Can´t beat the real thing

Coca leaves for sale on a typically large scale, Potosi, Bolivia

Its probably appropriate that we talk a bit about Coca - after all, we are in Bolivia, and we have made numerous oblique references to it, without really going into what its all about. So, for those of you who have their heads completely in the sand, let me start by saying that Coca is to Bolivia what Sheep are to New Zealand, and bacon is to Denmark - unavoidable.

First off, coca is, as you probably know, the base from which cocaine is made. The processing of the leaf is fairly straightforward - basically just a soak in sulphuric acid to produce coca-base, and then a final concentration in ether to produce the real thing, ready for consumption by the wealthy of the western world (and by the odd Argentine soccer god too). Bolivia produces epic amounts of coca - more than 50% of the entire economy is coca by some estimates. As you can imagine, Bolivia was very popular with conservative 1980´s US administrations and the US Drug Enforcement Agency (DEA) has been active here ever since, trying to eradicate crops and destroy (bomb!) production facilities.

But you could argue that it is fighting a battle that it probably will never win. Why? Well, it is such an ingrained part of the culture, that you would probably have to wipe most Andean countries off the map to get rid of all vestiges of it. The leaves of the coca bush are used here in a manner analogous to chewing tabacco (refined cocaine is virtually unheard of here - even though they produce such prodigous amounts of it, it all goes for export) - a stack of leaves (10 for gringo beginners, 40 for the locals) are placed inside the cheek where there are sucked and the juices swallowed. They can also be used in conjuction with an alkaline cataylst, which is supposed to increase the effect. It is particularly common in the high mountains, where it is supposed to be good for altitude sickness, mainly due to its nature as a mild stimulant which overcomes the lethargy caused by altitude. It is also very popular amongst the miners, who use it as an appetite surpressant while they are underground for a twelve hour shift or so. Interestingly, coca was also used as a form of currency amongst the incas, and in many ways it still is - it is common to give gifts of coca when you are visiting a place, or as a tip to someone.

So, I know you´re all wondering, what´s it like? Well, this jury is still out as to its effectiveness, but we can both assure you that we are not going to come back addicted to it - much like chewing tabacco, its pretty smelly and unpleasant. Our first experience with it was crossing from Argentina to Chile, over a 4800m pass - it was obvious to everyone that Dorthe was really suffering from the altitude, and so they gave her some of the local medicine, so to speak. We had a minor panic when we came to the border, not wanting to get busted with an "illegal" substance on us - only to find that the border guards were chewing as well.. Oh well. We´re not exactly sure whether it works or not - its pretty hard to guage these things - if there is any effect, it is pretty minimal, anyway.

Unfortunately, coca also has its bad side - the largest is probably that caused by outside bodies placing political pressure on Bolivia to change what in many ways is an ingrained part of their culture - the coca farmers are generally the poorest members of society here, and feel the brunt of these policies very harshly - but that doesn´t stop them from growing though. The result has been to force the farmers to defend their crops, and there are parts of Bolivia where, as a gringo, it is not wise to be seen. The arguments about this sort of thing, are, as you can imagine, endless. Long term use (people generally use it from their teenage years to the grave here - many of our patients in the house somehow manage to get some past the nuns to have a quiet chew) also seems to be pretty hard on the stomach, as you might expect.

But one side effect that we hadn´t thought of came and greeted us personally on Monday. One of the patients in the house (one who I was particularly fond of) was admitted to hospital suddenly - apparently he was a long term sufferer of tuberculousis, and it had spread into his intenstines, causing a great deal of pain. He was in hospital on Saturday and was improving a bit on Sunday night when the sisters went to see him. On Monday morning he got up and went for a bit of a walk, and, as you do in this country, a chew of coca. He was found dead shortly later - the autopsy revealed that he must have had a coughing fit, and swallowed the coca leaves, which lodged in this throat and suffocated the poor man. A rather tragic way to die for a loverly Bolivian who was just doing his thing.