a visit to my backyard

It's easy for me to get caught up in my work and life here at the UAC-CP that I often forget to see the reality of the people who live in the surrounding communities. They are the people whose lives serve as very real, but sad reminders of why the College is so important.

This past Wednesday morning, when I joined UAC-CP's public health team for their regular rounds to homes in the local area, I was reminded of the poverty that exists in my backyard. And the work the College does to address it.

With the ambulance loaded with simple supplies, the six of us ventured out at 6 a.m. In the front seat sat our driver Salvador, Hugh's mom Elizabeth, and UAC-CP Nursing student Alcira. I sat in back on the sideways seat with the College's full-time public health staff: Dr. Wendy and nurse Micaela (UAC-CP '08).

Doc Wendy and Mica walking along a trail leading to a family's home.

As we made our way to the first stop, Dr. Wendy and Mica filled me in on some public health care basics. "We go out to the communities for home visits at least 12 times per month," Wendy explained. "We serve 12 area communities, plus Carmen Pampa [where the central health post is located and managed by the UAC-CP]." In total, Wendy estimated, they serve a population of approximately 3,000 people (including the College).

The UAC-CP's primary goal when doing community visits is attending to pregnant women and children ages five and under--as the Bolivian government reimburses the College for certain medicines prescribed and attention provided to those targeted groups. They also provide a gas allowance, though Wendy said the 10 gallons a month aren't enough--they rely on assistance from the College for extras (like their salaries, for example).

Dr. Wendy asks one of her younger patients about his regular diet.

At about 6:20 a.m., seemingly in the middle of nowhere, we pulled over to the side of the road. Everyone jumped out and I followed their lead. Measuring stick, scale, immunization cooler, health charts, and registries in hand, we made our way down a narrow trail lined with banana trees. "How do you know where you're going?" I asked. Experience, they responded.

At our first stop, a two-story adobe home, Dr. Wendy and Mica spoke with the mother of a newborn baby. The mother, whom I would guess to be 18 or 19-years-old, wasn't familiar with the country's new Juana Azurduy bonus program which pays women up to $28 US for pre-natal health check-ups and pays parents when they vaccinate their small children.

At this particular stop, the new mother seemed unfamiliar with the program and Dr. Wendy explained that she needed to register herself and her child at the mayor's office in Coroico and then start vaccinating her child. The catch? The child can't be vaccinated at the hospital--he has to receive regular care from public health nurses. Dr. Wendy explained that hospitals are overburdened with "basic things" that health posts, such as the one in Carmen Pampa, can really handle.

A young patient is weighed. In this particular case, there was some worry about weight loss.

The rest of our visits throughout the morning were similar--we would stop the ambulance, get out, walk on a narrow, mountain path and arrive at homes to find mostly young, teenage moms with either infants or toddlers. The health problems were pretty consistent: diarrhea, respiratory problems, weight loss, and Tuberculosis. Dr. Wendy and Mica, regulars to the homes, also had sad stories of abuse present (physical, sexual, mental, and alcohol) and poverty ("this family struggles just to put bread on the table"). Seeing all this makes me all the more amazed that many of our students come from situations like this; it's amazing that they've prioritize their education and have arrived here--at college.

Our youngest patient on Wednesday morning was the one-month old. The oldest was a 94-year-old Aymaran woman--completely bent over at the waist from, I imagine, years of working in the field. Unable to speak Spanish, Mica served as our Aymara to Spanish interpreter. "She said she stopped taking her [TB] medicine. She said it just made her sick," Mica translated. As we were leaving the home, we ran into the woman's son and Dr. Wendy and Mica talked to him about caring for his mother.

Alcira and Mica measure a little patient.

Much of the care they provide is often on the road. Literally. "We have to get to the homes early in the morning," Mica explained, "because people leave early to go out to their fields." If they miss people, they often find them later by coincidence--passing each other on the road. It doesn't matter," Dr. Wendy said, "we can do a quick consultation right in the middle of the road. We give immunizations that way frequently."

"We forget, don't we?" I asked rhetorically as we finally started back to the UAC-CP and mind wandered to the morning's visits. "How good we have things in Carmen Pampa." Mica and Dr. Wendy nodded in agreement. "We have running water, toilets, showers, electricity, Internet, ..." I listed off. And Dr. Wendy continued, "...and regular transportation and an on-site health post." All the things so many of us take for granted in the U.S., I am reminded after a visit to my backyard, are luxuries throughout the developing world.

tyson

Just when you think you know yourself, try moving to the Bolivian campo. Here, you realize all sorts of things about yourself that you never thought you were capable of doing...or thinking or feeling.

Considering all I've learned, I think one of the things that has surprised me most is the notion that I could perhaps become a "dog person."* This is what Tyson has taught me. Tyson is a mid-sized, unidentified breed who has made my tiny canine-Grinch heart grow a couple sizes during the past year.

As my friends and family can attest, I am not an animal lover. And, in particular, I've never been a fan of dogs (especially here in Bolivia where mangy mutts keep me in fear of impending and unwarranted attacks and/or bites). But somehow Tyson has nuzzled his way into my life and, to my surprise (and everyone else's raised eyebrows), I've taken a bit of a shine to him.

I'm not sure where Tyson came from, how he ended up roaming around Carmen Pampa. But Doña Panchita, one of the women who provides regular lunches and dinners for UAC-CP faculty and staff at the Campus Leahy kiosk, told me he just showed up one day and she started feeding him. I took a liking to Tyson about a year ago when he started accompanying me on my evening walks home from work--I especially appreciated his bold, machismo when it came to warding off his barking, four-legged counterparts.

Since then, Tyson has been a permanent fixture in my life--and the lives of the other volunteers. While he isn't allowed indoors (though, for a while, it was difficult to keep him out of my open-door-policy office), most mornings I wake to find him laying outside the front gate of the house or sitting under Hugh's doorstep. He's the friendly face we come home to after a long trip; he's the energetic body that accompanies us wherever we go.

To be clear, he isn't "my" dog. In fact, I usually claim him when he's good and deny knowing him when he's bad (he has a nasty habbit of attacking motorcyclists and chickens). Really, Tyson seems to kind of "belong" to everyone--or, at least, anyone who will give him attention. Though most people, I will wager to bet, attribute Tyson's existence to the volunteers.

I can't explain it, but he's a different kind of dog. He has a little doggie persona that exudes kindness and confidence, loyalty and excitement; it's a persona that somehow supersedes all other wayward pups in Carmen Pampa. Which, I think, is what makes him special--it's what makes me like him.

In this place where I have learned (and continue to learn) so much about things, like the virtues of patience and understanding and the finer concepts of cooking and the details of Spanish grammar, I have surprised myself most by finding a special sort of love for a flea-infested pooch.

*Just to clarify, I'm not saying that I have officially crossed over to becoming a "dog person."

picture pages

When I asked my friend Kelly, who recently spent a week as a visitor at the College, what she liked best about her experience in Bolivia, she said, "The people."

The following are a few pictures of the people--whose mere presence and character add flavor to the UAC-CP.

A mix of Nursing, Veterinary Science, and Ecotourism students on Campus Manning. Approximately 250 students live on the College's lower campus.

First-year Nursing student Jose Luis Gomez with his father outside their home in Carura--a 7-8 hour drive (pieced together with public mobility) from the UAC-CP. The family hosted Hugh, his sister Paula, and me for three days in July.

Sr. Jean Morrissey, one of several Franciscan Sisters who has taught students at the College throughout the last 16 years. Above, Sr. Jean is pictured with three UAC-CP "products" at various stages in their academic careers--Victor, a current Nursing student, Piter, a thesis student, and Aldo, a graduate.

Pre-University Students, all wielding machetes, take a break from clearing bush along the road between the upper and lower campuses as part of their community service work. Seventy-four students are enrolled in the Pre-University Program this semester--52 women and 22 men.

Future UAC-CP students? Vladimir and Max, the sons of UAC-CP graduates, are good friends and playmates.

carmen pampa credit

When Mary Murphy, a Smith College math professor who frequently comes to volunteer at the UAC-CP, arrived back to the States a couple months ago, she e-mailed Hugh and me to tell us of a serendipitous encounter she had with a woman at El Alto airport.

The woman, Barbara Flynn, organizes and leads Quaker community services trips and had recently led a trip to the rural town of Sorata, Bolivia, where Benito Jallurana--a UAC-CP Education thesis student--works as part-time administrator of a supervised, student residence funded by the Bolivian Quaker Education Fund. It is a program for students who live too far away from town to walk to school each day; it provides them with guidance and educational support in a safe place to live, study, and eat.

Both women were, understandably, excited to make the connection that Benito is a product of the UAC-CP. In fact, they later exchanged e-mails and Mary forwarded me a link to the BQEF website where it explains that the Pallcapampa Boarding School "is the fulfillment of a dream of...Benito Jallurana, who made the 3 1/2 hour walk [round trip] for 3 years. Benito recently completed his university degree in alternative education with a specialty in administration of rural internados [boarding schools]. He is now part-time administrator of the Internado."

Barbara later wrote in an e-mail to Mary that people at the UAC-CP "...may be interested in knowing something of Benito's impressive record of accomplishments since completing his course work. These include guiding the internado expertly--3 of our 4 graduates are enrolled in university study; public service--as an elected representative to a council for 28 communities he was part of the executive committee. Called on frequently to settle disputes in a community, he imposed community service instead of the traditional fines; and volunteer work--he has organized other recent university graduates in Sorata to offer support to young people. He is certainly a credit to Carmen Pampa."*

It is exciting for us to make connections with other organizations doing good work in Bolivia--especially so after attending a brainstorming meeting in Coroico yesterday about ways the UAC-CP can work together with NGOs and Government entities in the Nor Yungas to coordinate projects that efficiently and effectively support the healthy development of people living in the rural area. As the College works to make change, we recognize that it's essential to build and maintain partnerships with other efforts that have similar goals. Thanks to the Bolivian Quaker Education Fund for their work to provide education to young people--maybe some day some of those students will find their way to the UAC-CP!

*Special thanks to Barbara Flynn for allowing me to share her words.

la asunta: parte tres

I felt a bit out of my leauge a couple months ago when I arrived, for the first time, to La Asunta--a remote, under-developed pueblo in the Sud Yungas. And after spending more than an hour walking the dimly lit main avenue, asking unknown locals if they knew any of the UAC-CP students or graduates on my list, I recognized defeat and surrendered myself to the rustic hostal accommodations I had secured for $2.50 US.

But, as it always does, my luck changed almost immediately when I set off at 8am the next morning. Within an hour of running into Janneth Quispe on her way to work, I suddenly had all sorts of interview/visit opportunities. Perhaps one of the most exciting was a surprise--I learned that two 4th-year Nursing students from the College were doing internships at the hospital in La Asunta.

Me pictured with Estela and Veronica in front of the sign for La Asunta's Hospital.

Vernoica Quispe and Estela Mollo, both students from rural Bolivian communities, were awarded paid internships with USAID during the College's July/winter break. Their work was originally supposed to focus on a program for Leishmaniasis, but with limited trained staff available at the hospital, they quickly found themselves working with a variety of public health programs.

After a tour of the hospital, the two aspiring nurses guided me to the public health room where signs about common infectious diseases adorned the walls. As I sat with paper, pen, and voice recorder, poised to note their every word, they started to tell me about general nutrition (or lack thereof) in the countryside.

In La Asunta, they explained, people eat mostly carbohydrates. They supported this claim by listing the foods most commonly found in the daily diet: rice, plantain, pasta, and yuca. I admitted that I had noticed the overt absence of veggies and asked them why. "It costs more," Veronica said, adding that farmers in La Asunta are primarily dedicated to growing coca--a plant that has sucked the nutrients from the land and makes it difficult to grow other things.

Proudly donning their UAC-CP Nursing uniforms, Veronica and Estela stand in front of shelving that houses tupperware containers--each representing a patient actively being treated for Tuberculosis.

"In addition to poor nutrition," I started to ask, "what is one of the most common things you see here at the hospital?" They responded immediately and simultaneously: Niños. Children. They attend to a lot of children with diarrhea, digestive track infections, and respiratory problems--all of which stem from unsanitary living conditions.

"Do you see children die?" I inquired, calling to mind vague, but frightening statistics about the death rate of children under five-years-old in Bolivia. There was a noticeable pause before Estela responded carefully. "Not a lot, but it happens." She recalled the story of a woman who came to the hospital the previous week. After explaining that her small child had been sick with diarrhea for three days, the doctor went to check the young patient only to find that he had already died. "The mother didn't know it," Estela said, "but she brought her dead baby to the hospital."

All public health visits to homes in communities surrounding La Asunta must be recorded. In the log, Veronica and Estela note the names, ages, and relationships of people living in each household and the public health topics discussed at each visit.

In this case, as in many others, people live too far from the health centers to come for medical attention at a moment's notice. "Of course," Estela said, "we tell them, 'You must come to the hospital as soon as you notice a problem." But that isn't how it works. They have to wait until there is transportation--usually Friday and Saturday [market days in La Asunta]." In fact, Friday, Saturday, and Sunday are the busiest days at the hospital.

Because people can't come to the hospital, Veronica and Estela take the hospital to the people. They traveled up to 5 or 6 hours a day, visiting remote, rural households "after hours" when farming families can be found at home. In addition to visiting private homes, they also gave talks at rural schools and, every Thursday during the month, they hosted a radio talk show in La Asunta that was broadcast throughout the countryside (topics included: Leishmaniasis and Tuberculosis).

The women's ward in La Asunta's Hospital is sparse, to say the least. Because the entire town is without electricity from 11pm at night until 4pm the following afternoon (at which point a town-wide generator is turned on), women give birth by candlelight. Emergency operations are sometimes performed with help of an electrical generator.

It's common for people in the countryside to be skeptical of outsiders, modern medicine, and hospitals (quite frankly, after touring the hospital, I can't blame them!). But Veronica and Estela claimed to have no problem working with the gente of the rural sector. "They like that we talk to them; they listen to us, they trust us," Veronica said. "They ask about diseases and ask about the symptoms and what can happen to them. We are there to answer those questions and, in some cases, encourage them to get to the hospital immediately."

Part of the reason they are received well, they said, is because they are each fluent in their indigenous language--Vernoica speaks Aymara and Estela speaks Quechua. "Today, for example," Estela offered up, "a woman came here and nobody understood her, so I had to interpret. The doctor gave her a prescription and the woman went to the pharmacy [in town] to buy her medicine, but when she came to show me what she had purchased, I realized that the pharmacy had cheated her." It was because of her language abilities, Estela said, that she was able to help the Quechuan-speaking patient make sure she understood the prescribed dose and potential side effects. "It's beautiful to be bi-lingual," Vernoica added.

Both young women agreed that it had been a great experience for them to work at the hospital. "It makes me realize that I'm getting a good education; I can work alongside all the other trained professionals," Estela told me. Veronica agreed. "It's good preparation for us," she said. "And it's a good feeling to know that we are helping our people of the rural area."