2008 Bolivian Mission Journal

We are now celebrating our tenth anniversary of the mission. During the summer of 1997 I went to a mission fair on the campus of Western Carolina University. Like a beacon of light from the cloudless sky, I was led to a booth conducted by the Andean Rural Health Mission. I told the man who was in the booth that I wanted to go to Bolivia. Quite frankly, I don’t know why I said Bolivia. It just came out of my mouth. Quite frankly, I was hoping to go to Belize, where they speak English and have some fantastic archeological sites. The following Monday, a person from the mission called me to confirm that I wanted to go to Bolivia and asked if I spoke Spanish. At that point I spoke no Spanish and she tried to convince me to go with one of their work teams to Haiti or Central America. I said I wanted to go to Bolivia. Really, my knowledge of Bolivia was limited to the movie, “Butch Cassidy and the Sundance Kid.” I told her I wanted to go for a month and I asked how many volunteers went for that long. She answered that most go for a week. Then I said that I thought I could raise a lot of money and she said that they would try to find a translator for Joanna and me. I don’t believe in coincidences as all of our meetings are set by God. Here in the US, we are too preoccupied to notice these “coincidences,” but in Bolivia the bringing together of seemingly unrelated people is remarkable. Our translator was taking a two year leave of absence from her successful accounting practice in Atlanta. She was considering a career in medicine, but she was unsure of her choice. After working with us she decided to go into medicine and later received a full scholarship to the prestigious Johns Hopkins School of Medicine. She has been back to Montero two times with our group and will be joining us for the last time as a student this year. On one of those visits, she met the leader of the University of Mississippi group, Robert Wicks, and subsequently he enrolled in Johns Hopkins also. Many of our partners in Bolivia have come to us in unusual ways, but the hand of God is always visible. We now have a foster home, help with feeding programs and medical and dental clinics. We own a carpentry shop, help with home building, church construction and we have donated thousands of Bibles during the previous ten years. This year we will have groups coming from Ole Miss, (11), The University of North Carolina at Asheville, (16) and 15 medical students from Johns Hopkins, in addition to the 13 people coming from Highlands. Speaking of coincidences, the faculty advisor from UNC-A was chosen because she is fluent in Spanish, but she worked in the department of environmental health. Linda Block’s email address included the phrase, “leadprevention.” I had always been interested in checking the children for lead poisoning as there is no good disposal of batteries or anything else for that matter. Now one of our big projects will be the testing of 1000 children for lead levels in their blood.

This is the second year for severe flooding in the lowlands of Bolivia. We helped with the flood relief by providing $10,000 for basic housing in Beni where the flooding was the worst, but I felt badly that I did not visit the flooded areas. This year I want to visit the devastated areas and see if we can play a greater, more direct role. We could take our mobile medical clinics there and do some feeding of the poor. I have one week in Bolivia before the first group comes from UNC-A. Then 26 people come at the same time. That will be the largest group we have had in Montero at the same time. I look forward to seeing how our partners, who have been helpful for ten years, will step forward and help out. The Rotary Club has been our main partner, but several of the local hospitals, clinics and individuals have been very important to our mission and have allowed us to do so much in such a short period of time. Over these ten amazing years we have donated over $1,000,000 worth of medical supplies and equipment and trained medical personnel. We have built many houses for the poor, constructed schoolhouses and clinics in addition to building and supporting the foster home where orphan and abandoned children now have a chance to become productive adults. I have no doubt, due to all the “coincidences” that have occurred in only 10 years, that something special will happen to some of our boys. In the meantime, I will be satisfied that they are being protected, fed and educated. What happens next is in God’s hands and with His guidance, we will be led in the right directions to further His goals on this planet.

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Thursday, February 21, 2008

It is Thursday and we have arrived once again. It was a nice day to travel yesterday, but I understand it is cold and snowy in Highlands today. It is amazing how many times the weather is really bad on the day before or the day after we travel. Another of those coincidences again. The temperature was 88 degrees when we arrived and that is a fairly cool day here in summer. We left Miami two hours late due to a mechanical problem, but I am glad to be here as I really thought we would not be able to leave at all last night. Going through customs was a breeze, which is unusual. The only people they checked were the local Bolivians. Perhaps the local government has seen the drop in North American volunteers coming to this area due to the negative tone of the Evo Morales rule in La Paz. The people in the lowlands do not like him or his government but they are welcoming us with a lack of suspicion. Last year going through customs was an ordeal. We were met by several of the Rotarians and Dr. Dardo Chavez. Joanna came to Montero in Herman Landivar’s SUV and I came “home” to the Pinocho in the car of Jesus Plata, the Rotary Club president. We discussed several pressing issues on the way to Montero from the airport as we drove on the new four lane highway, or at least on the soon to be completed four lane highway. It has only been two years since they started the improvement to the road and by the look of it, it won’t be finished soon. My thoughts last year were correct as they haven’t planned very well. They seem to build and then repair the mistakes in drainage that were obvious to me as we drove by last year. They are putting in the drains now that should have been placed before they laid down the road. There are no markers for lane changes, or anything to indicate that there is an approaching hole other than a pile of dirt. You just have to know. I wonder how many accidents have occurred in the last year on this stretch of road. On the other hand, it is amazing how few accidents we see in general in Bolivia with all the seemingly dangerous places there are with little or no barriers. Clearly the people are more careful and there are no trial lawyers here as we know in the USA. Bolivians are, generally speaking, very careful. There are no insurance companies to bail them out if one is unfortunate enough to have an accident.

We spent most of the siesta unpacking. I have the extra work of unpacking the stuff I leave here every year. I leave my computer printer, all the other electronic devices, hair dryers and other things I never use at home like fishing hats with mosquito netting, audio-visual equipment for movies and slide shows and the like. Cell phones are always a lot of fun. Generally the batteries won’t charge after being left in a box for 10 months. Also the chips need to be changed as the phone number is cancelled if the phone is not used for six months. Perhaps I should pay someone to use the phone every once in a while so I don’t have to go through the process of getting a new chip every year. After unpacking I went out to fix the phones. The process is always the same. I can get the chip in one store, the batteries in another and the phone cards in yet a third. After getting the new phone numbers, one for me, one for Joanna and a third for the group that needs it the most, called “the blue phone” I get business cards made to distribute to my friends and contacts. Last year I went to the same place, but it is now under new management. I could order 100 cards last year, but now I had to order 200 which was their minimum. Also they won’t be ready for a week (next day last year) and, of course, they were more expensive. I got a new cartridge for the printer, and some food for light lunches, as the Pinocho won’t serve lunch and dinner until the group arrives next week. Of course today, having arrived two hours later than usual, they fixed us a three-course lunch which they brought to our room. I love this place!

One observation I had as I shopped was that there were fewer people in the stores and not a single store that I visited, including the supermarket, had enough money in the till to make change for a hundred dollar bill. Normally making change for that amount is no problem. Dr. Patzi mentioned that the people here might not want to take dollars as the currency is falling. Imagine that! The Boliviano is going UP on the almighty dollar! That should give us all cause for concern.

In the evening Joanna and I went to the Rotary Club meeting. I always try to come on Thursday, the day of the meeting as this club is our partner in many projects and very important to the mission and me. I think they are getting tired of some of the projects that continue on and on like the foster home and the carpentry shop. Most projects are finished in a specified period of time, but our foster home and the carpentry shop will go on for years. We will need to find someone or group to be the administrator of these projects as the interest is and has been waning and that is not good. The well-being of too many children is at risk. The family that is in the home has not had a rest for several years, and while the work is not hard, it is a 24-hour a day job. We will visit the home tomorrow. For dinner we had roast pig. Back home that would be a real event, but here this type of meal is quite typical, at least for the well-to-do. It was very good, served with rice, salad and potatoes. It might be common here but it was a real treat for me.

About midway through the program, my lack of sleep caught up with me. I practically fell asleep during the meeting and did actually fall asleep quickly when we returned to the Pinocho.

Friday, February 22, 2008

It rained all night and I had no idea, sleeping comfortably the whole night. By morning there was only a light drizzle, but I nearly slipped on the slick tiles near the dinning room. The owner apologized for the paucity of the fruit they had for our breakfast, but for us, the papaya, mangoes and pineapple were a tropical treat and they were so good. You can’t get fruit tasting like this in non-tropical areas. Unfortunately, we import the fruit green and let it ripen. Nothing tastes as good as tree ripened fruit. The lack of fruit was due to the flooding again this year. While it was not as bad here in Montero, to the north and in the mountains where most of the fruit trees grow, the flooding has been worse than last year and I remember people telling me that it was the worst they had ever experienced.

Following breakfast I went to the Rotary Club to do some planning for the groups that will come and then Joanna and I went to the foster home. The place looked in good repair, not like last year when it was so wet that nothing could be planted and the grass couldn’t be cut. As we turned the corner to the home, corn, in various degrees of growth and other vegetables could be seen growing. Once inside the complex, we saw our old friends, the dogs, and several new additions to the animal population. There were four new cats and at least one new dog. The mother dog looked so thin and tired, we thought she might be dead, lying still in the grass near the driveway. She has had a hard life having puppies all the time. We need to spay and neuter these pets and guard dogs.

In the home, the boys were all in the study room taking their English classes. Their English is much better, but their pronunciation is still poor. They would all become fluent quickly if they had the chance to come to the US or other English speaking country. The new home we built last year stands unoccupied. This is a shame and may be another indicator why we need to change the administration. I can’t believe that a family couldn’t be found to work here and take some of the burden from Irma and Pedro, the house parents. The work is difficult, but all the money earned could be saved as the food is free and there is no cost for the house. It is as difficult to save money here as it is in the US, but it would be, at least possible for these people. In a normal job here in Bolivia, you would go from day to day just earning enough to survive and never have a chance to save. After the English lesson we walked around the grounds and looked at the garden more closely. The ground is fertile here needing little or no fertilizer due to the floods and all the dirt is alluvial with no rocks. The fact that the soil has no rocks is good for the garden but not good for the roads. Once again the road to the home was very bad due to ruts from the traffic, but the places where we put rock in last year were very good. I told the boys we would bring them some baseball gloves and balls tomorrow and we left for another meeting at 12:30.

Our friend and director of the laboratory here came to see us at the Pinocho. All the equipment we brought seven years ago is still in working order. The new laboratory equipment in the US is so technical that it is outdated in a few years and needs to be replaced at a great cost. Here, everything needs to be repaired as there are no new parts for these old machines, but they keep plugging along. The technicians here, whether for this type of medical analyzers, or for automobiles and other machines, must be smart and resourceful or they are out of business. She gave us another side of the many stories that we have already heard about the economy, the foster home and many other issues and soon we will know first hand what the reality is. The Children’s hospital has been taken over by Cuban doctors, supplied by Hugo Chaves of Venezuela who provided the money and Fidel Castro of Cuba who provided the doctors. Everyone says the care is horrible, but it is free. Also the hospital looks better from the outside. I will visit it early next week and see if our students can go there to observe. I think it would be good for them to see a totally different sort of medicine, not that what they will see here is anything like the hospitals back home. The General Hospital, of course was run by crooks and the economy was bad, according to Terri. That I have already observed to be true.

Saturday, February 23, 2008

We slept in a bit today and now we feel well acclimated to the area after the trip. Even though there is only one-hour time difference, the trip is still long and difficult. Following breakfast we went to the boy’s home and distributed the baseball gloves and we began to play the first baseball game in Montero. The boys are so one handed that they tried to put the gloves on the right hand and then throw the ball with the gloved hand. None were left landed that I can tell, although I did bring a left-handed glove just in case. They had a plastic bat that they had used before and the men in the carpentry shop used for a pattern to make a wooden bat. Baseball is a difficult game to explain even if one were fluent in Spanish as the rules are complex. Since they are trying to learn English, I thought that I would explain as much as I could in that tongue, but I resorted to Spanish quickly, although many words are the same in both languages, e.g. pitcher, batter, catcher, etc. Pablo is a great athlete and he was able to throw and catch right away, but all the children wanted to bat. Playing the field is not very interesting and soon the boys were sitting on the ground or going off to play other games. They tried to stop the ball with their feet as soccer is their familiar game. Several of the new boys could throw very well, but catching was a problem. The gloves are stiff and they will improve with age as will their skills. The game was just getting good when it was interrupted by rain. It has not rained hard or rained all day, but it has rained every day since we have been here. As we left we drove by the plaza and it was obvious that something was going to happen by the activity going on there, but we went home for lunch and didn’t linger. We usually watch CNN on the TV but I decided to surf through the channels and found my old friend Aldo Pena singing and I recognized the plaza when the camera went to a distant shot. I took two of the young men who are children of the owners and told them I would introduce them to Aldo Pena who is quite famous for his singing and composing and we shot off in the car to the plaza. As we walked up to the gazebo where the program was taking place, Aldo saw me and greeted me by name. He asked me to say a few words for the camera but, at this point, didn’t know what the program was about, so I said I was happy to be back in Montero and that Aldo was a great singer. As the time went by, it was obvious that the event was a fundraiser for the poor folks that lost everything in the floods to the north of us in Beni. I was hoping to go there to see the situation for myself, but it is quite far away and difficult to travel there due to the floods right now. Last year the flooding was much worse here in Montero, but it is actually worse in Beni this year due to all the rain in the mountains. Three rivers run into the lowlands there, one from here and two from the mountains to the north of here. I have seen photos of the capital city Trinidad and it is completely underwater. When they began to ask for donations, I made a donation and gave bills to my companions to donate also. People drove by with bags of clothes which were collected. Then I remembered seeing a large truck earlier filled with bags that I thought were garbage. Now it dawned on me that they were picking up donated food and clothes. It made me feel that my small donations were very small, indeed. It reminded me of the story of the widow’s mite in Matthew. I am sure we will augment our donation when we find a suitable recipient organization. Apparently, the government is doing very little, as Beni is one of the four districts that has made it known that they want out of Evo Morales’ Bolivia. I danced with some of the Red Cross volunteer women, and when we returned to the Pinocho, the owners greeted us as champions! They had seen the event on TV.

From the look of this photo, you would have thought these boys had played baseball all their life, but this was the first time they ever had a baseball glove on their hand

The rain continued and the rest of the afternoon was spent reading and doing small tasks such as communicating by Internet with our friends and groups that will be coming soon. They have wifi at the Pinocho, but I cannot send emails, only receive. I did finally find an Internet café open and responded to all the letters I had read. Tomorrow we will return to the boys’ home to eat lunch and continue the baseball game, and then go to the market to see what has happened to the prices and check out the quality and quantity of the produce and then attend one or two different church services.

Sunday, February 24, 2008

The rain interrupted our game again, but the improvement was impressive. The boys were dressed in different colored uniforms so it was green against red. The hitting is much better than the fielding, but eventually we made three outs and changed sides. We managed about two innings before the rains came. We had planned to have lunch at the home and, as usual, we sat in the place of honor. The mother cooks, serves and doesn’t eat with us or the other boys. I don’t know what it would be like in a normal home but this bothers me as she acts like a servant, not the mother or a member of the family. Quite frankly, I think the older boys could do some of the serving, or even more such as washing the dishes.

The football team (soccer) is actually good in Montero this year and there was a game this afternoon. We made arrangements for the boys to go and we added two of the boys from the Pinocho and their father, who is the husband of the administrator. All dressed in red, we piled into the two pickup trucks and met at the stadium. The field was in bad shape from all the rain, but I know I could maintain the field better than this. Before the game two boys came out with a blanket, a cup and a bucket and tried to remove some of the water from the many holes in the turf. There is no drainage! Some sand and drainage tiles would solve the problem. Then some new grass seed and fertilizer would improve the situation. The game began with our side controlling the game, but midway through the first half, the score was still 0-0. They had an aging, but big center who was very physical, but our team had two wings that were much faster than their men. This finally turned the game as we scored twice to their one goal. The second half was sloppy as the field took its toll. Our first goal was a long shot that bounced funny and eluded the goalie. They had a penalty kick for a score and we followed with two great goals to finish the game at 5-2. At the end the police needed to interfere between the referees and the visiting coach. All in all, it was a good game with lots of excitement despite the wet field. The boys enjoyed the event and that was the important part.

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Monday, February 25, 2008

This was another one of those difficult days. After all the fun and joy of yesterday, I suppose this was to be expected. First we went to the boys’ home. The lathe I brought two years ago lost its speed adjustment feature. I tried to fix it and after taking the electrical aspect apart and then putting it all back together, I inserted the mandrel, the heavy metal rod on which you put the wood to be turned. The lathe suddenly ran with such speed that the mandrel flew out, twisted on to the floor. If I had been standing to my right or one of the boys had been there, it could have killed or at least maimed one of us. Fortunately for me none of those things happened but this machine is inoperable. Perhaps we can ship another part from the USA but this equipment does not exist here. I am sure someone put the plug into the 220 outlet, ruining the speed control mechanism. After the English lessons the boys came out to the field anxious to play baseball. I tried to organize them moving from first to second, etc, until everyone batted. Others came late and wanted to fit in but they only added to the confusion. Soon, many feelings were hurt and emotions easily came out with quarrelling and even fights. They all seem so tense and angry this year. I feel that one of the new boys may be to blame as he seems to be the center of most of the problems, but he is so small. He never gives an inch even after being well trounced by the older boys. Irma, the housemother, is tired and depressed and much of the problem stems from her inability to provide the love and attention to all these boys. I fear we may have to change the family and that may be the first thing the new administration has to do when they start soon. Speaking of terminations, only the chief of the carpentry shop was at work today. All these workers are new and he stated that on Mondays, usually no one shows up for work. Back home this usually means that they are hung over. The original plan for the shop was for it to furnish the funds to maintain the foster home so we wouldn’t have to provide the finances for the home indefinitely. However, it has lost money every year. My idea at this point is to lease out the facility, as it has some of the best equipment in the town, and we would be sure to have some income. Unless someone has a better idea, that is what I will suggest.

After lunch I was to meet with the people at the Children’s Hospital, but they had gone to Santa Cruz, even though Dr. Chavez and I had an appointment. This is the hospital that has been taken over by the Cuban doctors. I thought it would be interesting to see how it is run and how qualified the doctors were. Perhaps this will not be possible. After that visit I got some emails about the instrument we will use to check the soil for lead and other heavy metal contaminants. Apparently this equipment contains a small amount of radioactive cesium. (So do all the smoke detectors you can buy at the hardware store) I, unfortunately, wrote the director of the Institute of Science and Nuclear Technology that it had milligrams rather than micrograms, one thousand times less, of the radioactive element and that became a big problem. I know nothing about this machine and I wrote the letter by memory. Still, I knew it had micrograms. I just wrote it incorrectly. With my bad Spanish and his bad English, I think we solved the problem on the phone and on the Internet. We still need an organization here to certify that they will be responsible for the machine for the two weeks or less that it will be here. I am sure Dr. Chavez will do that.

In the evening I went to the Rotary Club to discuss the foster home management problem. We signed an agreement to let a church that has experience with this type of home run the facility for two years with an option to continue for eight more years if they are successful. This is a church with which I am familiar. In fact we are doing a small microfinance project with them at this time. All the money will continue to be funneled through the Rotary Club and the church’s benefit, as far as I can tell, will be that this home will become their biggest such facility in the area and a resource for bringing more children, orphans and abandoned, into a safe environment. I met a former exchange student, Sarah at the meeting. She was gravely injured in an accident that killed another exchange student here five years ago. Her name was Etta Turner and two eating centers are named for her in Montero. Sarah is currently working with the Etta Turner Center that, hopefully, will run the big microfinance program next year, for which we have a Matching Grant in the works right now. She has been in China learning the ins and outs of microfinance for the last six months and she will be here for two more years. She is a remarkable, beautiful young lady. I can’t believe she would return to a place where she almost lost her life and be willing to give so much more to this community. She will be my partner in the tennis match tomorrow night. I try to get a little exercise every Tuesday night playing tennis with my doctor friends. After today, I think I deserve a little diversion. The only real pleasure of this day was seeing the four kittens at the foster home.

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Tuesday, February 26, 2008

I awoke in the middle of the night with the noise of heavy rain on the roof of our room. I have never heard the rain this loud in all the years I have been here and that was over the rumble of the air conditioner. The one thing we don’t need here is more rain.

This was the day set aside to finish the things left undone yesterday and Friday. Most of the day was spent on getting our permit to bring the heavy metal testing machine into the country. Because it contains 10 micro curies of cadmium 109, we need to go through a huge bureaucratic mess even though the director, a very nice man, said that it would be a formality because the amount of radiation was very small. He emailed the form and it took all morning to find the correct information to fill in the blanks. We both faxed and emailed the returns to him and he made some corrections and suggestions for us to resubmit the application. As it was noon, we took a break to finish after lunch. Starting the process again at 2PM, we made the changes and submitted the proposal once again. He said it was nearly correct, but the forms needed to be sent to La Paz by courier as they needed the originals! The flight leaves from Greenville, SC tomorrow and they can’t bring the machine without the permit. Finally he said he would send the permit TOMORROW. The machine could not be delivered to Asheville until the permit arrived but the company made an exception as they had a copy of the forms we had sent in and believed that the permit would be, finally, delivered. I am glad I was here in Bolivia, but now I wish I had come a week earlier. It probably wouldn’t have made any difference as things are always left to the last moment when it becomes an emergency.

During the time between my visits to the clinic where the forms were filled out, I went to the Children’s Hospital to see if we could use the facility for the medical students who would come later. Even the Cubans warmly welcomed me. I was told that they would not let me see anything at the hospital. My doctor friends also said that no one would go there, even though it is free, but I found the place busy, well run, and clean. I think my friends need to see reality rather than what they wish to see. A decision would be made at a later time and reported to me as to whether they would like to join our teaching effort. This was a positive sign in a few days of disappointing results and much rain. I was not able to go to the boy’s home for lack of time so I spent the rest of the short time left before lunch getting a haircut and filling the pickup with gas. It cost 178 Bolivianos to fill the tank, or about $24 dollars. I spent most of the early afternoon visiting the other location that we will use for the med students and where I had planned to go last week before our planning session at the first clinic lasted all afternoon. There is no way you can utilize your time here as in the US and it takes a little time to adjust to the cultural changes. A visit becomes a social event with the coffee, soft drinks and food. Joanna and I visited the CLEM office, a small clinic for women and children where we decided we could use to do some lead testing in the afternoon sometime next week. The visit took several hours.

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Wednesday, February 27, 2008

As usual, there was intermittent rain throughout the day. This is just enough to keep everything wet and muddy. We went to the foster home, having not been there yesterday and found the boys working in the garden, planting the seeds that we had brought. I immediately joined them while Joanna went to the house to teach English. The soil was soft, not rock hard as it was after the rain last year and the sun baked it like a brick. Some of the boys cleared the weeds and a few planted the seeds. I planted at first and then took over from one of the boys who was weeding. Soon a shower moistened the ground, good for the seeds, but it ended our work. Shortly, the rain ceased and we were able to play a little game of catch, teaching the position of the mitt to catch the ball thrown in different areas. These hand movements are intuitive to those who have played all their lives, but these boys “catch” a ground ball with their feet and then pick it up. Pablo is the best athlete in the group. We played a game of catch where you step back one step after each catch and a dropped ball is an “out.” Eventually we were quite far apart when he finally dropped the third ball. Three outs! Then the player needed to change gloves with another boy. All the boys had shared the gloves and somewhat begrudgingly, gave up the glove to the next player. I was so proud of Pablo, having played the game for at least fifteen minutes while the others watched. He wouldn’t give up the mitt. Finally he relinquished, but went off to sulk. This was the first time I had ever seen this happy child act in this fashion and I really didn’t understand his behavior as he had done so well. This type of behavior will improve when the other gloves arrive and every boy has one.

Soon it was time to leave, after I had a conversation with the two foster parents who are fearful of the administration change. This may result in their leaving, but I told them they have my backing, but I am not in control. Several issues were discussed that have been bothering them as they have little contact with the Rotary Club who should have been involved with these issues before. Following lunch I went to a small church, Church of Nazarene, where we have helped with small projects for five years. They are in charge of a feeding program funded by the American charity, Compassion USA. Compassion provides the money for food and administration, but not for building. In the past, when I provided money, the projects were started and finished rapidly. This is important for our groups, as it is nice to see the progress in the short time the groups are here. Our mission will fund about $2500 to build the last of several classrooms that we have built in the past. The classrooms are used to teach the children after they eat as they all go to school only four hours a day. Since feeding children and the poor in general, and educating children are the main concerns of our mission, this project fits our goals perfectly.

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Thursday, February 28, 2008

Dr. Dardo Chaves, and I brought our pickups (actually they are both his) to carry the luggage and we hired a microbus to pick up the group from UNC-A. This is the first, I hope, of many trips to the south of the border for a new program, Mountains to the World. This program was funded by a grant from a former Highlander David Sweat, to give students an alternative to the normal spring break and give them experience in a Latin American country. Since David knew me and was familiar with the mission, it was suggested that they contact our group to see if they could come with us this year. This year their main focus will be the lead testing project. We have enough kits to check 1000 children and hair samples, soil, water and environmental surfaces will be tested for lead and other heavy metals. Those samples will be tested in the laboratory in Asheville. I have no idea if there is a problem with this element that can cause fetal death, low birth weight, hyperactivity, low IQ and anemia in children, and hypertension and heart disease in adults in addition to countless other illnesses and symptoms. Some of the students want to teach dancing and music in addition to visiting the orphanages and hospitals. The plane was on time, but our group did not emerge from the customs for a long time. I feared that they had held up our monitors we had brought, but, alas, one of the students had not obtained a visa and had forgotten her forms, so all this had to be done before she could enter the country. Finally we were able to take our bags to the waiting trucks. None of the bags were checked by customs, so our initial experience was not a fluke. It had been cloudy all day and raining hard on and off, with no let up in the precipitation for the first time this trip. It rained hard the whole day. Fortunately we had tarps to cover the baggage. We arrived back at the Pinocho and unpacked. The students mostly wanted to live with families and the Rotarians found beds for nine of them. The rest made their home for the next week in the Pinocho. Lunch and dinner will now be served at the hotel in addition to the usual breakfast. Joanna and I will go from skimpy sandwiches to a full spread of meats, vegetables, rice, potatoes, and dessert.

In the afternoon we all went to the different venues of work in the same bus that had brought the group from the airport. The rain had let up but it was still drizzling when we finally approached the road to the foster home. Since the bus could not get through the muddy road, all the people got out of the bus and got in the pickup for the final journey to the foster home. Those in the back of the pickup had an exciting, albeit, short trip. Last year we made such journeys to the campo to hold mobile clinics and the roads were this bad or worse and the trips were for 50 miles or more. This was a cakewalk. Unfortunately, the gate was locked and no one answered the bell. The boys always go to school in the afternoon so it was no surprise that they were not there. I suppose the parents took this opportunity to take a break from the place. After our blunted visit to the home, we retraced our steps and then visited two more locations and finished our visits at the Cruz Roja Clinic where a small gathering was held to hear about the lead project and gather support for the project. The minister of health for the district was there and she threw her weight behind the project. Dardo had obviously done his homework to get all these important people here for this meeting. No one had heard of lead poisoning before. Linda Block, the faculty leader of the group had a slide show she had given in Mexico. When she heard who would be there, she grabbed her flash drive, I brought my computer, and Danny Ortiz brought the clinic’s projector, and in less than

Linda Block demonstrates the Niton XRF lead and heavy metal tester

30 minutes we were ready to perform the slide show. It is amazing what can be done in this age of electronics. The ability to get the permit for the machine was another example. We were able to communicate in two languages in two continents for two days completing a task that would have taken weeks in “the olden days.” The newspapers and the television media were there so everyone will know about our project in a few days. After the meeting we had a few minutes to rest before the Rotary Meeting. The Gringos definitely outnumbered the Rotarian hosts. The lead project was again explained and following the meeting, the students went to their beds tired and ready for sleep after a long day. By the way, they never did look at the paperwork for the machine that had the small amount of radioactivity. I was not surprised by the lack of communication with the different levels of government. At least we had copies of the needed documents in case they had looked.

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Friday, February 29, 2008

I woke ready to begin the lead project. We had a meeting with the leaders of the Etta Turner Center at 9AM. We explained the project to them and told them of the benefits to the children and the community as a whole for this project. There is in reality, very little treatment for the children, but prevention of disease is cheap. Treatment of disease, in general, is expensive and only available for the lucky few who can afford it and with lead in particular it is very expensive. We don’t know if there is a problem here until we test the children. In the US lead is mainly in paint. Here no one painted their homes in the era of lead paint so that will not be a problem; however other sources of the metal are common here, e.g. mining and industry in general and poor disposal of batteries and other garbage. They finally seemed to agree to the project, subjecting the youngest of their children to be tested. At 10:30 we went to the Villa Cochabamba clinic to demonstrate the technique of lead testing. After ascertaining that the controls were in the correct range, we tested one of the students who had a slightly elevated level of lead in her blood. We then tested several of the Bolivian nurses and they, too, had elevated levels. I suggested we check the alcohol that we were using to clean the fingers before taking the sample of blood, suspecting that this might be the source of false elevated levels. Sure enough, it had the highest level of all. Using a different kind of alcohol to cleanse the finger for the test, the results were lower, but not zero as they should be. I checked the tap water and it was high also. The test was not approved to check substances other than blood, but I am concerned with these levels. This is the same alcohol that is sold in stores for medical purposes, but also it is consumed by people looking for a cheap drunk. These unfortunate people may be at risk of lead poisoning. Three ounces can be bought for less than a quarter. We broke for lunch and then returned to visit a local school near the mercado to check our first patients. It was an interesting afternoon. The children’s classrooms were isolated from the other parts of the school. At first the little ones were reluctant to have their fingers pricked, but when they found they would be rewarded with a balloon, most were persuaded to have the test done. The girls all were tested, but several of the boys resisted and we didn’t press the issue to test them all. All children had some lead and one had a high level. In all, twenty five children were tested. Two nurses drew the blood and two students performed the tests. Data were collected and it was quite well coordinated, considering it was the first time, with the work we had done before having forms ready and the teaching sessions for the health care workers. They will continue the project after we leave. I think the lead is coming from the gasoline, although Bolivia supposedly removed lead from

The nurse takes a sample of blood as the other children watch. Most of the children were very cooperative and brave.

the gasoline in the 1980’s. Even small children are passengers on the motorcycles, which spew out fumes at alarming rates. Tomorrow we will check some homes and then go to an industrial area near the sugar factory. Unfortunately, while we were busy doing the blood tests, a student and Linda were checking soil samples outside, and that student’s camera disappeared. Only the nurses, the children and the teachers were present in that room. I know people in the police and they will check into this theft. This was a birthday present for this student, which was given in advance of her birthday next week. For her, and us, this was a real tragedy. Several of the students went to the orphanage and several more never made it to the orphanage that is near the market. They got engrossed in the lure of the mercado and got lost. At least they had an experience even if it wasn’t the one they had planned.

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Saturday, March 01, 2008

We received the results of the lead tests that the nurses performed after we returned last night. The actual test in the machine takes three minutes, but with three nurses taking blood samples the ability of the machine to cope is quickly overwhelmed. There is no way to speed up the machine; therefore the nurses did the tests in the clinic at night. They seem very dedicated to this project already. Three results were in the high region and one in the critical area, over 20-micrograms/ deciliter. The lead group went out to check the home of the child who had such a high level and found no lead there. They need to check 20 homes to have enough information to come to some conclusions, and hair and water samples, in addition to soil and fish need to be taken home to UNCA for analysis.
I think I already know the answer, but it is dangerous to jump to conclusions. The air that we breathe is contaminated by lead from the gasoline. The translator, and our friend, Daniel Ortiz lives most of the time in Santa Cruz. There are fewer motorbikes there and the cars and taxis generally run on natural gas which has less or no lead. Although the levels we have found so far might not make the children sick, it could affect their potential IQ and cause premature mortality when they are older. Apparently adding ethanol to gasoline to boost octane is nothing new. In the 1920-30, blended gasoline with alcohol was common at 15-20%. Prohibition and a cheaper form of gasoline additive, tetraethyl lead, or THL came along and replaced the more expensive ethanol. The industry thought the level in gasoline would not hurt the public, but children living near the expressways in big cities developed many problems similar to those in children, and adults, living in mining

The UNC-A students plant seeds in the garden.

communities or smelters of metals which included lead. Since our preliminary tests don’t find lead in the soils, it is probably the fumes from the cars. Only a few developed countries still have leaded fuel, like Indonesia, and they will soon fade it out, but many undeveloped countries still have lead. Since 1980, Bolivia is not supposed to have lead in the gasoline. Since the ministry of health is interested in our project, perhaps something can be done to hasten the elimination of this toxic element from the gasoline, if that is the cause, and thus, the air. While they were checking the homes for lead, the rest of the group went to the foster home to plant seeds, play baseball and soccer. We played a spirited game of soccer in the mud and rain. The Bolivians (the children) against us (the adults) which ended in a tie, 2-2. I played goalie for our side and managed to stop a ball with my face and right shoulder. Right away I noticed the smell of feces and, unfortunately, the taste. I didn’t swallow my saliva until I had a chance to wash my mouth out with clean water and mouthwash. All the boys were on their best behavior. When there are more people around to play with the children, there seems to be less fighting as no one feels left out. Little Lorenzo, the newest boy who fights a lot, scored a goal and that made him feel really good. Later when we were playing catch with the Asheville students, to show them how it should look, I asked Lorenzo to throw to BJ, who by now was quite far away from me. He threw a perfect ball to him. Others came into the game and we had a large circle of players throwing from one to another. They all want to bat. That comes easily, but catching and throwing are the keys to the game.

After lunch we all went into different directions. Some went to the hospital to see births and did get to see a Cesarean section, some went to the resort, Las Lagunas, others just walked around the city, while some rested, especially the group of three Highlanders who arrived this morning. Joanna had met Steve Hott, Michelle Hott and Jessica Connor, all of whom have been here before.

Wilder and Fredy play catch

In the evening, I unpacked the new suitcases and repaired the two monitors that had some internal parts come loose during the flights. The students and one of their leaders went off to Santa Cruz to see a concert. They went with Daniel in whom I have the greatest trust. Still, they won’t be back until 1 or 2 AM and like a good parent, I will worry until I hear them return.

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Sunday, March 2, 2008

Today was an interesting day, as most seem to be here during the mission. After breakfast we visited the Dios Es Amor Church which is always a treat for me. This is the church where we had the feeding program several years ago, feeding up to 2000 people at a meal. Immediately we were recognized and announced to the members, who had noticed us also. Even though it was the Queshua service, the language of the Incas, the only words I understood in the service were, “We need two thousand dollars more to purchase the land for our new church in Portachuelo,” which was spoken in Spanish. I am quite sure the pastor said those words in Spanish for my benefit. Their church is still in the process of being finished even as they are beginning a new church in that nearby city. (Portachuelo is actually more than 500 years old, but still a very small town) I was impressed that they are moving ahead with such a project before their church is actually finished.

Joanna and I went to a birthday gathering in Santa Cruz while the students from UNC-A went their various ways to Buena Vista, about 50 miles to the north, to Las Lagunas, the resort with the giant pool, to the hospital, to the foster home and some just walked around talking to people randomly on the streets. There are many Spanish speakers in the group giving them the confidence to venture out. I was concerned about their going to Santa Cruz last night, but they all returned safe and sound and did so again this afternoon. Perhaps I have been too protective of the groups in the past.

Following the lunch in Santa Cruz, our host took us to a movie theater, the largest I have ever seen. There were ten different theaters within the huge building with shops and restaurants in the complex. There may be bigger theaters somewhere, but I have never seen one like this. We saw the “Bucket List,” which was in English, with Spanish subtitles. It was a very good movie with Jack Nicholson and Morgan Freeman. It is worth seeing even if you don’t like movies. Returning back to the Pinocho just in time for dinner, eating is a full time job here, we ate and then planned the following week’s activities. Our construction project is at the comedor at the Nazarene Church and other projects involve the hospital, the foster home and orphanage, home visits with the visiting nurses and the lead project. I called several of my friends to set up meetings with the water authority and the leaders of the government to help us obtain the information and samples we need to complete the project. One week is not enough time to do such an important project. We spent the evening into the night completing the consent forms in Spanish and making lists and procedures. Much of this should have been done back in Asheville. Finally, around midnight, I managed to go to bed and breakfast is at 7:30. Like last year I will be spending much of my time as a taxi driver.

Monday, March 03, 2008

My belief that I was to be a taxi driver today was a sound one. The first group left for the hospital at 8AM. I met the medical doctors on rounds and introduced the students to them, but they wanted to see deliveries again. On the way to the delivery suite, we met Enrique Escharagay, a quite well known TB specialist who has chosen to stay here in Montero with his meager office rather than going to almost anywhere else to practice. I am trying to obtain a Gates Foundation grant for his office and work. TB is a terrible problem here. At 8:30AM the construction group led by Steve Hott went to the small church to begin the classroom. By the end of the day, he, his wife Michelle, several students and two Bolivians had finished 5 courses of bricks around the whole place. Another group was led to the foster home by Joanna and I took Laura, whose lead project is a major focus of the trip, to the supermarket to buy notebooks, plastic spoons to collect soil samples, plastic bottles and other things she needed. I went across the street to buy a measuring cup which was not available in the supermarket and some distilled water from a laboratory run by friends. This came in a liter bag, like IV fluids. Because the director of the lab is a friend, they would not charge me. We need six more liters so I will offer money and take nothing less than “yes” for an answer when I return tomorrow. We returned to the Pinocho to pick up the rest of the lead team and off we went to the Villa Cochabamba to pick up the nurses that have been so gratefully donated for our efforts. We were late by this time and I thought I knew approximately where the school we were to visit was, but the nurse giving me directions led me back to where I had just come. Eventually we went around the block a few times and came out where I was intending to go originally. I have found several shortcuts, or at least routes that avoid traffic, over the years, but she made me go in all the really congested areas. Eventually arriving in the area called Guabira, we again made a wrong turn and continued to go the wrong way down one-way streets. It became apparent to me that she had walked these streets, but never had driven on them. When one is walking, there are no one way streets. Finally, as we arrived, at the school, we met the health director who had just started to leave, giving up on us I am sure. Over the years I have developed a reputation for being on time. I hope I don’t lose that over the next few weeks as it took a long time to change the behavior of these very nice, but tardy people. We managed to check the walls and floors of the school for lead and other heavy metals, and found none. The children, however, had moderately elevated levels as we have found everywhere else thus far. We were able to check about 20 before the school let out for lunch. The parents who came to pick up their children were very happy to have them tested. I have always found that the parents are happy to have tests done on their children if it has anything to do with their health. One mother wanted to be tested, so we did her out of courtesy. Adults and older children generally will be negative for lead, as she was and I checked her for diabetes also which was also negative.

After another wonderful lunch we met with the sub-prefect (there are nine districts in Bolivia and each has a prefect. There is a sub-prefect in each of the “counties” in the district). He knows everyone who is important and he made us an appointment with the chief of the water department called COSMOL. That would take place at 5PM. We went back into the outskirts of the town to meet up with the other parts of the team that were checking houses, which takes a long time, and the children in those houses. It only takes a short period of time to check the children and most never cry. The balloon given as a gift for their pain and suffering always seems to be enough to make them happy. As I have noted from the first year of the mission, the poorest children are the bravest.

The children happily playing with their balloons after the tests

Soon it was time for us to meet the water people at COSMOL and off we went leaving the others behind. I was not sure I could find them again, but there are several in the group who speak Spanish well and there were three nurses who know the way around these parts like the back of their hands. Without their help, who knows who would have the confidence in us to let us do this kind of work? The meeting was interesting to me. They showed us how they check the water and the results. There are 9 wells scattered about the city that are over 200 meters deep. The water from each well is checked every six months and the data was there for anyone to see. Actually it looked too good for me as there were no abnormal reading ever! Even in the USA it is impossible to be perfect all the time. We got permission to check the wells and also we were given a computerized map of the water system showing the type of pipe, the oldest being cement and the newest being PVC, and when the pipes were last repaired and the size of the pipe. It was really quite impressive. I left Laura and Danny (to translate) at the office as I returned to the group I had left behind. Just as the sun was beginning to set, I found them. They had just finished the last house. At dinner, the hospital group reported that they had not seen much. The hospital has had such bad administration that, I think, the people have lost trust in the place. At least the ceilings that had fallen down last year were repaired. The construction team had completed several more courses of bricks. I like this kind of work as you can measure your progress from day to day. The temperature was OK as it was overcast and threatening to rain all day but actually rained only enough to keep the temperature down and the dust under control. The men at the COSMOL agreed with me that there is still lead in the gasoline even though it was supposed to be eliminated almost ten years ago. However, we have found little in the soil where it would usually remain for years. However, it never rains like this in any place other than the tropics and it may have been washed away. All the people, including me, have no real proof that there is lead in the gasoline, but everyone I have talked to suspects that it does. Since we can’t take a sample back in the airplane, we might never know.

It is not uncommon to see livestock just walking around in the city. One of these sheep is hairless, breed for this condition because of the heat. Inbreeding has brought out the hairy gene in his sibling which can make life miserable in this heat.

Everyone was a bit concerned about the politics here with Evo Morales, the president, doing all sorts of weird things and trying to have a populist movement to redistribute the land to the poor, but today I saw in the newspaper that there is a possibility of war between Venezuela, Ecuador and Columbia. Who would have thought it? The people here have no interest in fighting, but, if pushed, they might resort to conflict, especially if the government tries to take away their land. The nature of the two different areas, the mountains versus the tropics, is vast. In the mountains, the farm land has been cultivated for thousands of years, while here in the tropics, only since the malaria has been reduced by insect control has the land been able to be cultivated in an efficient manner. Also sugar cane, Soya, and cattle need to be raised in large farms to be efficient. Small farms cannot afford the large equipment to reap the crops. Mountain crops are often maintained by hand in small farms. Evo also wants to stop exporting crops, to keep the food in the country and thus keeping the price down. Again, this hurts the tropics and helps the mountain people. The oil and gas are all in the tropical area and it is closer to export it to Brazil and Chile than it is to send it to the Alto Plano. I think he will be out of office before he can institute such foolish policies.

Tuesday, March 04, 2008

This was a pretty good day. After taking everyone where they needed to go and some now get there on their own, I was able to go to the foster home for the first time in several days. The new lathe had to come in separate pieces as it was too heavy to come in one piece. The largest part is here but it is useless until the other parts arrive in the few weeks. In the meantime, we are cutting up the wood parts, drilling them and inserting the metal tubes. All this can be done in anticipation of the arrival of the rest of the machine later this month. Then the pen making will be rapid. The three oldest boys worked with me, Pedro, Fredy and Wilder until I needed to pick up the lead testing group at 10:30AM. Pedro said he would take the students and Joanna back to the Pinocho. That relieved me of one more thing. Fortunately for me the lead group was close by, but I didn’t know exactly where they were. I got directions and found the school, 12th de Abril quite quickly, albeit, over some really bad roads. They were set up in a new classroom with an unfinished roof and bricks for a floor. Thankfully it was not raining. About 20% of the children have elevated lead levels which is a very high percentage for the USA where only 1 or 2 % is normal. We left there and went to the comedor, the feeding center, where we are doing the building project. There we checked 25 more children with similar results. When the samples are tested in Asheville, we will have a better idea of the source of the lead, but currently, the dirt, paint and other surfaces have not shown a significant amount of lead. Water will be tested back home as we don’t have the technology to do that here.

Following lunch, I told the lead project group that I would take them to their first place and then I had other plans. I didn’t know that the first place would be “over the river and through the woods…” literally. I had been the general area before, but I had never passed the dike like area previously, and if I had gone there before, I would have stopped and turned around. The elevated structure was, indeed, a dike. There was a river beyond which, from the look of it, floods frequently. Beyond that were a series of brick making kilns and holes that fill with flood waters, leaving behind the clay which can be mined, made into mud bricks and baked in the drier season to make the bricks that everyone uses to build their houses or other buildings. It is amazing how the raw materials are brought to the area by the rivers. There is the sand in the big rivers, and clay in these shallow low lands that need the flooding to replace the material that is dug out every year and used to make the ubiquitous bricks. Then there is the fuel that bakes the bricks. This is also renewable as they use wood to stoke the fires. That process should create the possibility of contaminating the air with many toxic substances. I left the researchers and the nurses, but, needless to say I arrived back at the Pinocho more than an hour late. I really thought the ride through one river and down some roads to the houses of the workers that live there was an interesting one, to be sure.

After lunch and completing my taxi duties, Joanna and I went to a nearby town, Portachuelo, with a few of the students, just to get away for a bit and buy some honey products to sell back home. The skin cream is well known by our volunteers to be as good as any similar product found in the USA. Upon returning we ate dinner and then I was called to come to a “brief” meeting at the Rotary House to hear the final reading of the legal document pertaining to the administration of the boy’s home. The meeting was important but the discussion of every little detail is boring to me. Finally everyone seemed to be in accord with the document as written. The major issues were the fact that this group is a protestant evangelical organization and the boys have all been brought up as Catholics. They stated that they would not try to convert anyone at least until they came of age and that we didn’t want any older boys to come in from the outside, only those who grow up within our home. That decided, I left to play tennis, but two of the persons present at the meeting were my prospective tennis partners.

I warmed up with young man who was a son of one of the doctors with whom I play.
Eventually, everyone arrived and we had a good game. I have been asked to help one of the boys in the tennis program get enough money to pay for a trip to La Paz to play in a tournament. I came up with the idea to sell some of the racquets I have brought to help defray the cost of the trip. The racquets that were donated by the Mountain Laurel Tennis Club are older models but are very modern to the people here.

Wednesday, March 5, 2008

Wednesdays are always fun as we usually work only half a day and go to Santa Cruz for shopping and go to a restaurant. After my taxi trips and taking a few photos, a big group went to the boy’s home. I did the pen project with the same three boys and a fourth, Marcelo, entered into the fun and was trained by the other boys. As in the past, the drilling of the wood blanks and the gluing and inserting of the tubes are the easiest part of the pen making process and the boys do this task well. Following about one hour of that work, we played baseball, using a light ball that was obtained from McDonalds and brought here last year. The boys can hit well, but no one wants to play in the field. Due to that fact, I decided to stop hitting and let the boys play soccer. One of the boys got the plastic bat and the light ball and tried to hit it into our group of soccer players. I told him to stop three times and finally he hit one of the boys in the head with the ball. Fortunately, it was this light, whiffle type ball instead of a real baseball or it could have been a tragedy. Instead it was a learning experience. I took to bat and ball from the boy and took him to the garden. I don’t know what was going through his mind as we walked, in silence. We were in the garden alone and I told him to pull some weeds and then we talked about the incident. Walking back to the house, my arm around him, he seemed relieved and I hope he will remember to be more careful. This child has had problems in the past, and despite his size, he is a crybaby when the others fight back and he is teased even by the little kids. I worry what he might do, especially when the children use machetes to cut the grass.

Every group was in a position to be picked up in a logical order and all were ready for a little relief when I arrived at the respective sites. We have been working hard in the various areas. The classroom has four walls and is about ready for the roof and the floor. Tomorrow the students will carry sand into the structure to level the floor and then bricks will be laid, and then, finally, cement will cover the bricks and the building will be finished. The doorframe and windows were inserted as well.

The lead project is coming along well with samples taken from all the sites to see if there is lead in the city water wells, in the pipes or in the houses. We continue to find about 20% children with elevated levels. The latest source for lead exposure seems to the bronze faucets where older children are able to put their mouths on the metal take a drink. The smallest children cannot reach up that high.

Off to Santa Cruz we went after lunch. It was good for me not to have to drive. Having been so many times to the big city recently, I went to the camera district to see if I could find a similar camera as the one stolen earlier this week at the school. We do have a lead on the theft as one of the students saw a young boy playing with a camera, but the likelihood of recovering the camera is slight.

Having spent most of the afternoon on the quest for the camera, I didn’t have time to do anything else until I finally got the group together at the main plaza and took the bus to the Casa Camba restaurant, one of the favorite places for students to go for dinner and dancing. The restaurant didn’t disappoint. We asked all the nurses who had helped with the lead project to come and we paid for another bus to bring them to the restaurant after work. They arrived about five minutes after we did and we had a table of 35 people including the bus drivers. We ate and danced until we were tired and returned to the confines of the Pinocho for a well-deserved sleep.

Thursday, March 6, 2008

I had a tight schedule this day as we began the day with a photo opportunity loading a small truck with a chlorine solution that makes even bad water safe to drink. Almost since the day we arrived I have been working with a pastor from Beni, the area to the north where they have had flooding for the second year. We purchased $5000 worth of the chemical that will serve 200 people for three months. Hopefully then the situation will improve and families can return to a normal life with safe water options. We also donated $2500 for basic food such as rice and cooking oil. This was all photographed not so much for our glory, but to document that this money and things were donated. Pastor Dennis will email photos from Beni when he delivers and distributes the items. That will complete the cycle that maintains trust in this area. This type of checks and balances has worked well for Dr. Chavez and I am happy to learn from this successful administrator.

I dropped off the lead work team at a classroom and another meeting of the lead crewmembers was planned for 5PM this afternoon. Food and drinks would be served by these kind people in appreciation of our contribution to their mission work.

During the meeting on Tuesday evening the new administrators of the home wanted me to see the project they run in Buena Vista. It is a home for drug addicts and alcoholics. As we drove into the property, I recognized it as a property I looked at in 2001 as a possible purchase for a home in Bolivia. Obviously, I didn’t buy the land then, as it did not fit into what I thought the mission would become. Immediately it was obvious that this facility was well run and that is what we need in the boy’s home. The last part of their addiction treatment has the persons going to a home of a couple without children. The addicts have to work to earn money or they don’t get fed and they don’t have electricity if they can’t pay the bills. Many leave, and that is that! I think this group of couples will be the source of families to work in our home. There will always be a source of families from which to choose, so our home will not be left without foster parents. We had lunch in the town of Buena Vista in a restaurant on the square. Since last year the roads have been bricked and the area is just beautiful. It is a small and tranquil town. I bought some coffee beans and raw chocolate to sell at the summer’s auction at a shop on the main plaza. Traveling with me were the president of Rotary and his exchange student from Japan. I could understand her Spanish as well as North American’s speaking Spanish. As a second language, the syntax and speed of speaking make it easier to understand. We talked about food, topography and the cultural differences between our three countries.

I made it back to Montero just in time to pick up the group to do the lead project in a nearby eating center. I did the blood samples and when we finished with the children, I checked the blood pressure and blood glucose of the mothers of the children. Our monitors that we purchased for this function worked very well. Tomorrow we will take several monitors to the Guarani Community to do the lead study and a screening of the adult Indians there. This year we are much more organized with no carbon required printed forms which creates a duplicate for the patient and a copy for us in addition to the vital sign machines that will allow all the students to be involved. Blood sugars will also be performed with the handheld machines that are very easy to use.

I planned to rest for a few minutes before my 5 o’clock meeting at the construction site when it began to rain hard again. It has been raining all week on and off. No one has seen the Southern Cross, which is a shame for those who have crossed the equator for the first time. It cannot be seen on our side of the equator. It is the equivalent of our North Star. I got a call that they were waiting for me and I felt a bit indignant as I was not yet late. It is very difficult to be on time with a group this big as there is always someone who isn’t ready when it is time to leave. I drove to the church in the rain and it was obvious they could work no more in this downpour. The people of the church wanted to show their appreciation for our

Lauren Wingo, Lydia Doll, Kassidy Heffner, Steve and Michelle Hott and Jessica Connor have nearly completed the last classroom of the feeding center

contribution and work on the classroom so they had a little party for the workers and me. So far I have not laid the first brick although I did bring a few wheelbarrows of sand to the site. We had coffee, tea and a variety of locally made breads followed by a wonderfully moist, sweet cake. I generally don’t like cake as it is too dry for my taste, but the cakes are moist due to jell-o like fillings and fruit between the layers. The rain stopped as we were finished eating and Steve Hott jokingly said that we could begin to work again and one of the Bolivian workers got up to do so. We laughed and decided the workday was ended and we went home. The pastor invited us to church at 10AM on Sunday which was good as the Penial Church had asked us to be there on Sunday at 9AM. Later I got a call from the pastor of the church that Danny’s brother is building to be there at 8PM. Since this project will soon be finished, we will need another small project to fill our building needs in the coming weeks and that church may be the site. Our Sunday church card is now filled.

In the evening we attended the Rotary Club where Ashley performed an example of clogging, which used to be the famous dance of the mountains of North Carolina. She still teaches this type of dance but the center of clogging has long since left the mountains to other areas where it has increased in popularity. It is hard to think of Highlands in the 70’s without thinking about Helen’s Barn and clogging on Saturday night. Now both are gone.

Friday, March 7, 2008

The lead project is into the home stretch, at least as far as the home visits are concerned. The machine which contains the radioactive material needs to return with the UNC-A group and it is the most important part of those visits. The Niton XRF can detect elemental metals just by applying the machine to the surface and is good for paint, china, metal and practically any surface material. How it works, I do not know, but it is amazing! It reads out the percentage of metals in order of their content as long as it is out of the predetermined range. Lead shows up as well as iron, zinc, arsenic and some elements that I didn’t remember from chemistry. Thankfully, no chemicals are turning up in dangerous amounts aside from a few sources of lead, mostly in the brass faucets. Brass is not used for that reason in the US for plumbing, but many older, quite expensive fixtures were made of bronze. I know I used to have some bronze fittings in my house before we replumbed the house in the 1980’s. After dropping off a few people again, I visited the foster home and continued the drilling of wood for the pens. I don’t remember where I put the rest of the parts of the lathe, but I hope they come with Eugenia Green and Michelle Main who come tonight. I didn’t put them on the list of priorities because I thought the old lathe still functioned. An electrician is coming later and maybe he can fix the velocity regulator and then we will have two, which was the original idea. I really thought the lathe parts were in the group of suitcases brought by the UNC-A group and I hope they weren’t removed to make room for something else. Then they won’t come until next year!

After lunch we tried to go to the Guarani Community. The main road is being repaired but it is paved and created no problems. The dirt road that we turned into was bumpy but not a problem. After driving about 10 Km on this road we came to the path to the Guarani
Community and the gate was locked. I understand that there are two reasons for locking the gate. One is that the bridges are washed out. In that case, we will never be able to enter the community during this trip. The other is that they don’t want people using the road when it is muddy as the tires make so many ruts that the road can be ruined for several months. I hope the latter is the case. I knew another route to the community so we backtracked to the main road and took the road to that goes by Las Lagunas, the resort. A cry rose up from the ranks to go there instead of doing the lead tests but I wanted to do testing on the children in the campo, the country. The road was not good but it was passable. Finally we came to an end of the road. I asked a man whether we could go to the Guarani Community and he said the road was not passable. Then I heard him speak to his wife and I recognized the Guarani language and asked him if the Guarani lived here. He said, “We are all Guarani.” Apparently we fell upon one of the three Guarani Communities that dot the landscape in this part of Bolivia. I told him what we could do, checking the adults for diabetes and hypertension, and the children for lead. Since we were there, I thought

Everyone ready to go to the Guarani Community

we might as well do something. Soon there were about 20 children waiting in line to get their fingers stuck all without crying. Even the toddlers didn’t cry. How they know to be stoic at this young age, I do not know, but this has been my experience in all my years here in Bolivia. As the other children in the city, the levels were slightly elevated but not alarmingly so. All fell between 5 and 8 micrograms/deciliter. While these levels are elevated, they probably won’t effect development of the brain. Still any lead will eventually cause premature death from a variety of medical problems, including heart disease and hypertension. The community did have a central water system and there were the ubiquitous brass faucets in the home and in the yard. We returned to the Pinocho feeling that we were lucky to go to such a remote area and return without getting stuck.

In the evening Joanna and I went to a meeting of the Civic Community of Montero, a group of mainly women who perform volunteer work in Montero. After many speeches, they finally gave four women awards for their volunteer work. Joanna was one of the four. She is a professional volunteer in Highlands as well but it is nice to get some recognition of her efforts here as well.

Joanna and three other volunteers receive their awards

As soon as she received her award, Herman and I left for the airport to pick up Maria Eugenia Green and Michelle Main at the airport. Once again the plane was late in arriving. Since there is no landing in La Paz on the night flight, the problem had to be in Miami. When they finally arrived they told the tale of waiting on the tarmac for several hours with mechanical problems. They thought the flight would be cancelled but finally they took off, delaying the arrival by an hour and a half. More groups are arriving tomorrow when we will have the most people at one time in Montero in the history of the mission.

Saturday, March 08, 2008

This turned out to be a day I will not soon forget and, unfortunately, not for a good reason. The AA flight was late again, this time by 1:45 minutes. After loading the two buses with luggage and people, there were 26 total, we headed to Montero. The two buses left just before me and I followed in the truck in which I carried Elaine Clark of Ole Miss, Shannon Shea, a senior at Johns Hopkins, and Robert Wicks who developed not only this group from Johns Hopkins, but initiated the first group from the University of Mississippi in 2005. Just before we got to the roundabout at the south side of Warnes, the town next to Montero, a crowd had gathered and two or three automobiles were in front of us. It was apparent there had been an accident. I asked Shannon, whose Spanish was much better than mine, to go and see if we could be of some help. She returned to tell us that one man was dead and another injured. I wondered how she could be so sure about the one who was dead, as she had been gone for only a few seconds. We identified ourselves as medical personnel and they waved us toward the accident site. One man was in pain with an obvious broken leg. The unfortunate one had been a motorcycle taxi driver. The bike apparently fell in the mud and pools of water that had collected in this part of the road and he was run over by a truck. I won’t describe the scene further, but the image is ingrained in my mind to the smallest detail and I don’t think it will soon be erased. We helped put the injured man on a stretcher and offered to place him in our truck, but he would have had to have been placed sideways with two or more people in the back of the pickup to hold the stretcher to be sure he didn’t fall out. It would have worked but a bigger truck was close at hand and they let us pass and loaded him in the other truck. Soon, traffic was moving next to the dead man as if nothing had happened. Traffic would have been backed up for miles in the US until the body had been properly removed. Death is more commonplace here. I hope his family will be all right and I am praying for them right now.

By the time we reached the Pinocho, lunch was being served. Luckily none of the others witnessed the accident, being only minutes ahead of the tragedy. I warned the crowd about using the motorcycle taxis as many of the UNC-A students have used them.

The rain continued to fall and we decided to go to the foster home, as we really couldn’t do anything else. The road was horrible having been traveled many times while muddy. The ruts were deep and they caused the passengers to lurch back and forth. Finally we arrived and there was no welcome by the boys or the numerous dogs. The rain was that bad keeping the boys inside and the dogs under the eaves to protect themselves from the rain. Normally, if there is a chance to play outside, the boys take it. We all went inside to play with the kids and there was no outcry to go outside to play baseball or soccer. I took some to the carpentry shop to continue the drilling of holes in the wood for pens. Fredy was proud to be able to do this quite well all by himself. He does try to drill too fast causing some of the wood pieces to break. Of course, he didn’t think it was his fault, but that is OK as there are a lot of wood pieces. Mostly we have guaycan and tajibo wood at the present time. Both are fine woods for pens and furniture. The adults and one 8 year old inserted the brass tubes covered with epoxy into the drilled pieces of wood, so these will be ready when the rest of the lathe parts arrive, or when we are able to fix the old lathe. We have a lot of pieces ready for the lathe when all the pieces finally arrive. The boys and I can hardly wait!

Lauren Hodges and I collect water samples from the river. The main flow of the river is in the middle, but this river was filled from one side to the other just two days later.

Lauren Hodges, who is doing the lead project as part of her schoolwork, needed to collect some water samples from the nearby canal and the big river, Rio Piray, that carries water from the mountains to the Amazon basin, through Beni. Quite frankly, the canal near the boy’s home is the real reason why I decided to fund this project in the first place. It is very nasty, draining water from the whole city of Montero. We collected the sample from the canal first to gain experience, as we would need to obtain our river sample from the Eisenhower Bridge over the river Piray that is some 200 feet below the bridge. We had some string that Irma allowed us to use. We were able to collect water with a plastic bottle that would fill only partially and we needed to get three samples to fill a quart bottle. Driving to the big river some ten miles away, we parked by the bridge and began to walk to the bridge, as there was a traffic jam as no one was allowed to cross the bridge. There was a dirt road off to the left just before the bridge and we decided to take it and see if we could obtain a sample from the river’s edge. The road, like all others, was in bad shape. Being so close to the river it was very wet and slippery. I spotted a path to the river and stopped in the middle of the path, not being too worried that another car would need to pass. We were able to collect a sample using the same technique, as the water level was so high the water was right up to the bank where we were. Normally, we would be several meters from the river’s edge and this could have been quicksand as it had been recently deposited. The path we took was covered with large leg bones of cattle. How they got there, I can only guess. We collected our samples and returned to the truck. The road was so slippery that we fell into the roadside ditch even though we were traveling very slowly. Finally we were able to retrace our steps and return to the main road. Traffic on our side of the road was blocked allowing us to travel back to Montero without any other cars on the road. We later found out that the road on the other side of the bridge had washed out on the southbound part of the road.

On returning to the boy’s home to pick up the rest of the students and Joanna, we made the road even worse. This part of the road must be filled with stone. Apparently this is private property, but they have to give us access. Improving the road should not be an issue, as the repairs would make their property more valuable. They say this will be fixed by Monday for the birthday party at the home. Personally, I don’t think having a party at the home is a good idea because of the road.

In the evening I showed the movie, “Wit,” a story about a woman with ovarian cancer. We show this movie to hospice volunteers to show they how not to interact with patients and I showed this to the med students to show them how not to be a doctor. There was no empathy from the doctors and only at the end did the nurse really get emotionally involved. There is nothing wrong with being empathetic with your patients. Some of my fondest memories of patient care were not about saving lives, but making the transition to the next life easier and less frightening. That is a trip you can only take once and practice doesn’t make perfect. I hope these young students will become “real” doctors, not just smart ones. Having seen the movie, which recalled the death of my mother from cancer and the badly mutilated taxi driver, I got emotional trying to explain how a good doctor becomes involved with the whole patient, not just the disease that the patient has. Actually, maybe this will be a good thing for them to see a mature doctor able to feel pain and sadness and show emotion even after a movie. These are human emotions needed to care for human patients. Tomorrow they will all go to Samiapata, an archeological site about four hours away. Some of the students from Ole Miss have tried to go there twice before, but were unable to get there due to the weather. One of the bridges was washed out earlier in the week, but two students from UNCA were able to get there today, making the trip to Samiapata, at least, a possibility.

Sunday, March 09, 2008

Steve and Michelle Hott left this morning and the UNC-A group will leave tonight. There are two different time sequences that work here all the time but are more apparent when one gets ready to leave. On one hand the time seems to go by so fast that it feels like you just got here and on the other, when you add up all the things you have accomplished, it seems like you have been here for months. It is difficult to explain and I think it needs to be experienced first hand, but everyone who comes here feels the same thing.

I went to the Pineal Church with Eugenia Green at 9AM, followed by a service at the Nazarene Church where we built the classroom. I would meet up with the pastor again later in the day when we went to the soccer game at the stadium, two blocks from the church. Following lunch I had to collect fish samples from my fishing friend Herman who said he is working all the time except when he is fishing. Yesterday, as we went to the river to collect the water samples, we passed his farm and I saw three or four men fishing in the small pond and he said he was one of them. He caught several fish that they use for bait to catch big ones. I had to skin and filet the fish and they were the toughest fish I had ever cleaned. I don’t know how the other fish digest these fish. In addition to the tough skin, they also have poisonous spines. I got two other samples from his freezer at his house. These samples were dated, and the name of the river where they were caught was recorded. This concluded the project as far as collection of the food, water and soil samples. The blood collection from the children will continue for some months to come.

After lunch the soccer players from UNCA wanted to see a football game so off we went, keeping one eye on the clock, as they had to leave shortly after the game and the other on the weather. It looked like rain all day but it only drizzled a little. The field came into play as the home team was out played by the visitors for most of the game, but the only score came on a penalty kick resulting from a dubious call and our team lost 1-0. The bad field made the outcome in doubt until the final whistle. Bad weather or a bad field can be a great equalizer in many sports.

After the last supper, the group left for the airport tired and ready to return home. I went to the market to buy two last minute soccer t-shirts for one of the students and they were off in the bus. Finding a plastic bag filled with souvenirs in the lobby after the group left, we raced after the bus to give the contents to the owner, but, alas, they had too much of a head start and we will need to bring these things to Asheville in April when we return. If that was all they left behind, I will feel that we did well. Tomorrow begins the five rotations at the various clinics and hospitals with the medical students. I hope it goes well as I will have to rely on my friends to make this work well. After coming all this way, these students deserve a good experience and I cannot be with all of them.

Monday, March10, 2008

I awoke at 4AM with stomach pains and diarrhea. Perhaps the Popsicle I ate at the soccer match was the cause, but who knows? If that be the case, however, all the students on the plane that left last night may have the same problem and that would not be good. While I was awake I heard the rain falling hard again and I worry about the lunch at the boy’s home. The rain continued through breakfast but all the groups were able to go to their five destinations. Two groups walked to the work places that were nearby, Dr. Patzi took one group to the hospital and taxis took the remaining two groups to their respective locations. I needed to talk to the TB doctor about a Gates Foundation grant so I went to the General Hospital to talk to him to see what he has done so far and see how the students were faring. He has been writing me about his plans and I have given him some advice about how to proceed. Apparently he has gathered a coalition of civic groups, one being the organization that gave Joanna the award last week and has talked to an architect and engineer about the building. He and I both agree that the process needs to proceed without the “help” of governmental agencies. The sad state of the hospital is an indication of how graft and corruption can sap a program. To obtain a grant, I told him, our project needs to be self-sustaining and be something new and different so it can be an example for other third world clinics to emulate. All third world countries have similar problems in dealing with TB and other diseases and they have to contend with corruption, either open, as it is here, or hidden. We need for all our money to go to help the poor people and not end up in the pockets of some bureaurcrat's pocket. Dr. Esheraguy is an honest man who also has knowledge about how things work here. Dr. Chavez, one of our partners, is another. Both could have left and found better paying jobs elsewhere, but decided to stay and make a difference here. After this group leaves and I have more time, we will get together, perhaps with a few important people and talk more. The process may take a year or more.

Due to the weather, I decided to see if everyone got to where they needed to be. I knew from experience that the two clinics would be quiet as the patients and some of the employees can’t get to work in this kind of weather. The roads were full of water but the roads near the Red Cross clinic were rivers. At least 18 inches of running water was flowing by the clinic. There were only a few patients so I made sure the students were able to look at some specimens of parasites that they may never see again if they practice in an urban area. The group from Johns Hopkins is very diverse, talented, intelligent and interesting which did not surprise me in the least. Two were from China, one from Italy, one from Viet Nam and one was born in Africa. Many different geographic areas of the US were also represented. All the students had arrived at their proper areas and several of the Ole Miss students joined them on their rounds. They are getting along well, as they are not that far apart in their studies. The rest of the college students went to the boy’s home with the Highlands’ volunteers in the pouring rain. The canal near the home is the main exit point for all the rain that falls on Montero. Now I know why these roads in a fairly unpopulated area of the city were paved last year ahead of more traveled roads in the center of the city, as they act as a drain for all this water. The canal is obviously the lowest part of the town save the brick making area further to the north, which we visited last week. That place must be under many feet of water today, replenishing the clay again. We drove over roads that were completely under water. Only a few high spots were visible. I knew where the road was but the students must have thought we were crazy! We finally reached the home and soon everyone was busy playing with the boys. Just before noon I left to pick up some of the students at the Pinocho and the rest got in the microbus to take them to the foster home for my birthday celebration. I told the driver that we would meet him where the paved road met the dirt road, as this was not covered by water when I left 30 minutes ago. I made it to the predetermined site and found it covered with several feet of water. I took the group I had brought to the home and called the driver to meet me near a hospital that was higher and out of the water to pick up the rest of the people. It took two more trips through the raging water to get all the people to the home. While the water was on the road, it actually was less dangerous as there was no slipping and the ruts were filed in making the road smooth, although we all felt like it was an adventure with water up to the floorboards of the truck. One mentioned that it was like a ride at Disney World and he felt he should get a snow cone as a reward after he arrived at the destination. The party finally commenced with a few songs from the boys and we feasted on the chicken dinner with yuca, rice, carrots and fried bananas. For dessert we had the two cakes we had picked up and brought back with the second group. There was plenty left for tomorrow and the evening meal. The rain slacked off during the meal enough so that the boys wanted to play outside. At first we played catch, as several in the group were former baseball players. We were able to show them how to throw and catch. Soon, however, a soccer ball appeared and a game commenced on the wet field. There were several puddles that the ball always seemed to find. The students and the boys were falling in the mud, often on purpose and soon everyone was soaked, the boys much more so than the rest. All their uniforms we bought last year were completely covered with muddy water. At least they had changed out of their new clothes they had worn for the party. Finally we left, taking everyone in two trucks full of people to the bus, the dirty people were relegated to the back of the truck for transport, as I didn’t want them fouling the bus. Originally we had come in four truckloads, with 22 people in the last trip. I think they all had a great time and no one was injured, which was a miracle considering some of the falls playing football.

We had time to bathe and change clothes before the next party at the Rotary Club. The clubhouse is owned by the club, unlike in most of the richer countries of the world where the space is rented. Perhaps that is why we have money left over to support missions like this one. At any rate, there is a space large enough to play basketball, if they played that sport here. There is a deck on the second floor where the meetings can be held if the weather is good, a smaller room across from the deck area with air-conditioning and the office where the fulltime secretary works.

The explosion of purple dust actually took me by surprise as the piñata flies apart

Herman and I had brought ice to cool the soft drinks and beer to the club earlier in the day. We filled two large cement tubs made for this purpose with the ice that came in pieces two meters long and about 10 inches square. These tubs would easily hold 200 liter bottles of drinks each. We arrived in two vehicles, which made three trips each. No one had to sit in the bed of the truck this time having set a personal record of 22 people in the truck on the last trip from the foster home. There was a live band, plenty of people and good food. Most of the people were at first hesitant to dance but soon practically everyone was dancing despite the heat. For Bolivia, it was actually cool, but very humid. Finally a piñata was brought out with a Styrofoam image of me with an American flag hat and an “autonomia” flag and a special autonomia shirt. This part of Bolivia doesn’t want to succeed from Bolivia but they want to be in control of their own government, thus the term, “autonomia.” I hit the piñata on the bottom and purple dust came out along with several “prizes.” The people dove in without regard for safety or getting the purple dust all over their clothes trying to get a candy bar or other items.

The explosion of purple dust actually took me by surprise as the piñata flies apart
I opened the presents that had been brought while the band continued to play and we danced until midnight. The students all walked home in a group, the rain having stopped for a while and arrived at the Pinocho at the same time that I arrived with the truck. I think a good time was had by all. I know I did.

Tuesday, March 11, 2008

The rain continued but lightly as the groups went to their respective places. So far the program is working well and the good Lord is blessing us with some very interesting cases. One rarity was a breech twin birth. This was the first birth these students ever saw and they couldn’t have known how rare it was to witness such a birth. Practically all twins are born by Cesarean section now, even here, and all breach births are surgically managed, as the risks are just too high to handle vaginally. The problem that can arise is that the two chins get caught one against the other and neither baby can be born. The second baby has to be delivered first over the first one with forceps which is a very difficult task, indeed. They witnessed a miracle and didn’t know it! Every day they see Chagas disease, dengue and parasites that they will probably never see again, but it is a good experience. I am, of course, gratified that they are all happy and I am proud of my friends who are making all this possible with their help.

In the afternoon, the groups went on house calls or conducted a screening clinic for adults where the students checked the blood pressures, oxygen levels in the blood and blood glucose for diabetes. To those who had problems, we gave advice about lifestyle changes to lessen the problem and the worst were referred to clinics and doctors. Screening clinics like this one are not performed by any other group other than ours, to my knowledge, here in Bolivia. The term “screening clinic” doesn’t seem to have any meaning to the medical people here. I may reserve two of the vital sign monitors to be used for this purpose in future years rather than giving them to the hospitals.

At the same time I took several med students to the Catholic Hospital in Portachuelo, which is on the other side of the Eisenhower Bridge. One lane was open and we were fortunate enough to get across quickly. The mother superior, a very thankful and gracious lady, met us. I have to admit that I have fallen in love with this marvelous woman over the years. It is always a joy to be in her presence, and my wife thinks so too. We set up the monitors we were donating to the hospital and they all functioned perfectly. We attached the monitor to one of the doctors to show all the features. I think we were all pleased with the reactions from the hospital staff. This kind of reaction makes it easy for us to work hard to raise money to keep the mission going. When we returned, the river was even higher than before filling the river from bank to bank. This is the river where we had collected the water sample just two days before. I would have been frightened to collect the sample today as one misstep would mean certain death. Many people were watching from the riverbank as the army was trying to fill the area near the base of the bridge with sand, but as soon as they put the sand in it was carried away by the force of the water. I have to think that this amount of rain was not a common event even in this part of the world where heavy rains occur frequently. Rains like this one coming on the heels of many smaller rains is a disaster and eventually all this water will end up in Beni where we recently sent our aid, adding insult to injury. Today I received word that the money we sent last year to build houses was finally all spent and four houses were built on stilts and many more families received tarps to offer them basic shelter. I hope they can withstand this inundation.

Lauren Zeitels takes the Madre’s blood pressure, while Trang Minh Vu looks on. Another doctor checks his oxygen level as another gets his heart monitored.

After some delay at the bridge, we rushed back for dinner and then I went to Rotary for the final signing of the document turning over the administration of the foster home to the Mision Global Peniel Association. This event was apparently news worthy enough to bring out two TV channels and a reporter. With all this rain, I would have thought there would have been something more news worthy. Unfortunately five children have been drowned or killed in mudslides so far due to the floods.

Wednesday, March 12, 2008

Finally we had a day without rain. It was overcast and cool with winds from the south. That usually means a few days of clear skies will come and then get hot for the first time this trip. The various medical student groups went to the five work areas and today we brought a monitor to the children’s hospital which was one of the five areas. We came unannounced, as I really don’t want all the fanfare we usually attract when we come to deliver expensive equipment. The nurses were happy to have the equipment and decided to put it in the neonatal area where the sickest children usually are present, but the monitor is portable so it can easily be moved to any place in the hospital.

Shannon Shea, a senior at Johns Hopkins stands behind the nurse at the children’s hospital as other nurses doctors and med students look on

I returned to the Pinocho and picked up the work crew from Ole Miss, a few of whom have really worked hard on the classroom project. I helped put some cement in the floor and then left to do some chores that needed to be done. Having little time to do what I need to do, or want to do, I decided to spend a little time with my wife. She, too, has been busy scheduling home visits with the visiting nurses and teaching English at the foster home. Also, she keeps track of where I am supposed to be most of the time. We ended up at the mercado looking for material for some projects and decided to have me fitted for a suit as we might be invited to a wedding in April, only if the date can be changed to have the wedding before we leave. It would be an honor to have someone change the date of their wedding just to accommodate our coming, but it seems like a major task. Just in case, however, we need some formal dress. After purchasing some fabric we went upstairs in the market where there are at least 25 different booths of people sewing, most of whom were men. We chose one who had a selection of suits that looked fairly much like the type I wanted. I was measured and the bill came to about $50. I decided to get a pair of pants made to replace my tuxedo pants that I bought when I was 18 years old, in high school. Over the years they seem to have shrunk somewhat and are becoming uncomfortable during the rare occasions when I am required to wear a tux. Describing how the satin stripe on the pant leg should look required my best Spanish. I wonder how the pants will look! For only $10 I am not terribly concerned if they don’t come out correctly.

After lunch, and our discussion of the cases the group saw in the morning (which we do after every lunch and dinner) I decided to drive out to the Eisenhower Bridge to see the river. It was down at least four feet from the last visit yesterday and one could see the sand again in the middle of the riverbed. Unfortunately the river had dug a channel near to the opposite side of the bridge undermining even further the base of the structure. Where the river used to be straight, or nearly so, there is now a deep bay where the bank has been worn away. This bay, which is now about a half mile across, will need to be filled in completely to save the bridge, in my opinion. The dirt has been washed away from the roadside on the opposite side from where we stood. The traffic has been halted and we walked to the bridge, having come only to watch and take photos. I wish I had a photo of the river when it was so high yesterday. We returned to the hotel just in time to leave, in the other direction, thank God, to go to Santa Cruz with our groups. Having spent all of my time last week looking for a camera for Lauren, the student from UNCA whose cameral was stolen, this time I did some shopping for the mission. I took the opportunity to buy some gems of Bolivanita, or ametrine, a stone unique to Bolivia. The same mineral of citrine and amethyst are combined in the same stone and if cut properly, it can be very beautiful with one side purple and the other golden or honey colored. I bought one large stone cut in the shape of a heart. I hope it will bring a substantial bid at the summer auction. These will be set by local jewelers in Highlands.

We had dinner at the Brazilian restaurant where Joanna and I had previously attended a birthday party earlier in the month. The students were happy with the choice having been to the Casa Camba on the way back from Samiapata on Sunday. It was good that they had gone there then as three bridges have been washed out on the road to the archeological site since this rain began. The food was good, as usual, even having a sufficient variety of pastas and vegetables to suit our vegetarian volunteer, Jessica Connor who is leaving tomorrow. She has been working mostly on the classroom and is seriously thinking about building a patio at her home with the experience she has developed during the building project. I told myself tonight that I would not eat as much as I did last week, and I don’t think I did, but I still ate too much. Even the desserts are difficult to resist. Including the drivers our bill came to just over $400, or about $10 per person. While this is cheap by our standards, $400 is a yearly wage for a skilled worker here in this country and certainly it would take several years to save enough money to enjoy such a meal with as many friends as this. Everything must be kept in perspective. The trip home was very short as I slept most of the way.

Thursday, March 13, 2008

Feeling like I didn’t need to eat for the next week, I ate a bit of fruit and yogurt for breakfast and took some of the workers to their sites. Dardo had made an appointment with me to show me what the needs were for the Cruz Roja clinic. This clinic has been a work in progress since I arrived 10 years ago. He gave me his vision of the building showing me the maternity ward that he hoped to open two years ago. The private rooms that will pay for the rest of the free deliveries were all single bed rooms while the charity patients will labor and recover in wards. Space for volunteers to live while they work in Montero was also allocated. This would be good for students and doctors that come here to learn the culture and the systems of these clinics and the TB program. Then they can take that knowledge to other countries. He needs 286 windows costing $3350 or about $11 per window. Also three more rooms need to be added before the building is complete costing another $6600. I will see how much more we will have in the bank after the extra expense of the aid to Beni. Also the groups from UNCA and Johns Hopkins have not paid yet needing invoices before checks can be made and sent. That amounts to nearly $10,000 that cannot be spent right away. I have sent an invoice to UNCA but who knows when that check will arrive? In addition to those funds, a special offering has been sent to the mission for the flooding in Beni. I don’t know how much that will be.

On the way home from the clinic the truck stopped. I had been noticing a sizzling noise after our short drives and looked at the motor twice and saw water from the road evaporating on the motor. I wondered why I had not heard this before as we have been in small lakes many times this week. I fiddled with the battery terminals that we found to be corroded. The truck started up again only to stop again and again. Finally a few taxi drivers helped after a suggestion to help us from Eugenia who was driving with me. We cleaned out the terminals with a knife this time and they ran off with the bolt that closes the piece of lead on the terminal and got a replacement that was not corroded. Returning in about ten minutes, we replaced the parts and the truck started up immediately. Can you imagine that one can buy a single bolt or screw in a store that only sells nuts and bolts? I called Dardo when we reached the Pinocho and he discovered that the water and oil were both on empty. No wonder we smelled an odor and there was that sizzling noise when we stopped. The motor could have been ruined. I don’t know if the motor had a fail safe mechanism that stopped the motor when it was too hot, or the battery was actually the problem and it was an act of God that stopped the automobile before the heat ruined the engine. I prefer to believe the latter, but I really think the former is more likely. In any case, the oil gage and heat gauges didn’t work.

We were supposed to go to the public hospital in Portachuelo Thursday afternoon to deliver more monitors, but it seemed hopeless to try to cross the bridge with all the news of the destruction of this very important structure. Most of the agricultural produce grown in the tropics that is transported to the mountains and then to export through the port in Chile travel over this road and bridge. Conversely, the fruits and vegetables grown in Cochabamba come to the tropics on the same road. The destruction of this structure would be an economic disaster for the whole country. Instead we went to the CLEM clinic and did another screening clinic for diabetes and hypertension. Shannon Shea had conducted a screening clinic at the Guabira health center on Tuesday and after the results were in today, she explained to the patients whose results were elevated what could be done. Some diabetics were high enough to require treatment right away. One who had a sugar of over 400 was given prescriptions and told to return to the clinic for follow up in one month. I hope she follows through as she has lost a lot of weight and doesn’t feel well. The few children that were at the clinic were tested for lead and they had the same moderately elevated levels that we have been seeing. None were in the bad range, but none were in the very good range either.

In the evening we went to Exponorte, a county fair like exposition where I paid for the Rotary Club to have their meeting, as they have been gracious enough to invite all our guests and volunteers over the last ten years without charge. I am sure we have been served a thousand meals in those years with never a complaint or mention of cost. I was happy to pay for the Rotarians and their spouses and our volunteers. Our wonderful meal was enjoyed by all in this festive atmosphere