Our first clinical experience here in Bolivia took place in Rio Colorado, at a school a couple hours outside of Rurrenabaque. To get to the school, imagine the worst dirt road you have ever been on, and multiply this for 2.5 hours, going 25 mph in a small van (called a minibus) with no shock absorbers, and that was the ride to Rio Colorado. Since it is the dry season, cars produce plumes of dust on this road, and by the end of the ride, we were all coated in it - we endearingly referred to it as the mousse we wore for the week - bug spray and dust.
Since Rio Colorado is 200 miles away from the nearest electrical grid, the only electricity available is by generator power, which is only run for 3 hours each night at the school, 6:30-9:30 PM. The temperatures are fairly mild all year long (it was about 70 degrees during the day, and it is winter here now!), so the bathrooms and showers are all located outdoors. Unfortunately, the no electricity and warm weather combination also resulted in no heated showers. Let me tell you, having ice cold showers is a great way to conserve water for those environmentally conscientious people out there.
Sara and I were sharing a room with a bunk bed, and I had the top bunk. We slept inside mosquito nets, but since Sara is a bug magnet, she was still paranoid about them finding a way to bite her. Our conversation the first night there set the tone for the rest of the week, it went something like this:
Riva: Sara, there´s a hole in my bed.
Sara: What do you mean?
Riva: I mean, there is literally a hole where my butt is!
Sara: You mean here? *pokes with her foot*
Riva: hahaha, yes, ow!
Sara: OMG, Riva, there is a hole in my net! I´m going to die!
Riva: LOL, should we try to fix it?
Sara: Let me just try to put my flashlight through it. Yes, this fits perfectly.
-5 minutes later...-
Sara: Did you just move?
Riva: No... you didn´t??
Sara: No! OMG, something just fell on my net!
Riva: What? What is it??
Sara: I don´t want to look!
Riva: What? Sara, look!
Sara: Nooo! I´m just going to go to sleep.
Riva: Are you crazy?! You can´t sleep without looking! What if it´s an animal?
Sara: What if it is? I can´t do anything!
Riva: Kill it with the machette!
Sara: No, I don´t want to look! This is not funny, why are you laughing?
-After 5 minutes of giggling, Sara finally looks...-
Sara: OMG, Riva, it´s a log from your bed! That´s what fell on my net!
Riva: What?? Which one? Sara, how can I sleep like this? What if my bed falls on you in the middle of the night?
Sara: Oh shit! The hole in my net got biffer! Now the flashlight won´t fit! I´m going to have to use my water bottle.
Riva: Should we try to sew it?
Sara: Oh yeah, my uncle gave us that sewing kit!
Riva: Or tape it! Í have tape in my bag.
Sara: I have to get out of my net again?? I´m going to die!!
-20 more minutes of giggling ensues...-
At the Rio Colorado school, we set up a health fair. This is a very rural area, so most people rarely see a doctor. We saw a lot of memorable cases, but mostly screened for TB, and treated dolor de cabeza and parasites.
Pictured here with one of our team members Paul is the coolest man ever - his name is Billy Baldo, and his name says it all. He is 66 years old (which is pretty old for a Bolivian), and it amazing shape. His heart beat was so slow, I couldn´t find it on my stethoscope haha. He sleeps four hours a night, chews coca leaves all day, and knows a ton about the medicinal qualities of many of the plants found in the rainforest.
Here are Sue and Oscar, screening the kids for TB. 
Mara and Jonathan fitting a man with a pair of reading glasses from our donations.
This was my favorite kid! If Alyssa´s prediction were to come true and I did come home with a Bolivian child, this would definitely be the one.
La Doctora Sara!
The kids had tooth brushing classes with Mara and Wendy, where the learned good brushing technique, and they got free toothbrushes and toothpaste from the donations we brought along!
On our last day of clinic, a mother showed up with her 5 kids, and one of them had a pet monkey on their shoulder! Since the clinic was already closed up for the day, la enfermera Sue did the visit outside on a wagon, and practiced true jungle medicine.
When we arrived at the school, we had a surprise awaiting us - we were told that the school cook had been diagnosed with TB three years ago, and had been undergoing treatment with the aid of a community health worker, but had not been taking her meds regularly and had started coughing up blood a couple weeks ago. Since this probably meant that she had developed a resistant form of TB, not only was her own life in danger, but there was great concern about the possibility of her having spread it to the faculty and staff at the school. Since there were no PPD tests available in any major neighboring city, we had to screen everyone by listening closely to their lungs and asking a series of questions. Any suspicious cases had to provide a sputum sample to be analyzed under the microscope. Luckily, no one other than the cook tested positive while we were there. Needless to say, we learned a lot about TB that week. Here, Sara and I are being crime scene investigators. This was on the night that standing up on the back of a truck at 10 PM, we accompanied Dr. Oscar and the local Chemist to a town 10 km away to analyze the sputum sample of one of the teachers who had a bad pulmonary infection. It turned out to be due to a fungal infection, which I totally called as being Aspergillosis!
Here is a picture of the pig that had been in the back of that same truck earlier in the day. This piggie was to be our lunch the next day for a big fiesta in honor of the mayor of a neighboring town who had donated money to the school, coming into town. Notice the poop, which we did not see in the dark, and imagine what we smelled like after that ride...
Lovely views of the school, looks like a tropical paradise!
Sara´s best friends (video to come)
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