Introduction: ready … or not, return from Galápagos Islands to mainland Ecuador, onward travel through highlands of Ecuador and Colombia. Following four months of travel, finally cross the equator. Weather is not ideal, rainy season.
When I think of Colombia, and at the risk of dating myself, recall the movie, Romancing the Stone (1984), starring Michael Douglas, Kathleen Turner, and Danny DeVito.
Travel is a numbers game, it follows a bell-shaped curve. After five years of travel, 65 of 200 countries, bitten by a dog in Ecuador, and face the existential threat of rabies, a viral disease, if left untreated before symptoms manifest, is 100% fatal in humans.
FRI 28 February: twelve-hour travel day from Galápagos Islands to Quito Ecuador, nothing went wrong, but, it was a tiring day. City bus (#198) travels from Quito airport to city center; transfer at Rio Coca terminal to local bus (E3).
At transfer station, inquire in Spanish if I am at the correct location for the E3 bus. Several high school girls point at me and begin to laugh. Gentle reminder, if you do not understand the joke, than you are the joke. Pleased that I could make someone laugh.
Sky opens up and begins to pour; streets flood as I exit the bus and walk to hostel. Long day, shoes soaked, eyes burning; weather goes from 82 degrees, hot and humid, to 60 degrees, cold and damp.
Quito elevation is 9,300-feet, twice the elevation of Denver Colorado. With less oxygen in the body, altitude sickness resembles a bad hangover; symptoms may include headache, nausea, and vomiting. Wake at 3am with headache, take Excedrin and half-dose of Diamox, used to mitigate symptoms of altitude sickness.
Identify bus terminals for onward travel to Mindo and Otavalo; explore centro historico, before headache pain becomes merciless, and need to lay down. Try to take additional dose of Diamox, but too late; everything that goes down comes back up.
SUN 02 March: I am vertical, which is not saying much, I am exhausted and completely weak. Would stay in bed, but, supposed to travel west to Mindo Valley. Continue onwards to Mindo, only because the valley reduces elevation to 4,500-feet.
Hostel owner is surprised, but relieved, to see me up; apparently, I was the cause of great concern. Quito is 40-miles long, but only 4-miles wide; local bus to Ofelia bus terminal in the north. Unable to purchase bus tickets on-line, or in advance, so stand in a long line. Later learn that it is Carnival weekend, four-day holiday.
Three-hour bus ride, landscape is lush, tropical, and green. Mindo is known as a cloud forest, and offers fantastic bird-watching, featuring, hummingbirds and butterflies.
Slowly recover my strength and energy, pass on zip-lining or ATV riding. Find a nice coffee shop, and for a reasonable price, enjoy a full-flavored Americano.
TUE 04 March: early morning, still dark, but, at least it is not raining. Return bus to Quito departs 6am; often elect early bus; when travel goes sideways, allows time to recover. Arrive in northern Quito, and local bus to city center. For a few hours, there is a glimpse of sun, before clouds and rain move in like a schoolyard bully.
When I traveled through Chile, contactless credit card was ubiquitous, and perhaps an indicator of a modern economy. In contrast, Ecuador is almost entirely cash-based, not just the Galápagos, but also mainland Ecuador. Even the public transit system (bus and subway), is cash-based with attendants at each boarding station. Don’t see how a country may modernize, and improve its standard of living.
Virgin of the Panecillo, located on a loaf-shaped hill in centro historico, is one of Quito’s iconic sights. It is not safe to walk (the stairs), but rather, take a taxi, due to persistent tourist robbery. I am also told not to walk in Quito after dark, but to use taxi or Uber. After four months in South America, I repeat like a scratched record.
There is a climber at the hostel, who summited 19,000-feet Cotopaxi Volcano. He recounted German climber who puked six times en route to the summit. Hostel guest recommended pre-loading Diamox in advance of altitude. I take 125mg every twelve hours, four doses over two days, and gradually acclimatize to elevation of 9,000-feet.
WED 05 March: ride Quito metro (subway) north to the bus interchange. Subway is immaculate; in service only 18-months. Local bus to Carcelén bus terminal; don’t climb the steps to board the bus, but rather, I am pushed by the large crowd behind me. Onward bus to Otavalo, two-hours, scenic ride, through rolling green valleys.
Drop off backpack at hostel, and explore the town, elevation 8,000-feet. One large square filled with merchants selling ponchos. It is Ash Wednesday, walk through Simon Bolivar Park, and observe its many citizens with the telltale cross on their forehead.
After breakfast, hike to nearby Cascadas (waterfall) de Peguche, and bitten by a dirty dog, between the calf and ankle. Dog attacked after I walked past. Pants not ripped, but the skin is broken with punctures, abrasions, bleeding, and bruising.
I am in the middle of the hike; continue onward to El Lechero, which provides views of Lago (Lake) San Pablo and Cayambe Volcano. Encounter 15 to 18 dogs during the hike, aggressive and territorial, some chained, most not, far different than city dogs.
My mind wants to race, why didn’t I hike the trail on the west side of the falls. Never win arguing against reality. Life is binary, pre-bite, post-bite, my new reality.
Return to hostel, clean the wound, pocket my vaccination card, and walk to nearby hospital. Greeted in triage by English-speaking doctor and nurse; they examine the wound. I inquire about rabies vaccine, but I am directed to the town’s medical clinic.
At the medical clinic, attended by an English-speaking nurse; he cleans the wound, and reviews vaccination card. Instructed to leave the wound open (to drain), and directed to the next room for Tetanus booster. There are three nurses, I am the curiosity of the day. Instructed to return to the clinic if there are signs of infection.
Not the day that I wanted, but the day that I received. How do I meet that which is not wanted. How do I accept this reality that was presented to me. Yes, and this, too.
Discussed rabies vaccine with travel medicine doctor, but, because I am not in remote areas, don’t work on a farm, don’t hike in caves (bats), and don’t handle animals, agreed that the vaccine was unnecessary. Rabies carriers often include: dog, bat, raccoon, fox, and skunk. I never liked dogs, now, I like dogs even less; man’s best friend, maybe not.
FRI 07 March: wake 4am, bus departs Otavalo for Quito 5am. Aggressive and territorial dogs at the bus terminal make it difficult to safely board the bus. Ghoulishly decorated bus resembles the taxiola from Planes, Trains, and Automobiles (1987).
Public bus to Quito city center, Ecuador’s capital, and visit hospital emergency room; feel fine, but want second opinion. English-speaking doctor refers me to local medical clinic. Subway ride south, check into the clinic. At triage station, nurse informs me that Ecuador does not provide rabies vaccine for dog bite, citing no cases in twenty years. Later in the day, I review the World Health Organization (WHO) database, where it is reported that Ecuador has NOT eradicated canine Rabies.
Led to nursing station; there are three nurses, none are alarmed when informed of dog bite, or alarmed when examining the wound. Nurse inspected and cleaned the wound, and applied antiseptic cream. I am told to return if the wound becomes red and angry, or, if I feel unwell. Treatment protocol in Ecuador does not resemble that of the United States. In any case, two hospitals, two medical clinics. It was never suggested that I seek care at a private hospital, or, return to the United States for treatment. World Health Organization (WHO) considers anti-Rabies vaccine an essential medicine.
Drop off backpack at hostel; sunshine warms my bones; don’t appreciate uncertainty.
SAT 08 March: wake 6am, take 1/2 Diamox, in anticipation of high altitude at Cotopaxi National Park. Arranged day trip with tour guide to facilitate travel; did not want to stay overnight in the region; only nine people in the mini-van.
Graced with good weather, blue skies provide clear visibility to the symmetrical stratovolcano, and its 19,300-foot summit. Group stopped at parking lot for hike to mid-mountain, Jose Rivas Refuge, at 16,000-foot elevation.
Group moves slow; receive permission to proceed at my own pace. It is cold, windy, and steep; not enjoyable, better to move quickly and complete the hike. Should have worn knit cap; ears do not like the cold and wind. Breathing is rapid, exhalation is palpable. As I gain altitude, head begins to hurt, feels like steel band digging into the back of my skull. Reach the mid-mountain lodge in thirty minutes; hikers that wish to summit the volcano, continue with crampons to negotiate the glacier, snow and ice.
Path back down to the parking lot is a straight line, mostly sand and gravel. With each foot step, I slide down the mountain. It is uncomfortable and unpleasant; it is easier to just run down the mountain. At the bottom, dump handfuls of gravel out of my shoes.
It takes time for the tour group to return to the bus. Fog rolls in, followed by clouds, thunder, and lightening, and that distinct metallic smell before a storm.
Drive north through Latacunga, Machachi and southern Quito, and drive past greenhouses of roses. Ecuador exported $2-billion of roses during the past year, one of the largest exporters in the world. Return to Quito before dinner, and before dark.
Local bus to Terminal Rio Coca, and bus 198 back to Quito airport. New airport opened 2013, 15-miles east of Quito. Previous airport operated with limited flight capacity in the dense city center, but, was high risk due to its altitude and strong cross winds.
WED 12 March: travel to Bogotá Colombia, visa free up to 90-days; tourists need to complete CHECK-MIG on-line form 72-hours prior to arrival. During the past few months, earned gold status on LATAM, upgraded seat assignment and early boarding.
Arrive Bogotá 9am, visit three hospitals for anti-Rabies vaccine; life feels like an episode of 24, race against the clock. First hospital doesn’t have emergency room. Second hospital has emergency room, but does not carry the vaccine.
Check into third hospital with passport, processed at triage. Colombian patient, who speaks English, translates for me at admissions, and I make a credit card deposit.
Hospital is swarming with patients and staff, it would be easy to get misplaced. Greeted by a nurse, and escorted to the international patient waiting room. English-speaking doctor conducted physical exam. Prescribed seven-day oral antibiotic for bite wound, and prescribed four anti-Rabies (antirrábica) vaccinations over two-week period (day 0, day 3, day 7, day 14).
English-speaking nurse escorted me to vaccination department; received first vaccination, with instructions to return Saturday morning for second. Discharged after six-hours of effort; cost $40 USD for doctor consult, antibiotic, and four vaccinations.
In the United States, anti-Rabies vaccine is only available at hospital emergency rooms. Excluding the specialized immunoglobulin dose, ER treatment cost ranges $5,000 – $15,000 for consultation, facility fees, and delivery of the four injections.
My risk for rabies is low, but not zero; I never felt ill. Variables include bite location, proximity to the brain, and how much virus is transmitted, via saliva. Once symptoms appear (usually 30-50 days, as early as 10 days, as late as 360 days), central nervous system is compromised, treatment no longer possible, and is 100% fatal in humans.
60,000 annual rabies deaths, one death every nine minutes; India records 20,000 deaths. Patients often experience a painful death within seven days of symptoms.
Fifty countries are rabies-free (in total or canine rabies); in part due to geography (ie. island nations), countries with rigorous vaccination (ie. dogs, cats), but also countries that use edible vaccine bait for wild animals (ie. raccoon, fox, skunk, etc.).
Rabies is transmitted via saliva, from host to a new carrier. Host loses the ability to swallow, which explains why there is a great deal of saliva and foam at the mouth.
In the United States, if bitten by “known” (vaccinated) dog, vaccine not required. If bitten by “unknown” dog, observe for ten days, if possible. Rabid dog will die within 3-6 days after manifesting symptoms; watch and wait. If bitten by “unknown” dog that cannot be monitored, standard of care is to vaccinate. I was vaccinated on day six (6); no evidence of dog owner, no evidence of vaccinated dog. Some people in this world are stubborn and intransigent, and don’t accept “no.”
Exit hospital, very hungry; did not eat all day except for coffee during morning flight. Street vendor sells pizza slices ($1 USD), best ever.
Return to hostel, re-schedule two weeks of Colombia travel, to comply with Bogotá vaccination schedule. Santa Marta falls out of the schedule. Grateful for flexible airline tickets. Email travel medicine doctor (Middlesex Hospital in Connecticut) to keep her informed of treatment. Her specialty is infection disease, and she confirms that treatment is appropriate, correct antibiotic (875mg amoxicillin + 125mg clavulanic acid) for dog bite; no additional care required when I return to the United States.
Thursday is low-key day, at least, comparted to yesterday’s drama. Purchased inexpensive ground coffee at supermarket. Make cup of (unfiltered) cowboy coffee. It smells like coffee, tastes like coffee, and feels like coffee (caffeine). Giddyap!
Explore La Candelaria neighborhood of Bogotá, popular with locals and tourists. Elevation is 9,000-feet, weather resembles Quito, perpetually cold and damp; wear knit cap indoors. Hot shower after dinner, try to melt my body, but it doesn’t work.
Bogotá is struggling with drought conditions. Divided into eleven districts, city residents are restricted from water use three days per month. On Friday, supposed to check into AirBnB for five nights. Building maintenance, and no water expected for the duration. Contact AirBnB and immediately cancel the reservation; first time, following 150 AirBnB reservations. Travel long enough, it all goes sideways.
Saturday morning, return to hospital, and receive second dose anti-Rabies vaccine, and depart with a continued sense of relief. Weather holds, no rain, and walk to Candelaria neighborhood, to hike Monserrate summit. Complete the three-mile round trip, 1,500-feet elevation gain (9,000 to 10,500 feet) in less than one hour. On the way up, I pace people for the duration, with great exertion. Take a few pics at the summit, and find that it is easier to run down than to walk. Stone steps, some are wet and slippery; at the bottom, legs feel like rubber from all the pounding. For the less motivated, there is a funicular, but didn’t want to pay $5 USD; need the exercise.
Visit Botero Art Museum (free entry); Pablo Picasso, hombre sentado con pipa (man seated with pipe | 1969), with its striking green background, captures my attention.
Visit Sunday market, meat smells bad, how do people not become ill. Other vendors sell flowers and vegetables; it is all very crowded. Walk back to Candelaria, few people on the street, heaps of trash everywhere, homeless people sleeping in dirty blankets, and the overwhelming stench of feces and urine. Museum d’Oro is free on Sunday; displays are signed in Spanish and English. Museum is well-curated, but very crowded. City’s flagship museum, Museo Nacional, is signed only in Spanish.
Monday, run through Parque Nacional. After breakfast, find barber for haircut; he inquires in Spanish about my travels; he wants to know if I have a girlfriend (mi novia).
Tuesday is Civic Day in Bogotá, received email warning from the State Department. President Petro called for citizens to rally in the streets in support of the government, between Parque Nacional and Simon Bolivar Plaza. It is an otherwise nice day, partly cloudy skies, moderate temperature. However, the crowds are uncomfortable and overwhelming, at least for an introvert, and I return to the hostel; rain settles in.
WED 19 March: never wanted to spend a week in Bogotá, simply a transit hub, and pleased to wake up with the anticipation of moving onward. Report to the hospital for anti-Rabies (contra rabica) vaccination number three. Afterwards, Uber to the airport.
Exit aircraft via air stairs; there is almost nothing that resembles an airport, and without grace, stumble into Cartagena de Indias. Feels like I am in another country, or at least, a tropical island; weather is hot and humid, 20-degrees warmer than Bogotá.
It is very windy, there is sand blowing everywhere, in my eyes and contact lens; too windy to wear a hat in the sun, even with a chin strap. Cartagena feels shitty, gritty, and dirty. It feels less safe than Bogotá, and makes Bogotá resemble a sparkling gem.
Successive motorcycle taxis offer a ride to city center, first $4, than $3, finally $2. It’s been a long day, and I accept the $2 fare. Once we arrive at the hostel, the driver asks if I want to buy crack cocaine. Um, no thank you. I just arrived and I want to leave.
Pre-dawn, six-mile run, to beat the heat and humidity; don’t wear a t-shirt. Run provides view of Cartagena’s modern skyline. Periodically, I shout “el guapo” (hey handsome), so that the local citizens don’t need to embarrass me; I can do it myself.
Explore in the morning, before sun, heat, and humidity become too intense. City is a UNESCO world heritage site, due in part to its historic walled city, but also due to its distinctive, Spanish-colonial architecture. It would not be a UNESCO site without Starbucks, which is unfortunate, as Colombia produces fantastic coffee on its own.
SAT 22 March: hostel guest snores, loud enough to wake the dead, sleep is impossible. Walk three-miles to airport, brief flight to Medellín. Combus operates 24-hours per day, with a bus to the city center every fifteen minutes ($4 USD); trip takes less than 30-minutes with traffic, transiting the five-mile long Oriente Tunnel. Weather, at 5,000-feet elevation, is a compromise between Cartagena and Bogotá.
In 1991, Medellín was the “murder capital of the world” with more than 5,300 deaths, including 700 police officers, at the hands of Pablo Escobar. Medellín drug cartel produced 80% of the world’s cocaine, making Escobar one of the world’s richest men.
Medellín transit system does not sell individual tickets, so I take motorcycle taxi ($1 USD) to the north end of the city, and save five miles of walking. 190cc Honda, with a quiet engine, but otherwise, an uninspiring ride. Traffic is light, but, lane-splitting at 50-mph, regret the decision, and imagine a high-side slide peeling off my skin.
Visit the sprawling Sunday market at Plaza Minorista, as local citizens complete their weekly shopping. City may have the highest concentration of homeless people that I have seen in Colombia, perhaps due to its temperate climate. Stench from trash, feces, and urine is overwhelming. Many of the homeless look unstable and desperate; the environment does not feel safe. Often concerned that someone may throw bodily fluids towards me (ie. Silence of the Lambs). Following two weeks in Colombia, I am grateful for the medical care received, but not much else, and ready to move on.
MON 24 March: wake early morning, dark, walk three miles to airport bus stop, without any palpable threats. It is a mini-van, maybe twenty seats, and it departs full. Van climbs out of the city, and look down in to the valley below, Medellín city lights twinkle, and looks beautiful; more beautiful from a distance, than up close.
Board the aircraft, and when the agent scans my boarding pass, she pauses, and hands me a new boarding pass. Surprisingly, I am upgraded to first class, which is humorous, because the flight to Bogotá cannot be more than 30-minutes. Ten flights on LATAM in three months, including the long-haul flight to Easter Island. Convert remaining Colombian pesos to Mexican pesos, and Uber to AirBnB; grateful for wash machine; considered burning my clothes.
WED 26 March: report to the hospital for anti-Rabies vaccine number four. Grateful for Hospital Universitario San Ignacio, and depart Bogotá with a profound sense of relief. I would hug the nurses if not at risk of violating cultural norms. Instead, I place hand over my heart, and offer a deep bow of humility.
Five injections in three weeks; shoulders deeply ache, as if, I was on the losing end of playing “slug bug” with a person twice my size.
Leading up to the final vaccination, my mind conjures all sorts of things going wrong; hospital runs out of vaccine, hospital is struck by a meteor, government holiday, protests and riots. Thankfully, none of these come to fruition.
During the past month, I learned more about rabies than I ever wanted to know. Intention is to maintain periodic booster shots for Rabies antibody protection.
As I exit the hospital, stop for cafe tinto, as a treat. Person at the counter pushes a button, grind beans, add hot water, but, there is no skill, and no care. After the first sip of crema, it is mostly brown-flavored water. It wasn’t expensive, but, whatever I paid was too much; with little joy, call an Uber to the airport.
Five-hour flight north, along the spine of Central America, to Mexico City (CDMX), one of my favorite cities in the world. There are no snacks, no water, no coffee, no in-flight entertainment, and seats don’t recline. Wonder if I boarded a Spirit Airlines flight in error, instead of Avianca. Surprised that there is no charge to use the toilet.
Processed quickly at immigration, in Spanish; walk to airport subway station. Recharge my CDMX metro card with pesos – don’t leave home without it – and on my way.
Thursday, slow start to the day, enjoy chilaquiles for breakfast, one of my favorite comfort foods; sauce is blistering hot and eye-watering spicy, wash it down with café de olla. Explore the Del Valle neighborhood, and local coffee shop for ground coffee.
Mexico City is the largest city in North America, and comprised of sixteen neighborhoods. Scale of each neighborhood is self-contained, and quite intimate. Friday morning, explore Fuente de los Coyotes, murals along Callejón del Aguacate, and appreciate the watercolors at Alfredo Guati Rojo Museum (free).
In South America, credit card was contactless; surprised that Mexico uses chip reader. Contactless is more secure; chip readers are at risk of skimming. I receive email alerts every time that my credit card is used. Sure enough, Friday evening, there is a large credit card transaction that I don’t recognize.
Within five minutes, call Bank of America to report fraud. Agent recommends that I lock the card using the mobile app, so that I may continue to use the card strategically, until the bank may replace my card when I am in Austin Texas. On a long enough timeline, everything goes sideways. Journey has been nothing short of one insult after another, and wonder, when do I develop resilience. Perhaps a skimmed credit card is simply the cost of foreign travel.
Saturday, visit Mexico City’s historic center, and enjoy walking Avenida Madero, the wide pedestrian mall that extends from Alameda Park to the Zocalo, the location for the opening scene of James Bond, Spectre (2015).
SUN 30 March: subway to TAPO bus terminal, two-hour bus to Puebla. Two-mile walk from bus terminal to hostel, easier than searching for the colectivo. Walk is desolate and discouraging, stung by a fleeting sensation of homesick, and question why I didn’t fly from Mexico City back to the United States.
Last visited Puebla in 2022, UNESCO world heritage site, known for its blue and white Talavera pottery and tiles. Last stayed at an AirBnB in the El Carmen neighborhood; this time, hostel near the historical forts, on the opposite side of the city.
Walk more than 1,100-miles during past five months (seven miles per day)
Passport: 15-pages stamped, 28-pages remain, likely require early renewal (~2028)
Cost: cumulative travel costs, during past 155-days.
Lodging: $2,183 total | $14 day
Transport: $5,011 total | $32 day (plane | train | bus | ferry | taxi)
— Flight | Bogota > Mexico City: $460 ($90 per flight hour, non-stop)
Food: $319 total | $2 day
Other: $9,202 total | $59 day (FX | ATM | visa | tourism | RV & motorbike)
— Antarctica ($8,400 | ten-day expedition)
Total: $16,715 total | $108 day | $39,400 annualized
— Cash burn: $902 | $6 day (when credit card not accepted)
Spend more cash in Ecuador than previous four months in South America.
Conclusion: there are at least two kinds of travel. First, when you get picked up at the airport by a tour bus. Second, when you puke out your guts, and wished that you got picked up by a tour bus. There is no limit to how much money a person may spend to not experience discomfort or hassle during travel. I know people that fly to a foreign country, black car service to a resort, and never step foot in the country proper.
Did not visit Venezuela, rated Level 4: do not travel, by the US State Department. Did not visit Suriname or Guyana in the north, as I did not want to backtrack. During April, will travel north along the gulf coast of Mexico to Monterrey, and meet Roberto, graduate school classmate, before walking across the border to Laredo Texas.
What is the purpose of life’s obstacles and challenges. Do I learn how to accept that which is unwanted, and to breathe deeply into that space. Was it not Shakespeare, who suggested, it is neither good nor bad, but thinking makes it so.
Do not like uncertainty, but, likely need to accept uncertainty, or, at least to make friends with uncertainty. Reminded of the illusion of safety; there is no such thing as (absolute) safety; only alternative is to be present with uncertainty.
Perhaps foreign travel is about stripping away layers (of superficial tedium), and perhaps, at some point, reach something deep, that is truthful and authentic.
Perhaps one lesson learned from foreign travel is kindness, because, at some point, I will need help, and I will need to rely upon the kindness of strangers; people, who have no obligation to share upon me, the generosity of their gift-bestowing hands.
When I cross the border from Mexico to United States, will I be subject to a tariff.
garthmonroe 