Jungle Life

Here is a quick likes and dislikes of jungle life so far. I had to bus out for 45 min to the nearest city to use the slowest internet I´ve come across yet, so this will be short and more detailed later. I still have much to catch up on in regards to Samaipata and the Bolivian elections.

Dislikes:
1) Always wondering if my puma is going to jump me. She dragged me (face and body down in the ground) into the jungle the first day since I was carabined into her with rope and wasn´t prepared for her to run while I was attached.

2) Being around mossies who are smarter than me and eat me alive at any chance they get. They also can eat through clothes and so I have to wear multiple layers.

3) Feeding toucans who try to eat my feet daily and I hate going into their cage. I officially quit today and will look to have someone else feed them.

4) Sweating every second from the heat that takes a toll. I have to trade off the incredible heat and humidity in order to keep the mossies from sucking me dry. The first day, I felt like I might pass out from heat exhaustion and therefore take cold showers twice a day.

5) Serving as the scratching post for the chanchas or wild pigs with their hard spiky hair. They also have fleas and so I try to keep my distance.

Likes:
1) Working with the 3 pumas I look after, even if they want to jump me and have tried. They are beautiful cats who just don´t know their own strength sometimes.

2) Trying to outhowl Faustino, the alcoholic (but on AA treatment) howler monkey gives me great pleasure. I yell his name for as long as loud as I can as he howls with me in the mornings and the evenings. He always wins.

3) Feeling good about working with animals who need so much love and care, many of whom were saved from the Bolivian black market, ill treated at the zoo, or abused as pets. They have such a great life in the jungle with this organization and I can´t look at another cat in the zoo again.

4)Feeding Herbie, the Tapir, and Bambi and Rudolfo the two deers who can not go back to their natural environments because of various reasons. They are adorable and I love watching Herbie´s nose twitch at the food I bring him.

5) Feeling as though I´m going to be a stronger person after this experience that brings so much joy and so much demand both physically and mentally with my days completely full of very strenous work starting at 6:45am everyday. At least I hope it does.

blog on hiatus

Just so no one calls the police, I am letting you know that I will be going off into the jungle to volunteer at a wildlife animal refuge center so that I can play with big cats. I won't have internet, electricity, hot showers or filtered water for awhile. My cell phone probably won't work either. I leave tonight on another overnight bus that I am not thrilled about. Hopefully, after some 17 hours and 3 different buses, I will arrive at Parque Ambue Ari near Asuncion de Guarayos. I hadn't planned to go to this remote park, but to another one closer, but 2 friends who have gone before convinced me otherwise. Here's the website. intiwarayassi.org
Ciao

Down to 5 Lives

After camp, Erica, Leah and I went to Samaipata in the mountains to decompress for a bit while the rest of the crew headed back to the States. I had never traveled with someone with diabetes before and both Erica and Leah have it. I learned quite a bit on how to manage diabetes while abroad.

Every night before going to bed, Erica and Leah made sure to have some honey around in case they went low, which seemed quite often since we spent a lot of time hiking during the day. They would wake up in the middle of the night with a shaking body and just eat spoons of honey to get their blood sugar level back up higher. On our hikes, we made sure to bring the jar of honey, which is a lot lighter than bringing liters of coke and juice. After Erica told me of an emergency she had while hiking, I was a little worried for the both of them. However, I ended up with the medical emergency.

Erica, Leah, Steve a guy from Ireland we met, and I hiked up the surrounding mountains to see some waterfalls. We chose to forgo obtaining a guide because we thought with the four of us, and a hand-drawn map of the hike, we could figure out the trail. Sadly that was not the case. We found the waterfalls with no problems, but after hiking to the top of the mountain, we could not find the rest of the trail. Instead, we chose to make our own trail down the mountain. Unfortunately, my foot slipped on a rock that fell off the mountain as I followed it down head first. Steve later told me that he just saw this body falling down towards him and didn't know what was going on. Thankfully, my face hit a rock, and stopped my continued free fall. Surprisingly, I didn't break anything and only ended up with bruises, a bloody nose, and a swollen face. When Erica finally reached me, she asked what else hurt besides my face. I told her my knees hurt as well and asked her to get off of them since she was sitting on them while tending to my bloody face. Once the shock wore off, my nose felt like stinging ants had just crawled up it. Thankfully, Leah caught up to us to give me some ibuprofen to help with the pain.


Making our way down the mountain proved to be extremely difficult since we literally had to slide on our butts and stomachs to get down the really steep parts. Steve became my hero and supported me down especially since he thought I had suffered a slight concussion; my wobbly walking almost threw me off the mountain a second time. Many times on the hike down, Erica just cussed at the world since we weren't sure we would ever make it safely down. As the injured one, I tried to calm everyone down, maybe I was still in a state of shock. We really could have benefited from having a machete to cut down the branches and plants in the way or our new trail. We tried to yell for help to the worker men down below tending to their fields, but instead, they just chose to watch us slide around.

After 2 hours hiking down, we hit ground and took a bus to the hospital. I'm not sure I need overseas health insurance when my hospital visit only cost me $1.50. The doctor checked my nose, and because I don't really have a nose to begin with, I didn't break it. He gave me 3 different drugs which only cost $6 in total. Two weeks later now, my nose has healed and all the swelling and black and blue color is gone.

Leah left to go back to the States and Erica came with me to Cochabamba. Erica hasn't had any problems with her diabetes here although, she did drop a bottle of insulin on the floor and now needs more, which she can only get back in Santa Cruz. Whenever she does need insulin, she tells me that she needs to "shoot up", which I find funny.

The other accident I should mention involved a car crash in Santa Cruz. I sat in the back seat as Yanira who is blind in one eye from diabetes, drove me, Lourdes and Maggie in the rain to a home visit. Yanira drove right through the roundabout without looking the other way for oncoming traffic and hit a car heading in the perpendicular direction. She didn't want to stop to talk to the lady she just hit.However, so many cars honked at her because her light was about to fall off, that she finally got out of the car and yelled at the other woman for hitting her car. After exchanging phone numbers, we threw her front light in the back seat and headed off to the home visit. Maggie tried to get a taxi there since none of us wanted to get back in the car, but Yanira insisted on getting us there in her now beat up car, while still blind in one eye on that rainy day.

More Outreach Efforts

Before camp, we worked on outreach efforts in the community since only half the group could attend the Tarija camp due to the unexpected lower attendance of campers due to political issues.

One day, we visited a local center for malnourished children and educated the care takers on the symptoms of diabetes as well as checked the children's blood sugar level. This gave me practice using a glucometer. One child had a high blood sugar level, but the care takers believe that since he is new to the center, he has not been properly fed and cared for. A local doctor went to visit the next day to make sure the child was ok.

On another day, we visited a local orphanage with 120 kids to educate the "mothers" about the symptoms of diabetes and test any children who might have symptoms. I felt like we were trying to find a needle in a haystack, but the education part was important. The orphanage divided itself up into 11 houses with 1 mother in each and kids of varying ages occupying each house. I rather liked the setup, which made each house seem more like a home and family setting complete with its own kitchen. The mothers and kids surprised me with their knowledge of diabetes symptoms which include, frequent urination, constant thirst, drastic weight loss, constant hunger, and fatigue. I didn't even know the symptoms of diabetes before becoming involved in this project.

Maggie, Lourdes and I made other home visits. As a result of one, Maggie miraculously made it on Bolivian television to discuss the symptoms of diabetes with Carlos, a 15 yr old boy with diabetes who is also deaf and mute. We met him and his family the day before the tv interview. He is the most animated child I have ever met and partly because he needs to over express himself to communicate without an oral language. I enjoyed being around his peppiness. Somehow the family already had a scheduled tv interview and invited Maggie to join them.

We also visited Fabiola's family on the outskirts of the city. A taxi dropped us off at a local bus stop on a dirt road and the father picked us up and we bused over to their house. Fabiola is 12 and has had diabetes for 10 years. She is well-educated and seems in control of her condition, but seems to be under the constant watchful eye of her father. Her father is overwhelming to be around and I enjoyed watching Fabiola open up at camp without him there. At the end of camp, she didn't want to go home at all, and sadly avoided her father on the last day. Despite this, the father could not thank us enough for the homevisit as well as for the incredible happiness he saw in his daughter.

Our final home visit was to Laura Christina's house. She is 15 years old and such a sincere and sweet girl whose mother is her best friend. Unfortunately, the parents had to obtain second jobs and work longer hours to pay for the additional cost of some of the insulin. Thankfully, Nino Feliz offers test strips and some of the insulin for free. We learned how concerned the parents are when she sleeps at night. For the most part, parents are most concerned when their child goes low on their blood sugar than when they go high. This is in part because they can see the physical differences when the blood sugar is low and they are not able to wake up their child. However, continual high blood sugar can lead to severe future complications.

On another day, we organized a focus group of parents and kids to learn more about their needs. Instead of taking advantage of a Saturday night in Santa Cruz, I stayed up very late writing up focus group questions with Maggie and Erica. From the focus group, I'm thrilled that the parents had a chance to have their fears about camp resolved for the most part, and meet other parents. I even watched as the parents exchanged numbers to create their own support group, which seems to be a much needed element to supporting the parents. Based on the momentum in the room, I expect the parents to bond together to educate local schools about the needs of their children and rally the government for more healthcare support.

Despite being the oldest volunteer since the program is more geared towards college students and recent grads, I enjoyed spending NYE as well as working with the other volunteers. One of the funniest and most endearing comments came from Anna who said to me on the last day, "June, I am so glad you came. I hope that in 12 years, when I am as old as you, that I can be just as spunky. You give me hope that I have a future." I felt my age at the moment, but understood what she was trying to say and she tried to reclarify after too. I may have been the oldest volunteer by a decade, but I also was one of the spunkier ones around.

Cuban Influence

To better understand the healthcare system in Bolivia, we partnered with Ayenida who is the director of hospital networks containing 5 provinces with 57 hospitals; she administrates all of them. Before camp, she took Maggie, Lourdes and me on a tour of one of her provinces. We visited a couple of hospitals and I was surprised to learn that mother mortality while giving birth is extremely high. Many mothers prefer to give birth at home since they are often scared of hospitals. As a result, when they deliver at home, they do not take out the placenta and therefore develop an infection and die.

Just as mothers fear going to the hospital to deliver, many diabetics fear taking insulin because they associate the insulin with complications that can occur with diabetes. Pablo a 29 year old with Type I ended up with a kidney transplant and Yanira has gone blind in one eye. When Yanira's mother died of complications related to diabetes, her father blamed it on the insulin. He refused to allow Yanira to continue taking insulin until she finally lost an eye. Doctors finally convinced him otherwise to allow her to continue her insulin treatment. Other complications of diabetes include foot ulcers and amputations. Although diabetes requires out of pocket costs, general healthcare is more affordable.

Interestingly, Castro is supporting Bolivia's healthcare system by providing funding for new hospitals as well as loaning Cuban doctors to Bolivia. Some local doctors are not thrilled with the influx of Cuban doctors because of the cultural differences as well as a few complications under Cuban doctor care. But due to Castro's generosity, healthcare is more widely available.

Morales has recently implemented government paid health insurance for all children until 5 years of age and for adults older than 59 years old. For those in between in age, the hospitals in some provinces provide free healthcare or health care visits for only $1.50. Cuba's money is helping pay for these costs, but I'm not sure how affordable healthcare is in other regions.

Diabetes Camp-Happy and Hopeful

Camp remains much of a blur because of the constant activity watching over the kids, getting them from one educational activity to the next, participating in the fun stuff, checking their blood sugars and organizing the rally event with Danielle and Aubrey.

For the rally, we set up 7 events with 7 transition events for 7 teams to compete. The activities ranged from finding lemons in heaps of flour while using only your face to filling up a bucket of water using only the cup in your mouth. Surprisingly, despite the complicated logistics, the event went smoothly and everyone had a fabulous time. We even had a few people throwing water balloons at the campers as they worked each activity.


Other days, we played capture the flag and “find the gringo” in which a few of the monitors hid around the campsite at night and then each team had to go find them. Steve hid under a bunch of sticks on the muddy ground and only 1 group found him mainly because none of us thought anyone would be crazy enough to hide there.

The rest of the time, the campers attended educational activities. Because my group was younger, we missed out on a lot of the leadership youth empowerment sessions in which each camper sets out objectives for the year related to diabetes. Instead, we focused on acting out plays related to diabetes, took advantage of teachable moments throughout the day, and learned a little more about managing diabetes. Our group even created our own song and dance to represent our group number 2, which I can not remember anymore.




The parents attended on the last day to reunite with their kids. For many of the children, they had never left home before, even for a slumber party, because of their diabetes. The parents put a lot of faith and trust in us to be able to hand over their child to complete strangers for a few nights for the first time in their lives. Some parents insisted on calling Kendra's phone number demanding to speak to their child just to make sure she was still alive. Despite having 90 total people at camp with 90% of them diabetic, we encountered no emergencies. A miracle to say the least.

Upon witnessing their children dance the line dances we had taught them, many of the parents told me that they have never seen their kid so happy and alive. I teared up with them as they told me this. They thanked me profusely for the broad smile they saw and secretly told me that they also enjoyed their brief vacation of not having to wake up in the middle of the night to check on and worry about their child.



Highlights for me included:
Watching Maria Lizeth open up and feel a part of the community. She was quite shy at the beginning and did not participate in the activities with the other girls. This is the first time many of the campers have met another person with diabetes. Creating a sense of community clearly provided much needed support and by the end, she had made lasting friendships and even bonded with Stan the Stent Graft.

Hearing Naomi's father's question on whether Naomi could have children later in life; he has been worried about her future. He asked Joe who has had diabetes for 47 years if she could have children. When he said yes, the father broke down in tears of relief and joy. I broke down crying upon hearing this show of love and concern. I had paid Naomi's family a home visit earlier and was so impressed with her maturity not to mention perfect posture. She is such a wonderful child with a bright future and loving family.

Reading the older campers' testimonials. The older kids each wrote something about what they gained from being at camp or what they have learned. Some said it saved their lives and gave them hope that they have a future. Even Katrina, who is so thin she could barely walk, appeared happy and hopeful and healthier than when we had first met her at her home.

Final highlight, making connections with the girls despite my poor Spanish skills and becoming a part of their lives. I miss them all already.

Diabetes Camp-Blood Sugar Checks

All in all, about 60 youth ranging in age from 8 to 25 attended the diabetes youth camp. They came from all socioeconomic backgrounds and various experience and years managing diabetes. We took over 5 cabins, at a local campsite, for each of the various age groups. I, Maggie, and Lorena, from La Paz who also has diabetes, managed nine 12 to 14 yr old girls. We needed all three monitors for all that was required of us.

Very excitable girls greeted me. The very first thing we did after introductions was to check everyone's blood sugar level. Although, the girls only check their levels twice a day, once in the morning and once at night due to costs of the strips, we had them check about 6x a day. With my minimal training testing a couple kid's blood sugar levels at the malnourished children's center, I set out to help.

Their levels were surprisingly, or not, all over the map. One girl's level was even over 400 whereas a normal blood sugar range for someone without diabetes is 80 to 120. Our schedule for the rest of the camp was to check the blood sugar levels at 7:30 am, 10:30am, noon, 2:30pm, 6:00pm, 10:30pm and 1am, and 3am if they were low. Thankfully, we had enough test strips, lancets, alcohol swabs and insulin to last all four days for everyone.

After a lot of exercise, their blood sugar level would drop quite a bit and I often had to keep careful watch of Anihi who almost passed out twice after too much exercise, something her body was just not use to doing. At one check, I fumbled checking her blood sugar level as Maggie kept her conscious and Jairo helped me finish it. We gave her coke and cookies to raise her level. After just a minute of drinking the coke, she suddenly perked up and was ready to play again. I had to keep her seated so that her body had time to recover. After that, I felt like I had been given a tremendous amount of responsibility with very little training.


Due to my inexperience, another volunteer showed me and 3 others, who have no experience with needles and syringes, how to put air in the insulin bottles and then how to draw out the correct amounts as well as how to draw up 2 different types of insulin with one syringe. After that tutorial, I was able to competently teach the kids as well as the local endocrinologist assigned to my group, who didn't seem to be all together there, the proper method.

Checking the girl's blood sugar level at night provided me the most peace. I would enter into each of their rooms while they slept and prick their finger to check their level. If it was low, I would wake them up and give them coke and crackers to eat. I then had to check their level again 15 min later. If it was still low, I had to give them more to eat. Then, Lorena would check their level again at 3am to make sure it was okay. The night I had off, poor Maggie was up all night checking blood sugars because all the kids were low. I guess they had way too much exercise that day.

Where to inject insulin is often an issue since the girls have their favorite places. However, by always injecting in the same places, the skin becomes hard. We encouraged them to try other places despite their fear. We taught them ways to roll their arms against their knees to get a better angle to inject in the fatty area. They learned from each other as well. I, also, learned greatly from them too and enjoyed the vicarious as well as interactive role that I played. Fun stuff to be written about later.