These Places In Between

Ears popping in an ambulance, Charmian’s fall

I sat in the back of the ambulance with my friend Charmian lying strapped to a stretcher in front of me,  a drip stand precariously rocking at every turn as we careered down to the Chilean coastal city of Arica to experience their hospital’s emergency department. From 4200 metres above sea level where her fall took place down to zero metres in a number of hours, my ears were popping every few minutes and I wondered what I would do with the abundance of oxygen that comes with sea level air and if my altitude induced  flatulence and altitude facial swelling would now subside (yes, it is a real thing, and Nathan now calls me moon face amongst other insults).    Joking aside, my head was spinning, and I know Charmian’s was too about how she had a suspected fractured collar bone and it was looking as though her South American bike tour would be no more than a week long introduction.  Neither of us articulated these fears during the 12 hours it took from the incident up until the x-rays were completed and the results given.

Charmian is my friend from my London life and I had invited her to come and join me for the duration of the journey south.  She had taken a tumble going down hill on a sandy surface whilst we were riding in the Vicuña National Reserve in the Chilean department of Parinacota.  I had been behind taking photographs when I came to the brow of a hill and could see some dark mass at the bottom, I wasn’t sure what it was until I cycled down a little further and worked out that it was her.  In the 30 seconds or so that it took me to get down to her she did not move, I came down to find Charmian sat up in the road, her bike and some of her stuff scattered in the road and her sunglasses smashed.

I gathered up her stuff and moved her bike off the track, there was plenty of mining trucks on the road so we needed to be out of it.  I helped Charmian up and we sat on the edge of the road whilst I cleaned the dirt off her face and assessed her wounds, some serious grazes and a big gash on her left arm but nothing that would require stitches, and a giant blue bruise on her right leg.  The girl was confused, she asked me why she was here, I mean that is a question we ask ourselves every day but she wasn’t pondering a deep philosophical question she was just trying to remind herself why she was on the side of the road in the Chilean nothingness, “I’ve come out to meet you and I’ve been here a few weeks, and we are going to ride together for the next 6 months”.  Nathan had been ahead and when we didn’t appear straight away he knew what had happened and turned back, he had also fallen the day before.


Aw, poor Charmian all wrapped up

We dressed the wounds and kept her warm, her helmet had a number of cracks in it. Any attempt to move her left arm or shoulder resulted in cries of pain, Charmian is a tough woman so this was quite a concern.  We were lucky that this section of road had a steady stream of mine traffic and one truck stopped and said he would go ahead and alert the Carabineros (the old Spanish word for Police that they still use in Chile) and the mine’s paramedic.  It was over and hour before our cavalry arrived in the form of a bumbling paramedic with a speech impediment, making the consultation quite difficult, especially as I was trying to act as translator.  He just got her arm and tried lifting it before he’d even asked where was painful.  Charmian and I got into the truck, our bikes piled in the back and Nathan cycled on ahead. It was around 18km to Chilcaya with the Carabinero’s station and the beginning of the Salar Sarire salt flats.  We arrived at the Carabinero’s station, the paramedic cleaned the wounds with saline and redressed them and we were told we would have to go down to the medical centre in the village of Putre.  The Carabineros drove us in their pickup, and on the way we passed Nathan, stopping to give piles of food and say our goodbyes.

Arriving in Putre the doctor assessed Charmian and said she must go down to Arica for an x-ray, she was given a pain relief injection.  The doctor said because it sounded like she had lost conciousness at some point that we should go in an ambulance.  Chile has health and safety rules just as precautionary as the National Health Service in the U.K and this ambulance trip meant poor Charmian being strapped to a stretcher, neck collar and head brace.  She was given I.V fluids in a drip during the journey. We had to pay up front for the treatment and ambulance and since we had not planned on being in civilisation in Chile we had no Chilean Pesos, they were kind and let us pay in US$.  The primary care treatment and ambulance trip was $50 which I thought was not too bad.  They also let me use their wifi so I could make a skype call to Charmian’s insurance company.

We arrived in the emergency department in the public hospital in Arica.  Here we had to wait an hour and a half to be triaged, amongst the other stretcher bound patients, there was one who looked as though he’d had a football injury, another I thought had been in a fight, and then there was the token drunk who when gaining conciousness got himself out of bed and stumbled out of the door never to be seen again.  Once triaged it was another hour and a half before we were taken to x-ray.

The waiting reminded me of the NHS at home but the only difference is that at home the waiting is a result of the staff being incredibly overwhelmed that they don’t even have enough time to go to the toilet or take a drink, here in Arica the doctors and nurses were spending more time flirting and the porters were standing around exchanging homophobic insults.  It was after mid night when we were finally given the x-ray results, there was no fracture, it must have been some muscle damage.  Charmian’s wounds were again dressed and she was given some I.V pain relief before we were sent away.  I think the only difference in the treatment was that at home if you’d hit your head then you would have been given an MRI scan as standard.  The Carabinero in  the hospital had been informed about the incident via the Carabinero’s in Chilcaya, we were told they had also informed the British Embassy.

By the time we got out of the hospital at 1am we were both shattered, we had not eaten or drunk anything since breakfast time and we were very grateful when a nice taxi driver took us to a decent hostal and helped us with our bags.

We were in Arica for 4 nights in total.  One day was filled with making the 7 hour round trip back to Putre to collect our bicycles that we had left in the medical centre.  This actually worked out fine as Jukka (from Finland whom I had ridden with for a number of months in Peru) was in town, we lunched together and he helped me with the bikes.  This journey to Putre had been delayed by a day as the first time I had attempted it I had not realised that Chile was on a different time zone to Bolivia, and I arrived an hour late at the bus station.

Arica felt like being in Europe, the pedestrianised shopping street reminded me of my home town and there was no indigenous people in sight. I have not been to the coast since leaving Cartagena, Colombia and my body has adapted to the lower oxygen levels that comes with being up so high, it was strange to be at sea level once more. I was at first quite overwhelmed with the prices everything was double the price of Peru and Bolivia, but then that comes with better stocked supermarkets and higher quality all round.  My experiences had been positive, and I had confidence in the public services.

Charmian was obviously disappointed as this would mean a number of weeks of the bike to recover.  She suggested I should keep riding and she would catch up via bus which sounded good to me. She would go back to La Paz which was a lot cheaper than Chile and resume her Spanish classes and do some touristy stuff. We made the plan that Charmian and I would both get the 8 hour bus to La Paz, I would get off at the border and ask the Carabineros to drive me back to Chilcaya where the fall had happened, and she would continue to La Paz.  I had contacted Cristian at the casa de ciclistas in La Paz and another cyclist had agreed to meet Charmian at the bus station and help her with her bags and bike.

The night before we had been due to get the bus we had booked a taxi, asking for one with space to take Charmian’s bike and help with her bags.  The following morning a regular car turned up and refused to take the bike, and no other taxis were available.  It was Sunday morning and the streets were deserted, but I run up and down trying to find a taxi when I saw a touring bike outside a greasy spoon cafe.  It was a German guy who’d been staying at the casa ciclistas back in La Paz.  I asked him if we found no other options if he could come and help us by riding Charmian’s bike to the bus station.  He did, and we made our bus.  I am so proud to be part of a community that helps one another out like this.

I got off the bus on the Chilean side of the border and those nice Carabineros gave me lunch and drove me the 120km or so back to Chilcaya.  It was late afternoon by the time I arrived back there and the Carabineros insisted I stay the night in the station rather than head off in the late afternoon, it was cold and windy outside and inside they were watching T.V in front of a log fire so it wasn’t a tough decision to stay.  Again, I ate a delicious meal with them and watched a lot of Chilean football league.  The following morning I got back on my bike and continued the route solo.






2 thoughts on “Ears popping in an ambulance, Charmian’s fall

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