On the Streets of Cartagena


After a couple of super serious posts – It’s time to change the pace, back to the colorful life of Cartagena..  When we aren’t in Sincelejo, I’ve had a considerable amount of free time to enjoy the city.

Iris and I have had some great adventures (particularly gastronomic ones), but I have also spent a lot of time roaming around on my own, trying to make the city my home.

So I thought I would introduce some of the nice people I’ve met on my daily walks around the city. I don’t have photos of everyone, but I thought I would share the ones I do have..

aistedes 002

With Aristedes

 

(According to this picture, the  rumors are true – at least the part about my looks)

I almost didn’t post this picture of Aristedes Ayala and I – just because I look pretty awful but that would be a disservice to Aristedes, who has been a good friend while I’ve been here.  We’ve hung out various afternoons while he’s practiced his English with me.  I’ve tried to impart my southern accent during our lessons along with key American and southern idiomatic phrases, but I am not sure how successful I was.

But then again, it seems like my own accent has started to fade away from disuse.  (I have tried very hard to speak very clearly, and not to use colloquial phrases when I talk to non-native English speakers over the last few years – and I think I might have been a bit too successful.)

Gustavo

Gustavo

This is Gustavo.  He sells aromatic coffees, gum and stuff like that – one of the streets near my home, in a shady spot by the beach – so I see him almost everyday.  (I also have a slight gum addiction).

Gustavo is an interesting guy – he’s worked here near the beach in Cartagena for ten years – so he’s seen a lot of interesting and crazy things, particularly on holiday weekends when the beach is packed with tourists.

Prior to that, Gustavo, who is from here in Bolivar, worked in Agriculture in the coffee sector.

Miguel

Miguel

Miguel is a nice young kid I met who works for Aguilar as one of the delivery drivers (so he has what I consider to be an ‘essential’ job here in Cartagena).  I don’t know if the city of Cartagena issues badges for expedited travel during states of emergency like we had at the hospital in St Thomas, (USVI) but he should probably get one.  I can’t even image how life might grind to a halt if alcohol was suddenly absent from all the bars, restaurants and fancy hotels.

 

Willie

Willie

Willie is one of the vendors who works on the busy touristy zone in Bocagrande.  He sells a lot of the Colombian craft items.

Willie with his wares

Willie with his wares

Since I have been working on my first mochilla, we talk about my progress sometimes.  (I’ve made a lot of progress on my latest trip to Sincelejo).

making progress on my Colombian bag

making progress on my Colombian bag

Then there’s this guy.  I don’t know his name, so I will call him Juan Carlos (which is one of my favorite names).  Imagine my surprise to see that he has been here at the military base every day watching over me (which is across the street from my apartment).  I never even noticed him until today.

Meet Juan Carlos

Meet Juan Carlos

So I asked Juan Rodriguez (at the base) to introduce me – and he did.

Officer Rodriguez

Officer Rodriguez

I know the military here has a bad reputation (particularly for past misdeeds) but all of my encounters with them have been pleasant, professional and friendly.

I always feel safer when they are around.

Manuel

Manuel

Manuel sells jewelry and beads on the beach – but he was happy to make time for a short chat.

I didn’t get the names of some of the other vendors I spent a couple of afternoons chatting with.  (I wasn’t shopping – just passing the time).

Cartagena playa 015

 

I joked with this guy about being from Bucaramanga (he’s not, BTW) because I have the female shoe shopping fantasy about Bucaramanga.

Selling shoes

Selling shoes

 

I always imagine it would be a shoe paradise for me – lots and lots of shoes in small sizes!  (I wear a what is a child’s size shoe in the USA so it’s hard to find shoes without cartoons on them at home.)

Now  – that I think would be a great tourism opportunity – “Shoe Shopping Excursions”.  I’d be more than happy to sign up for a weekend trip to Bucaramanga to find at least one pair of comfortable shoes that actually fit!

I’ve actually tried to enlist my good friend Camila in a do-it-yourself shopping adventure, but to no avail.  (She’s expecting a baby soon which has put a damper on major excursions – but hey – a new baby isn’t so bad..)  She’s be the perfect accomplice because she used to own an upscale clothing boutique so she is very knowledgeable about the quality of leather, clothing, shoes and other apparel items.  She also has excellent taste.  (I have gringo taste which is nothing to brag about – so I accept all help offered.)

I dread shoe shopping at home because it’s an exercise in frustration and is often accompanied by tears..

But maybe I can enlist some of my fantastically fashionable Bogotanas on my next visit..

Cartagena playa 012

This nice kid was just hanging out, outside Juan Valdez – but he was happy to let me take his picture..

Cartagena playa 019

Now I don’t have a photo of one of my favorite people here in Cartagena.  His name is Juan Fernandez and he repairs shoes along one of my exercise routes.  He’s about 60 and from a small town outside Cartagena, though he has lived here for about 40 years.  I always stop and chat with him for at least a few minutes, and he always greets me by name.

When we both have a little more time, we talk about philosophy, life in Colombia and our shared experiences.  I look forward to seeing him – and he always asks about my adventures in Sincelejo.

Now I know I talked about some of the things I don’t like about Colombia in a recent post –  but it’s people like Juan Fernandez that make me love Colombia so much.  Just nice people – who are happy to talk to a stranger, make her feel at home and pass the time.

Made in Colombia


The operating room may have stayed dark for the last several days, but that doesn’t mean it’s been a quiet holiday week here in Cartagena.

Cartagena 010

the quiet streets of last week are just a memory

The relaxed, fun atmosphere of the city – due to the tourists, the beaches, the clubs (and the Chivas!) is contagious.  It’s impossible not to be affected by all the smiling, happy people out and around…

Boy

 Adventures with Iris

Iris and I have had a fantastic week – wandering around the city and enjoying all that it has to offer.  (I swear, my next book is going to be called, “Adventures with Iris” and I am going to chronicle all of our various escapades).  But since she’s camera shy, it would be kind of a crazy book – with photos of me standing alone in all sorts of cool places..

photo (44)

Hanging out with Iris usually looks like this (as she hides from the camera).  You can also see my new haircut from a recent ‘day of beauty’ with Iris.

We’ve been all over town, sampling various cuisine, drinking a micholada here and there, and enjoying the refreshing evenings that serve as a relief to the sultry heat of the day.  We get along great so there is always something to talk about when we hang out.

Coconut water from the source

Coconut water from the source

I have a bit of a routine here – in the early mornings (if I wake up early enough), I head out to walk along the beach for some exercise.  By 7:30 or so – the sun, heat and humidity are already out in full force, and it’s time to head back indoors.

bikes in el centro

The rest of the morning is spent sewing, writing, reading, or crocheting.

After lunch it’s time for a siesta to pass the afternoon before the ocean breezes come to shore and cool off the city.  (Without the daily afternoon cool down, I think the city would just be unbearable, particularly for someone like myself, who is unaccustomed to the heat.  People from South Florida probably don’t even notice it.)

Visiting with Iris' Colombian craft class

Visiting with Iris’ Colombian craft class

In the late afternoons – we head out for various activities..

at a recent Colombian cuisine and craft event in El Centro

at a recent Colombian cuisine and craft event in El Centro

Colombian crafts – continued

I am making a lot of progress on my first crochet project – the universal, ever popular  ‘Colombian bag.’

Made in Colombia

Made in Colombia – the typical/ classic Colombian handbag, “Mochilla”

Of course, mine won’t be as fancy as these here (since it’s my first) but I did add a jazzy yellow stripe.

Colombian bag progress update

Colombian bag progress update

Avenida Brasil – More drama than the hair-pulling, cat-fighting “Dynasty” style dramas of the 1980’s.  (That’s probably not their advertising slogan).

I also work on the bag some evenings while we watch “Avenida Brasil” which is one of the typical melodramatic (always crying or screaming) telenovelas on television.  As the name implies, it’s actually a Brazilian show.  It’s a bad stereotype of Latin American soap operas with tired story lines (everyone cheats – no one uses contraception, so everyone gets pregnant (but somehow never gets HIV).  It has none of the substance of “El Patron” but it’s popular here, so I watch it.   But maybe all soap operas are like this – I was never a big fan of the Young & the Restless or whatever…

For the last week of episodes: the wicked Carmina  has been crying/ carrying on (and manipulating everyone) in every episode.  She recently caught her husband, Tifon cheating on her with one of his old friends, Mona Lisa.  But that’s no surprise to chronic watchers despite the fact that Mona Lisa just married another guy..  ( and Of course, Carmina has not only been cheating on Tifon for several years – but actually lives in a shared home with her amante, Max, his unsuspecting family, as well as her in-laws and her daughter (whose father is actually Max.)

Probably the only interesting story line for me is the serial polygamist. I don’t know the name of the character – but he’s suave and handsome in kind of a bland Argentine kind of way.. It’s like he just can’t help himself – as he marries woman after woman and maintains several separate lives.  He was recently found out by his three wives (who were completely unaware of each other) – while dating and wooing a fourth woman.  It’s only interesting to me in that he seems completely oblivious yet totally manipulating and calculating at the same time.  It’s a common theme that reflects much of the ‘machismo‘ here.

Then there is Jorgita (Jorge), the son of Carmina and all of his trials and tribulations.  Of course, he is in love with one woman, while dating and impregnating another.   He’s supposed to be so wonderful and charming – but I find him quite revolting with all of his flashy jewelry and declarations of ardent amor.

Of course there are a myriad of other characters and story lines but this is probably enough to give an accurate depiction.

Hecho en Colombia

 

Handmade dress - about half way done

Handmade dress – about half way done

I’ve also been sewing a dress using some fabric and patterns I bought here.  I altered the pattern (quite a bit) to make it more of my 1920’s style and on a whim – have been sewing it by hand.

One of my preliminary handsewn seams.  (They are prettier when I finish).

One of my preliminary handsewn seams. (They are prettier when I finish).

Maybe when I get done – I can label it ‘Hecho en Colombia’ since I made it here in Cartagena using a Colombian sewing pattern, and Colombian fabric.  (Both the pattern company and the fabric manufacturer are in Medellin.)

Iris has a perfectly fine Brother sewing machine – (I used it to create a new helmet guard for Dr. B’s helmet light) but I just felt like doing it by hand.

photo (52)

 

Dr. B’s new helmet liner

It’s a cushion made of fabric covered foam that keeps the metal frame that holds the surgical light from shifting or weighing too heavily on his head during surgery.  It’s navy blue so it’s hard to see in the photos.  It has velcro strips to affix it to the metal frame, and adjust for individual sizing.

photo showing Dr. B and his helmet light.

photo showing Dr. B and his helmet light (and the old liner).

Haha.. Kind of funny how even sewing always circles back to surgery, isn’t it?

 

Downtime in Cartagena


Ribbons, fabric and sewing supplies in just one of several stores in El Centro

Ribbons, fabric and sewing supplies in just one of several stores in El Centro

As I mentioned in my last post – with no surgeries scheduled due to Easter week (Semana Santa), we returned to Cartagena Thursday evening.

For those of you who are unfamiliar with the custom, Semana Santa is a big deal here in Colombia.  People from Bogotá and other cities escape to Cartagena and the coast areas to celebrate and join in the parades and processions.

The city is already packed with tourists – enjoying the historic quarter, and the beaches.  The tour buses are full and blaring loud music for laughing visitors.  Clubs and restaurants are full to bursting and swimsuit clad vacationers wander the streets along side Cartageneros.

For my roommate, Iris and I – it’s a great chance to enjoy a leisurely Saturday.  We headed down to the old quarter to do some shopping. But instead of chotskies, tacky knickknacks or random souvenirs, we have a special mission in mind: Fabric shopping!

Outside a fabric store (with a very well-endowed friend) in Cartagena (photo Aug 2011)

Outside a fabric store (with a very well-endowed friend) in Cartagena (photo Aug 2011)

One of the things I love about El Centro is the abundance of stores devoted to fashion, sewing and clothing design.  There are stores filled with ribbons, lace and buttons; stores just for knitting and crochet with thousands of yards, threads and other accessories in a rainbow of colors.. Stores filled with sequins, beads and pattern magazines.

Then there are the fabric stores – all clustered within several blocks.  The richness of the fabrics displayed in the windows draws you in: elaborate laces, rich, silky satins, shimmering sequins and super-stretchy spandex.  There stores are different from the United States – where crafting and quilting have dominated and shunted fashion sewing to the side.  Instead of a huge assortment of quilting cotton, a large array of home decorator fabrics and a miniscule array of fabrics for clothing – here – fashion is king!  There are meters and meters of silky jerseys, swimsuit fabrics, lighter than air sheers, wrinkle-resistant polyester blends and traditional hot weather favorites like linen.   I am in heaven – and I’ve only just entered the first shop.

Magazines containing 10 - 40 different patterns

Magazines containing 10 – 40 different patterns

The next great surprise is the pattern department.  It’s not in the fabric stores – it’s at the bookstore or magazine stand.  Bianca, Quili and other brands offer the latest in fashionable attire in handy magazines.  Each magazine contains paper patterns for 10 to 40 different pieces of clothing  – and each costs 9,050 (COP) or less than five dollars.

Better yet – they have all the specialty patterns a girl like me could ever want.  (I enjoy making swimsuits/ exercise apparel in my spare time – and Kwik Sew is the only company in the USA that makes these sorts of patterns in any kind of variety.)

I am like a kid in a candy store – and I can’t resist buying a small handful of glossy magazines.

But before we go home, we head to the Getsemani neighborhood just outside El Centro – to a small local restaurant specializing in seafood called “A Casa del Buen Marisco“.  It’s down the street from a much more expensive place, Antilles de Mar, but has its own reputation for excellence among the locals.

photo (40)

I had the house favorite, the seafood soup and it was delicious.  I snuck glances at fellow diners plates – and everything that came out of the kitchen looked pretty savory.

After a terrific lunch – it was time to return home for an afternoon siesta.  Once the afternoon cooled off, we slipped out to get Dr. Barbosa a surprise gift before returning to work on my evening project: Learning to crochet.  (Don’t worry readers – Dr. B doesn’t read the blog so it’s still a surprise).

making progress on my Colombian bag

making progress on my Colombian bag

As I mentioned before, Iris is teaching me to crochet a traditional Colombian style handbag.  She’s been taking classes for months and recently received her certification from a specialized government agency.

It’s a pretty cool project, actually:

The Colombian government has a division that certifies artists who make authentic style Colombian goods.  The government offers classes to teach people how to make these crafts (or cuisine) in the time-honored way.  These free classes offer (predominately) women with a way to supplement their income, while preserving Colombian heritage.  These classes and the resulting certification process are also used to ensure the quality of the goods / services provided.

 

San Jacinto and taking the long way home


San Jacinto

As we left Sincelejo to return to Cartagena, I noticed that we made an unexpected turn away from our usual route.  This was confirmed as we passed the fitness center on the other side of town and headed towards Corozal.

The department of Sucre as outlined in RED

The department of Sucre as outlined in RED

“Ah, this will be my adventure today,” I said to myself.  Sure enough – I kept quiet and enjoyed the change of scenery as we drove away from Sincelejo into a mountainous area that reminded me of my high school years in Angels Camp – Murphy’s area of  California (Sierra Nevada foothills).

The terrain was dotted with trees interspersed with dry straw-colored grasses.  Cattle grazed in pastures on either side of the small, winding two-lane highway.

As we drove through Corozal, I ventured to voice my suspicions.  The good doctor laughed and confirmed that it was, indeed an ‘adventure’ designed for me – since he and Iris knew of my love of Colombian countryside.

avocados 002

the apple is just there for scale

First stop on our tour was for the famed avocados.   (Indeed – these famous avocados have been the source of much amusement among the cardiac surgery team due to a previous episode involving a “bait and switch” by another team member (who ‘stole’ a bag of these avocados from the good doctor, and left behind a small bag of more ordinary avocados in their place.)

woven fabric made on traditional looms

woven fabric made on traditional looms

We then passed into Bolivar –

Our next stop was San Jacinto, which is a town that is locally known for their artisanal crafts.  (The Sucre – Bolivar regions are noted for many of their textile crafts.  Some of the techniques date to the pre-Colombian era).

Having Iris as my tour guide was wonderful.  As a certified artisanal artist of traditional Colombian crafts, Iris was able to give me a detailed explanation of each of the different types of craft making – including information about regional differences in weaving designs, colors used, and other traditional items.

(For more information about the processes used in this craft work, click here.)

sincelejo 002

Since I am in the midst of  (very slowly) learning how to crochet one of the traditional Colombian bags  – I can certainly appreciate the amount of time and skill that goes into crafting each of these individual items.  There is no assembly line, factory floor or Made in China” labels here.  (Yes, I looked).

sincelejo 003

 

As the road wound its way back to the fork where we usually take the other branch) we stop at our usual coffee shop.  There we were greeted by a Palenque resident selling baked goods.

sincelejo 005

We bought a sweet, round ball of a popcorn(ish) treat called Alegra which contains corn with coconut and panela.  She then came and sat with us and attempted to teach us to speak a few words of Palenque.

After our brief respite, we continued to the main highway to Cartagena and proceeded home.  It took a little longer, but to me – it was well-worth it.  Thank you, Iris and Dr. Barbosa for my unexpected surprise!

!Eres Absurdo!


aortic barbosa

Eres Absurdo!

I’ve heard that several times since I’ve been here – but it’s not exactly as it sounds.  It’s slang: like saying “goofy-footed” when referring to snowboarders.  It means that I am left-handed, or left-hand dominant, since the operating room requires you to be somewhat ambidextrous.

So this week – that was one of the things I set out to do – to become more proficient with suturing with my right hand.  It wasn’t as hard as I expected but I certainly don’t have the speed I have with my left hand (which sadly, isn’t that fast).

Barbosa aortic

Monday

Today wasn’t a great day. Everything went well – harvested vein, closed incisions, in the operating room so it should have been another fantastic day – but…. I just a felt, a little lonely today, I guess.  Or maybe lonely is the wrong term – since I live with three other people here in Sincelejo.  I guess what I meant to say is it’s the first time I’ve really felt alone since I’ve been here – and it was kind of surprise to feel that way.

I guess because I am used to traveling frequently and in making unfamiliar surroundings my home that it came as an unexpected pang when I suddenly missed the camaraderie I have had at other hospitals.  Everyone has been fantastic here – particularly Iris, who I consider to be a good friend, but it’s not quite the same.

My name is Kristin.. Kristina is someone else

Here in Colombia, many people struggle to pronounce my name so it’s usually simplified to “Kristina”.  But that’s not me.  Just like my name, I feel like a bit part of my personality just doesn’t translate into Spanish well.  Not as a cultural metaphor or anything ‘deep’ like that – but literally.  When something that you take for granted – like having an extensive vocabulary at your disposal, is redacted, it kind of changes how you express yourself.  It also changes peoples’ perceptions of you.

Just for five minutes – I desperately wanted at least one person who really “knew” me to be there.

Dr. Barbosa is a fantastic teacher and a very intelligent and kind person – but we don’t have the kind of friendship that I had with either Dr. Embrey (in Virginia) or Dr. Ochoa (in Mexicali).  Part of that is probably due to the fact that I just haven’t been here all that long.  I worked with Dr. Embrey for almost three years.  Dr. Ochoa and I were together five to six times a week for months.

aortic valve 010

The other part is Dr. Barbosa himself.  Our perspectives are fairly different, so that tends to complicate things.  He is always friendly but still a bit reserved with me.  That might be due to the fact that I am still lacking fluency in Spanish.  (I understand a heck of a lot more that I can speak – but even so, colloquial phrases and subtle nuances in speech are usually a complete mystery to me).  So I miss most of the jokes in the operating room, or figure it out about five minutes too late to be part of the conversation.

But after a little while that feeling of intense ‘alone’ dissipated – and everything went back to normal, whatever that is.

aortic valve 012

Tuesday

This morning I went by the Cancer Institute of Sucre.  I had written to them last week, but received no reply, so I decided to stop in.  After about an hour, I was able to talk to one of the administrators but she said that I had to submit all my questions about their cancer treatment programs in writing, in advance.  I explained that is not how it usually works, and left my card.  I am sure that will be the last I hear from them.  It’s a shame because the facility is beautiful, sparkling and new.  They advertise a wide variety of cancer treatments including brachiotherapy and thoracic surgery so I would have liked to know more.  (The website looks like something circa 1996, so it’s not really possible to get information from there.)

Another case today – another saphenectomy!  But this one came with a potent reminder.   While I still need practice, I feel more capable of performing the procedure that I did before.  Things proceeded well, if slowly (still need a headlamp!) but then it turned out that the internal mammary wasn’t useable so Dr. Barbosa needed more vein conduit.  Which he proceeded to harvest himself, in about five minutes.  So – I still plenty to aim for.

The holiday week started mid-week, but I am still hopefully for a few new consults tomorrow.  I know we probably won’t have any surgeries over the ‘Semana Santa” period, but I can’t help but keep my fingers crossed anyway.

Wednesday

Aortic valve replacement*** today.  Dr. Salgua showed up early today – and looked pretty determined, so I decided just to stay out-of-the-way.  I figured since it wasn’t a vein harvesting case, I shouldn’t make a fuss.  After all, I am just a visitor here – and I’ll be leaving soon.

aortic valve 027

Not my best photo by far – but my favorite part of this surgery – placing the new aortic valve into position

Instead, I stayed behind the splash guard and took pictures – since aortic replacement is the “prettiest” of all cardiac surgeries.  Unfortunately, my position was a little precarious, balanced in two steps – and still barely above the splash guard.  So many of the best shots – ended up partially obscured.  (But I don’t want to give up any more surgeries to get better photos.)

Received a consult from the cath lab today but surgery will probably be delayed due to the Easter week holiday.  (The team is willing to operate 24/ 7 – but few else are.)

Both our patients from earlier this week are doing great.  Monday’s patient passed me several times doing laps on the med-surg floor.  He’ll probably go home tomorrow or Friday.

Thursday

No surgery scheduled for today.  Rounded on the patients from this week and spent some time explaining medications, post-discharge instructions and other health information with the patients and their families.  While I love the operating room – this is the part I enjoy the most: getting to know my patients, and getting to be part of their lives for just the briefest of moments.  It is this time with patients – before and after surgery that makes them people, families – not legs or valves or bypasses.  Without this part, I am not sure I would have the same satisfaction and gratification in my work*.  I love seeing patients when they return to the clinic for their first post-operative visit – to see how good they look, and how much better many of them already feel.

This afternoon – was exactly that as one of my first patients returned to the clinic after surgery.  The patient looked fantastic!  All smiles, and stated that they already felt better.

After seeing patients in the clinic, we packed up and headed for home.  Since we currently have no surgery scheduled for next week (Semana Santa), and our other consults are pending insurance authorization, I don’t know when or if I will be returning to Sincelejo before I depart for the United States.

*As I say this, ironically, I am hoping for a ‘straight surgery’ position for one of my future contracts, so I can refine/ improve my surgical skills for future contracts in different settings that encompass a variety of duties.

***More Aortic Valve articles, including my famous “Heinz 57” post can be found here:

Aortic Stenosis and Heinz 57 : (what is Aortic stenosis?)

Aortic Valve Replacement and the Elderly

Aortic Stenosis : More patients need surgery

Cardiac surgery and valvular heart disease: More than just TAVR

There is a whole separate section on TAVI/ TAVR.

 

 

Iris & Ximena


Here in Cartagena, I have been fortunate enough to have two great roommates; Iris and Ximena.

Dr. Barbosa made all the arrangements for me, and I was a little nervous about bunking down with another nurse (we can be temperamental and territorial at times) but living with Iris has been absolutely wonderful.

I was kind of worried I’d be living with some young, possibly flighty nurse who might resent having a middle-age woman in her home, cramping her style.  Instead, it’s like having an instant best friend and I love it.

For starters – we have a lot in common:  we are both academically and professionally inclined.  Iris is the perfusionist for Dr. Barbosa’s cardiac surgery service and is extremely knowledgeable.

Part of the machinery that makes up Iriis' professional life: the heart-lung machine

Part of the machinery that makes up Iriis’ professional life: the heart-lung machine

(In Colombia, Perfusion is an advanced nursing degree.  Iris obtained her master’s degrees in both critical care (National University) and Perfusion at (CES.).   She is widely acknowledged as one of the best perfusionists (if not the best) in all of Colombia.   Her peers frequently consult her seeking advice for a variety of surgical circumstances.

She is the only nurse to collaborate (and be listed on the cover) of a comprehensive Colombian textbook on Cardiology.  Her name is listed along side such esteemed Colombian physicians as Pablo Guerra, Nestor Sandoval and Sergio Franco.

Cardiology textbook

She also serves as a reviewing editor of several Colombian medical journals.  Research articles are sent to Iris to review the methodology/ study design and overall quality.  Articles she rejects will not be accepted for publication.

In her free time, it’s not unusual to find her reading the latest journal articles on cardiac surgery or working on presentations for the latest meeting or international conference on perfusion.  In fact, she recently returned from the annual Colombian conference on cardiology and cardiac surgery in Medellin.  She is equally enthusiastic about all aspects of nursing and the position and rights of women (nurses) in Colombia and in medical society in general.

She is particularly outspoken against much of the machismo that dominates life here.  She is the one person I have learned to expect to never ask me the unpleasantly intrusive questions that seem to pass for almost introductory conversation here such as “Why don’t you have children?  Don’t you want them?  What does your husband think of that?  Your husband permits you to be here [in Colombia] without him?”*

Even when we don’t agree on all issues, she never judges my opinions or thoughts.  She endeavors to understand my reasoning instead.  It’s refreshing.

This combination of intellect, insight and experience makes for a lot of interesting and engaging discussions in the evenings as we relax and enjoy the fragrant breezes that bring daily relief to the sweltering city.

A strong woman in a culture of machismo

Iris is also extremely forthright and independent (traits that also resonate with me.)  She takes no ‘guff’ from anyone and lives how she pleases in a society that has a lot of difficulty accepting that (unmarried, no kids with Ximena as a part-time roommate.)

Even my professor, as charming and intelligent as he is, defaults into this kind of ‘macho’ thinking.  He tells me he worries about Iris, as “she is all alone” without a man to protect her.  He worries she is missing out on true happiness and is destined to be sad, alone.  Nothing could be further from the truth.

Rather, Iris has chosen to defy tradition, and live life on her terms.  She has friends, family and romantic attachments like anyone else.  She just maintains both her privacy and her independence despite that, sort of like Elizabeth I of England.

It is sometimes hard as an outsider to understand why this attracts some much attention – a single woman living quietly in her own apartment.  But then I think back to some of the comments I get from friends, acquaintances, co-workers and even strangers regarding locums life, and I realize, that as female professionals; whether the United States or Colombia, we still have a long way to go.

It’s just that as an American, I think I have fallen for the illusion of the possibility of female equality in way that women in other countries never have.  (The irony is that at this moment in my home country, women’s rights; to reproductive, financial and professional freedom are being eroded more that any other time in recent history.  Hard won battles of the 60’s and 70’s are being erased with nary an outcry.)

Here ‘paternalism’ rules the day – and no one pretends any different.

But there is more to Iris that a forthright, intelligent, independent individual.  She is also a nurturer, a caregiver, a nurse in the very sense of the word.

What could be more nurturing that offering up her home to an unknown stranger from another land?

“Ximena”

photo (38)

Iris and the other members of her apartment complex have adopted a white and orange stray cat that answers to a variety of affectionate terms.  One of these is “Nena”.  One my first day here, I confused “Nena” as a shortened version of Ximena, so Ximena she is.

This straggly looking, mangy little ball of fluff is adored by the residents of the small apartment building.  Typical of most cats, she is “owned”  by none, but owns each neighbor in turn.  But it was Iris who took up donations to get Ximena surgery she needed and routine veterinary care.  All the residents share in the feeding and care of the street cat – including applying a cream to her healing surgical scar, but it is Iris whom Ximena usually seeks.

While most of the residents leave their doors open during the afternoons to invite Ximena in, Ximena is most often found either inside our apartment, or bellowing outside the door (on the rare occasions that is is closed.)  She wanders in with the grace and arrogance that only a cat possesses.

She carries herself with a dignity that belies her ‘homeless’ state as to say she isn’t a vagabond but a seasoned traveler as she visits each apartment in turn – but always comes back to Iris to stay all afternoon and overnight.

Some of the neighbors our jealous of Ximena’s attention, but with our weekly journeys to Sincelejo, they always have an apportunity to host ‘Nena as their favored guest.

Iris loves to cook – and does so easily, deliciously.  She embraces a healthy lifestyle filled with daily exercise and fresh fruit and vegetables.

salad made of exotic fruits

salad made of exotic fruits

We talk about my love of Colombian food – and together one day in the kitchen, we make brevas.  She tells me with a smile that she has never made them, but used to watch her grandmother cook them for a sweet tweet.

Boiling brevas: Photo by Camila

Boiling brevas: Photo by Camila

We savor the sugary treat, one breva at a time over the next several days.

In  addition to learning how to perform saphenectomies from Dr. Barbosa, Iris is teaching me how to crochet.  My first project will be one of the small bags that is in a style typical for Colombia.  I think it is ironic that it seems easier to suture that it is to crochet.

Iris 003

But Iris is endlessly patient with me – and slowly, slowly as I unravel my mistakes and start again, I am making progress.  She has a blogspot where she showcases her latest creations.  She recently received national accreditation as a ‘native artist’ to participate in festivals and art fairs that specialize in traditional Colombia crafts.

Today, as we sit on the sofa, crocheting, we talk about plans for the Semana Santa (Easter Week).  The secretarial staff in Sincelejo has vacation plans and wants to keep the office closed all week so she can visit a boyfriend in Medellin – but Iris and I think it should remain open for the patients.  We plan to offer to staff the office, so that patients won’t have to wait a week to be seen.  We will have to navigate and negotiate carefully and diplomatically to prevent causing any hard feelings but as Iris points out, it’s the right thing to do for the patients – and the doctors, and that’s what matters. (My motives are admittedly more self-serving: more clinic = more surgery.)

*This type of questioning is fairly pervasive throughout Colombia, and is often performed as part of introductory conversation.  Once a taxi driver in Bogotá directed me to the nearest fertility clinic when I responded “No” to the question about children.  He wasn’t rude, on the contrary, he thought he was being helpful.

** Iris prefers not to have her picture taken.

Sundays in Cartagena


El Centro

El Centro

Sundays in Cartagena are a bit different from Bogotá or Medellin. As a major tourist destination, Cartagena never really slows down the way other cities do in Colombia.  In Bogotá, my neighborhood (Chico) was essentially deserted on Sundays.  The only signs of life were on the streets closed for  pedestrian walking.  La Candeleria and Usaquen were the destinations of choice for Bogotanos who chose to stay in the city.

Instead the activities change – instead of business, the weekends are for boat trips to the Islands of Santa Rosario, long leisurely lunches, wandering around El Centro and looking at arts and native crafts, and walking along the beach.   Tourists stroll along Bocagrande window shopping at designer storefronts, eating ice cream.  The hotels host popular events in Castillogrande, and restaurants and bars feature the sports of the day, to standing room only crowds.

So today, after sleeping in a bit, Iris and I headed to El Centro for another leisurely stroll around El Centro.  Sunday mornings are a nice time for this – the streets are still pretty quiet and not yet packed with tourists.  (That comes later in the day.)

Cartagena 013

As we wandered down the tree-lined streets, I can’t help put take photos, even if I’ve photographed these same areas many times before.  Somehow, every time I encounter the colorful buildings with the beautiful blossoms on the curving cobblestone streets, I am enchanted all over again.

Cartagena 026

 

After walking around the neighborhood and making our way up the wall, we headed to the nearest Juan Valdez..

Cartagena 027

After our leisurely coffee, we walked back home to escape the heat of the day.  Now I am heading back out – to the beach.

 

Cuidad Delirio and the spirit of Colombia


This is Colombia!

kids in Cartagena

One the reasons I have so many posts on local culture (in addition to medical tourism) is due to the fact that I struggle to impart the sentiments, the spirit, and the very essence of the destinations.  

Viva Colombia!

The first time I came to Colombia, as we landed the JetBlue airline crew broadcast the song, Viva Colombia! and all the other passengers burst into cheers..  I guess it was that initial experience that has always stayed with me.

No, this isn't the Spirit of Colombia.

No, this isn’t the Spirit of Colombia.

Most of my writing is technically based so it is a huge challenge to attempt to draft essays that actually speak to the character of the people, the richness of the cultures.

there is more to Colombia than this..

there is more to Colombia than this..

But without these things, I think readers have a hard time separating the reputations of many of these places (for crime, or violence for example) from the people.  The news media are so filled with negativity, and one limited perception or view of everything:  Colombia is drugs and war, Mexico is violence and gangs, the United States is consumerism and spending, that it’s impossible for people to see, or read anything without this pervasive opinion poisoning our perceptions.

this is Colombia..

this is Colombia.. futbol

Now and then comes the occasional piece that takes a closer look – and I try to share those here.

and this..

and this..

I also try to include the often whimsical, charming or sweet details that give a better picture of what it is to be here.  What it’s like as a foreigner wandering the streets – seeing everyday life.. Not just sickness and health in the corridors of hospitals and clinics.  But the everyday lives and special occasions of the people I meet.

cartagena 014

For example, one of the things that really, for me kind of captures the spirit and the pride of the people of Colombia is the twice daily broadcasts of the National Anthem of Colombia..

Cuidad Delirio

Another was the delightful film, “Cuidad Delirio” that  I saw last night at the film festival in Cartagena.  The film, which was made in Cali and directed by Chus Gutierrez is pure eye candy.

My response to the film was almost visceral.. I don’t usually like this type of film – the silly romantic stories.. But the film just captured the essence of Cali (and Colombia) so beautifully.  The colors, the music, the liveliness..  In short, the film did in about 90 minutes what I have spent years trying to do – share the “feel” and some of the daily joy of life here*.

* I know skeptics are rolling their eyes – despite the many problems cause by socio-economic disparities and chronic warfare, many people here have a “Joie de vivre” that is unmistakable.  It is this sentiment that brings me to Colombia, over and over.

La Jaula de Oro and the 54th Festival de Cine


the outdoor film screening  area for "Gems"

the outdoor film screening area for “Gems”

Festival de Cine – The 54th Festival Internacional de Cine de Cartagena de Indias (FICCI)

It’s almost impossible to imagine more favorable conditions for a film festival or cultural event.  While the first showing I attended was in the air-conditioned theater inside the convention center, the second film was presented outside the convention center – and the setting was perfect!  (It was almost too good – it was so lovely, and so pleasant that it distracted from the movie.)

While Cartagena is steamy hot during the day, late afternoons and evenings are wonderfully refreshing with cool ocean breezes.

Outside the streets are lit with colorful lights, showing Cartagena in all it’s splendor.  Even the stars and the moon attend the event.

Accessible, and for the public

Actually, the festival offers films at multiple venues across Cartagena so residents can see films near their homes – but I prefer the chance to enjoy the city since the convention center is just outside the Historic quarter in the Gestamani area.

The view from the venue
The view from the venue

The showings are free and open to the public, the venues are comfortable, spacious and while well-attended – much less crowded than I anticipated.  All the hoopla, elitism and excesses of Hollywood are a million miles away.  Instead of overpaid movie stars in ten-thousand-dollar designer dresses, segregated behind velvet ropes, the filmmakers themselves appear to speak directly to the audience as they introduce films.  They encourage feedback and answer questions.

Colombian filmmaker, German Piffano talks about his film,"Infierno o Paraiso"

Colombian filmmaker, German Piffano talks about his film,”Infierno o Paraiso”

Infierno o Paraiso

The first film I saw was a documentary by a Colombian filmmaker named German Piffano.  I kind of stumbled into the convention center as I was out enjoying the evening breeze, taking pictures.

the convention center

the convention center

This documentary took fourteen years as the director follows the life of an addict.  When we first encounter Jose, he is living in the alleys of El Cartucho and is addicted to crack.  The film follows Jose Iglesia, a Spaniard, among the backdrop of the evictions and destruction of barrio El Cartucho (Santa Inez), as well as the course of his life over several years.  We see the evolution of a charming, if filthy-appearing addict as he attempts recovery.

It was certainly an interesting movie, particularly since it shows the underside of a life most of us only know of – not about.  The undertones of the movie are rather sweet as Jose develops a bond with the filmmaker over the years but it’s not a “happy ending” kind of story (Colombian movies don’t often have Disney endings, I’ve found.)  There is one heart wrenching scene as a twelve-year-old boy talks about how he came to live in El Cartucho after being introduced to crack.

While the movie was probably about 30 minutes too long for my taste, overall, it was pretty good.  While some of the camera shows are definitely artistic in nature (à la “in-your-face”) the documentary changes as Jose changes.  There were points where I laughed at his antics (along with crowd) and other parts when I though, “Gee, what a shyster.. Is the director buying this?”  Mainly, it was touching to see all the people who reached out to Jose to help him.  We always hear how harsh and cruel the world is – but this movie (along with the second film) also showed how generous people can be even in the most dismal circumstances.

The story of El Cartucho is pretty interesting in itself, and has been the basis of several Colombian documentaries.  A clip of one of them can be seen here at YouTube.

Recommended reading:  Dreams of El Cartucho: Violence, Fear and Trust in a Bogota slum.  Master’s thesis by Michael Soto.

The second film was the film I came specifically to see.  As I mentioned in a previous post, I was lucky enough to sit next to the director of this film on my flight to Cartagena.  He told me a little about the film and that was enough to wet my appetite.  I went because I was curious – it sounded good.. But it turned out it was wonderful in that way that leaves you empty.

the most beautiful 'theater' I've ever been too..

Set outside, the stars and historic buildings make a lovely backdrop..

La Jaula de Oro

I found this movie hard to watch at times.  It wasn’t due to violence, gore or the other reasons we usually think it.  At times, I had to cover my eyes because it hurt to see the hardship and suffering of the characters in the film.  Despite that – I loved it.

I admit I cried – but not because it was one of those tear-jerking tales that manipulates the viewer ala Steven Spielberg and the girl in the red coat in Schindler’s List.  I cried because it wasn’t.

In a lot of ways, this movie reminded me a “The Killing Fields”, a film I loved, but find hard to watch.  Unlike Schindler’s List and films on that genre, the director and the actors didn’t try to manipulate the watchers into false sentiments.  There were no overly dramatic scenes – just brutal reality of the everyday occurrences for Central Americans immigrating across vast distances to try to obtain “the American Dream.”  That doesn’t mean the film was entirely without symbolism, but I found the symbolism and imagery added to the characters and their lives rather that serving as just a visual distraction or “deeper meaning.”

Not too much artsy crap

But then – I am a philistine and tend to hate that sort of stuff.  I don’t like when artists try to tell me how to feel, how to interpret and what to think.. and this film did none of this.

Instead, it did what a good film should: it told a story.   And like the majority of stories based on reality, there aren’t any dramatic rescues or miracles in the last five minutes of the film.  There is also a scene where I felt shame – (a scene at the end when the characters have crossed into the United States).  I felt shame because I think of the militias and the so-called “Minutemen” border patrols, and I know that some Americans would shoot / even kill illegal immigrants – and think of them as less than human.

More significantly, I think it is a film more Americans should watch.  I am lucky enough to travel, and to see different places in the world – and that has changed me.  It’s impossible to live and study in Mexicali – next to the border fence and not change your perspectives; about immigration, and about humanity, compassion and seeing things (literally) from both sides of the fence.

But too many people don’t have that opportunity and will never get to see the lives of many of the people they condemn for crossing the border to come to the United States.

Film Festival, part II

Enough of such serious subjects!  Tonight I am heading back to the festival for another round of films – and more photos of Cartagena for my readers.

cartagena 014

More than just a pretty face


cartagena 012

Cartagena, Colombia is best known as a vacation destination and has a reputation for having a relaxed atmosphere and a “laid-back” populace*.  While “Chillax, it’s Cartagena!” isn’t the official slogan, for most visitors, it might as well be**.

cartagena 004

For the most part, this is true.   The hot, sticky days tend to encourage languid afternoons while the evening breezes are a perfect complement to the sound of rolling waves, and make evenings out much more enjoyable.

cartagena 005

But Cartagena isn’t all play..

the always evolving landscape of Cartagena

the always evolving landscape of Cartagena

While it may not have the reputation as the center of business and industry for the Caribbean Coastal region (à la Barranquilla), there’s more to Cartagena than tourism.

local woman prepares freshly caught fish

local woman prepares freshly caught fish

While this sector drives the creation of several new high-rise hotels and luxury apartments, the economy of Cartagena is supported by more than visitors enjoyment of the sand, sun and sea.  

cartagena 026

Construction workers on a high rise take a quick moment to say hello to yours truly.

Construction workers on a high rise take a quick moment to say hello to yours truly.

The Port of Cartagena

Just beyond the ongoing construction and ever-changing skyline of the barrios of Bocagrande and Castillogrande is the port of Cartagena.

Construction of another high rise crowds the ocean front penisula of barrio Bocagrande

Construction of another high rise on the narrow peninsula of barrio Bocagrande

While the history of the port itself is interesting enough – with tales of Spanish exploration and exploitation as well as swashbuckling pirates, slave auctions and all the elements of an action-packed tale, the modern-day port remains alive and active.

Contrary to popular belief, the port is more than a cruise ship dock.  The modern port terminal opened in 1934, and has alternated between private (corporate) and governmental control.  Since 1993, the port has been managed by the Cartagena Regional Port Society, a private entity.  As of 2005, this has included the separate terminal for shipping containers.

Unlike the convention center, with its picturesque tall ships, for the most part, Cartagena is a working port – filled with industrial machinery, international trade vessels and a large mountain of metal shipping containers.  There are also a number of fishing boats, boats for sightseeing and travel to nearby islands, as well as the previously mentioned cruise ships.  At any given time, multiple boats of all shapes and sizes are visible within the sheltered bay.

cartagena 013

Shipping containers as seen from the shores of barrio Bocagrande

Main port for shipping containers

While Colombia has several ports due to the nation’s extensive coastlines on both the Caribbean and Pacific seas, Cartagena is Colombia’s main port for shipping containers.  The port is a 24/7 operation, 365 days a year.

According to information provided by the society, over 1600 vessels pass thru the port each year.  While this number isn’t comparable to other ports, in larger countries such as the massive Port of Los Angeles, the port reports annual traffic of “including 975 container ships, 220 cruise ships, 380 breakbulk carriers, and 11 bulk carriers” which included almost two and a half million tons of cargo.

That’s more than just a pretty face..

part of the city's defenses against pirate attacks

part of the city’s defenses against pirate attacks

More about the pirates of the Caribbean, and attacks on the port of Cartagena:

While popular media such as films and romance novels often focus on the infamous Port Royal in Jamaica as a center of operations for privateers, buccaneers, corsairs and plain-old pirates, Cartagena was one of the most frequent targets of this motley assortment of (often secretly supported by their sovereigns) of seafaring crews.

Canons

Canons

Jean – Francois Roberval – pirate, attacked Cartagena in 1544.

Travel blog with tips about historical sites, and pirate history of Cartagena.

once used to defend the city - now a popular "make-out" spot for young lovers

once used to defend the city – now a popular “make-out” spot for young lovers

Sir Francis Drake – Famed English explorer, vice-admiral of the British Navy and Privateer (a pirate sanctioned by the British government, in this case, Queen Elizabeth I).  “Letters of marque” were issued to British captains to encourage the capture, sinking, plundering and other harassment of Spanish vessels and holdings.   Sir Francis Drake did a particularly good job of it – from coastal Virginia, Florida, and through out the Caribbean, including the wealthy seaport of Cartagena.

There’s a quite comical YouTube video about Sir Francis Drake’s excursions into Cartagena (it sounds like Jan Brady as a teenager is narrating).

Chillax, it’s Cartagena! 

* In comparison to Cartagena’s reputation as the siesta-ing sister by the sea:

– Cali, Colombia has a festive party reputation as the lively home of salsa dancing.

– Medellin is often seen as a city of art and culture

– Bogota is considered the “London of Latin America” (or a city of international trade and business)

– Barranquilla is the city of Industry

– Bucaramanga is the city of shoes (and textiles)

** I apologize the Cartagena residents.. “Chillax.. it’s Cartagena” is  my own literary invention.  Cartagena residents are much more suave than my out-dated phrase suggests.

Jewel of the caribe


I’m back in Colombia and here in Cartagena just in time for the annual film festival, FESTIVAL INTERNACIONAL DE CINE
DE CARTAGENA DE INDIAS ..

Just because it’s not Cannes or Colorado (Sundance) doesn’t mean that the Cartagena Film Festival is anything less than a world-class event..

First, there’s the venue – Cartagena

gate at the entrance to the historic el centro district

sunset in Cartagena, Colombia

Cartagena de indias is often referred to as the jewel of the Caribbean, and it deserves the title.  Bolivar’s star city is rich with history and ambiance.  Couples flock to the romantic and colorful streets historic quarter to celebrate their nuptials with family and friends.  Bridal parties are a common site on any given day, especially around the ever popular (and elegant) Sofitel Santa Clara.   The former convent is in high demand year-round for its luxurious accommodations and extensive wine list.

In the midst of this charming setting is the hustle and bustle of a busy, active city with motorcycles, bicycles, taxis and buses circling the streets around the historic quarter.   The city is a crazy mix of nationalities, ethnicities and other groups that all call Cartagena home.  Add an assortment of lively Chivas buses and an array of business visitors, eco-tourists, backpackers, and sun -seeking tourists and readers can begin imagine what a lovely, vibrant, living city Cartagena is.

The people: Costenos

It’s not a Spanish you’ve ever heard before – but then, the coast of Colombia is unlike any other place you’ve ever been.  The impact of the early Spaniards is unmistakable but Cartagena is no “Nueva Espana” (New Spain).

“The New World” as it was described in innumerable American grade school texts is (in this case) a wholly accurate and appropriate description.

This salsa of multiculturalism is the mainstay of Cartagena’s local culture and is reflected in every aspect of its art, music, dance and food.  The Afro- Caribbean influences combine with the traditions of the indigenous peoples and Spanish explorers to make a distinct dialect, fashion, and way of living that is specific to Cartagena, Barranquilla and Santa Marta.

The Film Festival

Filmmakers from around the world (especially Latin America) flock to this festival every year to display their talents.

This year, of the 13  featured ‘Gems’, there is a particular film that I am hankering to see, called, “La Jaula de Oro” or The Golden Cage.  This film, which won an award at the Cannes film festival is by Spanish born, Mexican filmmaker named Diego Quemada-Díez.   The film is a detailed portrait of the lives and journeys of some of the people who travel illegally to the United States from Latin America.  In light of all of the negative depictions, stereotypes and anti-latino sentiment in much of the United States, this film is a desperately needed reality check for Americans..

I was fortunate enough to sit next to the young, and eloquent filmmaker on our way to Cartagena.  The soft-spoken, bilingual young man reminded me a bit of one of my favorite Colombian filmmakers, Andre Barrientos but that was probably due to both his humble nature and neatly trimmed beard.  I would have liked to have interviewed him at length but a crowded airplane doesn’t seem like a fair venue.  (Nothing like a captive interviewee at 35,000 feet).

He’s up against some stiff competition but I’m keeping my fingers crossed for him.

The first showing isn’t until the weekend but hopefully I’ll have some more pictures soon.  If you are in Cartagena and are interested in attending – don’t worry, friends – all films are subtitled in English.

Cartagena update: Dr. Cristian Barbosa, cardiac surgeon


with Dr. Pulido (left) and Dr. Barbosa in Cartagena (2010).

I wanted to post an update on a fantastic surgeon (who has since become a good friend).  In fact, Dr. Cristian Barbosa was one of the first surgeons I ever interviewed back in 2010 – and without his encouragement, the first book would have never gotten off the ground.  Maybe not the second book (Bogotá!) either – since once I said the magic words, “Oh – I interviewed Dr. Barbosa in Cartagena last year,” plenty of other surgeons who might not have talked to me – started to take me seriously.

with Dr. Barbosa back in 2010

Ever since then – I try to keep in contact with Dr. Barbosa – he’s a great person and an absolutely phenomenal surgeon, so I email him every so often..

Since my last visit, back in August – Dr. Barbosa has left Hospital Neuvo Bocagrande – and is now operating in Clinica Santa Maria in Sincelejo, Colombia.

Sincelejo is the capital of the state of Sucre, which is part of the Caribbean region of Colombia.  Like most of this part of Colombia – it has a rich history, and was founded back in 1535 in the name of St. Francis de Assis, though it was long inhabited prior to that by native Colombian tribes such as the Zenu.  Unlike nearby Cartagena (125km north), Sincelejo is a more mountainous landscape, and is known for their agriculture, particularly cattle.  (wow – my stomach just rumbled  – must be missing those gourmet Corral burgers, which are my one Colombian indulgence.. Argentina has nothing on Colombian beef.)

Dr. Barbosa is still living in Cartagena and making a three-hour commute to perform life-saving surgery, while he works on creating a new cardiac surgery program back in our favorite seaside city.  (Hopefully, when he does – we’ll be invited back to take a look!)

gate at the entrance to the historic el centro district

sunset in Cartagena, Colombia

Summit of the Americas


cobblestone streets in the historic district of Cartagena, Colombia

Summit of the Americas – Cartagena, Colombia

As anticipated, President Obama is receiving some harsh criticisms for the Cuban embargo begun by fellow democrat, President John F. Kennedy in October of 1960.  (Despite the long-standing embargo, the United States remains the fifth largest exporter to the island nation.)

This embargo, which was initiated in response to the Cuban nationalization of private properties as part of the institution of a communist regime, reached full strength in February of 1962, and has continued unabated since then.  In fact, the American embargo was re-affirmed in 1992 with passage of the Cuban Democracy Act, and again in 1996 with Helms – Burton Act which further prevents private American citizens from having business relationships or trade with Cuba.

At the summit, the host of the event, President Juan Manual Santos (Calderon) has been one of the more outspoken critics of this on-going trade policy and public relations nightmare.  President Santos argues, fairly successfully in my opinion, that not only is the embargo an outmoded method of diplomatic negotiation, but that is has been an ineffective one (in inspiring governmental and philosophical change in Cuba.)

President Santos respectfully requests that Obama reconsider the decades old policies of trade embargo. Photo by AP press

This comes after President Obama was embarrassed by a prostitution scandal involving several of his private security detail.  At the time of this writing, eleven members of the secret service along with five members of the military has been openly disciplined, and returned home.

Colombian prostitutes – photo found at multiple sites, including another wordpress blog and http://azizonomics.com/tag/colombian-prostitutes/
(If this is your photo – let me know, so I can give proper credit)

Protests against the United States have been small scale and without injury as small explosives were detonated near the American embassy.

President Obama also fielded criticism on America’s ‘War on Drugs’.  While conceding that the efforts have been a multi-billion dollar failure (with the exception of small scale victories such as the capture/ death of Pablo Escobar in 1994), Obama refused to consider efforts to legalize drugs, as are under discussion in several other nations.

In other news – in a surprise move that may predict more future instability for Venezuela, President Hugo Chavez has decided to forgo the summit as he pursues treatment for cancer (in Cuba).  This move leads to intense speculation regarding both the presidential and governmental prognosis in Venezuela.  Previously, President Chavez had been adamant that his cancer was curable and disputed reports of a more serious condition. There are now several media reports that the president has widespread metastasis affecting multiple organs.  (May I suggest that you consider HIPEC, President Chavez?)

The rise of Latin America


Big news out of Cartagena, Colombia as Hugo Chavez (Venezuela) and Bolivia’s president, Evo Morales come together with President Barack Obama and Secretary of State, Hilary Clinton along with 30 other member nations for the Summit of the Americas.  Most certainly on the agenda – discussions regarding both Mexico’s and Colombia’s decisions to decriminalize drugs, as well as the continued drug violence affecting both countries.  President Evo Morales’, a former coca grower, position on drugs and the so-called ‘Drug war’ are already well-known.

While Colombia’s crime has decreased dramatically, the reverse is true in certain parts of Mexico* – where the nightly news seems more like Vietnam footage, as reporters discuss caches of guns toted by young teenagers, and Cuidad de Juarez claims the title of ‘Murder capitol of the world.”   Much of this criminal activity has been attributed to illegal drug commerce to the United States leading several countries to blame the USA for creating havoc in their home countries as suppliers attempt to feed the hoards of American drug users.

Tensions between Venezuela, Bolivia, and Cuba against the United States are unlikely to change as a result of this Summit, but hopes remain.  The summit is also expected to put pressure on the United States regarding the 50-year-old Cuban embargo.

It’s an interesting turn of the tide – as these issues along with the economic problems plaguing the United States (and causing problems globally) put the US at a significant disadvantage.

In related news – here at Cartagena Surgery, readers are asking:

— So how dangerous is Mexico? —

Since I am currently living in a Mexican border city, you’ve picked the right time to ask.

* There are still plenty of safe and beautiful places in Mexico – but it remains a tragedy that the Sinoloa gang / drug activity have resulted in over 47,000 murders in the last five years.  ([To put this into context, let’s do some simply math.. Simple math since I’m a nurse not a statistician, so keep that in mind as you consider the limited variables here.]

1.  Mexico has over a hundred million people (or 1/3 the people of the USA)

with  47,000 murders over five years (or that’s the number that has been widely quoted.)  Divide 47,000 by five = 9,400 people murdered per year.

2.  The US has over 300 million people, and had 18,361 murders in 2007 (last year available by the US census.) So three times the people.  Hmmm.  I can already see that 18,361 divided by three is 6,120. 

3. But to be fair – let’s also look at cummulative average for the US – and compare apples to apples.. (or five years of data to five years of data.)  It’s still not entirely comparable since our latest available data is from 2007.

2007:  18,361

2006: 18,573

2005: 18,124

2004: 17,357

2003: 17,732

for a total of 90,147 murders over five years.  If we divide that by three, we get 30,039 which is only 69% of the murders in Mexico in the same number of years.  Now you can argue it either way – since the USA numbers aren’t current, etc. etc.. but Mexico’s rate IS significantly higher..

So what does that mean for travelers?  It means – stay the heck out of Juarez..  Be extra cautious in Tijuana, and Nuevo Larado – but otherwise,  use caution & commonsense when traveling in other parts of Mexico (like you would any where else!) – and enjoy yourselves.