me as no surprise that people began to congregate to be seen by the medical team. In less than one hour there were at least 100 people waiting. Numbers were passed out and the patients would be seen in numerical order. This technique had always worked before when we had so many people and it worked again. While patients waited, Martha, Michelle and Maria Eugenia did skits to entertain and educate them about God. My medicine would only work for a few days or weeks, but their message might help some for much longer. The first patient had scleroderma, as diagnosed by his fingers which had a very characteristic appearance. If had lived in a cold climate, he would have ulcers on the finger tips, so perhaps he is lucky to live here. There is no cure for this systemic disease that affects the esophagus as well as the skin. I asked him if he had trouble eating and he said he could not swallow well. That, however, was not the problem for which he came to the clinic. He was having symptoms compatible with the dengue. I didn’t bother to tell him about his real problem as there is nothing we could do for him whether he lived here in Bolivia or in Boston where he could go to one of the best hospitals in the world.

Many, if not all the children had parasites. The microscope worked well and the eggs of the ascaris worm were easy to see when the stool samples could be obtained. Most of the kids and their family had actually seen the worms and these children we treated without doing a stool test. Many of the children and adults were anemic. Some of this is nutritional, as there is little meat in the diet, but most is from chronic illness like parasites. One thing that did strike me was the lack of the creeping eruption that proved to be so common in the previous clinic we had. Now I had the medicine for that problem and there was none. Foot fungus was common but we had no medicine for that problem. It will disappear when the weather is dryer. There were the usual depressed people along with many that had stomach pains. Some probably had ulcers from being infected with helicobacter pylori, a bacteria that cause inflammation of the stomach and ulcers. It comes from poor sanitation which surely is the case here. We tried our best to treat these cases with two kinds of antibiotics in hope that the combination might clear the infection. Soon it was 2 PM and we had to leave, with many patients unseen, and many more were on the way to be seen. As it was, we had seen almost 75 patients. Whole families were seen, but few of the children were really sick. The mothers just wanted them to be seen. All had their blood pressure taken and the adults had a diabetes test. I was happy with the way we were able to take care of the patients, as Mary Yoder did the Blood pressure and some of the finger stick blood sugars, and Nancy Main learned how to do the blood sugars also. Outside the school room Martha, Michelle and Eugenia managed to keep the people happy. As we were leaving they brought us chicken and rice which we politely refused as we had another birthday party to attend. Most of my friends here have birthdays in March. I felt bad about leaving and not eating their gift, but I knew the food would not go to waste, and I wouldn’t take the chance of eating in this place knowing of all the patients with the stomach bacteria and the children with parasites. On the way back the car was pulling strongly to the right. As we arrived at the hotel, there was the strong smell of brakes. I hoped that the car would not need another mechanic to fix it again. The car was muddy from front to back and top to bottom.

Thankfully it had not rained any more and the road had dried sufficiently to make the return trip a lot less adventurous than the one going in. The birthday party was at an estate in Santa Cruz. A German family had come here in the seventies and stayed, becoming quite prosperous. The son had married the daughter of the Rotary vice-president and a good friend of mine and several of the group had actually stayed with them over the years. We had gone from one extreme to the other, which is not all that hard to do in Bolivia. It is not unusual to have a beautiful home right next to an adobe hut. We returned home ready to go to bed as this was a fun day but a hard one. Maybe soon our bones will stop shaking from the trip down that road.

Sunday was one of those special days. First we went to the church service at the Dios Es Amor. We were given the opportunity to speak to the congregation, interact with the church members and enjoy the sermon and songs. Since the time was growing short for the dental team, I took them to the foster home to see the boys and the grounds, and also eat lunch there. The house mother prepared us all chicken we brought and cooked bananas or plantain plus rice to complete the meal. They know that we don’t eat leafy greens here as they are impossible to clean adequately for the gringos stomachs. A few of the group went to Santa Cruz for a meeting but I returned to play with the kids. I love playing with my boys. We had a successful soccer practice and a good game. Then we played make up games in the playground. There are several areas where your imagination can invent new games. There is a place where old tires are buried half way in the ground separating the play area from the parking lot. That area in particular was the source of new games. My first real job in 1960 was being a playground leader and that experience has served me well here.

I had hoped to write in the journal before I forgot the interesting things that have happened today, but other things got in the way. Nancy and I had a long discussion about the micro-finance project and whether it would be a Bible based program or a business based one. The business based plan has worked before but the Bible based one, to my knowledge, has not been tried. We will decide on the path tomorrow when we meet for lunch. Since we gave to cook a night off, I have not seen her to tell her that she might expect an additional 15 to 20 people for lunch tomorrow. She has always taken this in stride before, but I hate to do this to her.

Soon it was time to go to the various churches for activities that had been planned. As we began to leave I noticed we had a flat tire. I had traveled about one half a block before noticing the characteristic noise of the tire. What next, I thought. Two tires in a week! We changed the tire in about half an hour, not being familiar with the jack and it was dark. We had to find a few bricks to elevate the jack enough to put on the spare tire. I thought how impossible this would have been if we had been in the mud yesterday when the tire went flat. The good news was that the brakes seemed fine after the mud was washed off. We still arrived at the first church before their bus that was supposed to leave a half hour earlier had left. This is typical Bolivia. God knew what would happen and we were on His timetable. We did our business there and went to a small Presbyterian church where Michelle was supposed to do some skits. The service was over, but there were still people there as we arrived. Those remaining were mainly deaf, mutes signing with one another. What a perfect place to do the skits that really need no words or explaining. They did have several hearing signers who translated the Spanish to signs as our translator changed the English to Spanish. It was quite an experience. Also I know what happens when there is more than one translation. I don’t know signing, but it was probably different from the message given in English. I had previously planned to leave to write in my journal and then come back, but I was glad I stayed. Here were all these people who could not hear or talk, but I have never seen so many happy people. I was enthralled by the enthusiasm of one man in particular. Also their children, all of whom seemed able to speak and hear, were some of the happiest children I have ever seen. These people had practically no possessions and then God seemed to have taken away even what little they had left, e.g. their senses, but they were happier than many people I  know who are blessed with much. I think this is the reason I like this place so much and why everyone else enjoys being here too. It is way past midnight as I write, but I don’t care. It was a great weekend!

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Monday, March 05, 2007

The weather has finally turned to hot! This is normal Bolivian weather. The 70’s and 80’s felt cool to those of us who know how hot it can get, but today was the first day of near 100 degrees and it felt it. This kind of heat can sap the strength from you. After breakfast I told Teresa the cook and owner of the Pinocho that we might have 12 more for lunch and, as always, she didn’t outwardly flinch. Inwardly she must have been thinking, “Oh, no! Not again, you crazy doctor.” The truck went to the shop to get the tire fixed, so Nancy and I went to the Etta Turner Center to see if the women there could come to lunch at such a late notice. The message I had left last week did get to them and they were happy to come as the micro-finance project is something that should be of interest to this group. They train and educate and this can be the conduit for beginning a business for the women. While there, Celso came with the truck. He does all the maintenance of the vehicle and does other odd jobs for me as well. He had a box made for the microscope yesterday so it would be less apt to get broken when we travel to the country. We took Michelle to the Dios Es Amor church for her scheduled work with the children, but there was a misunderstanding and her work here was to start next week. I suggested we go to the girl’s orphanage which is right down the street instead. Mary Yoder was born in Poland and left when she was five, but spoke Polish to her mother until she died in 1987. The nuns at the orphanage were all Polish many years ago, but now only a few are as the majority have returned to their homeland after the fall of communism. Mary was thrilled to be able to communicate in her mother tongue and Madre Christina was happy to respond. Michelle worked with the little children while Nancy and I went to the other Etta Turner Center (Number two) to see how many women would attend the lunch for the micro-finance organizational meeting. This place is very large with a lunch room able to feed 120 children, class rooms, and sewing and craft areas. It has been funded by the Etta Turner Foundation and also The Mother Teresa of Calcutta Foundation, a Spanish Foundation and an Italian one as well. On the way home we picked up Michelle and Mary and made it back to the hotel just in time for lunch. Exactly 12 persons came to the function which was the guess I had made in the morning not knowing for sure how many would attend. No one we invited didn’t come. The meeting went on for two hours and I suggested we think and pray over the project and return on Wednesday to further discuss the project. It will be interesting to see how many repeat persons we have in two days since this meeting went on so long and seemed to be confusing to the participants.

As the meeting was breaking up, a woman who had twins just a few days ago came in with the two children. The minister who brought the family to me was concerned because the umbilicus, the navel, looked funny to him and the children were so cold on Saturday. The mother took the children out of the cloth sack that all these Colla women have and many literally carry all their worldly goods in these sacks in addition to their babies. I always wanted to see how they carried the babies in these blankets. I was shocked to see that the babies were wrapped like two Egyptian mummies. The first wrap was a belt like strap about two inches thick followed by a second layer of thinner material that prohibited any arm or leg motion, and I am sure, didn’t allow for ample breathing. Then there were the clothes that were made of a thin cotton material. There were no diapers. The two precious babies were perfectly formed and totally healthy. The umbilical cords had fallen off and there were no hernias. I don’t know what the men saw that concerned them but they said that it looked different now. Perhaps they had never seen a baby with the cord still attached. I guess that could look scary if you had never seen it before. One of the babies had a very mild eye infection so I gave her a tube of eye ointment I had bought a few days ago, anticipating a need but I didn’t need it for that patient. The woman who had been nursing the little boy child stood up and was only about four feet tall. Now I know what Shaquelle O’Neal feels like when he looks down on the likes of people like me.

In the afternoon I went with the Rotarians to Saavedra to deliver the last 10 wheelchairs. The town square was one of the most beautiful I have seen, and the writing on the town hall across from where we were sitting noted that the founding date of the city was 1804, only 28 years after the founding of the United States. Many of the small pueblos here are more than 300 years old. Of the ten chairs, most were given to small children with apparent severe brain damage. These chairs will make caring for them much easier. The others were old stroke patients. The most amazing thing of the evening was a man with really severe scoliosis, curvature of the spine. He was waiting with all the other patients who received a chair, but in the end, he didn’t have one and he didn’t seem to be concerned. I asked a woman there who seemed to know everyone and she stated that he didn’t need one as he could walk around quite well. He obviously didn’t walk well, but he was ambulatory. I guess he felt fortunate to only have a partial disability. We took the last chair to the hospital. If you could get into this hospital, you didn’t need to be there, the path to the door was so bad. There was a pool of stinking still water next to the path. If one fell into this water, I am sure you would just die. They asked me if I could help them purchase an ambulance that they thought would cost about $7,000. I told them I would try to help next year. For a day in which I only had two meetings, it was a busy 24 hours.

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Tuesday, March 6, 2007

Today I awoke with no plans except to play tennis in the night. It turned out to be one of those days when it is obvious that God is really in control. This kind of day is common here. We tend to take control of our lives at home as we are very busy and have schedules for every minute of our lives, fooling ourselves that we are in control. We often get angry when we have changes in our schedule, instead of accepting that God is trying to get our attention for His schedule. I went to the plaza with Jamie who is doing research for her thesis on the shoe shine boys. Since the boys that she knew had the creeping eruption were not there, I went to visit my friend The Camba Florencio, the local historian and story teller, who is the head of the cultural center, right on the plaza. We have much in common as he had a heart attack one week before mine (the third anniversary is tomorrow) and was the first patient to receive clot busters here. I was the second. He has stopped smoking and received my congratulations for that. After exchanging niceties, he told me of the drug and alcohol problems in the youth that often come to the plaza. Some of these youngsters are the ones with whom Jamie is working. He asked for a projector to give programs in the schools and the plaza and I said I would donate a projector if he personally made the video and didn’t use some off the shelf video that wouldn’t mean as much to the students and children as one that he was in. He is a very good communicator. Good story tellers are rare and he is one of the best. He is even immortalized in the mural in the plaza outside his office.

I went to the foster home and started to work with Pablo, the youngest of the three boys I am teaching the lathe project to, and the best. The president of Rotary came to look at the road and determine how many loads of gravel we needed for the road entering the foster home. I left Pablo alone to visit the gravel supplier where we did our business and returned to find that Pablo had done a fine job. I was not surprised. I returned for lunch and Martha made a request. She needed a projector for the movie she wanted to show the next night as Fred was using the one I brought several years ago to do some lectures in Santa Cruz. I feigned that this could not be obtained on such short notice, but a few moments later I told her that I was going to buy another one, but I needed to go to Santa Cruz for such a purchase. Shortly later, Pancho called and asked me if I wanted to go to Santa Cruz with Herman and him in the late afternoon. I gladly said yes, and called to terminate my tennis date.

We left at 4 PM which was early to go to Santa Cruz, but it soon became apparent that Herman had a lot of business to do before we would come home. We went all over this confusing city from one place to another until I had concerns that the electronic shops would be closed. Suddenly we were in the middle of the city and found a parking spot right in front of the electronics store. I had brought $1000 in cash as I thought that would be sufficient to purchase the projector, but I was $200 short. Across the street were three ATM’s. The first took my card but wouldn’t complete the transaction, while the second wouldn’t even accept the card. The third, however, gave me the money I needed. After completing the business at hand, the clerk left and brought out another machine that was more powerful for the same price. Herman had told the clerk that the projector was for mission work and apparently he thought a better projector for the same price was a good idea. God working again.

Finally we went to another fraternity in Santa Cruz. Now these members are the real movers and shakers in this place. My favorite singer in Bolivia, Aldo Pena, is a member, and there are generals in membership along with wealthy businessmen. I gave them the cork screw that Pablo had just made and they were all amazed, and seemed anxious to purchase some of the items at US prices, $25 for each one. I will have Pancho bring a few samples when he comes to the fraternity the next time. I was amazed that most of the members remembered my name while I, as usual, only remembered a few, which is actually good for me. These are good men, but I have never seen so many men talk as much as these fellows do. Communication is much further advanced here, approaching an art, as compared to the US. Any of these men could give a speech better than several well known politicians in our country.

We had a safe journey back to Montero with my projector in hand. I know that good things are going to result as a result of this machine.

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Wednesday, March 07, 2007

Today I went to the hospital to bring some items that the groups have brought. This was combined with medical rounds to see patients again. As before, the epidemic of dengue has brought five more patients into the hospital. Most of the people who get this malady never need to be admitted, as this disease seems milder than the form of the disease I am used to seeing. I am sure some of these patients have something else other than dengue but who knows. They all seem to be getting better. One good sign that a patient is ready for discharge is when you see the patient carrying their IV pole down the hall. Interestingly, they put mosquito nets over only these patients to keep the mosquitoes from biting them and spreading the virus to others. Actually, I have seen very few mosquitoes this year. However, many of my friends, who are in the upper class and their family members and their household employees, have had the dengue and I don’t know where they are being exposed. This disease can be serious and even cause death in rare cases.

I distributed the goods to surgery, the labor room and the medical wards. The intensive care unit is to be reopened again today but the staff has yet to be paid. In April, they will receive their salary for January. They will continue to be four months behind until the government has more money whenever that day will come. I can’t imagine American doctors and nurses working under these circumstances. I went back to the foster home to continue the pen project. Two of the boys who worked together before did a good job finishing three projects. These are the two 14 year old boys that are rivals in the home. My goal for them is to work together better. Competition can be a good thing and they did get along fine today. There is no real competition with the pen project. I returned in the afternoon hoping to see the road improved but the stones we bought were still had not been delivered. By the time they arrive the rainy season will probably be over. We are having mild showers daily which keeps the dust down but even these small rains make the roads to the foster home very difficult and dangerous. Due to the recent scraping of the road, the camber is so great that it is easy to slip into the newly created ditches. On the road by the drainage canal, that could easily be fatal, either at that time or later from serious infectious diseases. I don’t even like to look at the septic looking brew in the canal let alone falling into it.

Dr. Rodenbeck went to Santa Cruz to teach dental techniques while the rest of us went to a showing of “The Hiding Place,” shown by Martha Rodenbeck at 8 PM. This was just after the second meeting of the micro-finance meeting. We scheduled the meeting at 6PM and no one was there but our group. I thought of the parable of the seeds, and I thought our seeds had fallen on the path of stones. However, at 6:30 both of the groups we had focused upon began to arrive, much to my relief. The program will probably work with a group from Santa Cruz who is coming to Montero this spring. They do education and have had success in other areas and, probably more importantly, they have much more money available. They work in groups of at least 15 women, their loans are short term, three to eight months, and they usually give only up to $2000 for the first loan to the whole group. If the group is successful, they can apply for larger loans. Since they have the experience and the money I thought we could help our two groups be more likely to prosper by giving our money to the two groups to help lower the interest rates (that can be as high as 30%). In spite of the high interest rates, over 90% of the loans are repaid on time. We will have another meeting Monday night. I think we were all quite tired with the heat and the work schedule. Nancy Main went to Santa Cruz in the morning to talk to the Bank, Pro-Mujer, the micro-finance organization, and her daughter has made herself busy at the local schools and orphanages. Mary Yoder will go to Santa Cruz for the first time tomorrow as Fred is gone for the next two days. This is a “mature” group of missionaries, meaning that they have been here many times. I don’t have to spend my time taking care of them. They know what they want to do which makes my job easier.

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Thursday, March 08, 2007

I went to the foster home in the morning as I had hoped to spend more time with the boys this year. This was the first time I was able to be there for more than a two hours and the extra time plus the experience the boys have gained making pens is beginning to show. My next plan is for one of the boys to show another how to make the pens. After lunch I went back to the home just in time to find the boys slogging through the mud. The house father had slid into the side of the road as I had predicted would happen to someone a few days ago in the journal. There were only two fifteen minute rains today but the road was nearly impassible even with four wheel drive. The mud forms over the harder almost brick-like dry mud making it like trying to walk or drive on jell-o. I turned around and took the boys to school and returned to get Pedro and take him to buy a steel pipe for the tether ball court. Later, when the mud had dried, we would try to extricate the truck. The students from Ole Miss can “plant” this pole when they come on Sunday. They usually like to go somewhere special, like the jungle or historical places, but they have little time this year and the rain has made travel nearly impossible. Unlike Tuesday, when everything seemed to go smoothly, today was just the opposite. Pedro and I ran over a board with nails in it and had to go to another tire shop to have it repaired. About ten motorcycles came in with flat tires while we were there, so I am not alone. Still, this is the third flat I have had in about ten days. They must be throwing out nails on the road to improve business. I was to meet Herman to check out the truck for the trip tomorrow to fish and when we finally got together, he decided buying the pole and related material would be more important. We bought the pole which had to be cut in half. The man who cut the pipe really didn’t know how replace the saw blade in the hack saw. With our help, he was able to complete the job and we went to the hardware store to purchase the eye bolt with which to attach the rope. There were none to be found. Here, you buy rings and have them welded to a bolt. We did find a “come along” apparatus that had an eye bolt in it. But the threads were left handed, so we couldn’t find a nut to fit on the bolt. We decided we could cut off the end of the “come along” bolt and use it for the nut. At the carpentry shop we drilled the hole in the pipe with the drill press. If we had not had the drill press we would still be there drilling. The drill bits here are not good. The eyebolt fit in the hole and the cut off end of the “come along” worked perfectly. We covered the sharp edges with epoxy and this part of the job was finished when the carpenters made a filial out of wood on the lathe to keep out the rain that would eventually fill the tube and rust it out. This was a lot of work for a little bit of benefit but the kids will love this apparatus, especially because the ball will always be there. The foster home parents have a habit of hiding the balls and other equipment for reasons I don’t understand. Perhaps they are worried that they might get lost, stolen or worn out, but that is the case everywhere.

In the evening, I attended Rotary where they celebrated the first of my birthday parties along with other business. I would be happy if this were the last party as well. Because I have to get up at 4:30AM to go fishing, I left fairly early to go to bed, but it was still 11PM.

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Friday, March 09, 2007

Afraid my alarm clock wouldn’t go off, I slept poorly and arose at 4:30 calling my friends to be sure they were awake. Herman answered on the first ring and Pancho called me before I could call him. It seemed to be a good start to what I knew would be a long day. Pancho is the sub-prefect of this area and the trip is part of an official visit on his part. He told me to bring the medicines as he wanted me to see some patients in the small town we were to visit; therefore, I brought the medicines and the microscope. This kind of laboratory equipment is basic even in a country like this. Even though I was with three locals who knew the roads, I drove the first leg of the journey in the dark. Basically we went north east from Montero. The sky began to lighten to my right which made me feel good as the roads are poorly lined with paint so the limits of the pavement are difficult to see. It became a beautiful day as the sunrise painted the sky with hues of red, pink, grey and blue. After about 100 Km, the asphalt ended and the dirt road began. It hadn’t rained here for a while making the road very dusty. Initially, this was no problem as we were the only car on the road. We passed several small towns where the plazas were occupied by pitched tents housing people whose homes had been destroyed by the floods. They were cooking their breakfasts over wood fires and gas stoves. Soon the traffic became worse as this is the harvest season for Soya beans. We passed large slowly rambling trucks carefully through the dust that was as thick as a dense fog. When a truck heavily laden with beans would pass in the other direction, we had to close the windows to prevent the dust from coming in the windows. Suddenly, it began to rain. It seemed only to be a small cloud over us but it had rained a lot in this place. The dust disappeared and was replaced by mud. With the heavy trucks using the road, several low areas became oceans of mud again. There had been a lot of work on this road recently as evidenced by the newly formed mounds of dirt at the edge of the road. This actually trapped the water at the sides of the road making driving at the edges of the road impossible, but necessary when two large trucks passed. Before long we encountered a huge line of trucks. Ahead, two trucks were stuck on opposite sides of the path creating a very difficult situation. There was no way to even get a large tractor in to extricate the large trucks. Fortunately for us this blockade happened in a small town and there was a private elevated narrow tract of land where we were able to pass the bottleneck. Since all the trucks were in this mess, there was practically no traffic for the rest of the journey. My main concern was whether this mess would be cleared by the time we returned. Obviously this was a very selfish thought, but I have to admit it went through my mind. The commerce of the whole region depends on this road being functional.

Acres of crops were ruined by water that still remained after the rains had stopped their daily deluge several weeks ago. Where the water was deepest, the road would be muddy even after the recent improvements had been made. As far as the eye could see there were crops of corn, Soya and sugar cane. We finally came to a small town called Colonia Piray. The river Piray actually comes very close to Montero, but, of course, the fishing is always better only after a long trip. It was about 8:30 when we arrived in the town and soon the sub-prefect had assembled the mayor of the town who just happened to be about 4’ 6” tall, chewing coca leaves from a small green plastic bag and a group of other town officials. The mayor removed the central vein of the coca leaves before he put them in his mouth, a practice I have never seen before. We visited the hospital which was poorly equipped, which was no surprise. I set up the microscope which needed to be reassembled as the journey had caused many of the lenses to come loose despite the new box. I put many of the medicines out in the small exam room, and the sub-prefect opened a box of medicine that had been donated to this hospital. The lab didn’t have a microscope which was hard to believe as this is essential to practice the basic type of medicine needed in a small town like this. It was soon apparent that the microscope had found a new home. I had planned to use it until I returned home at the remote clinics I wanted to set up, but then I had no idea where it would be donated after that. I had nearly $500 worth of medicine with me and I knew I would need much of it on Monday; therefore, I gave only some of it to the hospital although I can easily purchase more when I get back to Montero. Several photos were made and they were very excited to get the scope. What an amazing set of circumstances that had to take place for this scope to end up here, exactly where God wanted it to be. I was to return to the hospital at 4PM after fishing to see a few patients in consultation.

We were looking for a boat and a motor. No one here seemed to know of anyone who had one of these. I am used to going on adventures here that are usually, by the nature of the place, mostly unplanned. We were “given” a guide who would take us to our first destination where we might find a boat. I thought this would be a fairly short trip, but we drove for miles on private dirt roads through fields of neatly tended crops, finally reaching a grand plantation that reminded me of the Edna Ferber book, “Giant.” Right in the middle of this 60,000 acre farm of Soya and sugar cane was a beautiful house. There were no electrical lines so they ran a generator 24 hours a day. The tanks of diesel were larger than those at most gas stations. I can’t imagine what it cost to fill them. We sat down with the owner’s wife and a maid came with refreshments as we talked. Nothing happens quickly here. There is a culture of trust and benevolence here unknown in our country anymore. The woman said she had a battery and two paddles but a neighbor had a boat. About the time we were to depart for the next leg of the journey, her husband and son appeared and we began the process over again. It was 12:30 in the afternoon by the time we left, and she invited us to dinner when we returned to have a roasted pig. I felt like the prodigal son and she didn’t know any of us! We arrived at the adjacent farm which took almost an hour to reach. The private roads were well maintained as they were the life line of the farms and not much traveled. The owner of the former estate apparently had sent a message by a radio as we were greeted by several employees who knew what we were seeking. The motor was quickly placed in the truck and off we went with two more employees to guide us. We came to a small canal where the boat was tied up, and I expected us to all get in and go off to fish. One of the men lent to our group went off in the boat to meet us in another location as we left to go to the rendezvous. We waited there almost two hours for our boat. I wondered how far the boat would have to travel, thinking that we had gone the long way by land.  Finally at 3PM he came around the corner of the canal and we were off in two boats having by now collected four workers from the two estates. This is the harvest time of the year and the owners gave us their workers for the day to help show the strangers a good time. The motor had not been working well, which was the reason it took so long for the boat to arrive and now it had to tow another boat. We hadn’t gone far before the motor stopped altogether. “Another adventure,” I thought, but in a more remote location that ever before. It was apparent I would not be seeing any patients this day and, since we are nearing the fall equinox on this side of the equator, I knew that the sun would go down at about 6:30 as it arose at 6. The boatman was sucking gas out of the fuel tube that was stuck in a plastic gas container with his mouth and blowing the liquid into the engine. “No wonder it didn’t work,” I thought to myself. Finally our guide jumped into the other boat and removed the gas filter, removed the water and the dirt from the filter and reconnected it to the engine. The motor ran well from that time until we left. Soon we were leaving the dry land behind coursing through the wetlands that were normally dry land. Monkeys and birds of all kinds were everywhere. The most common bird I could recognize is a parrot. This bird comes in two sizes here and they seem to travel together. Hearing the chatter and the experience of seeing these animals one usually sees in a zoo was wonderful. Soon we were at the Rio Grande. The river is always murky with soil but the mixing of clearer water from the wetlands and the mainstream muddy water caused visible eddies to form creating interesting patterns of red and brown colors. Pancho caught a small fish immediately, and I thought our luck had changed having caught few fish in my many years in Bolivia. Unfortunately, the rest of the day was practically fishless. I had a few bites but all the nibbles came up empty. We did catch a skate like fish that our guide was frightened to touch as there was a possibility of a poison sting. At least that was interesting. It was the same color as the muddy water, and this fish would have been invisible lying on the bottom of the river.

Suddenly the wind came up at about 30 miles an hour as a harbinger of the rain that soon followed. There were two short but furious showers.  As the daylight dwindled down to the last half hour we headed back to our rendezvous spot just in time to see flock after flock of parrots fly over our heads. The fishing was not good but the sights and sounds were excellent. I was worried, however, about the state of the roads because of the rain, but the private roads were more covered with grass and not that muddy and certainly less traveled than the main roads. The sun set quickly and in the headlights were sights to be seen. As we hurried between the fields of sugar cane, millions of insects had come out along with bats and thousands of owls. The owls would sit in the road, their eyes reflecting the light from the headlights and suddenly would fly away at the last moment. I can’t believe we didn’t kill a few, but there were no telltale feathers in the grill when we stopped. I am sure I saw more owls this night than in the rest of my life combined. Overhead were flocks of ducks heading home to roost. I had seen more ducks before in the outer banks of North Carolina, but they were so dense they looked like clouds in the darkening sky. Soon I heard the flop, flop, flop sound of another flat tire. This noise had become all too common a sound in the last two weeks. The flat tire was the new tire I had just bought. With all the help we had, we changed the tire quickly and reached our first destination, reversing our course. This time there was little time wasted in returning the borrowed goods. The typical farewells were made and we eventually arrived in the town of Colonia Piray again, giving our regrets to the doctor for missing our appointments.

The town dignitaries and the hospital staff had arranged dinner for us of the fish we caught along with duck and chicken. This we ate as the tire was repaired. The new tire had an old inner tube with a bad patch job. The patch had come loose with all the bumpy roads. The spare was a bad tire but we didn’t want to spend the time changing it.

Since my birthday was close at hand, it was celebrated with greetings and blessings (plus the thanks for the microscope) with beer, hugs and confetti of all colors. This was a very friendly place. As we went to pick up the truck at about 10:30PM, I passed a group of children playing games in the street. Whenever a car would stop, they would run around the car several times, their bright white teeth reflecting the car lights through their smiles. The sound of laughter drowned out the poverty of this place. There were no TV’s or computer games to ruin the simplicity of their lives.

Off we went again after leaving this town of about 2500 people until we had another flat tire at 12:30 AM, this being the same old spare tire I was worried about. Surrounded by barking dogs, we changed the tire quickly as we were very experienced by this time. There were no places open at this hour to repair the spare so we finished the trip on faith. The place where the trucks were stuck was hard to determine as there were several areas that were quagmires of mud along the way, but the trucks were long gone. The half moon lit the sky and in the farthest reach of the heavens, in the east and west, flashes of lightning indicated localized showers. Fortunately, there was no rain near us. The cool temperature in the night was a blessing but also a harbinger of showers that would surely come later. Overhead of us now was a spectacular display of stars, and a line of planets from one horizon to the other. The Milky Way was as bright as I have ever seen it as there was no artificial light nearby and the dust had been cleared by the rain. The Southern Cross, only visible on this side of the equator, was showing the way south. We finally arrived in Montero at 2AM. Twenty two hours of excitement all stuffed into one day and now the prospect of several parties tomorrow for my birthday caused me to be even more tired. I have regretted all invitations except for the one at the foster home, but I know there will be more as the day progresses. I think I would rather rest the way I feel now.

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Saturday, March 10, 2007

Fred, Mary and Eugenia left this morning. I got up and sent them off in Dardo’s truck. As predicted, the rain had come in as a soft shower. This would not last long, but the prospect of getting into the foster home for my birthday party, especially if there were many cars, was daunting. I went back to bed for another hour of sleep and took Martha, Nancy and Michelle to the home where we played with the children. I had Pablo show Martha how the pens were made and she bought one for her father whose name is Paul, “Pablo”, in English. She took pictures of the whole process to present with the pen so her father would know it was made just for him. With four wheel drive the trip in was not that bad for us as we were the first to come, but the others had made quite a sea of mud by the time we left.

The party was special as the boys did two dances followed by our dancing in a kind of square dance followed by a snake dance. A young boy of 12 sang for us. He has been singing for years and has even made a CD. I think he could easily do well in American Idol if he were to come to the US. He is handsome, had good stage presence, and he sings like a professional, which I guess he already is. We were well fed, as usual, and then the cake was presented. While taking a bite from the cake, which is a tradition, a person pushed my face into the cake, which is also traditional. I had removed my glasses before this happened taking a lesson from the past when this happened. Later I took the boys out to play football, doing a little practice before the game to let the food settle. Michelle Main, who is 21, played with the boys and did a good job of keeping up. She is remarkable in many ways. She also sings and has a heart of gold. After a while the heat got to me so I took Pablo and Freddy to the work shop to see if Pablo could teach Freddy the technique. Unfortunately, Pablo may be a good maker of pens, but he is not a good teacher, at least not yet. He hardly spoke a word to Freddy. I was disappointed as the boys teaching the other boys is the only way they will all learn the skill. Pablo is younger than Freddy and that may have been part of the problem. Despite the teaching deficit, the pen turned out good until the last step when the tube was bent. I was able to salvage the pen for use but not for sale, which was too bad as it was pretty good before the “accident.” It had gotten so hot that the safety glasses fogged up making it difficult to see. There is always a problem here with something. This is Bolivia!

A series of calls, visits and invitations followed in the afternoon, but I was able to rest and regret the invitations. Everyone is so kind and wants to be friendly and helpful, but a nice day of rest might be the best birthday present for which anyone could ever wish. For dinner, Martha Rodenbeck made soup to give Teresa, our cook and owner of the Pinocho, a rest. We had two cakes that were given during the course of the day and no one pushed my face into either one. Thank goodness! I took the group to a church to show the movie, “The Hiding Place,” again, and then I wrote the journal the rest of the night as I didn’t want to forget the sights, smells, and thoughts from today and the day before.

The University of Mississippi group comes tomorrow and another adventure is planned for our group at the foster home. It is raining again. This could be one of those all night showers which would really make the roads very bad again.

Sunday, March 11, 2007

I hate to be right about the weather but it rained the whole night. I am preparing to go to the airport to pick up the Ole Miss group and I hope they are able to fly in. The rain is not heavy right now, but it is persistent. I think I will have the Rotarians from Washington return as it didn’t rain the whole time they were here.

The rain stopped just as the flight from Miami arrived. I waited with the driver of the bus, but the group did not arrive. They had sent an e-mail at 8:45 last night that they had missed the flight. I had checked my email at 8PM. Oh, well! They apparently had tried to call me on the cell phone, as the group leader had kept my card from last year; however, if a cell phone is not used here for six months, the number becomes inactive. I have a new number which I had e-mailed to them. Unfortunately, they thought it was the same number and didn’t write it down. A comedy of errors. They will come tomorrow, but their time here, as short as it was to be, will now be a day shorter.

I have begun to feel pain in my joints and a mild nausea has developed. I think I will now begin to pay for eating in the campo two days ago. I had not eaten breakfast, leaving at 4 AM, and lunch passed us by. By the time we ate dinner at almost 11PM, I was really hungry. Gringo stomachs are not as strong as Bolivian ones.

I did feel well enough to play tennis in the evening but went to sleep immediately upon returning home. Perhaps the good Lord knew I was getting sick and gave me a day of rest.

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Monday, March 12, 2007

At 4AM the tourista hit me with vengeance. I refuse to vomit, but I felt like I would feel better if I did. I had to go to the airport at 8AM and as soon as I arrived the group from Mississippi came out of the building. The driver of the bus that I had hired yesterday had not arrived. I had left a message on his cell phone and I had tried to call him all morning, but his phone wouldn’t answer. Thankfully, another driver asked if he could drive the group to Montero, but his price was double the usual fare. We waited another fifteen minutes to see if our driver would arrive and finally used the new driver. The Ole Miss group had breakfast as I went to the clinic to set up. I had planned to do that yesterday but really didn’t feel up to it. I wish I had as I fell worse now. I paid a few bills and returned for a nap. I almost never take a nap, even at siesta, trying to cram as much as I can into 24 hours, but it felt good to take one today. With nothing planned other than my clinic, we all went to the Cruz Roja where we painted, grouted tile and saw a few patients. Only six came in over the two and a half hours due to all the rain yesterday and the day before. The students were covered by paint at the end of the work day, but they seemed to be having a good time by the laughter I could hear. They really accomplished a lot. As for me, I was so tired I could hardly work. I was having trouble understanding the patients which is not usually a problem for me. I thought I had forgotten all my Spanish. When I got back to the Pinocho I checked my blood pressure and it was only 89/51, which is really low. I had a bite to eat and retired to bed at 8PM and slept until dawn.

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Tuesday, March 13, 2007

Physically, I feel back to normal but my stomach is still a bit under the weather. My-Linh Ngo, one of the two leaders of the Mississippi group has organized the twelve students into three groups. This morning, one will go to the children’s hospital, another to the general hospital and the other will come with me and go to the boy’s home. Yesterday, before lunch, I had taken a few of the women from the group to see where the children’s hospital was (only two blocks from the Pinocho) and to bring a nebulizer for the asthmatics. The director of the hospital, Dr. Torico would be expecting the students this morning. Dr. Patzi arrived at 8 AM to take his group to the general hospital and I took my group to the boy’s home. Margaret Hines, the other leader, was already feeling sick. It is a bit unusual to get sick this early into the trip unless she brought her infection with her. If that is the case, she should be feeling better soon as our bugs seem to be more tame than the ones caught here.

The Mississippi group is an interesting collection of honor students and includes four that have been here before. There is a young woman from Bangladesh and one whose family recently came from India. One girl actually lived as a child in Santa Cruz, but doesn’t remember much about her life here. One of the men knows the son of the owner of the import company we have used in Santa Cruz. It is, indeed, a small world.

We had a grand time at the hogar for the boys. We began to play football, but the grass was too wet and everyone was falling, especially the students who were taking the game way too seriously despite the fact that the boys were beating them. We decided to “plant” the metal pole we were going to do on Sunday for the tether ball.