Ascending into Bolivia
From the desert town of San Pedro de Atacama we ascended to the Chile-Bolivia border on a narrow windy road whose sides are littered with bottles and trash from previous truckers. Jared cautioned us (once again) to put on sunscreen; the sun’s rays in the highlands (altiplano, high plains), being less absorbed by the atmosphere, is harsher than at the sea level, and explains the deeply tanned and wrinkled skin of elderly Bolivians we will encounter (as well as the elevated rates of skin cancer in that population). At the end of the day we would be at an altitude of 4800m.
Besides a harsher sun, the other manifestation of high altitude is the cold: snow resides where the sun do not shine. A chemists’ interjection: gases cool down as they expand (as you may have felt when spraying a can of aerosol). Air at a lower altitude is “more tightly packed” (if I can use the phrase for a gas) due to the hold of gravity, and thus as air travels upwards and experience less gravity, it “unpacks” and this is accompanied by cooling. The combination of unforgiving elements left few plants and animals in the region, mostly some prickly yellow grass (ichu), and camelids (alpacas, llamas, guanacos, and vicunias) that feed upon them.
The border crossing was a simple mud shack with a corrugated aluminum roof, where two uniformed men sit at their desks with stamps. Outside the shack was the dead and rusting hull of a bus, which, at this desolate location with no running water, serves as an outdoor toilet for travelers. I noted the resemblance of the poop boundaries with a shadow cast from the shack’s ray.
With our passports stamped, we transferred our backpacks to the jeeps, which will take us across the gigantic Uyuni salt-flats in the next few days. (Specifically, we transferred out backpacks to the roof of the jeeps. Princess Sophie’s suitcase took teamwork.) We also met the drivers, upon whose competent skills in navigating featureless terrains and fixing salt-/sand-etched machinery our lives will depend upon. (Of course, none of us realized that things could go wrong until several days later, when our jeep, cavalierly driven away from the rest of the pack for hours, was lost in the middle of vast horizons of salt. More on that later.) The drivers hail from Uyuni, a town across the other side of the salt-flats, our destination, the name-sake of these salt-flats.
An hour’s drive on the jeep brought us to a mud-shack adjoining a lagoon. An adorable elderly Bolivian lady, wife of the lead driver, will be our chef for the next few days. We ate. Megan was sick. Another side effect of the altitude, and the cause of the cold, is thinner air; at 4800m the available oxygen is about 66% that of sea-level, and can cause all kinds of sickness. I felt fine.
After lunch, a few intrepid fellow travelers jumped into a hot-spring which sources into the lagoon. (This included my roommate DJ Animal, who no doubt attracted admiring fans with his hot (and largely white) swimwear-underwear which has LOVE written across the cheeks.) This area is geologically active, and we passed by a multitude of geysers, hot-springs, and lagoons with a multitude of colors in the remainder of the day.
We arrived our sleeping place in a few hours, a (another) mud-shack in the middle-of-nowhere, with corrugated aluminum roofs held up by wooden beams and down by heavy rocks. Megan is still sick. Then I got sick, and will be for the next day.
Sick: pounding headache, like a percussionist rapping his sticks expertly inside my head. Stuff coming out both ends of my GI tract. For the whole night, when I was not groping in the dark throwing up/down at the toilet (no electricity here), I was shivering under the thin stiff blanket, which freely let in the cold wind that the adobe freely let in. Common prescription for altitude sickness was first, to rest; second, to drink plenty of water. Sadly neither was valid strategy for me.
By the next morning Megan and I were deathly pale. I ended up in another jeep – there was a reason for it, which I was beyond caring to note. With me getting worse by the hour, our driver soon brought out a small green plastic bag with thumbnail to thumb sized dry leaves in it. Coca leaves, from which cocaine could be extracted, is native to the Peruvian/Bolivia Andes. I took about thirty leaves, chewed them, and held the mushed ball between my teeth and cheek. This is the traditional cure for altitude sickness; this, I would learn, is traditional cure for just about everything.
I know not what to expect. Besides being bitter, there was no sensation at the beginning; then no sensation sets in, as the saliva-extracted alkaloid numbs my cheeks. In an hour or so, I felt fine. Nothing special, but I was normal. The percussionist inside my head ended the show, and I didn’t feel like someone who ate nothing, drank nothing, and did not sleep for 36 hours. My training cautions against anecdotal experiences and blithely ignoring the placebo effect, but it was a very real (and surreal) experience for me. In the remaining days in Bolivia I learnt more about this miracle plant, from our exuberant (and excellent) guide Jared, through my own reading, and from experience. (With this not being my area of expertise, and this being a topic I want to learn more about, I welcome your input in the comments.)
Indigenous people here believe in Mother Earth as a goddess, Pachamama in their tongue. Coca leaves was mythologically a present from Pachamama and historically reserved for the nobility. It was said that Pachamama made the coca plant to help the ancient Andean people survive the hardships of highland living: “if you are hungry, chew the leaves, and it shall take away your hunger. If you are thirsty, chew the leaves, and you will not feel the need to drink. If you are tired, chew the leaves, and you shall not need sleep“. It is the gift that grants strength and energy, and wards against cold, fatigue, thirst, and hunger. Ancient clay figurines often show a bulging cheek – this is a reference to their access to coca leaves (and thus status), and its use dates back to 400BC, roughly the same time as when Athens was conquered by Sparta.
As the Spanish conquest gone well underway, coca leaves becomes a productivity tool, much like tea for industrial age laborers in Britain, or perhaps coffee for modern day worker in the West. (And no, coca leaves doesn’t help with writing; I tried. Alas, so much for hopes of “motivation in a green bag”.) To this day coca leaves are still heavily used by hard laborers in the region. Miners in Potosi, for example, are sometimes underground chiseling rocks and planting dynamite for 24 hours shifts, and doubly bulging cheeks is a necessity to pass those days.
Even today, however, the leaves retain their sacred character and also have a social importance for the highland people. For example, amongst the Taquiles on Lake Titicaca, men carry a pouch of coca leaves with them; part of greeting a friend involves putting leaves in his pouch, and he yours.
While it’s possible to infuse the leaves into tea (mate de coca) or syrups, the leaves are usually chewed in a process called acullico. One separates the veins from the leaves individually with the teeth (a process that I got quite proficient at), and chew the leaves into a ball with a lye that helps in extracting cocaine from the leaves (this is often some kind of cured sweet potato or banana, which also masks the bitter taste). 60 leaves would be sufficient for a single ball, which would take 10-20 minutes to prepare, and would be held in the mouth for 2-3 hours.
Chemically the active ingredient is trace quantity (~1% w/w) of cocaine, a CNS stimulant (“upper”). It is also a topical anaesthetic (by blocking sodium channels – ion channels are everywhere! :) ); the “cure” for thirst and food seems to be merely numbing the stomach. Between “the dose makes the poison”, and a different method of delivery, the psycho-/physiological effect of coca leaves is very much different from cocaine: it causes no addiction, no social consequences, and negligible physical harm.
Interestingly/appallingly, the international law written in the 60s does not make a distinction between these two, and places both coca leaves and cocaine under Schedule I, that is, they are illegal to cultivate or consume. Bolivia sought to reverse this judgment by appealing to the UN in 2009, but this was blocked by 17 of the 184 countries that was part of the treaty (your usual suspects: the US, UK, Sweden, Canada, Denmark, Germany, the Russian Federation, Japan, Singapore, Slovakia, Estonia, France, Italy, Bulgaria, Latvia, Malaysia and Mexico).
As a scientist who relies on empirical evidence, I am appalled and exasperated, especially when viewed in the context of the recent leak of a 1995 World Health Organization report. The WHO/UNICRI Cocaine Project was the largest study on cocaine ever undertaken. Between 1992 and 1994, information was collected from 22 sites in 19 countries about how cocaine is used, who uses the drug, what effects cocaine has on users, and how governments have responded to cocaine use. From the coca leaf chewers of the Andes to the crack smokers of New York and Lagos, from cocaine injectors in Sao Paulo and San Francisco to cocaine sniffers in Sydney and Cairo, the project has examined cocaine use and users across a broad spectrum of cultures. The conclusion from this comprehensive study states for coca leaves:
“Use of coca leaves appears to have no negative health effects and has positive, therapeutic, sacred and social functions for indigenous Andean populations.”
And even for cocaine, the conclusions strongly conflicted with accepted paradigms,
“Cocaine-related problems should be kept in perspective. In all participating countries, health problems from the use of legal substances, particularly alcohol and tobacco, are greater than health problems from cocaine use. [...] that occasional cocaine use does not typically lead to severe or even minor physical or social problems … a minority of people start using cocaine or related products, use casually for a short or long period, and suffer little or no negative consequences, even after years of use.”
Why was this report leaked instead of published? The report, which included recommendations such as, “adoption of responses such as education, treatment and rehabilitation programmes as a desirable counterbalance to over-reliance on law enforcement” was suppressed by the US in exchange for future funding (“if WHO activities relating to drugs failed to reinforce proven drug control approaches, funds for the relevant programmes should be curtailed”).
John Maynard Keynes famously said, “When the facts change, I change my mind. What do you do, sir?” He probably didn’t anticipate the answer by public officials in one of the most scientifically advanced countries to be “we change the facts”.