Paramedic Pete (and anyone else with solid info) - one of my college kid nieces is going to Bolivia in September. The rough itinerary is:

8 weeks
home stay in Cochabamba (9,000 feet, major city) there may not be running water or electricity all of the day

4 weeks
wherever, doing her research and data analysis

5 days
rural work stay with indigenous native speakers of Quechua where there will be no
running water

Excursions to (and staying at hotels, cabins and bed and breakfast, and if the big city doesn't always have running water, I doubt if some of all of these rural outposts will have running water):

La Paz ans Lake Titicaca (13,000 feet altiplano)
Sucre and Southern Highlands
Santa Cruz (low land semi tropical) and
Bolivian Amazon

Bolivia is not Ecuador and so forth, but any general (or specific) tips/advice? And/or do you have any acquaintances who have recently spent time in Bolivia I could talk to?

I know the usual sources of information and so forth; am looking for reliable first-hand tips.

PM me if you prefer or leave it as an open discussion.

Aside - I'm about to have paramedic #2 son and #1 son is no. 2 on the hire list for the Fire Department. Yay!

Regards,

Tom

Hmm, I reckon some places it ain't easy being christian either.

Back when I was in the Navy, I recall some pretty harsh times abroad. I wonder if I can sue them because they didn't tell me life could be tough away from home???

I bet there's some kids in Compton California that wouldn't be anymore traumatized by such treatment than they already have been. Then again, they didn't have a choice in the matter, so I suppose that makes it different.

Not that I'm saying the exchange program isn't at fault, but the boy survived, and maybe learned a thing or two about how the rest of the world really works. Might be some value in that.

Then again, if it were my kids, I reckon I'd be on the next flight to Cairo looking for some payback.

Hi AyersTG

Your niece may need some time acclimatising to the altitude, by spending a few days at say 4000, 6000, 8000 feet each and watching out for mountain altitude sickness (AMS)

http://en.wikipedia.org/wiki/Altitude_sickness

Going straight to 9000 feet can sometimes present problems especially if your neice has never been in high mountains areas.

Ingnoring the warnig signs for AMS can sometimes be fatal.

I can't help you with info on Bolivia, sorry But welcome back! Long time no hear from...

The things I would make certain to bring; immodium -- a bunch of it, water treatment whether chemical or otherwise -- a few straws might be nice, antifungal creams -- my sister once came home with ring worm, antibiotic ointments, and some plain old antibiotics.

I have been quite lucky in my travels throughout Ecuador in terms of not becoming significantly ill. My family and I have gotten the stomach and associated aliments for maybe a day or two after visiting some of the more remote rural areas. A few doses of Pepto-Bismol, Citrucel and some yogurt or lactobacillus tablets were generally sufficient to reestablish intestinal stability. Once or twice I resorted to anti-diarrhea medication, so far I have not had to resort to any antibiotics (usually CIPRO). I did get sick real bad one time, but that was due to motion sickness while riding in the back of a bus along the curvy and rough roads prevalent throughout the country, so having some motion sickness medications might prove helpful. She should bring and use hand sanitizer often. She should bring her own first aid supplies and may consider purchasing a kit which has needles, syringes, sutures and other sterile medical supplies, that can be hard to come by in many areas.

Quito, is around 10,00 ft and no matter how fit one is (my daughters 18-22 yo were at the time, competitive swimmers and still had as much problem as their old unfit dad) or is not, the altitude can have a profound effect on your ability to function. Climbing stairs/hills cannot only make you winded, but you muscles will burn and headaches may be common. For us, it is hard to acclimate to the altitude, as we will often leave for the coast (sea level) or other low-lying areas for a few days and then return Quito. You can get DIAMOX, which works by increasing respiration rates and can offset some of the signs and symptoms of mild altitude sickness, but for severe altitude sickness (pulmonary edema) the only easy remedy is to get to a lower altitude.

For water purification or beverages, stick to bottled/canned soda, boiled water (not bottled, unless it is sealed and a major brand) or use some type of purification system. I have and use the Katadyn Exstream Purifier Water Bottle most of the time, as it provides a ready source of drinking water (and for brushing one’s teeth) without being too insulting to our hosts. If, I belive the circumstances warrants not using the water bottle, I will either ask for tea/coffee or bottled/canned soda –no ice (Coke products are widely available, even in some of the smaller towns). I also bring an MSR ceramic filter, Steri-Pen and MIOX and use these as needed, mostly to produce larger quantities of clean water or for others to drink or for medical applications.

I avoid fresh vegetables and salads whenever possible and try and eat only fruits with a peel (plantains, bananas, oranges, mangos, papaya, etc,) although I have been known to eat a washed apple. She might want to bring snacks to munch on and to make friends by sharing.

Make sure to get all of the vaccines (yellow fever, Hep A, typhoid, etc.) recommend in enough time for them to be effective. I also take anti-malaria medication, use insect repellent (if I remember) and sun block (I received a severe case of sun burn on the top of my bald head during my first trip). Mosquitoes are not a problem in the higher elevations, but if she travels, she needs to consider being prepared.

As to safety, we have been very fortunate, in that we for the most part we travel with native Ecuadorians, although we have been placed on the bus a couple of times alone, but so far without any problems. For the most part wherever we travel in-county, we are accompanied with someone who speaks Spanish fluently and in most of the smaller towns and villages, we are treated as honored guests/family and the residents keep a close eye out for our safety. We have had a few near “incidents” where things could have gotten dicey, but local intervention kept things to minor inconveniences. The roads are terrible and very dangerous, especially in the mountains – no guardrails (several thousand foot drop), narrow (it is nothing for them to pass two-three deep including buses and trucks on a narrow-windy road) and in many areas washed out or non-existent. Pedestrians have no right-of-way, be very careful crossing busy streets. Adherence to red lights is spotty at best.

I generally, do not bring anything I would be sorry to lose; I have a cheap Timex watch, distribute my money (do not bring traveler’s checks), they are useless, even in the bigger cities and found only one bank in all of Quito that would even cash them) into several wallets and have a “throw-away” wallet with a few dollars to surrender if needed. We are lucky, in that Ecuador uses the US Dollar as legal tender, so no conversions, although I understand the new president has considered going back to the Sucre (sp?). Ecuador mints it’s own coinage, but also uses US coinage, so even their coinage is standard with US coinage (pennies, dimes, nickels and quarters) and also like the US coin dollar, since it lasts so much longer then paper money. Small bills are preferred, so mostly $1s, $5s and $10s. Twenties can be a problem. Even though, she is not going to Ecuador, I suggest smaller Bolivian bills and coins. We take a chance with our cameras and so far have been lucky. We carry large quantities of medical/rescue/fire equipment and supplies and again have been very lucky, I think once people find out we are providing medical/rescue care and training, they take extra care to make sure we are okay. Still I am very cautious in the bus terminals and areas where the locals really don’t know who we are and why we are there.

I make several copies of my passport, drivers license, airline tickets and in-country contact information and distribute these copies throughout my luggage. I also carry my Paramedic license, and since I was made a formal member (I have the rank of lieutenant) of the Tosgua Fire Department, the ID they presented to me, just to demonstrate that I have in-county contacts and that I am there for the benefit of the people.

We have stayed in some very nice hotels/hotels and some very bad ones. Most of the homes we have stayed in are nicely maintained. Have her bring her own toilet paper and carry some with her at all times, most of the public rest rooms/out houses do not have TP. On our first trip, while traveling on a bus to the coast, we stopped at a roadside restaurant and my daughter went to the bathroom, on her way some guy was waving TP and trying to get her to buy some, she did not realize until she got into the stall there was no TP.

If I think of any more items or if you (she) have any questions, I would be glad to try and help out.

Congratulations to you and your sons.

Pete

I even use chemical treatment on the bottled water.

I was in Egypt and had been buying bottled water from a local store until I saw the kids taking our empty bottles, refilling them from a wall tap and popping a sealed cap onto them. They would then take the refilled and sealed bottle back to the local vendor and get a bit of change for "recycling".

Now when I travel I usually try to take my own water bottle and treat my own water. Chemical treatment is nice in that it is easy to slip into a bottle without pulling out an elaborate filter and you are not as likely to offend anyone by implying that they are giving you something contaminated.

The recommendation to take motion sickness pills is good but be aware that they can cause drowsiness so make sure you are with someone who can look out for you if you fall asleep.

In addition to Pepto or Imodium I like to have some electrolyte powder to help get the body back in balance if you get dehydrated from diarrhea or other illness.

Thanks; I'm pretty familiar with all of that and she should be, too. On second thought, I may have been taking her knowledge for granted, so I'll run her through it to be sure.

...and "Howdy" back at you! Seems like I get so darned busy I almost never check in any more. Scanned a few of your recent posts and sounds like y'all are enjoying life.

Best regards,

Tom

(Last was to OBG - I'm readin in flat mode and quick reply seems a little off...)