***

Visiting the rural areas of Bolivia is like traveling to a whole other world. One day we left Puesto Fernandez early so our bus driver could show us some smaller villages in the area. We had not traveled long down the highway before we reached the end of the pavement. The driver eased the bus down off the pavement and began to wend his way down a long bumpy stretch of road. The first several miles were under construction and were lined with paving crews and lots of equipment. The driver had to zigzag past all the road crews and, once we were beyond them, he had to zigzag past huge hudholes, other vehicles and loose livestock. It is not uncommon in this area to see cows, goats, pigs and even horses grazing by the road or wandering along it. Whole families of chickens and dogs seem to run loose just about everywhere, even in parts of Montero itself.

We drove through San Jose del Norte, Sagrado Corazon and San Pedro and stopped to visit some of the churches in the area. These towns are similar to Puesto Fernandez ‹ small with dirt roads and built around a green square. Sometimes, if one is alert, one can see sloths and monkeys living in the trees of these town plazas. Houses are of simple construction, usually with slate or metal roofs and the occasional thatch roof. In the outlying areas, houses are made of wood slab walls with thatch roofs and typically are small, a few rooms at the most.

One also has to cross drainage ditchs on unsturdy wood bridges ‹ often just a board thrown across the ditch ‹ to reach these houses from the road. Barbed wire is a fencing staple in these parts, but it serves other purposes as well ‹ in some of the areas we visited, families were using it for clothesline. There never seems to be much heavy farm equipment in these areas, and what machines there are appear to be connected to the sugar cane trade. Sugar is one of the major industries in Bolivia, and hardly a day goes by when one does not pass multiple tractors and trucks each hauling three or four trailers worth of cane on its way to processing.

It is because of these trailers, which have no lights or signals, that our resident missionary gave us this advice before we climbed on the bus: 3I want you back on paved roads by dark.2 It is dangerous enough to drive down many of these roads, and even more dangerous at night, with few street lights and few working headlights on vehicles. Getting back to civilization before nightfall was a bit of a challenge, however ‹ it1s winter in Bolivia and gets dark by about 7 p.m.

Medical checkups

Another day, a group of us went to Villa Cochabamba, a health center in Montero, to shadow a nurse doing well-child checkups in a poor neighborhood. Many of these visits are coordinated through Curamericas (http://www.curamericas.org/), formerly Andean Rural Health Care. The organization, based in North Carolina, got its start in Bolivia and now has programs in Mexico, Guatemala and Haiti.

Curamericas was among the first health organizations to create and implement an intense, thorough program that saturates entire neighborhoods. Each nurse or doctor is assigned a neighborhood and visits every household, regardless of residents1 income, to weigh children, provide immunizations and vitamins, check feeding routines and track health and disease patterns.

By doing so, health care providers get to know neighborhoods and build up trust among families, encouraging parents to find clinics when problems arise. Records are thorough and provide a good look at the health of the population. When a nurse arrives at a house, armed with a cooler of immunizations and vitamins and a stack of folders and paperwork, mothers return to their houses to retrieve their own copies of child health records so all records can be updated.

It is difficult to believe the neighborhood we visited was part of the city of Montero ‹ it has a more rural feel to it, with simple wood houses and livestock everywhere. Many of the houses are only 12 by 15 feet or so, but all are wired for electricity. The neighborhood also is startling quiet, despite a large presence of children, and it meant so much for us to finally see a child who was smiling.

The nurse we shadowed is fluent in both Spanish and Quechua, a native language. This is important because some of the families she works with primarily speak Quechua.

We also heard from a doctor from another village who described Bolivia1s attempts to socialize medicine after Cuba1s model. The new president of Bolivia, Evo Morales, has aligned himself with Venezuela and with Cuba and the three nations are working together in many areas.

Cuba is sponsoring some eye treatments for Bolivians, for example, and has sent doctors to Bolivia to work. Bolivia is working to improve the doctor-patient ratios and to provide not only free medical consultations, but also free medications. The main problem, the doctor told us, isn1t the programs, because the programs are good. The problem is funding for medications and for personnel, especially providing personnel for home visits in the most rural areas.

Mission teams aim to combat this problem in various ways. While we were working in Montero, a medical team from North Carolina was visiting many of the same areas, bringing as much equipment and supplies as they could manage and providing checkups and whatever health care was necessary. This particular group has been coming to Montero for about 30 years now, so the doctors and nurses are well acquainted with the needs of the area.

***

Our second work project was within the city of Montero, on the sprawling Iglesia Metodista campus. In 1957, the campus was a live-in veterinary college on the outskirts of town, with room for livestock and hands-on learning. Now, the city has grown up around the campus and in place of a veterinary school, the land is home to a regular K-12 school and a Methodist church, a branch of Hasta Crecer and various other programs.

Our job was to assist a local work team and another U.S. youth crew in building a brick and chain-link security fence around the campus. We hauled sand and river rock, added bags of cement mix, and shoveled the mounds back and forth three times until well mixed. It gave a whole new meaning to moving mountains. Everything is done by hand here. Even the river rock is dredged and sifted by hand from rivers such as Rio Surutu near Buena Vista. We had no tools besides shovels, wheelbarrows, trowels and tire-size bowls in which to mix mortar. The job was not as physically demanding as hauling water and digging in knee-deep mud had been, but it required considerable endurance and care, and the results were easily visible.

We had less contact with youngsters this week, because they usually only showed up for a few minutes in between classes. They would come running out of the building and gawk at us for a minute or so before the bell would ring, summoning them back to class.

With less of an audience at this project, we were able instead to bond with the local work crew, and particularly their foreman, Pedro. I1m considering writing a list after the fashion of such posters as 312 things I learned from my dog2 ‹ lessons from Dom Pedro.

He set the standard high from the outset, knowing that we would be encouraged to achieve the best. If he didn1t think the bricks were laid properly, he would remove and fix any offending bricks and explain what was wrong with them. His perfectionism was disheartening for us at first.

By the end of the week, however, he was freer with the compliments. When he would walk down the row and only lightly tap a few bricks into place and say, 3muy bonita,2 it was cause for cheers and high-fives on our part. He told a few of the group that we had learned quickly and that he was sad we had only one week to spend at the work site.

Santa Cruz

While still definitely a part of Bolivia, the city of Santa Cruz is something of a culture shock for those who have been in the outlying areas for several days. Why? It1s a real city! Streets are marked, and stoplights rule the intersections. There1s more variety in building styles, with clear differences among residential, governmental and business buildings.

There1s even a Chinese restaurant across from one of the churches we visited.

There are real stores in Santa Cruz as well. In Puesto Fernandez, markets are small and often are part of people1s homes. In Montero, there are various markets, including a long block we came to know as el mercado. Dozens of fruit stands line the street. And a huge, cramped complex houses everything from toiletries to clothes to knitting supplies. Each merchant has a small square of floorspace which he or she fills to overflowing with wares.

The most surprising thing we saw in this market? An open-air meat market. Large cuts of meat hung from the ceiling, and a few animal heads lay in a pile on the cement. Several scales were visible. Compared to this, Santa Cruz is a little surprising. It1s the biggest city in Bolivia, with roughly a million residents.

It also doesn1t hide its poor very well. In most of the areas we visited, everyone seemed to have a roof to live under. Not so in Santa Cruz. When we got off the bus, we immediately were greeted by children, perhaps 5 or 6 years old, begging for handouts. Their families were camped on the sidewalk nearby, quietly sitting there, with their scant belongings around them. As we drove through the city, we would notice some families sitting on mattresses in large, dry drainage ditches.

We did not interact with these families, because that was not our particular mission in Bolivia, nor was it our reason for visiting Santa Cruz. But it is difficult to forget the faces, and the feelings of utter hopelessness that seemed to permeate the air around them.

After seeing these homeless families in the city, I understood what two of our group had meant when they told us the children we were helping in Montero and in Puesto Fernandez really were quite well off. They had meals to eat, buildings to live in, and adults to care for them and give them an education. The street children of Santa Cruz are not so lucky.

***

Political activism is out in the streets in Bolivia in ways I have not seen at home (I1m too young to remember the 1960s and 170s firsthand). The first thing we noticed was the number of buildings and walls splashed in various election colors ‹ blue and white, with the words 3Evo presidente,2 dates to the most recent presidential election. Given the number of buildings painted in Evo1s colors, it is easy to believe the statistics that Morales is the first president of Bolivia elected by a true majority.

Other buildings were painted in green, the colors of the referendum, and the letters 3A.P.B.2 ‹ autonomy for Bolivia. This is in reference to the nationwide vote held July 2 to decide on changes to the government, including the possibility of decentralization.

Every day that we were in Bolivia, we heard and saw noisy political parades in the streets of Montero and elsewhere. A large truck would be in the lead, with a live band in the back playing music. Or sometimes the lead car would be equipped with rooftop speakers, broadcasting propaganda for the vote.

Following behind would be a long line of cars decorated with balloons and flags appropriate to whichever view was being promoted, and supporters would walk along the sidewalks passing out fliers. This was happening several times a day toward the end of our trip. At toll stops and intersections, people would hand referendum propaganda through the bus windows. Everyone we talked to agreed the vote was unprecedented Bolivia1s history and would be a landmark in national politics.

We were scheduled to leave the country the day of the vote, but there was one problem - travel between cities was prohibited that day in order to facilitate the voting process. We were told we may have to leave our hotel as early as 4 a.m. in order to reach the airport before the roads closed, unless we were able to obtain a travel permit.

The day before we were to leave, we learned that, while our missionary and other locals had applied for a travel permit for the bus, the paperwork never actually showed up at the hotel. Our backup plan was to have the only person we knew with a travel permit follow behind our bus. If we were stopped by the authorities and our papers questioned, this person would take a few of us at a time in his vehicle, with his permit, to the airport.

Fortunately for us, we were not stopped and reached the airport without incident.

I cannot help but wonder what the referendum results were. So far I have seen only preliminary results posted. And I wonder how successful Evo will be in reforming the country. His goals are lofty.

Bolivia is the poorest nation in South America, but it is home to some of the largest oil reserves. Evo has sought to remedy this by nationalizing the oil industry. He also has sought to return the land to those who live on it and farm it. And he is working with Cuba1s Fidel Castro and Venezuela1s Hugo Chavez on many other reforms. Will his plans meet with the intended results? Or are they too idealistic and contrary to prevailing Western wisdom?

It is too early to know the answers, but I pray that whatever happens is what is the best for the people of Bolivia. They are a vibrant people, living under intense conditions and are on the brink of many changes. There is much work to be done in Bolivia, and it has only just begun.