Uyuni and the Salt Flats

Hello Everyone,

Have had a great few days travelling and am now in La Paz. Last time I wrote I was in a city called Potossi which is the highest city in the world. It was a world famous silver mining place during the Spanish reign in South America. In first year I wrote an essay on the columbian exchange and all the good and bad things that occured because of it in the world. I am really enjoying seeing the history I have researched in practice and seeing how it still affects people today.

We went down to Uyuni and the Salt Flats and saw some amazing stunning things. Saw volcanos, giant cactuses, mountain of seven colours, beautiful coloured lakes, swam in a natural pool of 34 degrees water so so much more. Those of you who are into photography I would love to take you there. Unfortunately Kats battery ran out so most of the photos are on my camera and I have no cable, so you will have to wait until I get back!

Travelled in a group of six, which was such fun. Travelling is a really friendly activity. You see someone who looks like they speak English and you get chatting and laughing. That would never happen back home. I suppose there is a slight problem that 99% of people speak English but it would make a friendlier (Is that how you spell it?) place.

We had a tour guide and a cook who were fantastic. Something that made me mad is that they earn in a month (If they work everyday of the month) less that the six of us paid for one tour! Some of you may well be thinking that is the way the world works, but it doesn´t mean it is right. The cook got up at 2 am to make the food for the day and worked through til gone 9pm. They work everyday because they have 3 kids that they want to send to University.

We´re spending the day in La Paz before heading down to Lake Titicaca. The plan is to spend two days on the Bolivian side and then two days on the Peruvian side before heading up to Cuzco.

An advance warning, I will be flying home on the 8th June and will be in Shropshire til the 12th. I would love to see as many of you as possible, as well as seeing my family and applying for a job! Please email me if you would like to meet up. For those in Brum I will see you after, sorry. I´m looking forward to coming home and getting back into a routine. Oh I am such a creature of habit....

God Spot:
The city of Potossi was a central place for evangelism in the Spanish reign of Latin America. So many people came through that strategically it made alot of sense. It has got a lot of beautiful churches that were made up local craftsman which means that there are pictures of Jesus and Mary next to the sun and moon and other pagan worship symbols. This makes it a bit bizzare, but it something else that has really got me thinking. The working conditions that the Spanish inflicted on the miners was (Still is) horrific. To me the whole message of the gospel was therefore missed. They preached the good news and then treated them like dirt. How is this possible, such hypocrisy. But then it got me thinking about hypocrisy and how it is so easy for me to see the hyprocrisy elsewhere and not necessarily the injustice right infront of me. Almost a plank and spec think but also an exciting challenge to rise too. As many of you know, I really don´t like challenges so this made me sad (JOKE JOKE !!!!). Anyway a point to ponder.

Secondly and on a lighter note. I have seen some magnificent creation over the last few days. I think that God must love seeing people enjoying what he was made and having fun taking photos and all sorts. Some of the places I have been have been so cold and so high that it was very easy to get burnt, altitude sickness and not feel your toes. It makes me wonder what the new heaven and earth are going to be like. Are we going to be able to play in snow and not get cold? Are we going to be able to climb mountains and not get burnt? What is it going to be like? It makes me very excited and my imagination has gone wild. Let me know if you have any thoughts.

Lots of Love Zara

Final Week - Placement is over

Hello All,

Well I have now finished placement and the Harry Williams Hospital! Woop. I am really grateful for the experience but exceedingly glad that it is all over. How are you? How are things in England? Thank you to those of you that have been encouraging me through the process.

Well the week started on Sunday with a night shift. We had a C section and key whole surgery going on at the same time with one anaesthetist running between the two rooms. The key whole surgery was a removal of a gall bladder and he wasn´t under general anaesthetic and his heart rate was really low. Was a bit scary. Looking at the hospitals general anaesthetic machines, I would rather not have a general anaesthetic either. The machines look about a hundred years old! We also had a very traumatic labour, but I won´t go into details as you women will probably cross your legs and you men may well scream!

Tuesday got to go out to the community again. We went to a different place and had alot of fun playing with the kids. Not many people came to see the Dr and so we learnt alot about the culture and witchcraft. Many people consult traditional healers and spiritual healers before going to the hospital and then they present late to the hospital in a bad state!! The kids were just playing in the dust and the dirt and we brought some balls with us and had fun playing catch. They also love having their photos taken and taking photos themselves.

As my Spanish has improved I have been learning things in the presentations done by the interns this is always exciting. Some of the things they come out with can be quite amusing. Had one on diarrhoea infections inbetween my tummy playing up which I found interesting!!

On Thursday we went to take part in a health check of children in a near by district. This was fantastic, I was with a really lovely Dr. She got me to take the history and do all the examinations and then report my findings to her and say what drugs I would like to prescribe. At first my Spanish was a bit hesitant but it got better. Was really sad seeing kids with bad pneumonia and having no medicine. One of the really bizaare things was in the afternoon we saw kids with obesity, followed by kids with severe malnutrition and back to obesity again. The cycle just continued and I found the injustice rose within me.

On Thursday night we had our goodbye back with the girls. There was alot of laughter and giggling. Such good medicine. Kat and I ended up being houseparents on Wednesday night and we taught soem of the girls the song Great Big God is Spanish. It went down a treat. They literally were obsessed. We sang it so many times!! They also love Shout to the North the delirious song, funnily enough they only know the verse about women.

Anyway Friday involved a meeting with the Captain and starting our travelling. I am now in a place called Potossi on my way down South. I´m hoping for a relaxing holiday before 5th year starts.

Looking forward to seeing you soon, I am back in England in two weeks.

Love Zara

God Stuff
I´m running out of time so will have to be brief sorry.
God has very much been on my case about money. I have been listening to sermons on generosity and one of the books I am reading has been talking about it to. Something that has come up twice is about now living in Poverty Theology or Prosperity Theology but in Generosity Theology. I am trying to remember that God is the God of abundance and he will give us our daily bread. I want to try and live everyday living in His generosity and giving out his generosity, not just with money. It is only a year til I start earning and I am very aware at how money can corrupt. I am well aware in my reading of Acts that the early Christians were very concerned with their care of the poor and their teaching of the word. Sorry to be brief.

Secondly last year when I left the girls I knew I would be coming back. Yesterday morning I was grumpy because God hasn´t told me I am coming back. I am reading in Galatians about the fruits of the spriit and was reminded about being patient and faithful. In Jeremiah God talks about when we seek him with all our heart we will find him. I know He has my best at heart and now I have peace that if I will come back I will.

Got to go....xx

Photos

Hello All,

I forgot my usb camera cable so haven´t been able to show you any photos, but I managed to borrow one so here are a few:
1) Teaching the women in the community to make furniture out of cardboard


2) Me in my hospital scrubs preparing for a C section. Check up the rolled up trousers and the rather fetching boots.
3) Kat and I and some of the beautiful girls we live with.
4) Learning how to make donuts in the community.
5) Two of the girls wearing our hospital clothes and finding it amusing.
6) The community van with the Dr inside. Inside here is a nurses station, doctors examining room and a dentists room!

7) Playing wheelbarrow races this morning with some of the girls.



Hope you enjoy these.

Love Zara

Best week yet

Hello Everyone,

How are you all? I wonder what you are up to at the minute.

Wow, what a week. It is always slightly difficult to know what to right, but as usual I will give it a go. Firstly health wise I have managed a full week in hospital yahoo!!

This week I have tried to be much more productive with my time. I have been doing Obstetrics and Gynaecology which I am really enjoying. Every morning I have been going into clinic and I have been learning and practicing skills, this should be really useful for when I get back to England. I love watching babies being born and listening to their hearts beating inside their Mums tummies. Unfortunately children here are often just commodities and products of sex and are often not loved.

On Monday afternoon Kat and I spent the afternoon playing Cards with the girl with Chaggas Disease. The nurses didn´t quite know what to make of it, it was obviously quite counter cultural. I learnt some new games and it was good fun. I had to keep reminding myself what I was doing was important even though it wasn´t medicine.

Spent alot of time in the community this week and I love it. I would be there all day every day if I could. I love loving the kids and checking their health is ok. It is really sad to see such ill kids especially when they scream when they see you. A frequent punishment for kids is being threatened to being taken to the doctor and having a shot.

Yesterday, we went to the community to teach the villagers how to make donuts. It was so much fun watching everyone making them and joining them. I wasn´t doing medicine as you know it but it was medicine of a different kind. It was about building community and showing that white people muck in and are not superior. It was funny because Kat noticed an Operation Christmas Child box on the floor. Everytime I go out I try to look for a skill that I can learn from the people. The women are amazing seamstresses (excuse the spelling), their fingers move so fast that you can´t see them.

After teaching the women how to makes donuts we had a community team social. We understood that we were going to play either squash or tennis but we were a bit confused about the location. The word for market is the same place for court except we didn´t know this! We thought we were going to attempt to play squash in the food market but it was alright as we went to the suash courts! I managed to be part of the winning team in two games but that was probably due to the other player. I was great fun and good bonding especially as I developed a habit of running into the walls.

On Tuesday when we did do medicine and the women were being taught how to make furniture out of paste and cardboard. One of the women had a pet monkey and the monkey decided to eat the glue which caused much amusement. Unfortunately it is quite possible that alot of illness is due to pets. The mobile unit had no running water and so we introduced the Dr to the concept of alcohol gel spray. We gave him the bottle and he just didn´t know what to do. It was very amusing. The outreach Dr is much more like UK doctors and we have great chats about medicine and evidence and trials etc. He did a trial in 2005/2006 of 9000 women to see how many of them suffered from genitourinary infections, only 9/9000 were infection free!!

Did a night shift last night and have another one on Sunday. Saw two beautiful girls being born last night and saw some stab wounds. It was quite a quiet night but Sunday night here is getting drunk night so I wonder what that will hold.

Last week in hospital this week and then travelling. What an opportunity I have had, I am very grateful for it.

God Stuff:
Praise God for good health and a better week. Learning to be faithful is a continuing challenge, but I have seen seeds of it entering my way of thinking this week. It is great to have something to work to, but then I have to be careful not to make it a success story in its own right.

At the girls home there is a 10 year old who is mentally disabled. Her speech is very tricky to understand and her level of comprehension and therefore her behaviour is poor. Sometimes she can be sweet but most of the time she is really tricky to deal with. I have been praying and asking God to help me and I was reminded of this verse

⁴⁵"He will reply, 'I tell you the truth, whatever you did not do for one of the least of these, you did not do for me.' Mathew 25

It has given me strength and a challenge to continue. IT is amazing when she prays, her prayers are beautiful, not that anyone understands them. When people are praying she can tell and she lays her hand on them. When she worships it makes me want to cry and it makes me want to worship. It is amazing how God can relate to everyone and anyone and show them love. It reminds me that God uses the foolish things to shame the wise (1 Corinthians 1:27).

I am really enjoying reading the Bible and spending time with God, I could write for hours about what he is talking to me about but will leave it there. You are in my prayers.

Lots of love

Zara xxx

An interesting week

Hello all,

Reflecting on this week it has been a really good one and then I remembered I have only managed 3 half days in hospital! Maybe that is why it has been happier. Not a great attendance record. I have been ill, with a high fever and a dodgy stomach. Luckily the fever has gone now. Today I managed to eat breakfast which shows an improvement as I haven´t really eaten since Wednesday. I have some vague recollection but Kat likes to remind me when my fever was bad I told her about 25 times that I didn´t want to eat any more rice!!

Exams results were celebrated with Guarana ( A fantastic sugary fizzy drink I discovered in Brazil) and a twix bar. It felt good. I still can´t quite believe. It is great to come to the internet cafe today to find out my other two medic housemates passed as well.

Some of you have asked how Kat is; apart from spending alot of the last 24 hours vomitting she is fine. She has an impressive bruise on her face but otherwise has nothing wrong. I really do thank God for that. The people here are fascinated by the bruise due to her white skin and the story has helped to form conversations at hospital with both patients and staff!

The girl with the tropical disease Chaggas is back. It is sad story and without a miracle I wouldn´t be suprised if she dies before we leave. Have started to develop a relationship with her and during the ward rounds when the scary doctors aren´t looking we make silly faces at eachother. She has the most beautiful and warm smile and doesn´t have a clue what is round the corner.

Another little boy came in this week. He is 15 months old but could be 7 months. It is sad seeing so may malnourished kids here. His parents moved to Spain to earn money and left him here. He is under the care of his uncle, who doesn´t seem to know how to look after him. The boy has little muscle tone, fungal infections all over his skin, a chest infection, a gut infection and not even enough energy to cry. It is heartbreaking. I spent a while hugging him the other day just trying to show him the desperate love that he needs. I want to try to hold him everyday he is there. I don´t know if he knows what love is.

Spanish is improving. I participated in a medstudent teaching session on blood results and knew alot of the answers which certainly gave me a confidence boost. Bolivian definitions of conditions are a bit different than English for example to have anaemia your haematocrit has to be below 33%.

The best part of this week was getting to go out on the mobile unit. This really excited me and I knew it was important to go. The unit goes out every afternoon to different poor areas surrounding the city. Each place gets visited once a week. We went to an international rubbish dump, which reminded me alot of Malawi. The people are starting to get quite ill but the land is so cheap that people keep moving there. When they go out they concentrate of four things (This may not be 100% accurate as is relying on my Spanish translation!)

1) Medical Care
Every child gets a free health check and dental check. The state of their teeth is awful. I´m so glad I´m not training to be a dentist. It was great as the Dr got Kat and I to do all the examinations. He hardly checked any children. It was the most medicine I have done since I got here. Asking the children if they are ticklish before palpating their tummies always breaks the ice. We were asked to examine all the boys to check they had two testicles. This was my job; I understand that this is important but if they had two testicles last week then I´m not quite sure how they could loose one!

The mothers get health promotion lessons. This week it was on different ways bacteria and parasites etc get into food. They were teaching the women to wash their hands and wash, cook and store the food properly. They were told if they didn´t they or their kids could get quite ill. IT could be as simple as get someone to build you a long drop. This still hasn´t been successfully implemented in the two years they have been going to this area. It seems when people need to go they just go!

2) Spiritual Care
In the hospital vision statement the hospital says it aims to give hollistic healthcare. This isn´t really seen in the hospital but it is fantastic to see it is done in the community. The villagers get taught about Jesus and how he can help them in their daily life. They sing songs and share the peace. I don´t think I have ever kissed so many toothless people in my life!

3) Physical Care - Working
The women get taugh crafts and other skills, including cooking, so that they can help make a life for themselves. This week they were being taught how to make baskets out of news paper it was impressive.

4) Social Care
The families are encouraged in community. They go on excursions and do things together, both the people that live in that community and the people that come from the hospital.

This for me was a fantastic afternoon, this gets me so excited. They are trying to do make a hollistic difference, I see it that they are taking Jesus to the people.

I switch to OBs and Gynae this week, so it should be fun!

God Stuff
Having been ill alot this week, I have spent alot of time with God. It has been great, I have been reading about Mother Teresa and it has been really excitingly challenging. I would like to share two quotes with you that have really got me thinking:

"We are not called to be succesful only faithful."
" We can do no great things, just small things with great love. IT is not how much you do, but how much love you put into doing it."

Jess and I have a tradition of giving eachother cards when we go away but not being allowed to open them until we are on the aeroplane. This year Jess´ card was all about love. She wrote the passage in 1 Corinthians about how not having love is like a crashing cymbal.

Medicine is so based around success, it is so based around knowledge. I am learning that knowledge can stop love, that success can stop love. My elective is about being faithful to God, showing his love and not whether I get to do as much as some of my friends are doing. I want to be Jesus to people, to show them complete dignity, to treat them as if I am their servant and they are my master. I pray that they look into my eyes and see Jesus and I pray I look into their eyes and see Jesus too. That is what love is. Thank you Jess for reminding me.

Praise and Prayer points:
Please praise God for vaccinations, otherwise the likelihood of having Hep A is so high!
Please pray for health, my stomach really isn´t happy. It makes me feel weak and not want to eat.
Praise God that I may officially be here on elective but that he is more concerned with my heart than anything else.
Pray that I will be like Jesus and show his love and aim to primarily faithful.

Thanks for all your love, care and encouragement.

Lots of love Zara

Exams

Hello all,

Just a quick note to say I passed my exams! Woop woo. I am happy with my results as well. Thank you for all of you who got me through it.

Haven´t been back to the hospital yes as Kat, who I am with had an accident. She fell nearly ten foot onto concrete. It is really a miracle she hasn´t broken anything. Thank you God. Yesterday we had to go to a different hospital to get her an xray. It was great to go to a different hospital and be appreciated. We are off to hospital now to continue are elective.

Will write again soon.

Love Zara

Life and Liver

Hello All from a hot winter in Cochabamba,

Thought I would start you off with a joke (Cheesy Zara style), an embarrasing story and an interesting fact.

Fact: Mosquitoes prefer O blood so that is why I get bitten so much. Interesting eh?
Joke: A school teacher writes on a whiteboard the letters A-P-A-T-H-Y. One child turns to another and says "What does Aapathy mean?" and the other replied "I don´t know and I don´t care!" teehee.
Embarrasing Story: I went to ask one of the girls aged about 8 if she was embarrassed and instead asked her if she was pregnant! I think I was more embarrassed than she was when I realised what had happenned.

How are you all? Thank you very much for the lovely replies that I have had, they make me smile. It is Friday afternoon here and we have it off because it is Labour day so we only worked until twelve. Well I think that is what the Captain said to me, he spoke so fast and I couldn´t see his lips and so I will find out on Monday whether I was right or not! Oops.

I thought I would tell you a bit about the hospital. It is a small 25 bed hospital that is based around two parrellel corridors that interconnect. On one corridor there is outpatients, emergencies and peadiatrics and of the other there is Obs and Gynae, Surgery, Theatres and Medicine. It looks how you would expect a developing world hospital to look; run down, dark and old fashioned. Spoke to the Captain yesterday and he says we can take photos so I will hopefully be able to show you some. A member of the theatre staff took photos of a woman delivering the other day! Don´t worry mine won´t be that graphic.

I have been trying to be very proactive with my time, so as to learn and to fill time. On Monday I went into Paediatric Clinic and we had patient after patient come in with Hepatitis. They don´t bother finding out which type because it is expensive! I was feeling endless livers and was reminded of how last year here I had to eat liver and smiled and the fact they don´t buy it at the girls home anymore. When we get back to the girls home we eat their lunch for our tea and I sat down and took one look and realised it was liver! Luckily the pieces were small enough to swallow whole but Monday was definately liver day!

The rest of the week has been quite tough. The intern I was meant to be assigned today up until today just ignored me most of the time and gossiped about me to the doctors. I often can understand what they are saying which isn´t easy. Yesterday I was literally a ghost for the whole day and at the end of the day I burst into tears. However embarrassing this was it seems to have made a real difference. This morning was fantastic, I spent the whole morning busy and smiling. Next week the interns shift rotation so it could go pear shaped again.

This morning I was in theatre and saw a C section. Got to help examine the new born and got to do odd jobs around the theatre. Then I was changing dressings and assessing a woman in emergencies. The woman who had the C section had a large cyst removed. The cyst needs to be taken to a big lab across the city. The cyst is then but in two half broken bottles and then given to the relatives to take to across the city to the lab yuk.

I have discovered a new use for a catheter here. Use it as a tourniquet! This is what happens here, I don´t dare ask whether they have been used. They don´t look new and knowing the multiple uses of things here I should think the answer is yes.

I have just seen that Swine Flu has hit England. Only getting to an internet cafe once a week means I am out of touch with the news. It is a good lesson for me in not getting frustrated! The president of Bolivia is taking some extreme measures but I´m not sure if they will really filter down the system, we will wait and see.

Medicine is very different here in so many ways, here is an example. There is a poster in the peadiatric ward explaining to parents about respiratory infections. It has to go as far as explaining that breathing is what helps to keep us alive by getting oxygen into our bodies.

It is exam results on Tuesday so I will touch base on Tuesday with some good news hopefully. I have sat through some painful medical student exams here this week. The way everything works is so different. The idea of having finals with no practical exams seems crazy.

God Stuff:
Praise God that the dates for applying for a type of job I am thinking of applying for have been moved so I don´t have to make any big decisions until I am back home.
Praise God that today was different, please pray that it wasn´t just a one day thing and that the new intern next week will include me.
Praise God that my Spanish is improving and pray that it continues to.
I often wondered what significance coming out here last year was and now I see it was partly to have good relationships with Jon and Linda and the girls. To come home to them is fantastic, please thank God for them.
On one of my bad days this week I got on the bus to come home in a really bad mood. Kat has been with an amazing intern and I was struggling. I read James 1 and it put me in my place. I know that God loves me and that he is teaching me, moulding me and hopefully making me more mature.
I felt that it was right for me to go to the English speaking church on Sunday, it is less my style than the Spanish church but it felt right. At the end of the service a woman came up to me and it turned out she was visiting Cochabamba. She is English and her son lives in Kings Heath! I was able to chat to her and encourage her which was special.

Lots of Love

Zara