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Looking for rain

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The Pharmaceutical Journal Vol 265 No 7128p924-928
December 23/30, 2000 Christmas miscellany

Laurence Middleton Jones

Laurence Middleton Jones describes his adventures in Colombia

Cintur?n?”I asked. Don?t I put a seat belt on?”Me siento?”Don?t I sit down? Captain Alvarez glanced back, shook his head and grinned as he pulled back the throttle levers. Well over 50 years old, the Douglas DC3 vibrated like a blender as we lurched forward through the tropical wind. Was I doing the right thing? It was too late to change my mind. Surrounded by radio and navigation switches, I had nothing to hold on to except my camera.
A mechanic was also squashed in the cockpit with me. They had just installed a reconditioned engine and this, as I had somewhat belatedly found out, was a test flight. Having the mechanic responsible on board was a uniquely Colombian form of quality control. As we gathered momentum along the streaked tarmac, he did, indeed, seem to take an acute interest in every change in note in the giant 14-cylinder Pratt&Whitney engines.

the plane

The team from Captain Alvarez?s airline with the DC3 in which the author flew in the background. From the left: trainee pilot Gustavo, the author, Captain Alvarez, co-pilot Diego and two of the ground crew

To my great relief, this iron lady did rise into the sky. But just when I was beginning to enjoy the view of the Meta river and this city at the end of the Andes, they started the tests ? first, 60 degree banks and turns, then closing down one engine (which at first would not restart!). Oh why had I talked my way on board in the first place?
The Jesuits called this city Gramalote, a name it held until the 1850s. Then it changed to Villavicencio, its name today, in honour of a Spanish Royal Commissioner. He had arrived, very sensibly, on horseback. The town had grown to 350,000 on whom I felt about to fall.

Four-hour race

It used to take about a week to arrive from Bogot?, 9,000ft higher up on the plateau. The journey was now a stomach-wrenching, four-hour race around hairpins and precipices: bad enough in itself but rendered extreme by the driver?s choice of jolly music. And for several passengers there was the bitter irony of the bus actually having toilet facilities somewhere in the back.
Above the city, the views of precipices and mountains suddenly gave way to a panorama of the upper Amazon basin. The Llanos is a huge area once totally overgrown, now scattered with ranches, famous for wildlife and tropical fruits. The first glimpse after the mountains is breathtaking ? like looking down on a billiard table that stretches away forever.

Commando

I had come here to call on Jos? Campillo. He had promised to give me a tour of the medical facilities of the area as he worked in a clinic of one of the largest health and welfare providers, Cofrem. This stood for Caja de Compensaci?n Familial Regional de Meta. Meta was not only the river but also the region of which Villavicencio was the capital. If you followed the river downstream, you would eventually reach the Orinoco.
I mentioned to Jos? that I also wanted to work in a pharmacy.
“This is not problem,”he said, after a moment?s pause. Jos? could fix anything.
Jos? de los Santos Campillo is a remarkable character. He learned English from a 1920s book written for Germans. Having just learned some basic German it was “double practice”. He has a military manner and bearing. This is a traditional South American trait, the result of years of military dictatorships and news announcers who seem unaware that radio operates differently from the hand-held megaphone.
So sometimes this five foot five, fragile, white-haired, man would suddenly come out with remarks more in keeping with a six foot four German commando of a previous generation.
I struggled to keep up as he quick-stepped towards the Cofrem clinic. As I looked up at the clumps of tough grass growing on the telegraph wires above us, Jos? suddenly grabbed my arm and stopped. It must be serious ? had he spotted a terrorist? With an almost wistful sweep of the sky and a purse of the lips he intoned:
“Laurie, I look for rain …”
I cottoned on ? after all, in the Llanos, heavy afternoon rains are not uncommon.
“Well ? actually, today we say something like ?I think it?s going to rain?,”I ventured. But he shook his finger at me as if I had made an elementary mistake.
“No, Laurie. I look for rain!”
It was futile to argue with Jos?. When his mobile phone rings, it plays the tune “For he?s a jolly good fellow”.

Beautiful

The main entrance to the Cofrem clinic is across a dual carriageway down which thunder trucks, busetas and donkeys. There is no pedestrian crossing and I am glad I have not arrived on this side of the road with gout. Jos? strides out like Napoleon.
The clinic is large, modern and crowded. We pass queues of people waiting to make appointments or to see the five consultants, 10 doctors and six dentists working here. Then I am thrust into the computer room as the five incumbents look up from their work.
“This is Laurie, I will return.”As he passes me, he adds in an aside: “That is Patricia, she is beautiful.”And Jos? is gone.
It is not easy, standing in the middle of a room, to suddenly find small talk. Were they using Windows, I inquired. I had struck a chord of dissent. Yes, they had had problems posting and reposting drug prices updates and invoices. Yes, the system did crash regularly.
The invoices are sent to the health insurance companies, some of which were departments of Cofrem itself. The clinic was just the tip of the iceberg, part of a huge Cofrem conglomerate. Patricia explained something about it but I don?t remember what it was. Just her eyes, reflecting the windows …
I wanted to find out more about the health insurance schemes ? what about the very poor, for instance. The next moment I was walking into a room the size of a small gymnasium shared by the six dentists. They operate with only head-high screens between them ? so every drill and squeak is also shared. All the equipment was new and immaculate.
“This is Alexandra, she is beautiful”, says Jos?.
One of the older dentists tells me that they are all lucky to work here. Now that the majority of patients belong to one or other health schemes, there was little other work left. All medical professions were being forced under the wing of one of the private welfare co-ops. This all came about through the Ley de Cien or Law of the Hundred. Before this law there were lots of private medical practices. Now there was lots of unemployment.
Alexandra tells me I must visit the Cofrem supermarket, the Cofrem public library, the Cofrem pharmacies, the Cofrem hospital and the Cofrem holiday camp.
Then we met Sandra in X-rays. How could Jos? know simply everyone?s names? Sandra told me they handled at least 20 cases per day on their Toshiba X-ray machine.
The Cofrem hospital was attached to the clinic and had been built only 12 months before. Maria Luisa led us past the four incubation and two pre-natal units out into a courtyard where water gurgled from a beautiful arrangement of traditional earthenware pots of pre-Colombian design. It was a relaxing environment, on a single level, with sun and light pouring in.

Anaesthetic

Jos? then deposited me in another room and vanished. The room was tiled and totally white. Two surgeons sat on the floor, “dressed to spill”. The third sat on the tiled bench. This was the rest area to the operating theatre and they were chilling-out prior to an appendectomy. Fortunately, one of the surgeons had worked in a hospital in Ruislip, which broke the ice. Norton, Cerro and Micha were very friendly and we discussed the facilities in the hospital. Norton said it was the administration that made a good hospital. This one was good but needed scanners and “periscopes”. I felt I ought to go before they had a case of peritonitis on their hands.
Jos? was talking to a receptionist outside. He turned to me:
“Now we see Hospital Wheels!”he enthused.
Somewhat perplexed, I followed as we left the building and entered a yard where a massive truck, the back converted into a huge cabin, rested in the shade of a large mango tree.
“Here I come when I …”Jos? made a circling gesture with his finger by the side of his head, followed by the classical inclined-head-on-closed-palms gesture. “Guayabo,”he added. This roughly translates as “a fine place to take a nap when you have a hangover”.
He introduced another friend, Gabriel, a white-whiskered, sanguine gentlemen from logistics who opened the hospital truck to show us around. This vehicle lumbers over unmetalled roads to provide medical and dental services to distant villages. Cofrem tendered for these contracts and won by being cheaper than competing providers.
As most of these outlying villages were now dangerous because of guerrilla fighting, the truck was not used much at the moment. But some companies paid for the service of truck and crew to bring check-ups to their employees, many of whom would have no other access to medical services. The truck would arrive as a perk.
The truck was well equipped with a dental surgery with gas, medical examination rooms, nurses? rooms, reception, oxygen and autoclave. There was a shower, eye and ear testing and even an X-ray room, but the director, Julio, would not permit the truck to carry the development liquids so this facility was not currently used.
“The only thing we don?t carry,”said Gabriel, “is money. That?s because we don?t have any!”
In his opinion what was lacking in this area of Cofrem?s strategy was administration and “pushing”or promotion.
Gabriel lights a cigarette in front of the nitrous oxide as Jos? tells of two friends who died from anaesthetic. Gabriel tells proudly of an operation he had for a lump on his head, without any anaesthetic at all. It is a macho land still.

Private nuclear facility

Jos? wants to take me with him to get a contract signed in El Barsal, the Harley Street of Villavicencio. We are going to find Dr Nuclear ? a Russian specialist with “a private nuclear facility”and the only person doing radioactive diagnostics in town.
We sat waiting in his plush foyer for 20 minutes. His secretary had a bowl of biscuits on her desk with a notice that read: “Comida sana $400. Por gusto y solidaridad.”This roughly means: “Healthy food 400 pesos each. Buy them for taste and solidarity.”Was this a bona fide Marxist recipe, I wondered? It turned out that Dr Nuclear was either too busy to see us, or indisposed. I hoped it was not a touch of nausea. Jos? told me he was very highly respected, with a string of glowing tributes.
We eat a three-course lunch in a corner caf? for 50p under a huge, beautiful tree with yellow flowers.
“What?s this beautiful tree called,”I ask the waiter.
“It?s the yellow-flower tree,”he replies.
The main course is carne, verduras, platano y patacones: meat, vegetables, boiled cooking banana and deep-fried, squashed cooking banana.
In the heat of the afternoon sun, Jos? likes to eat pineapple sprinkled with salt from a roadside seller. I drink an ice-cold “avena”made from flour, water and milk flavoured with cinnamon. The seller gives me a second top-up free “so that you?ll return”.

Princess Anne

Jos? has been a disc jockey on a coastal radio station, a taxi driver, and a truck driver taking aguardiente, the national spirit, across narrow tracks through Andes. But when I first met him he was head of immigration for DAS, the Colombian secret service, based at Bogot? international airport. That was after resigning as the police sheriff of Kennedy, one of the largest suburbs of Bogot? founded on a visit by JFK himself in the 60s. This is a country in which the only limits are in your imagination.
I remember an old story about Jos? and Princess Anne. She was visiting on behalf of a children?s charity and one of Jos?s staff was handling the formalities of her passport in the airport at Bogot?. He was standing by to ensure all proceeded smoothly.
“You speak very good English,”said Princess Anne to the official.
“Oh yes,”piped up Jos?, “he learned in your country.”
“Oh really,”said Princess Anne, “Where?”
“In prison,”said Jos?.
Princess Anne did a double take and laughed but the passport official never forgave Jos? for the joke.

Preparada

Jos? Campillo, Pepino and the deadly drink “preparada”

But now we head towards the town centre and the Edificio Cofrem, the company?s main headquarters. On the way, Jos? suggests a “preparada”? another kind of drink sold from a street trolley. Jos? gestures at the sky ? this drink is also good for hot weather. He introduces me to Pepino, the owner of this particular trolley. From the greeting he gets, Jos? must be a regular. I am given to understand that what I am about to receive is pineapple juice ? but it turns out only to be based on pineapple juice. And “preparada”means fermented.

Cadbury?s Dairy Milk

When we finally arrive in the imposing marble entrance hall of the Cofrem headquarters we are both in fairly high spirits. Jos? slaps down a large bar of semi-melted Cadbury?s Dairy Milk chocolate on receptionist Sandrita?s desk. That was one of my presents to him! But he scored a hit.
As we ascend the stairs, I realise he is going to take me to the office of the top man, the director general himself. In fact he?s probably bargained the Dairy Milk to set it up. But I feel totally un-preparada with no reassuring list of questions in my notebook!

El Doctor

We enter the private reception on the top floor and our jaws drop simultaneously at the sight of two spectacular young women in tight black dresses. Owing to the preparada, in a blink we are both doe-eyed idiots. But Jos? is never silent for long:
“She is ?,”he stops, deadly serious, gripping my arm, searching theatrically for the words: “they are ? beautiful.”Then he vanishes behind the face of a mystic.
I have to concede he has a point ? but why on earth are the women, Pilar and Jeanette, dressed like this, to what ancient stereotype do they adhere? Jos? surfaces brusquely out of his abstractions as the women smile out of politeness or embarrassment or both.
“Beautiful, beau?tiful!”He turns to me in a grand, public display: “Oh Laurie, ees problem cardiac ? to see theese woman!”
I fear he is going to make a complete ass of himself ? but suddenly we all notice that the door of the inner sanctum has opened. Oops. Suddenly quiet, we are now ushered into the office of the man himself, myself glowing more than sunburn alone could account for.
Eduardo Zarate Torres is a man preceded by his eyebrows and he grips my hand like a lumberjack. Large art drips off walls that recede into his suite of offices and, as Jos? and I sit lightly and primly in front of an expansive mahogany desk, he swings into his big chair and beams at us. Jos? tells him he has brought me here to interview him and I fumble with my blank pages.
Eduardo served as a doctor in the Colombian navy and spent a year on the forces sail training tall ship travelling the world. He had risen rapidly within Cofrem and has been the director for four months. He expands on its philosophy of care and assistance. But there are problems now because of the Colombian recession. This followed the withdrawal of United States trading status and the escalation of guerrilla fighting. Inflation rates, and salaries, are rising but customers were downgrading membership or defaulting on payment. And there was also the long-term aim of replacing equipment and increasing facilities to contend with. A new scheme, called co-pago was intended to address some of these problems. It enabled individuals to receive lower cost medical insurance in exchange for them paying part of the cost of medicines themselves should they be needed.
Se?or Torres was very interested in publishing a copy the article I was researching. He was sure this would show how important Cofrem was, ideal for the Cofrem in-house magazine. Could I send him a copy? A sticky moment… . Luckily Pilar brought in a pile of cheques for him to sign, almost on cue, distracting everyone?s attention.

Generics

Those were quite unusual uniforms,”I say to Jos? as we wait for a buseta outside. He misses the irony and grips my arm again.
“No,”he says, “not ?uniforms? … they are dressed … informally.”
We drop in at the Cofrem supermarket pharmacy. It is really nothing more than a large counter but the gentleman running it, Luis Pinilla, was a pharmacist of considerable experience. He claimed to have worked in one of the first three pharmacies in the country to compound mercurials over 50 years previously. He said he had studied very hard to be a pharmacist, assisting in the local morgue whenever he could. They use to let him “finish off the sticking up”. He pauses to tell a customer, politely, that the item they require is in aisle number four.
I ask him about generic prices. He brings out some examples. Thirty Voltarol 50mg (Voltaren by Novartis) cost 23,220 pesos, about £8. But the same number in the national Memphis brand cost 5,245 pesos, about £1.80. It is similar with Squibb captopril, £7.80 vs £2.20. But sometimes the generics don?t work, he said. If you want to save money, get the generic. If you want to get better, spend money. As regards retail prices, anyone with a Cofrem card is entitled to a 30 per cent discount on all drugs from affiliated pharmacies.
We pass two aisles dedicated only to rice in its infinite varieties, all of which look the same to me, before going upstairs to meet two administrators at the supermarket, also friends of Jos?. Their office is hot and dingy with three ventilator fans, all of which point at the walls. That is so that they have some chance of working with the piles of paperwork while still at their desks.
“Ah Pinilla,”says one, “he?s nearly pensioned.”
“Pinilla,”says the other, “he?s an education!”
Now Jos? takes me on more personal business. Cofrem has not paid him ? and he is owed two months? salary. Despite all his protestations, nothing has yet been done. This time though he has a new and unlikely weapon, a copy of the PJ, which he asks to borrow. I watch in the distance as he waves it at cashiers and supervisors alike. Amazingly, it works like a magician?s baton and under its spell even the most obstinate become placid and helpful. I cannot imagine what he is telling them is in it.
But now there follows some of Jos?s own work. For a full hour and a half a roomful of advocates debate clinical investments and contracts. Even the photocopies passed around are plastered with rubber stamps. Jesus suffers on the wall above us, wearing his crown of thorns. His eyes yearn off to the upper left. The artist has captured this kind of suffering so well, I feel immediate sympathy. Things are so boring that I even catch myself reading my old copy of The Journal, voluntarily. Once the work is done all the advocates turn to me wanting to know how much laptop computers cost in the UK.
The afternoon is nearly over and cars, taxis and busetas are thronging the roads. We head back to Jos?s.

Superstitions

Jos?s family live in a conjunto, or housing development, of single-storey buildings on the outskirts of Villavicencio. It is very peaceful as there are no through routes and hardly any cars. The parrot in the tree outside says “Quiere cacao, quiere cacao”which means “Care for a coco?”.
The warm, dark evenings bring everyone out into the porches in rocking chairs, as the young play in the alleyways. Two dark-eyed children run up, a nine-year-old boy and his sister. They have been sent by their mother to beg for a few drops of breast milk from Angelica, one of Jos?s daughters who has a young baby. Their mother wants it to put in their brother?s ear to treat bad earache. We give them an empty carton of cephalexin and tell them to go to the pharmacy to ask for this and ear drops instead.
Another of Jos?s daughters, Katya, tells me of “Descuajo”. This is mysterious diarrhoea in infants and the subject of much fear. She says doctors have not discovered the cause and it might happen if the child simply falls or bumps itself. People are particularly afraid because children die quickly. The treatment is chicken soup made from a chicken that has not had sexual relations. I inquire if these are hard to find in Villavicencio. One doctor apparently tried all the antibiotics to no avail and the mother only saved the child by taking him to a witch doctor who laid on hands.
Many superstitions still exist here ? but not only in the suburbs ? there are placards on pharmacy counters that translate as: “You want to purge your child? We have the remedy!”
Jos?s family have a maid. This is common in Colombia where both adults work and live-in maid costs as little as £30 a month. But Cecilia is much more like everybody?s grandmother and lives down the lane. She is a great cook, sluices the floors with creosote every morning to keep down the flies, and stops for a long natter when the day gets hot. She invites us to try her carrot cake, cooked slowly on a hob in an old iron pot because the oven has broken. It is so good that I ask for the recipe.
“You don?t have snakes?”she inquires. Cecilia hates snakes.
“No.”
“How wonderful.”
“You have rats?”
“Not in our house.”
“Marvellous.”
“You have cockroaches.”
“No.”
“Amazing,”and she shakes her head in wonder. Then frowns.
“What about potholes?”
She lists the snakes in this vicinity. I don?t like the sound of the one that drops down on you from the trees and make a note to always pull my rocking chair forward. Some people keep a “Uio”, (pronounced “Weeo”) she shudders, to control the rats. People wear them around their necks. But only when they?re young because they grow to 20 feet long.

Celia’s carrot cake
Ingredients
1 cup of finely grated carrot
4 eggs
1 cup of flour
1/2 cup of oil
1/2 cup of sugar
1 spoonful of baking powder
1 spoonful of cinnamon powder
Method
Mix and cook (add a spot of water only if needed). (If cooking on a hot plate, place in the heaviest saucepan on the lowest heat.)

Civil War

Then Angelica cycles up. “I?ve got some gossip,? she says. “They?ve closed the road to Bogot? because of fighting with the Guerrillas.”
We turn on the news and there is indeed a war going on. My route out is closed. I am astonished by the style of the presentation as reporters wade after the soldiers, thrusting microphones into the strangely calm or mildly bemused faces of the bloodied and dying guerrillas. These, understandably, are not very informative when asked how they feel about what has happened. One says “Uuuuuhhhh”, and rolls over into the bushes. Another groans, adding, straight out of Shakespeare, “They have killed me”. We used to laugh at this line at school thinking how unrealistic it was. The camera then cuts back to model presenters in the studio who move effortlessly on to the next subject.
And it?s not only the road to Bogot?. There is fighting all around and it?s getting closer ? even now at Acacias, just 14 miles away. Apparently one of the guerrillas? targets had been to blow up the entrance to a main tunnel connecting Villavicencio to Bogot?.

Eternal damnation

But there is further bad news. Jos?s 11-year-old grandson, also called Jos?, or Batty for short, is in big trouble with the church. This is his third attempt to be christened and the godfather-to-be now cannot get here from Bogot? because of the fighting. On the two precious occasions the godfather also didn?t turn up so this time the padr? has given Batty an ultimatum ? it?s now or never. This has really scared him. He is desperate to avoid the eternal-damnation option. I volunteer to help ? and end up being godfather to two as Batty?s nephew, little Sarita, is also going to be christened in the same ceremony.
A low shudder passes overhead. “It?s the phantom helicopter,”Katya says. No one has ever seen it or knows who is using it ? the military, the CIA, the narco-traffickers or the guerrillas.

Cowboys

But that doesn?t stop Jos? rustling us up ready for a night on the town. The first nightclub we go to takes a traditional llanero theme. On the stage, a group of cowboys play harps while wailing explosively. A female singer built like a Neath prop forward then strides out to test her lungs. Appropriate enough, perhaps, for the Cardiff Arms Park, but less attractive with a microphone a foot in front of your larynx.
My theory is that folklore of the area is the result of a chance encounter. A very homesick, pioneering, Spanish Gipsy flamenco singer stumbled across the remains of a harp left by an equally pioneering wandering Celt. Out of this unhappy fusion was llanero music born and the great migration to the cities began.
The folk dancing, the inevitable accompaniment to evenings of this nature, is also a sight to behold. The taller partner, the lady, resplendent in embroidered black frock and ornate lace blouse, wiggles her hips while her legs do a kind of Michael Jackson moonwalk. Not bad. In complete contrast, however, the shorter, macho partner ? in our case a ranch-thin coyote of a man, wearing his Farmer Johns and braces ? tries to impress the lady with a demonstration of how fast he can stamp. In slippers. While his legs thus perform, his elbows, due to one of the laws of thermodynamics, perform an equal and contrary motion, giving one the impression of a particularly uncouth farmhand bolting his grub with a bus to catch. All this to the accompaniment of the wailing cowboys. It was a mystery why the young lady did not moonwalk backwards right off the stage never to return. I tried to be reverential in the face of such authenticity, but the art escaped me several times.
Then we follow Jos? with some relief out in to the warm, dark air and two taxis. The streets are deserted and as we drive through the outskirts, we turn, to my horror, down a road signposted “Acacias”.
“Excuse me,”I say, “but isn?t this the road to …”But I am interrupted by an argument as several share my unease. The miles pass by with not a single vehicle in sight and I am becoming increasingly alarmed. I start to think that every next corner will reveal the Uzis, AK47s or indeed the phantom helicopter scraping the dust towards us, guns blazing. In fact the next corner, and a turn- off, reveals only the blazing lights of a huge hacienda discotheque that is full of other suicidal revellers.

Kidnapped

We head back into town after that and sit alongside the road at a club that plays exclusively ?60s Colombian music. Soon after the drinks arrive, Katya looks at me urgently: “Get up, now ? follow me.”She leads me into another taxi ? and the rest follow shortly after. She had noticed a Landcruiser with all the windows blacked out. It had cruised slowly past us twice and then a third time stopped close by. It was dangerous, she said. It might have been a kidnapper. But it had removed me from the swinging 60s, for which much thanks ? an era which bore all the acoustic hallmarks of having been recorded in a bathroom.
Everyone is a little edgy because Angelica?s boyfriend, an American aircraft engineer, has been kidnapped and held captive by a guerrilla group for nearly a year. The guerrillas are asking for a huge ransom because he was working for British Petroleum, of which they are not very fond. The only person willing to risk his life, venturing days into the jungle to negotiate for Matt?s release on behalf of American institution that must remain nameless, getting shot at, and himself held for 10 days, is Jos?. But that?s another story.

Red dawn

Lulled to sleep by the cigarras (like cicadas) and a ventilator fan, I am roused after what seems like minutes. It is 5.45am and the ladies? cycle club is about to depart on their morning run. Having previously expressed an interest in seeing the Amazonian dawn, my bike is waiting. I feel like letting Angelica and the Amazonian dawn down ? but cannot.
The ladies? cycle club turns out to be Angelica and her friend Fulvia. Fulvia is an extremely large lady somehow decanted into a pair of red Lycra shorts. She tells me the club cycles every morning ? but totters so precariously on her bike that I can scarcely believe it. A bunch of giggles, she swerves and wobbles past parked cars and goes in all the potholes.
I, meanwhile, am unable to adjust my saddle ? which means that I am in danger of taking my ears off with my knees if I try to hurry.
At first light we turn away from the opalescent Andes that rise over the town and head out into the Llano towards the upper Orinoco. Large, strange Amazonian birds fly overhead and one cycles right in front. Angelica, in the lead, is full of praise:
“This is a marvel … everyone should see what a wonder it is … the pure air, so delicious.”
Latins get romantic at any time but she is starting to remind me of her father.
“The trees, the birds,”I add, out of politeness.
We pass a Guama tree. Fulvia says:
“That one, Guama, mmmm, that?s delicious.”
“We don?t talk about food, we?re on a diet,”scolds Angelica.
People are walking to work in small groups, silent along the miles of roads as the great sun rises over the infinite plain. It was one of those once-in-a-lifetime experiences of breathtaking beauty. Or it should have been ? but the romance of my moment was clipsed more than somewhat by a red panorama of a different nature.

Scrumping tangerines

On the way back Fulvia pulls up on the roadside and points down to a barbed wire fence. There is an orchard the other side.
“Over there.”she says. “Tangerines ? go on!”
Angelica nods ? she is thirsty too. So am I. But isn?t this trespassing? I don?t know the Spanish word for it ? so I don?t ask. Do they keep Dobermans in this neck of the woods?
I tiptoe in, ducking to look across, under the trees ? hoping no to see four-legged terrors bounding towards me. There are some nice big juicy tangerines up in these trees. But I can?t reach.
“Shake the branch,”shouts Fulvia.
I am hanging on the branch delighted at the four big tangerines glowing on the grass when something occurs that changes my demeanour considerably.
Also dropping out of the tree is a swarm of class A Colombian wasps. They accelerate to 60 in zero seconds straight at my head. Fulvia shouts in alarm:
“Abispa! abispa!”
This means “Wasp, wasp”. One: her maths is not very good. Two: stating the obvious at this time is not helpful. I am now jumping up and down whirling my hands around my head at very high speed. Three workmen are walking past on the road ? no doubt discussing whether my actions belong to a class of primitive, Welsh raindance.
Some of the wasps have dropped down the neck of my teeshirt so now I?ve got this halfway over my head as well. Not a good idea when you are running through an orchard.
I emerge on to the road to find Fulvia and Angelica in stitches. Women! They have no appreciation of the sufferings of the hunter-gatherer. But somehow, along with the five stings, I?ve managed to grab the tangerines ?which they quickly relieve me of. I spend the rest of the day feeling as if I am being used remotely for voodoo practice.

Chloramphenicol

Jos? takes me to meet Oscar, Hoover and Dario in the Cofrem bodega or warehouse. They check all incoming medicines. Hoover tells me they all keep a watch out for counterfeits. They all have the eyes of eagles, he says, and usually spot the slightest discrepancies in the pack ? the normal sign of counterfeit drugs. If they do get any, then Cofrem will not deal with that supplier again.
A Government department checks Controlled Drug records every 15 days in the warehouse and in all pharmacies. Suppliers come preferably from well-known national generics companies. All orders are taken by phone and hand written ? most places have not been computerised. I asked Oscar about the social problems.
“Pregnancy, assassination and robbery,”he says, matter-of-factly.

mobile clinic
Jos? Campillo and the Cofrem mobile clinic

Then I meet Carmen Pontea who has been managing a pharmacy within the Cofrem headquarters for the past eight years.
Unlike traditional pharmacists like old Parilla, with his degree in pharmaceutical chemistry, Carmen took the free pharmacy course organised by Cofrem. These are part-time and run from 7am to 8am in the morning and then from 8pm to 10pm at night. Before doing pharmacy she spend 10 years managing a shop selling washing machines and cookers. Many people take the pharmacy courses after first being pharmacy assistants or “contadoras”.
Her hours are 7am until 7pm with a three-hour lunch break. However she uses this to catch up on the paperwork and gets paid extra.
There is a lot of paperwork ? hand-written lists and manual typewriter sheets abound. She receives hand-written lists from small pharmacies in the outlying villages and has to assemble these herself while writing invoices in triplicate to send to accounts. I ask why this is not done by the three blokes in the bodega ? but apparently they only do the big orders. There is also a monthly return that has to be typed up and sent in listing all quantities of each medicine sold and the warehouse that each came from. The Department of Health also requires typed submissions and quantities in and out of each drug, plus copies of all invoices and prescription references.
Carmen tells me that she likes the work although it is hard. She only has an assistant for part of the time so has to manage for long periods on her own. But she knows her work is important for the poor, the addicted and the other unaffiliated because their first port of call is the pharmacy, any pharmacy. She counsels people who have no other recourse to medical or social help.
When dispensing she sticks to the old rule “Respect the prescription”? unless the patient requests otherwise. The patient, for instance, could request a cheaper generic instead of the branded medicine prescribed by the doctor.
Someone with a bad cold comes in and ask for “El Matrimonio”(the Marriage) this means ampicillin and Sinutabs. No prescription required.
I sell diclofenac and then chloramphenicol eye-drops without a prescription. It is a liberating experience. I could get used to this. Then some proper steroid cream, along with specific instructions on use. Power. And effectiveness. This is the life.

A hundred years of solitude

As I leave, Carmen tells me I must bathe in the river Meta ? because once you?ve bathed in the river you always come back.
On the way to Batty?s christening, Jos? tells me of his grandfather on the coast. They lived just down the road from Aracataca, the setting of the novel ?A hundred days of solitude?, by Gabriel Garc?a M?rquez. Jos?s grandfather used to own a pharmacy. He let his wife run it: “the crazy one”. She fermented sugar cane into “guarapo”and recommended it for everything.
The children have been ready for the evening baptism since 9am and the house has been in turmoil for most of the day ending in all of us, dry and dusty, queuing for the shower. When we get to the church we find a huge throng waiting for mass. This time it is the padre who is late.
The church is partly finished; the outside being unrendered concrete block. Inside, the padre moves the chairs and parks his car there during most days, while he runs the church school next door. Tonight the drops of holy oil and water go on to both baby Sarita and big Batty. In the padre?s office during the paperwork, poor Batty gets scolded for having missed school ? something it looked as if only the robes had prevented from happening in the church itself. As we leave, the skies open, and we all have to dash for home. Tomorrow I must fly back to Bogot? but tonight, with the tropical storm tipping down outside, it is party time. The bottles are opened and Jos? has a big surprise. Somehow he has found a couple of llanero dancers to perform in the front room. And guess what, he says, putting the cowboy hat on my head to the raucous laughter and applause of the guests, it?s me that they?re now going to watch, attempting llanero dancing in my beetle-crushers.

Postscript update

The final result of Jos?s negotiations with the commander of the ELN guerrilla forces was the release of the American Matt Butchell after more than a year in captivity in the jungle. Jos? is now working for the Colombian Department of Justice as a locum judge

Laurence Middleton Jones is a freelance writer and part-time locum pharmacist. His flightin the Douglas DC3, together with llanero music can be seen and heard in streaming video onthe website www.actionstream.co.uk by anyone with the free Real Player or WindowsMedia Player software

Citation: The Pharmaceutical Journal URI: 20003903

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