Tuesday 18th; Drive to Tiraque with Abraham, 3600 metres,small town with picturesque square, meet with mayor who introduces Bronni and I to medical director for local 4 Dr hospital and medical service of area. <drive to <<<<<<<<<<<<<<<kaoti about 15 km away but another 1000 metres higher. Koari is a 130 family village in a pass between two beautiful peaks. This is Winter of course and with a strong wind that comes through the pass temperatures feel sub zera. Winter here is dry and no rain is expected until November. This is one of the first place that Sue and Abrahm worked in Water provision for these isolated locals.
the first night we stayed in one of the childrens bedroom and they slept in another bedroom in the house. The kitchen is a separate room outdoors with a gas fire and no running water. There is running water outside the house which is the nly source. Unfortunately this altitude started to have some health effects on Bronni.
Wednesday 19th.
Today 15 patients came through the clinic which we consequently moved to stay in. This is a new clinic built by Mano o Mano two years ago. All equipment is brand new and facilities in the health cinic for the patients and the nurse to stay. It has running water and electricity. Most of the patients seen today were nurse only consultations for anti natal checks, contraception continuation and well child checks with vaciniations if required. From our side, we saw patients with Asthma, bloody diarrheoa, lower respiratory infections and upper respiratory infections. Unfortunately the altitude was taking a heavier toll on Bronni with severe headaches, vomiting and fortunately we had medication to assist. At Midnight we were able to assist the nurse with an emergency visit by an Argentian family who had a sick 7 month old child with persistent diarrheoa and vomiting and they had been in Koari for only 2 days.
Thursday 20th.
This village was a little problamatic that the only shop that existed here ran out of food due to a womans soccer tournament being held here yesterday and the food we had bought we had given away already to the Mayors wife, however the people were very generous.
We saw 21 patients this day, once again sveral well chil checks with vaccinations and patient <i became involved in had diarrheoa, respiratory track infections, epistais, abdominal colic, nappy rash, facial abrasions, noises in heads and eye problems. Bronni spent whole day in bed, stable on medication but I was looking forward to returning to a lower level tomorrow . As soon as the sun sets in Koari the temperature plunges and this is worsened by strond winds. However wearing many of our clothes seemed to do the warming trick.
Friday 21th.
6am raising to complete packing up and catch a taxi shuttle at 730am to Teiaque, 1000 metres lower which greatly aided Bronni's return to normal health and cheerfullness. we went to the hospital and were invited to help in a obstetric clinic which is held twice weekly. Anti natal and post natal patients. Examining them by ultrasound and physical examination and assisting the intern Doctor where possible.
Friday is market day for this town and hundreds of stall are set up for selling fruit, vegetables, meat, and all manner of consumables. This also means on friday the nurses ffrom the ehalth post around the area come to Teirque in the morning to complete their paper work thus the rura medical service really only exsists 4 days a week as nurses then return to their home towns of Pernata or Cochabamba by bus on Friday pm for the weekend