As the Time-Dateline goes, when flying West, Bronni and I landed in Buenos Aries in med afternoon and stayed overnight in the Howard Johnson de Vinci hotel until our flight to Santa Cruz at 0900 where we waited for the next flight to Cochabamba. There are several flights a day on at leat two airlines, BOA and Aero Sur (528 Bolivianos for two adults and 120 B´s for 35 Kgs excess luggage/medicines). We were met by Sue (An expat New Zealander who had generously offered to help us in Bolivia) and Abraham who we stayed for and spent the week exploring theri contacts for working in a rural and remote area with little of no medical service.

First we met Dr Maria Isobel (Chabi) who runs an Orphanage for 50 children, has a clinic in the city, and once every two weeks goes into the rural areas for community clinics.

On Monday we attended a public rally against domestic voilence and sexual violence protesting about the apalling rates of rape and sexual violence, expecially toward children and demanding that the government take note of these statistics and address the problem through harsher penilities for offenders, education, and provision of a just legal system. At this rally we met Jose Miguel, the Cochabamba representative of MAP (Medical Aid Partnership), Dr Orlando who has created a local rural hospsital and more involved NGO´s.

The next two days were spent at MAP International Bolivian Consensus centre where their is a subsidised clinic, birthing rooms, dental surgery, las advocacy and psychological counselling for violent sexual victims. There is a department for support and training of the diasabled as well as a large group of voluntary health promoters who are trained in Cochabamba and return to their communities as educational, health, agronomy, and water advisors.

Next door is a school that begins as a day care centre for infants from 6 months of age and goes to 7th grade, teaching children their community responsibilies, how to develop enquiring minds and basics of good hygiene as well as normal school subjects. Bronni and I visited each class in turn, talking to each teacher and learning about the disparities that often plague the education system in Bolivia.

All the children at this school are feed twice during the day and the cost for each child for all their education requirements is 1 B per day.

This complex has been going for more than 22 years and is suffering from decreased funding from MAP Intl, we were told so staff are already being laid off. Unfortunately although it is an excellent stand alone model (apart from American financial support) there is no talk of replicating this example.

The next day had us visitng Dr Jacobs at the Rural Research unit at Cochabamba Medical School to hear of some of the areas they are doing research, but after some discussion they appeared to not be a gateway to rural medical service for us, but are interested in Bolivian diseases. It was interesting to hear that with the closer ties Bolivia is creating with Cuba, there has recently been an infusion of 5,000 Dr´s from Cuba and Argentina into Bolivia.

In the afternoon we were going with Dr Patricia to a peri-urban Ushpa Ushpa, around 10000 inhabitants on the edge of Cochabamba where immigrants from rural come to find work in the city which already has very high unemployment rates.

This area has no available running water and all the water is brought and sold in 200 litre drums and then needs to be sterilised for drinking purposes.

Here Bronni and I visited a similar model of health and dental clinics attached to a school providing service to the community founded by Saiant Vincent de Paul Society. Dr Patricia gave a nutritional improvement talk to the gathered employees that came from families that have a very starch based diet.

The next day we met Dr Maria Theresa who runs Fundacion San Lucas which has been running 18 years for a population of 3500. She has managed to lower the high infant and maternal mortality in this area over 18 years through community health promoters, rural clinics, improved nutritional education and weekly money investment in a transport system that takes acutely ill people to Cochabamba some 2 hours away by road.

Both Dr Patricia and Dr Maria Theresa want a large mobile clinic to see patients and to do laboratory testing in, to further their improvement of rural health.

On Friday afternoon we met with Mayor Fidel Salazar who heads a small rural community of 14,000 in Tiraque, 80 kms outside Cochabamba. He is happy to have the offer of a Dr and nurse for some of his communites of 200, 300, and 400 (around 5,000) families who have a limited nursing service only, and we agreed to meet him in his province next Tuesday to access if we may be of use/service there.

Saturday was a day of joining in the large local festivity of Urkupina at Quilla Collo, not far from Cochabamba where a festival occurs to commenorate a sighting of the holy virgin hundreds of years ago at this sacred hill Calvario. A three day festival of worship and praise to God with dancing and parades and prayer and church services all involving maybe 5000 people.