Story updates: Be care my friends, and Mexicali

Posted on October 13, 2014 by K Eckland

It may have been a while since my last post, but I haven’t been idle. In the last few weeks, I’ve traveled to Mexicali to check in, have some dental work done as well as attending professional conferences and working on my next locum tenens assignment.

First – some updates on Mexicali:

I don’t have photos to accompany these updates, but the new emergency department at Hospital General de Mexicali is big, beautiful and open for business.

I also met with both Carlo Bonfante and Dr. Carlos Ochoa to talk about some of the upcoming improvements to the Hospital de la Familia. Nothing has been completed yet, but they have some big plans to improve services for local residents and medical tourists alike. I’ll write more when I have the rest of the details.

I also had a chance to catch up with Dr. Horatio Ham (Bariatric surgeon) and Alejandro Ballestereos (Anesthesia). Dr. Ham reports that Dr. Abril’s radio show has been revived as an internet radio program.

Sadly, Dr. Alberto Aceves, a well-known Mexicali bariatric surgeon died in a private plane crash back in June.

My Mexicali dentist: Dr. Luis Israel Quintana

Dr. Israel Quintana with one of his American patients

I don’t have dental insurance but I have a history of bruxism (grinding my teeth) so I am pretty fanatical about taking care of my teeth. I’ve written before about the difficulties in reporting on dental tourism, as well as my previous experiences with Dr. Quintana, so when my dentist at my last locum assignment gave me a work estimate for almost eight thousand dollars!*, I knew I needed to plan a trip to Mexicali before my next assignment.

I ended up having 12 fillings (no cavities but plenty of damage from grinding), as well as a root canal and a partial crown. He also made me a new night guard since my old one obviously wasn’t preventing ongoing damage. While several days in the dentist’s chair was no picnic, I had minimal discomfort and little damage to my wallet. All told, the bill was less than 1300. I still need some additional work, but the majority of my teeth are now taken care of. I don’t have to worry about having a dental emergency while I am working a contract.

Dr. Quintana also reminded me that his office accepts most American insurance plans – with no co-pays or other payment required.

* My initial estimate in Dallas only covered work on four teeth. The additional surface fillings were not included.

Story Update: Please be careful my friends!

Baby making and Planet Hospital: Lots of money and no baby

Some readers may remember the sad story that I received from a childless couple last year. The couple had contracted with Planet Hospital for surrogacy services after receiving devastating news on the birth of their only child. The child had been born with a terminal disease (the child later died). The couple also learned that due to a rare (and previously undetected) genetic condition, it was likely that any future children would also contract this disease. The couple had started a blog to document their journey into surrogacy, but after several months, it devolved into a story of deception, with the couple being defrauded of thousands and thousands of dollars by one of Planet Hospital’s contracted facilities.

Recently, Planet Hospital and their surrogacy scams made the front page of the print edition of The New York Times. The story by Tamar Lewin rips the mask off of Rudy Rupak, the shyster I told you about previously. (I also wrote about his shady transplant tourism practices at the Examiner.com back in 2012).

Surprisingly, the “Medical Travel Quality Alliance,” a branch of the MTA that advocates for “self-regulation” of the medical tourism industry only seems to partially condemn the practice of tourism surrogacy and Rudy Rupak in their latest publications and newsletter. Of course, anyone with even a few years experience covering medical tourism remembers that Rudy Rupak was the poster child for the medical tourism industry for many years, even after the first rumors of shady business practices emerged in 2010. Mr. Rupak has since filed for bankrupcy, but knowing of some of the deals Planet Hospital was involved in, I think he should be in prison.

The second time is the charm!

Posted on September 18, 2014 by K Eckland

My apologies to my dear readers for this late post. I usually write about surgery and surgeons, but occasionally drift into other things.. I visited the new Clinica de Medellin facility in late July, but didn’t have time to write about it before now.

Dermatology

Just before travelling to Medellin to cover Colombia Moda and the ALAT conference, I developed a dermatology problem. As my American readers know, getting an appointment with a specialist in the USA can often take several months. In fact, I was given an appointment in early July for later this fall.

However, during my stay in Medellin, my dermatology condition continued, so I decided to give the Clinica de Medellin another try. I had heard rumors about some re-organization of the medical travel division so I decided to use this as an opportunity to verify those rumors. I am very pleased to report that after sending my initial email to the Clinica de Medellin requesting a consultation with a dermatologist that I received a reply that same day (from Adriana Henao – email: ahenao@correo.clinicamedellin.com.co).

The coördinator called me back to confirm my availability and to ask if I would be willing to go to a clinic at one of the other Clinica de Medellin campuses. (She also asked about my level of Spanish fluency so she could direct me to the appropriate physician.)

By the next day, an appointment had been scheduled for the end of the week.

New clinic

The clinic was so new that when I gave the address to the cab driver, he merely raised an eyebrow before starting the car. On arrival, he expressed surprise – and said, “This wasn’t there before.” The Clinica de Medellin Sede Occidental is divided into a hospital and an outpatient clinic area. The smell of fresh paint was still evident in the immaculate, and sparkling facility.

The officer at the information desk had me personally escorted to the correct clinic when he heard my American accent (and hesitant Spanish). I waited about fifteen minutes before being escorted into the private office of Dra. Sara Gonzalez Trujillo. She was very friendly and pleasant. We reviewed my past medical history and current treatments before she examined me. She explained the condition in-depth before writing several prescriptions and requesting a lab test.

She provided me with a full copy of my medical records to take to my upcoming appointment and gave me her contact information.

Total cost of consultation: less than $50.00

Lab:

The labs cost about 25.00. After a quick lab draw, I was given a lab slip with my record number on it. I later received an email with my login to access my results. Since I was headed back to the states, I emailed my results to Dr. Gonzalez, who called me with additional treatment recommendations and an explanation of the results.

Since seeing Dr. Gonzalez, I have been using the medications as prescribed – and my condition has improved dramatically.

Follow-up:

I have been taking the medications as prescribed and it is getting better. I will email Dr. Gonzalez after seeing the dermatologist here to give her an update.

To make an appointment with Clinica Medellin, click here.

Crazy days!

Posted on August 3, 2014 by K Eckland

It’s been a couple crazy, busy days here in Medellin. I have a bit of a backlog of posts – from a day learning to finger crochet in a group crochet class, the festival of flowers, a visit to Clinica Medellin Occidente and the ALAT conference. It will take me a little while to post everything before heading home in just a few short days.

The ALAT conference was fantastic. In addition to numerous wonderful, learned speakers from all over Latin America, it was a great chance to connect with innovative thoracic surgeons from practices all around the world. We also re-connected with surgeons we’ve interviewed in the past – to hear what they have been doing since my last visit.

One of these surgeons was Dr. Andres Jimenez at Fundacion Santa Fe de Bogotá (SFdeB). As astute readers of the Bogotá books may remember, our encounters haven’t always been as collegial as they could have been. However, he did grant me an interview, and permit my ingress into the operating room. To my surprise, I found that while he was a hesitant interviewee, he was also a promising young surgeon.

With that in mind, I re-connected with Dr. Jimenez briefly to ask about the program. Dr. Jimenez reports that they have started a lung transplant program and recently performed his first lung transplant at SFdeB.

Dr. Carlos Carvajal (right)

Dr. Carlos Carvajal, who was a thoracic surgery fellow when we first interviewed him – is now a practicing thoracic surgeon at Hospital Santa Clara in downtown Bogotá.

Dr. Ricardo Buitrago continues his work in robotic surgery at Clinica de Marly. Caught up with Dr. Luis Torres, the young and charming thoracic surgeon from Clinica Palermo.

But the biggest surprise at all – was the twinkling brown eyes of Dr. Cristian Anuz Martinez. (The twinkling brown eyes above a surgical mask are all I remembered from my 2012 trip to the operating room with Dr. Frnando Bello in Santa Cruz, Bolivia).

with Dr. Cristian Anuz Martinez

We spent some time over coffee talking about the current state of cardiothoracic surgery in Bolivia, his private practice and his colleagues.

The conference itself was phenomenal – the amount and range of topics covered – from sleep medicine, tuberculosis, critical care medicine and pulmonology in addition to thoracic surgery.

The Festival of Flowers

The festival of flowers, one of the largest events in Medellin also started August 1st. The event which is expected to draw 19,000 visitors to Medellin this year – celebrates the floral industry of Antioquia with ten days of events. The events are staggered through out the city and include musical concerts, singing contests, parades, flora displays, children’s events and arts.

Festival of Flowers displays in Plaza Mayor

Tomorrow: Clinica de Medellin – Second time is the charm!

Street of Dreams – Calle 49

Posted on July 28, 2014 by K Eckland

el centro map with shopping districts outlined -high resolution

During Colombia Moda, I met several American business people looking for more information about fabric and textiles than the small booths could provide. Many of them wanted to go out and see the fabrics, some of the shops and the factories but no one thought to take them to see any of these things. All of the people I met were first-time visitors to Medellin (and some may never be back). I can’t help with factory tours (I’d like to see those myself) but I do live nearby, so I thought maybe I could help provide some information for future visitors to this fair city. Since I thought wandering around El Centro as a first-time visitor without a guide might be a little daunting, this post might help people feel more comfortable. So I spent all day Saturday wandering around the district – to take pictures and be able to provide more information to people interested in finding fabrics and materials while in Medellin.

A note about Fabric shopping in Medellin: If you are looking for super cheap – crazy bargains, you probably won’t find them here. But you will find a huge array of all kinds of fabric – most of it made right here in the city. For someone like myself who is sometimes (okay, frequently) frustrated by the lack of floor space given to apparel fabrics in the United States – (where it seems like 90% of fabric is for quilting and such), it’s still a bonanza.

Also, while it isn’t made in the USA (which is increasingly rare, I know) – I still feel a bit of loyalty towards buying locally sourced items – even if Medellin is that source. Still interested? Good.

How to get here – the real Medellin

The best fabric and general shopping in Medellin isn’t in the fancy malls of El Poblado and Enviagado. It’s in the busy, teeming streets of El Centro. El Centro is also where many of the most famous tourist attractions are, so if you are interested in seeing some of the famous architecture, the Botero collection (at the Museo de Antioquia) – you can do that too. El Poblado and Enviagado are the rich, sanitized versions of Medellin – so if you have friends that aren’t interested in shopping but would like to see more of Medellin – this is a trip to take them on…

1. Taxi – if you want to take a taxi, ask him to take you to the Plaza Botero. It’s a few streets away from your destination, but it’s a nice central space – especially good if you are meeting friends or other visitors.

2. Metro Train – the metro train is cheap, clean and quite reliable. It’s also a good way to see a bit of the city. Take the (blue line) train to either Parque Berrio station or the San Antonio station. San Antonio is closer to shopping, but Parque Berrio puts you right at the Plaza. (For more information about the Metro, see this helpful article at Medellin Living).

Get a map – Now, I know this is a digital age, but sometimes a paper map is just easier.. Safer too because it makes you less of a target for thieves who prey on upscale tourists for all of our fancy electronic devices.

tourist kiosk with maps

There are several of these kiosks located in/ around Plaza Botero and around the Parque Berrio station. Just ask for a map “Mapa, por favor” and they will be happy to provide you with a free map of Medellin. I used this same map for reference for the shopping areas, to make it easy for visitors to recognize where to go.

Navigating the city Places like Medellin and Bogotá are particularly easy to navigate because streets use numbers, not names for the most part. (Once you get used to the system – our system of street naming in the USA seems needlessly confusing.) Everything is basically on a grid – Calles run in one direction and are abbreviated as Cll. Carreras run in a perpendicular direction and are often abbreviated as Cr. It makes locating a business very easy. For example, my favorite fabric store in Medellin is Textiles El Faison – and their address is Calle 49 #53 – 101. This means that they are located on Calle 49, about 101 meters from the cross-street, Carerra 53.

Now that you are here – with your map Walk south towards Calle 49. (To orient yourself – remember that Medellin is set in the foothills. If you start walking uphill, you are heading East (the wrong direction) – towards the financial center of Medellin (near where I usually stay). On Calle 49 – turn West (or downwards on a very slight grade) The next several streets will be crammed with shops filled with all kinds of sewing related items – thread stores, fabric stores, sewing machine repair etc.

Sewing machine repair and sales

Many of the shops look tiny compared to JoAnn’s or the big craft stores you may be used to. Sometimes they are tiny – but sometimes, it’s just the entrance to a larger indoor mall.

Entrance to one of the small fabric markets

Fabric

Now, the fabric stores line Calle 49 and many of the cross-streets.. But sometimes notions can be a bit trickier to track down. A lot of tiny shops sell just one product – like elastic or ribbon trims, buttons and the like.

small shop in an indoor fabric mini-mall (Shanghai) off calle 49 selling thread

elastics and trims

As I mentioned before, my favorite fabric store from my wandering on Saturday – is Textiles El Faison. It’s a big store, and not quite as claustrophobic feeling as some of the smaller shops. (When the shops are crowded, and the fabric piled to the ceilings, I get a bit closed in feeling in some of the smaller shops..) Not that this would prevent me – if I saw ‘the fabric’ there.

many shops are small but piled high with fabric

Lots of great stuff- but limited luggage space, so I move on to the next ones.

as you can see – the width of the store is pretty narrow, maybe 12 feet in total. Now add ten customers and I get a bit ‘crowded’ feeling

But for general browsing, or to see fabric in a shop more like what most of us are used to – Textiles El Faison is a well-lit two story shop. Jaime Sosa is the manager there – and he is very nice and helpful. My photos are a bit blurry because I was relying on my small phone (an older model) because I don’t like lugging my fancy Nikon down to El Centro).

Jaiime Sosa

Here’s the address for people who want to skip the adventures and go straight to his shop:

Textiles El Faison Calle 49 No 53 – 101 Medellin

displays piled high with fabric

But that’s not the only great place.. I really liked Portofino Textil too.. It’s located on the ground floor of a little textile mall. (It’s a very interesting mall – about half the shops sell custom printed fabrics).

One of the malls for custom printed fabric

I was trying to cover a lot of ground, so I didn’t stop in and get all the details on custom printing – even though I saw little storefronts printing the fabric during my wandering. (Maybe I will get a chance to go back and ask some questions.) Custom may be the wrong word since most of it seems to be more like “Small lot pop prints” but at one shop, I did see a customer hand over a jump drive filled with images for printing). But some of the other shops / kiosks didn’t look to have computers just their own style of pop prints (justin beiber, popular artists, other cool designs).

small storefront.. the lady in the blue tank is printing custom fabric

Portofino Portofino has more of a warehouse feel – and a two meter minimum. Fabric is priced by the kilogram. I couldn’t resist one of the fabrics there – and my two meters of this lightweight lycra was 0.7kg in total. For an example on prices – the tag on the bolt said 45,000 per kilogram but advertised a discount.. After the discount, my fabric total 27,156. tax added a bit – for a total of 28,350 for my two meters of a 60 inch (or there about width). According to today’s exchange rate – that’s about $15.35 (or around 7.50 a yard since a meter is a couple of inches more.) So, like I said – not a crazy, amazing deal – except that I love the fabric, it was made right here, and it’s certainly not something I’d find at Hancocks or Joanns (if we even had one in my town). It’s actually located under another fabric store but I found it to have better selection, and salespeople that were very helpful and friendly. (Fabien was particularly nice – and patient with my limited Spanish).

I just couldn’t resist..

Portfino Textil #162 Carrera 53 No. 49 – 68 Medellin There were quite a few other shops – so you will just have to make you way down Calle 49 and find your own favorites. Patterns Pattern magazines can be especially hard to find – but when you do find them – they are a great deal.. Most pattern books contain anywhere from 20 to 200 patterns. It depends on the magazine. My favorites are Bianca, Quili and the more simply named Patrones. Bianca has a lot of the patterns that are hard to find in the United States – like an extended variety of swimwear, lingerie and exercise apparel. They also have a great assortment of patterns made for the new stretchy fabrics; lycra blends and modal.

Magazines containing 10 – 40 different patterns

Patrones is a grand brand because it has copies of a lot of the designs by major labels. Want to wear your own Dolce & Gabbana? Then patrones is the magazine for you. Sometimes you can find the magazines at larger newsstands or bookstores like Panoamericano. Some of the patterns in Patrones are pretty intricate and instructions are limited (and in Spanish) but at 4,000 to 10,000 pesos (2.25 to about 6 dollars) a book – if you are an experienced sewer it is still quite the find.) Now – for patterns on Calle 49 – the best place to go is – this little shop..

the place to buy patterns Calle 49 #53 – 14

The place is tiny, so you have to ask to see the pattern books (or point, if necessary.) They don’t have long aisles to browse like some of the bigger bookstores. But the owner is very sweet – and they have a large array of titles available.

some of the patterns available at this small shop

Yarns

Now, Medellin has that ‘perpetual spring’ climate we have been talking about, so I didn’t find as many places offering the bulky and superbulky yarns that I love. Quite a few thread stores offered the smaller crochet threads and yarns similar to Lily’s Sugar N’ Cream but since I am on a superbulky yarn kick – I will keep looking.. I did see a couple, but shame on me because I didn’t write down exact addresses or take pictures (but since one of them is on a street close to home, I may venture out later this week – when I’ve exhausted my current supply and get some pics.)

yarns

Now before you head out for your shopping adventure – review a few things to make your shopping more enjoyable and safe.

In Medellin – alone or not quite ready to venture into El Centro by yourself?

I am always up and willing to lend a hand – if I am in the city. (It’s a good guess if I am blogging about Medellin, then you can find me here.) You can always call me/ text me at 301-706-3929 (If I am not in Colombia, I won’t answer) or email me at k.eckland@gmail.com I’d be happy to arrange to get together for a day tour of the shopping areas. We can check out museums, eat some tasty street food, buy local produce, window shop – or hunt down that one special piece of fabric you’ve been waiting for..

If you don’t catch me on this trip – I’ll be back.. I’ll definitely be back for Colombia Moda 2015, so if you come a few days early (in July) we can have some fun.

Under Une Canal

Posted on July 25, 2014 by K Eckland

Now that it’s over, I can say it’s been another wonderful week at Colombia Moda: I met Miss Colombia (she seems sweet) and took a picture of the President of the Republic..

Didn’t get to meet President Santos, but maybe someday. (I promise not to talk politics.)

Miss Colombia, Paula Vega of Atlantico region (Barranquilla)

Luis Martin

I even say hello to one of the models (since we were heading down the hallway) and we had a nice conversation. It’s funny – I guess I always get intimidated by people taller than me, etc.. and I guess sometimes the expectation is just that models aren’t that nice.. But nothing could be farther from the truth. Luis Martin – a local model from a neighborhood here in Medellin was very nice, sweet and pleasant. It must be weird for him – I mean, his face is really familiar to me – after two years of seeing it thru my lens..

Luis Martin, model and a nice kid

I wish we hadn’t be racing down a hallway – I would have liked to get a photo because he looks better in his own clothes..(Better sense of style). Anyway, I thought it was nice of him to make conversation with a random gringa.. (We talked about Virginia of all things). So – I wish him the best luck, and hope he makes the cover of Vogue one of these days.

Last day of Moda

Yesterday was the last day at Colombia Moda, and I don’t have enough nice things to say about all of the photographers and videographers there. They are the reason I came back this year. Instead of treating me as an outsider, they have always been welcoming and kind.

the orange backpack shows where I sit during the runways

This year it was great to be back and see old friends like Stiven and Fredrico. I didn’t see some of the wonderful people from last year, like Estaban who kept me in laughter and good humor even when every bone in my body ached from long hours in contorted positions.

Always great to see Stiven

This year, I have to give special thanks and words of gratitude to the videographers of Une Canal (Channel One) of Medellin. Une Canal is the public television station for the city and during fashion week, they record live from the runway so it can be seen on big screens outside (so people without access to the runway itself can see it as it happens.) That means they are at every single catwalk – always smiling, joking and being friendly even while setting up cameras, untangling cables etc…

The Videographers of Une Canal

That’s the handsome Juan Carlos, the charming Danilo Gallego and the ever kind Hernan. For the entire fashion week, they allowed (and encouraged) me to take one of the plum floor positions beneath their cameras – in the dead center position of the runway.

Danilo Gallego of Une Canal

People with better equipment than my starter Nikon can take sitting positions and even rise up on the press bleachers, but without this prime spot on the floor – I’d have been toast. I never would have been able to capture 1/10th of the images that I’ve used in my recent articles.

I’d love to do a real (in-depth) articles on the videographers and photographers here at Moda, but it looks like I’ve already been scooped which I think it really cool. Yesterday, the reporter from Une canal turned the tables of the videographers and interviewed them before one of the runways.

Danilo is interviewed for a segment on Une Canal

I am hoping to see Juan Carlos, Danilo and Stiven at some future events here in Medellin before I leave in August.. If not – I’ll see you next year!

Colombia Moda and Examiner.com

Posted on July 25, 2014 by K Eckland

Colombia Moda is over, and I am exhausted.. Sorting through several thousands of photos while writing articles about fashion collections has to be done in as timely a manner as possible, which doesn’t leave much time for sleep!

The good thing about writing for the Examiner.com is that they don’t give me any deadlines or article requirements. I write about what I want – and submit it as fast as I can. But there is no editor to nag me for specific lines so I feel free to focus on writing about the fashion that I like, or that I think is important.

I don’t write about Gef France because I think it’s boring. I do cover Studio F if only because it is so immensely popular here – though I prefer the more daring and creative (and often smaller) lines.

But while I continue to gulp coffee and sort photos (even though my eyes are so tired I’m not sure if the photo is blurry or it’s just me, I wanted to give my readers links to my most recent articles (and photos) at Examiner.com

Lenonisa Runway

Agua Bandita and Onda de Mar – the Agua bandita photos are disappointing – the lighting was terrible. (I thought that was me too – but then several photographers grumbled about substandard lighting and showed me their photos..) They even called out during the runway to get better light..

Ipanema by Paradizia

Nonstop Runway: Faride Ramos

Nonstop Runway designer trio

Beverly Hills by Carmen Belissa

Studio F

I also talked to some Americans I met at the expo. They seemed a little overwhelmed and lost – as they looked for textile manufacturers to produce fabric samples for use in their designs. I bet they would have liked my textile/ fabric city tour idea.

I have a couple of articles I am still working on – and then it will be back to normal here at Latin American Surgery. The ALAT conference (thoracic surgeons from all over Latin America) will be here in Medellin next week, so we will be back to some surgical topics soon.

Colombia Moda, Fashion and wearable art

Posted on July 24, 2014 by K Eckland

It may not look like it, but photographers like Steven have a philosophical side

Because at the heart of it – isn’t that what fashion is really supposed to be? Wearable art that allows us to express ourselves through the vision of talented designers?

That’s part of the discussion I had today with several of Colombia’s best photographers while waiting for the runways to begin here on the second day of Colombia Moda. As we looked around at the many devotees to fashion – we saw a range of expression. Some ridiculously shiny and spangled in the bright light of the sunny afternoon, others ill-fitting or overly tight. Even the standard t-shirt and jeans of the working photographers were art. Many of the photographers wore t-shirts expressing their political, philosophical or personal sentiments.

Juan Moore, another photographer explained it best when we were talking about the fashion collections, and why we loved the fantastical student lines versus the somewhat tepid, often mundane but super popular lines like Gef and Studio F. It may be outlandish, impractical and extreme in nature, but..

As he explained, fashion is more than clothing – it’s an expression of the hopes and dreams of the artist, a view into the mind of the creator, and a vision for the future. That may seem like a heavy burden for a t-shirt or dress but that’s what makes fashion such a challenging field.

the work of young designers offers us a glimpse inside

So while I am writing (and publishing! articles and photos on the big houses like Leonisa, Studio F and Agua Bandita – it’s important to look at, and appreciate the work of the next generation of designers. It’s their work that inspires me, and keeps me typing long after I’d like to go to bed. It’s been a long day – cramped on the floor with strangers (and new friends) but they are the reason I do it – Los Jovenes Creatadores, Universidad Pontifica Boliviana and the rest of the young designers.

It may take me a few days – Colombia Moda ends tomorrow – to finish my writing commitments and sort through the thousands of pictures – but then let’s get back to the art of the next generation.

*For more photos and looks at the collections at Colombia Moda, I am in the process of publishing several articles over at Examiner.com – you can see the first articles here.

Crochet, crafts and traditional arts in Colombia

Posted on July 20, 2014 by K Eckland

One of my latest crochet projects – American flag scarf

Since learning some basic crochet (very basic) from my (very patient) roommate, Iris in Cartagena, I have continued to crochet. I find it’s an excellent activity for all the waiting that goes along with travel. I crochet in the car when we drive from assignment to assignment.

Hat and scarf

I need to learn some new stitches but I am getting a lot of practice with my basic stitch. I have switched to a very large crochet hook (15mm or an “S” hook) and cuddly soft bulky yarns (types 5 and 6). It makes it easier to see when I make errors and it works up quickly. Plus, the yarn is so plush and soft feeling.

I made a couple things for my friend’s new baby in Bogota.

My tiny model wearing the first hat I made

So when I went to see her – I spent an afternoon in Chapinero checking out the yarn situation. I was in a large bookstore in Chapinero when I met Ligia Morena Vega. I was looking at some new sewing pattern magazines (since I am a sewer who crochets) and she was buying crochet magazines.

So I asked her if she knew where I could find some yarns in the neighborhood.. Not only did she know – she took me with her to meet the proprietors and learn more about the crafting classes offered.

That’s one of the things I’ve noticed in Colombia – pull out a crochet hook or start asking about crochet, and instantly you make friends. I was on the bus to the airport in Rionegro when this happened the first time. (It’s a long bus ride to Medellin, so I pulled out my crochet..) Very quickly I made friends with several women on the bus as we talked crochet.

with Ligia, shopping for yarn in Bogota

Ligia crochets professionally. She was buying magazines to use as catalogs for customers who want custom-made clothing, including formal style and elegant ankle length dresses. Ligia’s husband runs a coffee and chocolate shop nearby on Calle 57 and Carrera 16 – so I will have to stop in and visit on my next trip to Bogotá (and get some pictures of her latest crochet creations too!)

We walked a few blocks to a short street, Calle 56 (with Carrera 13) where there are several stores selling a variety of yarns. While there was a lot of Red Heart and Lion Brand (especially the Homespun USA – my favorite, at home), I was able to find some beautiful yarns that are made right in Bogotá.

I fell in love with some of the yarns from Lanas Arvi.

One of the yarns is a beautiful tan and turquoise mix..

some of my new Colombian yarn.. with my gigantic crochet hook.

It’s destined to be a scarf.. This time I might even keep it. So far, I have gifted away everything I’ve made with the exception of a camera lens bag..

Several of the shops offer crochet and knitting classes. Todos Lanas and Almacen Mutifibras even print the class schedules on the back of their receipts.

The prices are about the same as Wal-mart (since JoAnn’s and some of the craft stores mark up the yarns quite a bit.) I also bought two small skeins of a lovely dark purple to make a gift for a friend – and two small skeins of a variegated yarn with the bright yellow, blue and red of the Colombian flag.. All of the other yellow/ blue / red yarns were sold out just about everywhere we looked. Several owners told us that between Colombian Independence Day (today) and the World Cup – they haven’t been able to keep any of the patriotic colors in stock for the last month.

Embajada de la Coca

During my visit to Bogotá – we sampled some delicious Andean style cuisine at the Embajada de la Coca. (To read my article on the experience, click here.)

welcome to Embajada de la Coca

Meet the artist: Isabella Klein

The next day, I spent the afternoon visiting the Klein family. If the name sounds familiar – it’s because one the sons, Albert Klein, PharmD is a close friend and my co-writer on several of the Hidden Gem titles. (The Kleins are a talented family; the younger son, Alex plays piano with the Bogotá Philharmonic Orchestra and the daughter, A. J. is an occasional model.)

(For more about the Bogotá Philharmonic – read this post by a blogger from the University of Texas at Austin.)

His mother, Isabella works as a professional translator as well as teaching English. But that’s just her job – art is her life. She works in multiple platforms – mixed media, paintings, photography and artisan crafts.

On today’s visit – we talked about some of her craft work as well as the large craft fairs here in Colombia. We discussed my ideas for ‘artisan craft style tours‘ where visitors could learn more about the crafting process and Indigenous cultures of Colombia.

She showed me some of her more recent projects – making decorative wooden boxes. Instead of using the traditional Colombian patterns, she designs her own.

Some of the wooden boxes designed by Isabella Klein

Her mixed media paints are arresting to look at. Unfortunately, I was too busy admiring them to take any pictures..

But I do have a couple more pictures of the boxes.

I think the next box is just fantastic.. It’s a design that just catches the eye. I like the combination of blues.

For a portfolio of some of Isabella Klein’s work – click here.

After too few days – it was time to say goodbye to my Bogota friends (new and old) and head back to Medellin to prepare for Colombia Moda..

with dear friends, Camila and Flavita.

Of course – it wasn’t all bad – these lovely ladies were at the airport in Rionegro to greet me.. The Aguardiente Girls!!

Welcome to Medellin!

Calling all fashionistas!

Posted on July 15, 2014 by K Eckland

While many of you know that Medellin isn’t my favorite city in Colombia – it does have its own attractions. I am not talking about the spectacularly breath-taking ride up to Parque Arvi on the metro cable or the Botero museum.

It’s the shopping – Medellin is the New York of Colombia and much of Latin America. As home to Colombia Moda and the Colombian textile industry, the array of shopping opportunities are mind-boggling. Most tourist guides will direct you to the upscale, brand name only shopping malls in the wealthier enclaves like El Poblado. While these malls are worth seeing, I advise visitors to go in the guise of a museum-seeking tourist.

indoor flower garden at upscale mall in Medellin (El Poblado district)

That is to say – go to look (at the sculptured gardens, majestic views and boutique brands) and maybe for a light lunch at one of the elegant eateries but save your cash for the real shopping mecca, in El Centro. Wear comfortable shoes – and plan to finish shopping before 6 pm..

To get here: Take the Metro (train) to Station San Antonio. That will put you in the center of the shopping district.

Biggest Open Air Shopping District in Latin America

Don’t worry, honey.. I stayed safely outside of this shop dedicated to crochet

At least, according to the banner hanging over one of the cobbled pedestrian streets. But it seems pretty accurate as I wander street after street of an amazing array of goods.. If it isn’t here – than you won’t find it in Colombia.

Since it’s not Buenos Aires (Argentina), yes – they have sizes larger than SIX.

There are streets filled with row after row of sidewalk vendors selling a multitude of items. A whole street devoted to shoes.. Sidewalk vendors selling ornamental sandals with adjacent stores sell every kind of shoe ever made..

Just one of the many, many displays of sandals in the shopping district of El Centro

Street after street with store after store of Shoes.. Appliances.. Clothing.. Cosmetics.. Electronics.. DVDs.. Porn… Lingerie.. Hats. Costume Jewelry. Fabric. Ribbons. Yarn.. Several stores filled to the brim with beads. Pastry and cake shops. Any kind of soccer (futbol) jersey you could ever want (and not because it’s the world cup – these stores are always here.)

Whole malls (centro commercials) for bridal wear.. Others filled with row after row of beauty salons.

Dollar stores for all the items you forgot to pack.. Luggage stores for extra space to bring back your fabulous finds..

About the only thing I didn’t see was a street devoted to mascotas (pets) but that’s probably just because I didn’t wander far enough.

You can find almost anything here!

Calling all Colombian travel agencies! Fashion and textile guided tours

Add this to my wish list for Colombian tourism businesses – or other ways to make Colombia accessible to tourists on a whole new level. For people who are familiar with Colombia, the tours would just be a nice, relaxing way to have someone else take care of the details… Not everyone lives in El Centro and has the ability to walk a few streets right into the commercial heart of the city.

But for first-time visitors; wives of travelling businessmen or people unfamiliar with this part of the city – a guided tour to the heart of Medellin’s fashion district would be absolutely essential, particularly as the area gets kind of sketchy after 6 pm. Tours for fashion sewers, crafters and knitters along with general shopping and factory tours just sounds like a fun way to spend a day. Throw in a typical Colombian lunch (not the enormous banda paisa but something featuring all of the great local fruits and vegetables) and a mixed group of tourists (Colombians, and foreigners from several nations) as well as a knowledgeable, bilingual guide – and I think there would be a line of people ready to sign up..

I think it would go along with my dream trip to Bucaramanga for a weekend guided factory tour and shoe-shopping adventure.

Alas! I am not a marketing genius – just a lover of fashion, sewing and crochet. But just for fun – I am going to add a survey here where readers can let me know what they think of this idea.. If I get enough interested responses – I’ll pass it along to someone in the tourism industry.

Proexport advertises Shopping Tours but they are short on details..

If you are interested in a personal beauty consultant – and shopping.. a bit pricey but here’s the link. (link is a bit short on details too..)

Fashion Tourism Survey

Tips for Shopping in El Centro:

– Wear comfortable shoes

– Don’t bring extras: jewelry, cameras, smart phones. (This is a high crime area).

– Bring mainly small bills: 2ooo, 5000 and 10,000 peso bills. It’s problematic to pay for a 3,000 peso purchase with a 50 mil bill for shopkeepers and may be impossible for outside vendors.

– keep your belongings secure – I recommend a zippered purse. Backpacks should be worn on the front. Messenger bags work for me – so I can keep the strap across my chest, and the bag close to my body.

– Try not to be too loud and (gringo-ey) in El Centro.. While most Colombians like Americans, in this instance, you don’t want to attract too much attention.

– Be prepared to leave by 6 pm – and don’t stay in El Centro after dark unless you are with a native paisa (person from Medellin). It is easy to get lost – and dangerous at night.

In general, use commonsense – have fun and good luck on your shopping adventures!

It’s not vanity and it’s not easy: NHS agrees

Posted on July 13, 2014 by K Eckland

As reported on Sky News and the New York Times, there has been a radical turn around regarding the use of bariatric surgery to prevent/ control and even “cure” diabetes.

Not a vanity procedure

Once relegated to the category of a” vanity” procedure, bariatric surgery has emerged as a legitimate, life-saving intervention which has been scientifically proven to have multiple major health benefits.

For years, patients have had to jump numerous hurdles to be considered for this procedure. One of the biggest hurdles was often that patients were not considered fat enough to qualify for this procedure. The traditional guidelines restricted surgery to morbidly obese people, and then required these patients to perform numerous tasks to be considered eligible candidates of surgery such as attaining a diagnosis of “carbohydrate addiction” and losing weight prior to surgery as a sign of “commitment” to weight loss. This was in addition to several months of therapy with nutritionists and counselors.

A punitive process

While including this ancillary education may have assisted patients post-operatively, it also felt punitive to people who were seeking medical help. No one forces lung cancer patients to attend smoking cessation courses or counselling before having their cancer treatment nor do we require several sessions of pre-operative classes prior to a bowel resection.

New guidelines – perform surgery earlier (2012)

But as the data started to emerge that showed long-lasting health benefits of surgery-assisted weight loss, debates raged between International and American physicians. Several years ago, several international organizations such as the International Diabetes Federation began to recommend lowering the eligibility criteria for bariatric surgery – particularly for patients with documented complications of obesity present (diabetes, coronary artery disease, severe orthopedic injuries). But these recommendations were ignored by American medical societies and many physicians including the doctors responsible for initiating referrals to bariatric surgery programs. Americans. it seemed were reserving the the more effective treatments (like gastric bypass or gastric sleeve) for the super-obese, and the prototypical 600 pound patients.

Obese patients who did not meet these rigid guidelines were often sent for less effective procedures like lap-band or balloon placement. Insurance companies often denied payment stating that surgery in these patients were ‘not medically necessary’ and thus it was considered a ‘vanity’ procedure. Additionally, in most cases, the procedures failed to produce meaningful or long-lasting results.

Adding stigma and shame to a medical condition

Patients who were overweight and seeking definitive treatment were often made to feel “lazy” for being unable to lose weight without surgical assistance. They were also told to return only if they continued to fail (or gain weight).

The Diabetes Pandemic

But as the obesity pandemic continued to escalate at breakneck speed along with obesity-related complications (and healthcare costs skyrocketed), the evidence began to become too overwhelming to ignore.

New guidelines were passed for eligibility criteria for gastric bypass procedures. These guidelines reduced the necessary BMI to qualify for surgery, especially in patients with co-morbidities such as diabetes. But it still ignored a large segment of people; non-morbidly overweight people with early diabetes – the very group that was most likely to have a high rate of success and immediate normalization of blood sugars*.

But now the government of the United Kingdom and the National Health Service (NHS) have adopted some of the most progressive recommendations world-wide; aimed at stemming the tide of diabetes and diabetes-related complications such as heart attacks, strokes, renal failure, non-alcoholic fatty liver disease (NASH) and limb ischemia leading to amputation.

The NHS should be commended for their early adoption of eligibility criteria that lowers the BMI requirement to 30 in diabetic individuals and eliminates this requirement entirely in diabetes of Asian descent**. Conservative estimates believe that this change will make an additional one million British citizens eligible for bariatric surgery.

* As a ‘cure’ for diabetes, gastric bypass is most successful in people who have had the disease for less than eight years.

Surge of patients but few surgeries

But can supply keep up with demand? Last year, according to the our source article (NYT), only 9,000 bariatric procedures were performed in the UK.

**Diabetics of Asian and East Indian heritage (India, Bangladesh, Pakistan) often develop a more severe, aggressive, rapidly progressive form of diabetes which is independent of BMI or obesity.

More from the Diabetes & Bariatric Archive:

Life after bariatric surgery

Bariatric surgery and the family

Bariatric surgery and CV risk reduction

The Diabetes Pandemic

Part II

Diabetes as a surgical disease

Gastric bypass as a cure for diabetes

The Eckland Effect

Posted on July 8, 2014 by K Eckland

It’s been a while since I’ve written – but sometimes between maintaining two blogs, a series on health for Examiner.com, answering emails from potential medical tourists, traveling and working long hours on assignment – I sometimes feel a bit like a candle burning at both ends.

But I am happy to report – that I recently completed my latest assignment and am back home in my native Virginia (for a few days) before heading back to Colombia.

I’ll spend the next couple days getting ready; contacting potential interviewees, researching articles,

The downside of frequent extended travel is the piling up of all the inevitable errands and hassles. Sometimes its just stuff like sorting through a couple of months of mail, but other times it’s paying property taxes (in person because I live in a small town) or renewing my driver’s license (now good until 2022!)

But now that we’re all caught up – we can get back to work (and writing!)

The Profiteer Model

Several interesting articles and posts have been written about medical tourism lately. We will talk about some of the other issues in future posts but today, I wanted to share this article by Stacy Hsu from the Tampai Times. This article takes issue with the “Profiteer’ model of many so-called “Medical Tourism” hospitals and clinics.

VIP Medicine

As we’ve mentioned in previous posts, the idea of exclusive hospitals designed solely for the wealthy foreigner is both a noxious and popular one. To many people, the idea of a resort-like or decadent atmosphere that caters to the every whim of the monied tourist or “Club Medicine” is a charmed one. VIP/ Executive health programs thrive around the world – from the hallowed halls of academic medicine like John Hopkins, the Cleveland Clinic to the Planet Hospital branded facilities around the world.

Much of the medical tourism industry has been based on this context. Programs are advertised on the basis of desirable location, gourmet cuisine menus, luxurious accommodations and nightly turn down service; not surgical skill or publishable clinical outcomes. No one hypes a short-length of stay or low re-admission rate when catered meals, high-speed internet and cable television are part of the selling points.

VIP versus Concierge: Not entirely the same

Don’t want to travel? But want your health care needs catered to? There are whole branches of primary care practices (ie. the “Royal Pains” practices) that are now based on this principle. On the surface, it doesn’t sound like much – patients pay extra money to have their doctor actually give them the time and attention they deserve* (during visits, phone calls and emails) but in reality, it can very quickly turn into something else as this ‘bonus’ pay approach changes the patient – provider relationship.

But “concierge medicine” as it is called in primary care medicine is a far cry from the VIP and Executive programs offered as part of medical tourism programs. In concierge medicine, patients still have a long-term and established relationship with their physician – and it is this relationship that can actually improve health care outcomes along with patient satisfaction. That’s because having more time with your family doctor means that s/he will spend more time answering questions and explaining care to patients. In turn, the patient is more likely to fill their prescriptions, take their medications and otherwise follow this doctor’s instructions.

*Instead of delegating more personalized care to people like me; the nurse practitioner (NP) or physician assistant (PA) which is more commonly done in standard medical offices.

But is ego-tickling medicine good for your health?

According to the scant amount of existing research, the answer is often no, when we are talking about short-term patient-provider relationships like the one-day executive physical or the spa style surgery service. In fact, patients often receive unnecessary and even potentially harmful, expensive tests and procedures (like the famed “Full body CT”).

I liken it to “T he emperor’s new clothes” syndrome, where the patient is seen more as a consumer / purchaser of goods than a person seeking health services. In this scenario, the healthcare provider is more concerned with keeping the customer satisfied than explaining why many of these tests and procedures are not necessary or may even be harmful.

Remember: First do no harm!

The customer is always right!

These contradictory objectives may become a conflict when the needed health advice isn’t what the patient wants to hear*.

Not even the humble fools dare tell the emperor the truth.

The ‘Eckland Effect’

But it looks like this may be changing. Several new research projects as well as recent articles are showing a move towards data collection and measurement of objective outcomes in regards to medical tourism. Instead of patient satisfaction surveys, researchers are asking about the incidence of complications.

Other organizations are talking about implementing more accountability, transparency and formal accreditation for medical tourism programs and facilities. Of course, accreditation is only as valuable as the organization offering it.

*Certainly this dynamic was at play in the care and death of pop star Michael Jackson under the care of Dr. Conrad Murray.

Additional articles for interested readers:

Al-Lamki, L. (2011). Medical Tourism: Beneficence or maleficence? SQU Med J Nov 2011, 11(4): 444-447. This is an excellent editorial that offers a concise overview of many of the ethical issues we have discussed here at Latin American Surgery including brain drain, transplant tourism, quality assurance, continuity-of-care and the overall impact of medical tourism on local communities.

In a related article, ” A European perspective on medical tourism: the need for a knowledge base” Carrera & Lunt (2010) argued for the urgent need for record-keeping and statistical data collection in the medical tourism industry. While this article is not available for free on-line, a related presentation by the authors is available here.

For readers interested in learning more about the correlation between patient satisfaction and clinical outcomes, I encourage you to read the works of JJ Fenton.

Fenton JJ, Jerant AF, Bertakis KD, Franks P. (2012). The cost of satisfaction: a national study of patient satisfaction, health care utilization, expenditures, and mortality. Arch Intern Med. 2012 Mar 12;172(5):405-11. doi: 10.1001/archinternmed.2011.1662. Epub 2012 Feb 13. This study in particular is a must read: in this study, Fenton et al. followed a group of more than 36,000 patients and found that high patient satisfaction was correlated with increased health costs, greater rates of inpatient admissions to the hospital and a higher overall mortality. Fenton et al have also conducted several additional studies examining the relationship between patient satisfaction and quality of care. The findings of these study question the utility of new programs linking patient satisfaction with provider compensation (ie. pay-for-performance) and question the commonly held beliefs that patient satisfaction = high quality care. It may be that the best care comes at a price: unhappy patients. But then again, isn’t not a popularity contest – or at least, it shouldn’t be.

Medscape subscribers can also view a series of articles on this topic including an inteview with Dr. Fenton on his body of work. Medscape has a series of articles examining both sides of the argument linking patient satisfaction with provider compensation.

Patient satisfaction is overrated – an excellent editorial about the cost to patients (in health and money) related to demands for ‘patient satisfaction”.

Is it safe to fly after surgery?

Posted on May 27, 2014 by K Eckland

Long haul flights are a health risk for everyone

While the risks of prolonged immobility and pulmonary embolism with long distance travel are well-known, many potential patients are unaware of the increased risks of thromboembolism after surgery.

Increased risks in specialized populations

People with a personal or family history of previous blood clots (PE or DVT), women on oral contraceptives, and patients who have undergone orthopedic surgery are some of the people at greatest risk.

Increased risk after surgery + Long trips

The heightened risk of thromboembolism or blood clots may persist for weeks after surgery. When combined with long-haul flights, the risk increases exponentially.

In fact, these risks are one of the reasons I began investigating medical tourism options in the Americas – as an alternative to 18 hour flights to Asia and India.

Want to reduce your risk – Follow the instructions in your in-flight magazine

Guidelines and airline in-flight magazines promote the practice of in-flight exercise to reduce this risk – but few have investigated the risks of thromboembolism in post-surgical patients by modes of transportation: car travel versus air travel.

But, is it safe to fly after surgery?

This spring, Dr. Stephen Cassivi, a thoracic surgeon at the world-famous Mayo Clinic in Minnesota tried to answer that question with a presentation of data at the the annual meeting of the American Association for Thoracic Surgery.

This question takes on additional significance when talking about patients who have had lung surgeries. Some of these patients require oxygen in the post-operative period, and the effects of changes in altitude* (while widely speculated about) with air travel, have never been studied in this population.

Now, Dr. Cassivi and his research team, say yes – it is safe. Mayo Clinic is home t0 one of the most robust medical travel services in the United States for both domestic and international medical tourists.

After following hundreds of patients post-operatively and comparing their mode of transportation – Dr. Cassivi concludes that the risks posed by automobile travel and air travel after surgery are about the same.

Additional reading

For more information on deep vein thrombosis, pulmonary embolism and safe travel, read my examiner article here.

AATS poster presentation abstract:

Safety of Air Travel in the Immediate Postoperative Period Following Anatomic Pulmonary Resection
*Stephen D. Cassivi, Karlyn E. Pierson, Bettie J. Lechtenberg, *Mark S. Allen, Dennis A. Wigle, *Francis C. Nichols, III, K. Robert Shen, *Claude Deschamps
Mayo Clinic, Rochester, MN

Schwarz T, Siegert G, Oettler W, et al. Venous Thrombosis After Long-haul Flights. Arch Intern Med. 2003;163(22):2759-2764. doi:10.1001/archinte.163.22.2759 . This is some of the definitive work that discussed the risk of long flights with blood clots in the traveling population due to prolonged immobility.

*Most flights are pressurized to an altitude of around 8,000 feet – which is the same level as Bogotá, Colombia. This is higher than Flagstaff, AZ, Lake Tahoe, Nevada, Denver, Colorado or Mexico City, D.F. – all of which are locations where some visitors feel physical effects from the altitude (headaches, fatigue, dyspnea, or air hunger. In extreme (and rare) cases, people can develop cerebral edema or other life-threatening complications at these altitudes**.

** Severe effects like cerebral edema are much more common at extreme altitudes such as the Base Camp of Mt. Everest but have occurred in susceptible individuals at lower levels.

the meat and potatoes of HIPEC

Posted on May 7, 2014 by K Eckland

So I have returned to the United States and back on assignment for the next couple of months, so it’s time to get down to business.

A couple of new HIPEC articles came out – which I thought readers might enjoy. For lighter fare, we will start with an article from the Vancouver Sun.

The first article, by Erin Ellis of the Vancouver Sun, is a Canadian fluff piece complete with sensationalistic headlines and dramatic patient interviews designed to draw attention to Vancouver General Hospital’s new HIPEC program.

Dr. Fernando Arias, Chief of the HIPEC program at Santa Fe de Bogotá

Now for the meat and potatoes

The second article, which is more academically and scientifically based, is focused on a study presented at the Southern Surgical Association in December by Levine, et. al. (2014) “Intraperitoneal Chemotherapy for Peritoneal Surface Malignancy: Experience with 1,000 Patients” looks at long-term survival with HIPEC in patients with disseminated peritoneal malignancies. This study is remarkable for both the duration of the prospective study (which began in 1991) and the large amount of participants for a single site study. The vast majority of patients enrolled in this study had appendiceal cancer as their primary, but the study also included patients with ovarian, gastric, mesothelioma and colorectal cancers.

The evolution of the procedure and institutional experience led to improved outcomes and reduced complications over the course of the study. Part of this was due to the development of better patient selection criteria.

This information comes as a ray of hope for patients with these diagnoses and previously given only dismal prognoses.

Dr. Edward Levine, the primary investigator, is the Chief of Surgical Oncology and Director of the Comprehensive Cancer Center at Wake Forest Medical Center in North Carolina.

It was published in the Journal of the American College of Surgeons, and summarized here, at Heme/Onc Today

Levine, et. al. (2014). Intraperitoneal Chemotherapy for Peritoneal Surface Malignancy: Experience with 1,000 Patients. Journal of the American College of Surgeons, 218(4): 573–585 (April 2014). No free text available.

Additional HIPEC posts: the HIPEC archives

On the Streets of Cartagena

Posted on April 26, 2014 by K Eckland

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..

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

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 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 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

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

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

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

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 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).

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

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..

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

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.

Love, Life and Surgery in Latin America is now Colombian Culture & Cuisine

Days of Summer

The Sincelejo Diaries