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Claus Hedegaard

Bolivia

The snow clad peaks of Illimani overlooking La Paz. La Paz is approximately 3800 meter above sea level, the southern peak of Illimani approximately 6400 meter above.

This is a brief summary of experiences gathered during about a month's stay in Bolivia. Some are 'experiences' in the sense that somebody told me, others I made myself, and some are 'experiences' in the sense that I REALLY wish somebody had told me (and that I had listened, obviously!).
I write this in La Paz while the last rays of the sun cast a red sheen on the hill, studded with houses outside my window. La Paz is in many ways a spectacular city, situated in about 4000 meter height in what is probably South America's poorest country. It is for all practical purposes a modern city with all its amenities, high-rise offices, expensive villas, restaurants, cinemas, etc. Walking in the streets, you notice it is different from Europe and USA: there are indeed many poor people in the streets, a vendor of candy, window wipers, soft drinks, newspapers, empanadas and things like that on practically every street corner and obviously a large number of Indians in traditional attire. It all adds to the charm of traveling.

The purpose of my visit was to oversee a new specimen mining project in El Desierto in southern Bolivia). Specimen mining is a highly specialised procedure to extract and preserve mineral specimens for decoration and collection, rather than as ore. It has only been applied to few deposits in the World, and this is the first specimen mining project in Bolivia.
El Desierto is near the town of Uyuni, one of the major tourist sites in Bolivia due to the spectacular neighbouring salt flat Salar de Uyuni, though it gets rather bland reviews in some tourist guides. One merely describes Uyuni as 'cold' and though absolutely correct it is hardly adequate. The landscape is spectacular and Uyuni has more tourist agencies than most other similarly sized towns, offering trips across the salt flat, trekking, etc.


Herd of goats passing in front of the cathedral of Uyuni.


Generally the weather is dry and cold during winter when night temperatures in the area often fall below -10°C and occasionally below -20°C, whereas it is wet - pouring rain - but warmer during summer. Day temperatures are quite pleasant in the range 15-25°C even in winter. Whatever you do, you must be able to handle Arctic winter and European summer in the same day.
The Salar de Uyuni is a 120-130 km wide salt flat. A 10-30 cm layer of saturated salt water covers it in the summer and is nearly impassable. In the center there will still be solid undissolved salt under the water and though slippery you can drive on it, but the edges will be water covering mud, which not only wreaks havoc on your car but also may cause you to get stuck. In the winter the salar is dry and completely covered by a thick layer of dry salt, hard enough to be a road. The dry salt forms a horizontal layer, divided into 30-50 cm plates separated by 3-6 cm elevated ridges. The latter provide for a constant rumble when you drive across the salt flat outside the usual paths.


Isla Inka Huasi Tahua is one of the numerous small islands in Salar de Uyuni with colonies of cactus.


Paths traverse the salt flat between villages along the edge and sites worth visiting. These sites include 'islands,' peaks sticking out of the salt, often completely barren except for tall cactus. It adds to the surreal impression of the area, you drive on hard rock looking like snow in a landscape without features - it is flat and white as far as you can see except for the mountain range in the horizon far away - and every now and then you pass a peak up to a few hundred meters in circumference, covered by a forest of cactus. These peaks do not have any lakes or streams and the cactus must get all their water during the rainy summer. It is a harsh condition and virtually all the cacti are large. A small cactus looses relatively more water than a large, because it has a large surface to volume, and there is consequently a recruitment barrier: it is difficult to survive while small, but you have a chance if you manage to reach large size. The cactus community in Salar de Uyuni is thus meta-stable like the human population in western Europe; there is an abundance of aging individuals and a comparative paucity of younger individuals to replace them.

Personal preparation

Do read Swaney (1996) for general advise and cultural background. It is an excellent thing to do over a drink at night before departure, and then review briefly on the flight or in the airport. Yes, I did mean the Lonely Planet guide, not Frommer's, Berkeley or anything else. It gives you a condensed review of what you may face and why things are the way they are. It is also a good resource guide to things like hotels, restaurants, buses, etc.

Documents
You need a valid passport (currently Europeans do not need visa, but rules change - ask before you leave!), and it must be valid minimum six months after arrival even if you only intend to stay one month. Sorry, those are the rules.
Bolivian law requires you always carry a photo ID with you and you also need a photo ID whenever using a credit card or checking into a hotel. Your passport is a natural choice, but expect to be in deep trouble if you loose it. For ID purposes a driver's license is equally good; you can keep the passport in a safe place.
You need a health and travel insurance. Your current insurance may already cover, but do check your policy. Few European health care insurances cover anything outside Europe. Your insurance may have restrictions on 'risky behaviour' like diving, rock climbing, etc. Do consider what you are going to do before you leave, and ensure you have adequate coverage.

Money
The Bolivian currency, Bolivianos, is next to impossible to exchange outside Bolivia, so do not change any more than you need, and do not change before coming to Bolivia. Bring US dollars as cash, not DEM or anything else. USD are accepted even in many shops.
Most hotels, restaurants, and major shops in La Paz take Visa card, almost as many take Mastercard, a few take American Express, and I yet have to find anybody taking Diners. Some take Visa & Mastercard in Cochabamba, a few do in Potosi and Oruro, but I did not see anybody taking any cards in Uyuni.

Health
You need to take good care of your health while in Bolivia. Ordinary care and hygiene will protect you against a number of things, but you may need to take special precautions depending on where you go. Note, that in this section I dispense medical advise, which is obviously meant for informational purposes only. You need to see your own doctor for proper advise and certainly before taking any medication.
Be particularly cautious if you have undergone recent treatments, are under continuous medication, and do know whether you suffer from allergy. Do let your travel companions know whether you are allergic to antibiotics or other medicine. In an emergency you may not be able to communicate with medical personnel and receiving treatment to which you are allergic may be fatal.

There is no reason to be scared about going to Bolivia or any other country for that matter for health reasons, but personally I find recent (i.e., currently functional) immunisations to tetanus, hepatitis, Japanese encephalitis, and typhoid indispensable. Do take malaria prophylactics, but only if you go to areas where malaria actually occurs (it does not in SW Bolivia but is prominent elsewhere).

Bolivia is invariably high above sea level and you are almost bound to feel some effects of the altitude. You will land in app. 4000 meter elevation in El Alto and go to La Paz a bit lower. Most of the geologically interesting parts of Bolivia are sort of up there or higher. It is unusual to experience serious effects beyond rapid exhaustion the first few days after arrival, unless you are particularly susceptible or suffer from respiratory or circulatory disorders. The best cure is to relax and adjust with minimum physical activity for a couple of days after arrival. See a doctor if you feel major discomfort, but do stay away from house-hold remedies. Mild symptoms are locally called soroche and 'treatment' can include any combination of caffeine, pain killers, coca leaves or tea, etc., some of which may be numbing, decreasing your awareness, or reduce the heart rate and thereby worsening the condition! Do not take anything beyond a simple painkiller (preferably paracetamol/acetaminophen, avoid Aspirin®/acetylsalicylic acid affecting blood pressure) and drink plenty of water.
There are medical approaches to lessen the problems, but you should see a doctor before embarking on these. If you increase your blood's hemoglobin content, it can absorb more oxygen, and relieve respiratory difficulties [this is very brief, look up Michaelis- Menten kinetics if you want the whole story]. You may be familiar with 'Epo' from the newspapers' sports pages, boosting hemoglobin content of blood. 'Epo' is short for erythropoietin [we really can not have words with many syllables on the sports' pages, can we], available from Janssen under the name Eprex. It comes in different strengths (2000, 4000 & 10000 IU/ml) and you will probably need 2000 IU every third day for 2- 3 weeks before departure.
Erythropoietin causes stem cells to divide, forming more red blood cells. This is a natural process, exactly what happens to your body when arriving to high altitudes. That is, by taking erythropoietin you can have the process start before leaving home, and similarly there is no point taking it after arriving to Bolivia. For it all to work, you need dietary supplements as well: vitamins C and B12, folic acid and obviously iron. A regime like the following should be advisable for healthy adults (do read the sheet included with the medicine and the supplements, it may be relevant!):

This is available as combined capsules called Confer (above doses correspond to 1-2 capsules), produced by Merck, but you get exactly the same effect by combining dietary supplements bought at the drug store. You can get different iron supplements; iron sulfate tends to disrupt your stomach, iron gluconate is a good alternative, note that many 'organic' or 'natural' iron supplements contain relatively little iron and may be quite expensive to achieve the dose. Just aim for something like above doses and act as if you suffer from iron deficiency. You may not need or want to do the whole thing with erythropoietin, but you will benefit from taking the dietary supplements the last week before departure and the first week after arrival. Do not take excessive iron supplements on a daily basis for an extended period. You do not need it and it is harmful to your health.

I bet you forgot already, maybe even just skipped it, so let me say it again: Do talk to your doctor! This is not something you should play with yourself.

Atahualpa's Revenge, Roskildesyge, the willies or whatever you call it: diarrhoea is the ailment most likely to affect you. It supposedly hits around 30% of all travelers within the first two weeks of stay. You can blame it on poor hygiene, 'bad food' or your 'weak stomach'. Whatever, it is a nuisance but not fatal (it can be a symptom of serious conditions like giardia, cholera, dysentery, etc., necessitating professional attention) and most treatments adopt a 'wait-and-see' strategy.
Prevention is the best approach. Be more assertive about hygiene than at home: wash your hands carefully with lots of soap [hardly ever available in toilets, nor is toilet paper!] after using the toilet and before eating, avoid salads and unprocessed vegetables, have your meat well done, avoid fast food from street stalls and where it has been prepared long time ago (as in many fast food restaurants), eat peeled fruits with a thick rind like banana and orange, avoid grapes, at least peel apples, etc. Don't be paranoid, sampling local treats and eating with your friends is one of the joys of traveling, just don't be stupid.
If you feel you have a 'weak stomach' you can take tablets with bacteria spores, boosting the natural flora in your stomach. They contain live cultures of Streptococcus, Acidophilus or something like that. They are readily available without prescription in Europe and are quite harmless. Get some that are far from the expiration date. In Bolivia you can substitute with yogurt [yes, I do consider yogurt to be medication] but get some with live Acidophilus cultures. Most yogurt in Bolivia and elsewhere is either synthetic (milk powder, gelatin, water, sugar, flavour, ...) or at least pasteurised, none of which will make any difference. The Bolivian brand Pil Cochabamba is made with live bacteria (the label reads '...y bacterias lácticas ...') and I don't believe it has been pasteurised.

Be ready for intense sun shine! I myself arrived to the Bolivian winter (remember, this is southern hemisphere!) with a medium Danish Summer tan and did not expect too many problems. Did I learn something! After the first day with 3 hours filed work, exposed skin parts (face, hands, wrists) were literally fried. The air is thin, the sun is strong and there is a very good reason why the local peasants are extremely dark skinned. Use a strong (SPF 20+) sun lotion whenever you are going to be outdoors for extended periods. Consider 'physical sun block' (SPF 25+) for exposed parts. In the good old days this was 'calamine' today it is mostly 'titanium white' (synthetic Anatase) - whatever, still a mineral!

Bring an emergency kit. You may be hours away from anything, and need to be able to handle small as well as (though hopefully not) large wounds. Schroeder (1995) gives good descriptions of how to handle almost everything. Many outdoors shops sell ready- made emergency kits that can be used as a base. This is what I believe your kit should contain (some of these require a prescription from a liberally minded physician and advise on how and when to use them):

You can always argue for more or less depending on your imagination, need for security and belief in ability to reach town. Given normal conditions most places in Bolivia, I would not start messing with a broken anything myself, but bring the patient to town (I might dope the poor bastard first, though).

Bibliography

Schroeder, Dirk. 1995. Staying healthy in Asia, Africa & Latin America. Moon Publications.

Swaney, Deanna. 1996. Bolivia - a Lonely Planet travel survival kit, 3rd ed. Lonely Planet Publications, Hawthorn, Australia, 496 pp.

http://www.cdc.gov/ - US government's Center for Disease Control. Gives advise on vaccinations.

http://travel.state.gov - US government's travel advisory.

This page is written and maintaned by Claus Hedegaard