Only in Bolivia…

The end of my practicum experience felt like it appeared out of nowhere. Friday, March 30 was my last full day and I couldn’t shake the feeling that I had just arrived only a few days before. Four weeks absolutely flew by and it was bittersweet when my flight left La Paz on 3/31.

I expected some sort of adjustment period or reverse culture shock, but aside from the spring-disguised-as-winter weather, I’ve had no issues adjusting to being back home. I was fortunate to stay in a very nice apartment with excellent water pressure, so I didn’t have issues adjusting to rustic-then-luxury accommodations. And we’ve got bad drivers, sudden weather changes, and a lack of respect for personal space in Chicago, too.

I do, however, miss La Paz’s personality and quirks. Where else can I find things like:

The weirdly aggressive (and judgmental?) store mannequins. US mannequin dressers are lacking some serious imagination. I’d be willing to buy something just to make these mannequins stop staring at me.


The llama-fication of everything! I don’t have a special affinity for the actual animal, but everything is a little more fun when it’s dressed like a llama.


Mixed public health messages. The sign on the left very bluntly states “Trash Kills” and announces fines for littering. The picture on the right was taken one block from this sign. This cluster of power lines remained low like this for an entire week before it was finally repaired. This is what it looks like to live and work in a resource-limited setting: public health gains and losses exist side by side, without complaint, because everyone knows the city will fix it when they can fix it.


The traffic zebras and donkeys! Thanks to John Oliver, I was aware of the traffic zebras – they encourage safe driving and pedestrian behaviors – and they were really fun to see in person. But I didn’t know that there are also traffic donkeys! They aren’t out as often as the zebras and they aren’t playful. They tend to scold people for unsafe driving and pedestrian behaviors. It’s surprisingly effective – it does feel a little shameful to be teased by a walking plush animal.



Syncretism (sincretismo): the fusion or mixture of Catholicism or Christianity and indigenous religious beliefs. Bolivia is a predominantly Catholic country, but many people also observe indigenous religious traditions.

In the Mercado de la Brujas (witches’ market), you can find all the supplies you’d need to make an offering to Pachamama, the Mother Earth goddess. Offerings include sugar candy (because Pachamama loves sweets), small candy plaques decorated to represent a special hope or wish (better job, a new child, etc), and dried llama fetuses, which represent a meaningful financial sacrifice. At night, the offerings are placed in a fire and left to burn overnight. If there is nothing but ashes left in the morning, then Pachamama has accepted your offering and will grant your wish. If the offering didn’t fully burn, Pachamama did not like your offering, and you have to make another, bigger offering. It is not unusual for people to attend mass and then burn an offering to Pachamama later that same week.

In the picture below, the statue on the left is Ekeko, the god of abundance. The statue is decorated with items that represent cultural, financial, and person abundance, such as a pan flute, money, flowers, foods, and various farming implements. Every day, the store owner puts a fresh cigar in his mouth – if it burns all the way down, Ekeko will grant your wish. If it doesn’t, you just have to hope that Ekeko will be in a better mood tomorrow. (Side note for the single ladies – Ekeko is needy and demanding of attention. Single women are “prohibited” from buying Ekeko icons because it is believe that Ekeko, out of jealousy, won’t bring them a husband.)

The market also sells spell potions and soaps – in the picture below, the Sabonete is meant to ward off domestic violence. There other potions and powders can help you find love, find a job, treat minor ailments, etc.


Vibrant street art, including sculpture, murals and graffiti. I didn’t get an opportunity to take a lot of pictures of the graffiti, but in general, it is very political in nature, and the messages change across city neighborhoods. Where I lived, most of the graffiti was very anti-Evo Morales – a lot of “Evo es dictador” (Evo is a dictator). In the older parts of the city, and in areas predominantly populated by indigenous persons, the graffiti was very pro-Evo – a lot of “Evo sí” (yes to Evo) and “Si no es Evo, quien?” (if it’s not Evo, then who?).

The most common message in all parts of the city was “Mi voto vale”, meaning my vote matters. The US has struggled with electoral apathy for a very long time. It was refreshing to be in a country where people are very engaged in politics and believe in voting.

(Some background info – Evo Morales cannot run again because of term limits. He held a referendum to change the constitution to allow him to run an unlimited number of times, and the Bolivians strongly voted No. However, Evo does not want to leave office, and while Bolivians like and appreciate his reforms, they believe he needs to honor their constitution and their vote.)


The traffic light countdowns! We really, really need these in the US. When the light is red, the clock that will count down the seconds until the light changes. Once the red countdown is finished, the yellow light will come on and a green clock will count the seconds until the light turns green. This builds in a few seconds between light changes to allow the intersections to completely clear. When the light turns green, a green clock will count down the seconds until the light turns red. Did i mention that we really could benefit from these in the US?


The very entertaining television shows that seem to be a mix of talent show and telenovela. They go all in on the costumes.



Mostly, though, I will miss my co-workers and friends, who showed me an enormous amount of generosity, courtesy, and affection during my time in La Paz.

There’s no place like home

Traveling abroad requires patience and understanding. Living and working abroad requires what feels like an infinite amount of patience and mental fortitude.

Shortly after graduating from the University of Kansas, I lived and worked in Mexico for six months, so this wasn’t my first time at the rodeo. But even with that experience, I still expected that it would take some time to adjust to life in La Paz.

La Paz is a modern city that is similar to Chicago, but just different enough to make me feel off-kilter. There are so many unexpected things that prove challenging, such as:

Technology differences:

This is the Bolivian mobile phone provided by my practicum organization. Do you know how hard it is to use one of these phones when you’re used to using to an iPhone? I swear it took me 5 minutes to send a simple text message and at least 3 attempts to add a new contact. (Disclaimer – plenty of people in La Paz use smartphones, we were given these simple phones because they are inexpensive and practical.)

Bol Cell Phone

My homestay has a washer and a dryer…except, the dryer doesn’t work as well as our dryers. It’s normal and preferable to line dry your clothes, which means you have to get used to displaying your drawers in public for days at a time.

Clothes Drying Rack

Sometimes you encounter really simple solutions to problems like keeping your windows open. In the US, “fixing” this would probably require multiple trips to Home Depot and a lot of cursing. This is a good reminder that differences can be positive, rather than negative experiences.

Window and Hanger

Transportation differences:

In Chicago, we have a pretty good system of public transit involving trains, the el, buses, and cabs. I know how to get from point A to point B, and I know which modes of transportation are safe. La Paz has a good public transit system as well – buses, mini-buses, cabs, and a cable car system, but it is frustrating those first few days when you have no clue where you’re going or how to get there.

Last week, at the end of a very long day, I had to wait 40 minutes to catch a bus and then another 30 minutes of travel time to get back home. My RBF was beyond extreme by the time I got on the bus. In Chicago, I would have hailed a cab after the 5th full bus passed me by, but I can’t do that here in La Paz. It’s simply not safe to hail a cab off the street when you’re female and traveling alone. To add an additional layer of complexity, you can call a taxi company, but there is one number for the south side of the city and another for downtown. I was in the south side and only had the number for the downtown cab company. Remember that bit about patience and mental fortitude?

Workplace differences:

Like most non-Western cultures, time is fluid here in La Paz. It’s normal and acceptable to be late, even extremely late. This can be very frustrating, as we practicum students are expected to be on time, always. Last week, a colleague scheduled a meeting for 9am, but didn’t show up til 9:45am. And when he did arrive, he spent the next 10-15 minutes greeting others in the office and making small talk.

There are other differences in workplace behaviors – it’s considered rude to not greet your co-workers with a kiss, a good morning/afternoon, and some small talk. The office closes for lunch from 12:30-2:30 – this is one difference I can totally get on board with, as it gives you time to eat a nice meal (at home or in the office) and socialize with your colleagues. Deadlines don’t always carry the same pressure – you may send an email to someone and get a response 2 weeks later. Being aggressive and/or pushy about follow-ups and deadlines is frowned upon.

The general pace of work is slower and less frenetic. I can’t say this is a bad thing, because it gives you a nice work-life balance (something that might as well be a four letter word in the US).

As Axl Rose once said: All we need is just a little patience.

Food/culture differences:

I love exploring local markets – they’re always so colorful and carry so many foods that we don’t get in the US. This weekend, I went to two different markets:

That first picture is a papaya. I have never seen a papaya that ginormous, hence the reason I took a photo of it. 🙂 These markets carry so many root vegetables and giant squashes that are unfamiliar (second row, first picture). And since we don’t get them in the US, I have no idea what they’re called in English or how to prepare them. The black corn (second row, second picture) was really cool. Apparently it’s sweet, and/or used in desserts. There are also several blocks of mozzarella cheese in that photo. The sales lady thought I was nuts when I asked if it was cheese. Unless it has a rind, I expect cheese to be refrigerated, not sitting outside next to a basket of corn. I gave it a strong side-eye and moved on to the next stall.

Probably the hardest thing to get used to is language-related. Bolivians have a pretty even/flat accent, so I understand their Spanish pretty well. But it’s been a very long time since I’ve had to speak it and my grammar is atrocious. Not being able to speak clearly is frustrating, but what’s really, really hard to deal with is when people make fun of/tease you to your face, because they think you don’t understand what they’re saying. The majority of the time, they’re not being malicious – you are as much of a curiosity to them, as they are to you. But it still stings, especially because the only thing you can really do is grin and bear it. Confronting someone who does this can lead to all sorts of misunderstandings and issues, so it’s better to remain quiet and move on (and then, if you need to, cry at home where no one can see or hear you).


(P.S. I’m totally allowed to use cheesy Wizard of Oz references because I’m originally from Kansas and cut my teeth on that movie.)


Why Bolivia?

I’ve traveled to quite a few places around the world, and the list of places I want to visit is probably a mile long, but I have to be honest in saying that the Plurinational State of Bolivia wasn’t even on my radar.

So how did I end up booking a month-long trip to La Paz? First, it’s important to state that I am not in Bolivia solely for a vacation. I’m here to complete the practicum requirement for my Master’s degree in Global Health.

Northwestern’s Global Health program partners with a fantastic organization called Child Family Health International (CFHI). CFHI specializes in developing/coordinating public health practicums and international medical rotations for students around the world. CFHI will recommend programs based on each student’s needs and interests, but the student has the final say in program selection.

I am vegetarian and have some chronic health conditions, so living in the bush in Uganda for a month simply wasn’t an option. After speaking with CFHI staff, they recommended their programs in New Delhi, India, La Paz, Bolivia, and Ecuador. I’ve been to New Delhi several times, so it wasn’t my top choice. Yes, I’d be able to easily find food and I have family there to help me out when needed, but I really wanted to understand what it’s like to work in a country or culture that I know nothing about. We spend a lot of time in this master’s program learning about the challenges and ethics of working in an unfamiliar culture and I wanted to put those lessons into practice. So that left Bolivia and Ecuador. There wasn’t a significant difference between the programs, but La Paz won based on two points: it’s a major city and it doesn’t have mosquitoes. If there is a single mosquito within a 10 mile radius of me, it will find me and bite me. I am that person. So the idea of working in a tropical zone without being subjected to mosquitoes and all the nasty diseases they carry was VERY appealing!


I can’t say I regret my decision in any way, shape, or form. I’ve only been in La Paz for a few days, but it’s a beautiful city and my host organization has assigned me to a very interesting project (which I’ll discuss in future posts). Despite the altitude sickness, I wake up in the morning and look forward to going to work. I can’t remember the last time I felt this way!

Say hello to my little friends

Altitude sickness is real, and it’s a monster.

La Paz sits at 3,460m (approx 12,000 feet) above sea level, whereas Chicago is only 181m (approx 594 feet) above sea level. I had some serious adjustment to look forward to. As recommended by my host organization, I am taking Acetazolamide to assist with the adjustment. But even with this medicine, I’ve been experiencing headaches and “GI discomfort”. (“GI discomfort” is code for puking on the street in front of my local coordinator, on the day that I met him. File this under things that will cause me embarrassment until the day I die.)

Any time I walk uphill/upstairs, no matter how slight the incline, my heart races faster than a horse at the Kentucky Derby, I get shortness of breath, and my lungs feel like they’re on fire. I might not be in the best shape of my life, but under normal circumstances I can easily walk up a few flights of stairs with no issue. I walked up one flight of stairs today and immediately looked/felt like this:

Heart Jumping Out of Chest

No, really. If my Fitbit could speak, it would have shouted “Danger, Will Robinson! Danger!”

Luckily, I’m staying with a Señora who knows a thing or two about altitude sickness. First, we re-arranged my diet so that I’m eating a good breakfast, a heavy lunch, and a very light dinner. Going to bed on a full stomach at such a high altitude is a gateway to that “GI discomfort” I mentioned earlier. Second, she’s been pumping me full of a concoction made from coca leaves steeped in hot water.

Coca Leaves

I had no idea that coca leaves have medicinal properties. Tony Montana never talked about that in Scarface! Seriously, though, this “tea” has been really helpful, especially with the headaches and nausea. I wouldn’t recommend relying on it alone, but in combination with the Acetazolamide, it’s been very effective for me.

I should fully adjust within the next 2-3 days, but if you read about an American tourist exploding in La Paz…