Saturday, December 28, 2013

Things you Need to Know Before Visiting La Paz

  • You will not find a clean wall, gate, or fence anywhere in the city. They are all covered with varying quality of graffiti.
  • If you want to go out for supper, think again. It is difficult to find anything open before 7 or 8pm. If traveling with a toddler who’s bedtime is 8:30pm, this proves to be a bit of a challenge.
  • Their big meal of the day is lunch and may leave you feeling full for days. Lunch includes soup, bread, a small salad, the second plate (which is usually some sort of meat and potato, or meat and rice), and finally you end the meal with a piece of fruit or pastry. Bolivians make some seriously delicious soup! 
  • In addition to feeling full, you WILL feel sick at some point. It’s best just to prepare yourself mentally and emotionally for that inevitability. Also, there is a strong likelihood that going to the bathroom will be abnormal probably 70% of the time.
  • When cooking for yourself you need to adjust all recipes for the altitude or you’ll end up with flat, squishy chocolate cake, or pancakes that just don’t hold together. There are many websites that can help you with this.
  • You will not completely adjust to this altitude. You will likely find yourself panting and/or partially blacking out a few times a day.
  • The altitude (and the monster hills you climb everyday) will make you lose weight. Depending on your size at the start, this could be a good or bad thing.
  • There are very few strollers here. Most people just carry their kids in their arms, sans baby-carrier. I challenge anyone to an arm wrestle when we get back…or a baby carrying competition.
  • You will find amazing coffee for cheap!
  • People don’t really care that you’re here. You aren’t an anomaly, and you aren’t special because you are white. It’s nice. You are free to carry on without any celebrity status.
  • Even though people don’t care that you’re here, they are very nice and are willing to help at a moment’s notice. They are even willing to put up with your terrible attempt at Spanish.
  • Most travelers and tourists seem to already speak Spanish. If you don’t, you are probably stupid and are definitely in a minority.
  • Language classes are cheap, so you don’t have any excuse to not learn!
  • People in La Paz, and perhaps Bolivia, speak Spanish with little to no accent, in comparison with their neighboring countries, so they are easy to understand. This also aids in language learning. 
  • You never know what is going to be open and when. So when you leave your house on a mission, be prepared to be disappointed. Perhaps it’s best to have an alternate plan, and be ready for that to fail too.
  • Speaking of open...this city seems like it is on social lockdown. All gates and fences are 8 feet tall, and are topped with broken glass or barbed wire. I don't know who my neighbours are and I'm not sure how to figure that out, short of ringing them at their gate. Also, little neighbourhood shops that are open midday are only kind of open. You aren't able to enter have to look from the door and point at what you want. Either there is a high level of distrust here, or a high level of threat. 
  • The Internet doesn’t always work. This is good for those of us who are used to having it all the time. You can’t stream anything quickly. In fact Facebook friends, could you please stop posting videos? I can only see the thumbnail.
  • The stray dogs are not scary like Thailand stray dogs. They are not aggressive, and keep to themselves.
  • People here seem to love dogs. There are dog grooming places everywhere, and no end to places where you can purchase dog clothes, dog shoes, and puppy paraphernalia. Around Christmas there were Santa dogs a-plenty.
  • Christmas is at midnight…so when someone asks you over to their house for turkey at 1, they don’t mean 1 in the afternoon. They mean 1am. Don’t show up to their house midday (that may or may not have happened).
  • It is incredibly easy to get around the city. Transportation is cheap and accessible, as long as you know where you are going. It’s best not to travel around 6pm or else you may be hanging out the door of the bus just to get a spot.
  • There are very few single occupancy vehicles. This pleases me.
  • There are even fewer bikes. Although, I don't blame them...I don't want to cycle up these hills either.
  • If you're a small kid in Canada, don't'll be the same size as other kids your age here.
  • If you are a kid, and you’re blonde, and you don’t like being touched or looked at, it’s best to learn the art of closing your eyes, or putting your head down early. In all likelihood you’ll eventually adjust or learn how to cope with the attention, just like a little someone I know did. 
Well, I hope that helps with any future plans of visiting La Paz. This place is spectacular, wild, and wonderful all at once. These observations are just the small ways in which we have needed to change or modify our own outlook as we learn how to live here. Some things have been hilariously different, and other things have been tremendously hard, but we are thankful for the opportunity to live here and discover how other people exist.

Thursday, December 26, 2013

Up and Running, and Walking

I’m pleased to say that the Center (clinic) is up and running and so are some new patients! Before Christmas we were able to complete three new prostheses and have started work on several others.

The Center invested greatly in a commercial quality convection oven and although we flopped a chocolate cake, the oven is doing a fine job of baking copolymer polypropelene :) For those that don’t know, one way to fabricate prosthetic limbs is called plastic thermoforming. A flat piece of plastic sheet (usually 3 or 5mm thick) is cooked on a teflon sheet at high temperature until chemical bonds are altered and the plastic can flow. The fluid plastic is quickly handled with gloved hands and placed over a modified plaster model of a residual limb. The plastic is sealed to a vacuum system and thus precisely thermoformed into the three-dimensional limb shape and left 24 hrs to cool.

Designing, fabricating, and fitting prostheses is an extremely rewarding craft, and the stories of success do not get much better than what is happening here at Centro de Miembres Artificiales. Meet A-----o:

A-----o is a young man born the same year as my middle brother. This makes him 36 yrs old. TWELVE years ago he lost his right leg above the knee in a traumatic accident, otherwise he is completely healthy. Since then he has used this contraption to restore body image and assist in standing. 

The inside of the prosthetic interface is peppered with metal staples that previously fixed some type of foam or plastic in place :(

He used lots of fabric from an old sweatshirt to pad the interface and help make the oversized and mis-shaped socket wearable. The prosthesis was suspended using a simple belt. The knee is some kind of outside hinge joint and the foot is broken. Everything is held together with some rubber strips. The unit weighs close to 10 lbs.

In comparison A-----o’s new custom made ischial containment socket fits so intimately to his limb that it is suspended solely with suction, aided by a one-way expulsion valve . The copolymer plastic is smooth and strong, yet allows some flex to aid in comfort. Below the copolymer socket is a new polycentric knee made in-house of delrin plastic and designed by Limbs International. The polycentric joint allows mechanical stability in the stance phase of gait and knee flexion in swing to provide normal (-ish) biomechanics and improved ground clearance. Below the knee is a Shape and Roll foot also made in-house of copolymer plastic. The total prosthesis weighs half of what his old one did.

Less than an hour after fitting the prosthesis A----o was walking independently without aids. That is a special thing to watch :) He walked home and left his old “prosthesis” for our museum.

Thursday, December 19, 2013


After a month in La Paz we finally completed our immigration process. We entered the country as volunteers, so we weren’t able to come under the normal tourist visa. Before we came we went through a process to gather all the necessary documents to obtain the Objecto Determinado, which only gives you 30 days in the country. You are expected (or perhaps not expected) to complete your residency application in those 30 days. We did not. Thankfully we were only 4 days over so our fine was small, but I don’t think that many people are capable of competing this task in the allotted time. Fortunately for us, we did not have to tackle this mission on our own (being that we don’t speak the language and had no experience in the country) and basically just had to show up at random offices and look pretty.

Let me take you through a bit of this process…our fifth day here (mostly over the general haziness that comes with high altitude acclimation), we went to the immigration office to get the list of requirements necessary to complete our visa application. We lost Pingu, got some photos taken and ate some saltenas. Overall, not too bad. A few days later we had to go to another office called FELCC. I’m not sure I can actually tell you what they do or why we had to go to them, but I’ll try.

FELCC: I think they have to corroborate your housing location. Maybe. We went to some small office in the middle of nowhere where we had to give them passport copies, our fingerprints, photos and a receipt that said we put some money in the bank. Don’t worry…I don’t know what that’s about either. They gave us some certificate. I think there were some other documents in there as well, but I don’t know what they were. Next was INSO.

INSO: I don’t know what it stands for, but it has something to do with checking out how healthy we are and whether we will be a drain on their health system, or will infect others with communicable diseases. They sat us down in a big waiting room and then they would call us into different rooms to check different things. We had to pee in a cup, they took our blood, they measured our height and weight (and called Duane “Jesus Christ Superstar” because their height measurer wasn’t big enough for him), they x-rayed our chests, a dentist checked our teeth, and finally we sat down with a doctor who asked us questions and checked out our overall health. This all happened in a matter of an hour, and afterwards we went for Api (hot purple corn drink) and pasteles (cheesy pastry). Next up, Interpol.

Interpol: these guys need to make sure we’re not criminals…possibly. This was my favorite part of the process. Their office was housed in an old mansion that had apparently been taken over by the police due to sketchy business on the part of the previous owner. It was like walking into a Quinton Tarentino film. It was basically an all boys’ club of official police, doing official things. We had to go back to this place about 3 times. The first time just to find out what we had to bring them, the second time to pick up our certificate (which wasn’t ready) and the third time to actually pick it up. Oh, Bolivia. We were fingerprinted again, and I think we had to put money in the bank for them too. I really don’t know what bank this money goes into and who gets it, but it has to be done.

After this we went to FELCC again…but a different office in a different location where they fingerprinted us again (this happened so frequently that Amelia started playing “fingerprints”), and we had to give them more documents. I believe this took us to the final stretch of our visa application with only a few days remaining in our time allowance.

Obviously the Bolivian government wants to know that we are able to provide for ourselves while we are here, so we had to go to a notary public to get our bank statements notarized. The problem with the notary is you can get them to notarize anything…a lie, the truth…you just tell them what you want the letter to say and they say it. So, we went to a notary, got our stuff signed and made our way to immigration where we were finally able to submit our papers.

We just went back a few days ago to get our visa and to finally wrap up this immigration fiasco. Our papers were ready, but the whole thing confuses me…instead of having our papers photocopied, they gave us the entire stack and told us to get them photocopied. After we had done so, we went back to immigration where they told us to return the next day because the papers had to be stamped. Uhhhh…does that take a whole day? So, needless to say, we aren’t finished yet. Hopefully we’ll get this all done before Christmas so we can carry on as temporary residents.

And on that note…we wish you all a Merry Christmas and a Happy New Year. For those of you who get to spend the holiday with family, enjoy the time you spend together, and for those of you who won’t be able to, find people who are like family to spend your time with. We are joining Ivonne and her family for their Bolivian Christmas celebration for which we feel so fortunate. Feliz Navidad! 

Tuesday, December 3, 2013


Where in the world can you travel two hours, drop 1500 meters, and go from a temperate climate to a tropical one? I’ll give you a hint…it rhymes with solivia.

This last weekend we decided to get away after the immigration insanity and take a bit of family time somewhere warm. We heard that many Bolivians travel to a town called Coroico due to its amazing temperatures, and proximity to La Paz so we decided to try it out. There are two ways to reach this town. One is via the “most dangerous road on earth” (aka Death Road) or by a newer highway. Many tourists opt for Death Road taking “gravity assisted mountain biking” tours down a sketchy path with nothing but a mountain on one side and a jagged precipice on the other. We chose the newer highway. Although that was our choice, for a long time I wasn’t sure we hadn’t somehow gotten on the wrong bus and ended up on Death Road.

For $5/person, we all piled into a station wagon style vehicle (Amelia in my lap) and began our ascent to 4800 meters. I guess you have to go up before you can go down. When we stopped for gas, all of the passengers remained in the running vehicle while the driver fueled up (my heart nearly stopped, but Duane assured me it’s very difficult to light anything at that altitude). We passed plateaus full of grazing llamas and alpacas and entered into some hostile looking mountains where somehow people had settled. The bumpy road twisted continually making visibility difficult, but that never seemed to deter the driver from passing.

We continued up until there was no more up to go, and came to our favorite part of the road that travels along the spine of the mountain…views on either side, and road as wide as there is space. And then we began our descent into lush and humid tropical valleys. I was amazed at how quickly the topography and climate changed.

Our driver opted for a bit of a short cut, and this is truly where we experienced our own Death Road. He cut off the paved, single lane highway onto a single gravel path…and when I say gravel I don’t mean what we have in Canada…I mean gravel the size of a fist. We bounded down the mountainside, passengers gripping their seats, everyone silent, steep cliffs mere inches from our tires simply to shave off a few minutes of travel.

When we almost reached the base of the mountain, we started our climb back up to the beautiful hamlet of Coroico, set at 1200m, surrounded by green abundance. Our ‘resort’ was set outside of the town, perched on the mountainside in an old coffee plantation turned Ecolodge. For only $50/night we had an amazing cabin with breathtaking views, an outdoor kitchen and profound silence. The temperature was on average 25-30C. We could walk around the property where there were many coffee plants (that provide organic coffee for all the guests), coca plants, banana palms, lime trees and tropical flowers. We spent our days lying in hammocks, swimming in the pools, and exploring (as much as one can with a toddler). When we got there Amelia said, “I love it here. I’ll live here when I’m older”.

Our cabin
The view from our porch
Biggest fiddlehead fern I've ever seen
Air filled spiky balls
These guys were everywhere
Milly learning how to swim
Our trip back was just as eventful. We drove through thick clouds, with limited visibility all set to an eighties/early nineties music montage that lasted for over an hour. On our descent back into La Paz I became convinced that our minivan had mechanical difficulties/possible brake trouble as our driver coasted down hills and had minimal, jerky use of his brakes. Thankfully we made it back in one piece…only a little travel weary. 

There’s nothing like some time away to make one thankful for “home” no matter how small, uncomfortable, or different it may be. I think all three of us felt this when we arrived at our apartment in Sopocachi, La Paz. We have all started referring to this place differently and felt a sense of relief when we experienced the familiarity of our neighborhood streets. I loved Coroico, but I’m not sure how soon I’ll be ready to make that journey again.