Information trip notes Bolivia, travel Mountaineering, climbing trekking South America Infinito Sur Expediciones

Bolivia
Visa & Travel Advisories: Entry and exit requirements: A valid U.S. passport is required to enter and depart Bolivia. U.S. citizens do not need a visa for a stay of one month or less (that period can be extended upon application to 90 days). Visitors for other purposes must obtain a visa in advance. U.S. citizens whose passports are lost or stolen in Bolivia must obtain a new passport and present it, together with a police report of the loss or theft, to the Bolivian government immigration office in La Paz, Cochabamba, or Santa Cruz in order to obtain permission to depart. An exit tax must be paid at the airport when departing Bolivia. For further information regarding entry, exit, and customs requirements, travelers should contact the Consular Section of the Bolivian Embassy at 1819 H Street, NW, Suite 240, Washington, DC 20006; telephone (202) 232-4827/4828; or the Bolivian consulate in Houston, Los Angeles, Miami, New Orleans, New York, San Francisco, or Seattle.
MEDICAL FACILITIES: Medical care in large cities is adequate for most purposes but of varying quality. Medical facilities, even in La Paz, are not adequate to handle serious medical conditions, such as cardiac problems.
MEDICAL INSURANCE: U.S. medical insurance is not always valid outside the United States. U.S. Medicare and Medicaid programs do not provide payment for medical services outside the United States. Doctors and hospitals often expect immediate cash payment for health services. Uninsured travelers who require medical care overseas may face extreme difficulties.
Please check with your own insurance company to confirm whether your policy applies overseas, including provision for medical evacuation, and for adequacy of coverage. Serious medical problems requiring hospitalization and/or medical evacuation to the United States can cost tens of thousands of dollars. Most air ambulance services cannot fly into La Paz, as their aircraft must be pre-certified for landing and taking off at La Paz's airport, located at an altitude of over 13,000 feet (4,000 meters) above sea level. Please ascertain whether your insurance company will make payments directly to the overseas hospital or doctor or whether you will be reimbursed later for expenses that you incur. Some insurance policies also include coverage for psychiatric treatment and for disposition of remains in the event of death. Useful information on medical emergencies abroad, including overseas insurance programs, is provided in the Department of States Bureau of Consular Affairs brochure, "Medical Information for Americans Traveling Abroad," available via the Bureau of Consular Affairs home page or fax: (202) 647-3000. .

Health & Vaccinations: Food and waterborne diseases are the number one cause of illness in travelers. Travelers' diarrhea can be caused by viruses, bacteria, or parasites, which are found universally throughout the region and can contaminate food or water. Infections may cause diarrhea and vomiting (E. , Salmonella, cholera, and parasites), fever (typhoid fever and toxoplasmosis), or liver damage (hepatitis). Make sure your food and drinking water are safe (see below).
Malaria is a preventable infection that can be fatal if left untreated. Prevent infection by Bolivia.
A certificate of yellow fever vaccination may be required for entry into certain of these countries.
HEALTH INFORMATION: Information on vaccinations and other health precautions may be obtained from the Centers for Disease Control and Prevention's hotline for international travelers at 1-877-FYI-TRIP (1-877-394-8747); fax: 1-888-CDC-FAXX (1-888-232-3299).
HIGH-ALTITUDE HEALTH RISKS: Prior to departing the U.S. for high-altitude locations over 10,000 feet above sea level, such as La Paz, travelers may wish to discuss the trip with their personal physician and request information on specific recommendations concerning medication and lifestyle tips at high altitudes. Although coca-leaf tea is a popular beverage and folk remedy for altitude sickness in Bolivia, possession of these tea bags, which are sold in most Bolivian grocery stores, is illegal in the United States.
Official U.S. Government travelers to La Paz are provided with the following information: The altitude of La Paz is over 13,000 feet (4,000 meters) above sea level. The altitude alone poses a serious risk of illness, hospitalization, and even death, if you have a medical condition that affects blood circulation or breathing.
The State Departments Office of Medical Services does not allow any official U.S.
If you visit the Andes Mountains, ascend gradually to allow time for your body to adjust to the high altitude, which can cause insomnia, headaches, nausea, and altitude sickness. In addition, use sunblock rated at least 15 SPF, because the risk of sunburn is greater at high altitudes. Government travelers to visit La Paz if they have any of the following:
- Sickle cell anemia or sickle cell trait: 30 percent of persons with sickle cell trait are likely to have a crisis at elevations of more than 8,000 feet.

- Heart disease: A man 45 years or older, or a woman 55 years or older, who has two of the following risk factors (hypertension, diabetes, cigarette smoking, or elevated cholesterol) should have a stress EKG and a cardiological evaluation before the trip.
- Lung disease: Anyone with asthma and on maximum dosage of medication for daily maintenance, or anyone who has been hospitalized for asthma within the last year should not come to La Paz.
All people, even healthy and fit persons, will feel symptoms of hypoxia (lack of oxygen) upon arrival at high altitude. Most people will have increased respiration and increased heart rate. Many people will have headaches, difficulty sleeping, lack of appetite, minor gastric and intestinal upsets, and mood changes. To help prevent these complications:
- Consider taking acetazolamide (Diamox) 125 mg twice a day, starting two days before traveling, on the day of the trip, and two to three days after arriving at high altitude. This medication inhibits the enzyme carbonic anhydrase, has a slight diuretic effect, and stimulates respiration. It is available only by prescription in the U.S. Pregnant women and nursing mothers cannot take Diamox. If you have a severe allergy to sulfa, you may not be able to take Diamox.
- Avoid alcohol and smoking for at least one week after arrival in La Paz.
- Limit physical activity for the first 36 to 48 hours after arrival in La Paz.
For those with diabetes, only the blood glucose meter called One Touch II works properly at altitudes over 6,000 feet. Other models give incorrect readings of blood sugar levels.
SLEEP DISTURBANCE: "A common occurrence during sleep at high altitude is periodic breathing, a condition in which the sleeper stops breathing every cycle. At sea level, this is a serious problem, and it will get you sent to a hospital. At high altitudes, it is a common condition that causes worry for tent mates who initially think that the other person has died. The quality of sleep at high altitude is poor, with more arousals lead to a person waking up while in the middle of a dream; hence, dreams often appear more vivid that at sea level."
(Bolivia a Climbing Guide by Yossi Brain).

ACCLIMATIZATION: "The Bolivian Andes are considerably higher than the Rockies or the Alps, and acclimatization; indeed, fit young men appear to have more problems than other people,
The majority of people feel ill on arrival in La Paz. This is commonly called soroche. Visitors occasionally collapse while carrying their luggage from the arrival lounge of the airport. Common symptoms of mild altitude sickness include breathlessness, a racing pulse, lethargy, tiredness, inability to sleep, loss of appetite, headache, and dehydration. These symptoms normally last for a couple of days.
The U.S.Embassy in La Paz recommends that people who fly directly to the city's 4058m/13313 ft airport from sea level should take acetazolamide (Diamox) prophylactically-preferably via sustainable-release tablets. Acetazolamide speeds up acclimatization by acidifying the blood, which increases respiration.
CDC Recommends the Following Vaccines (as Appropriate for Age):
See your doctor at least 4-6 weeks before your trip to allow time for immunizations to take effect.
"Hepatitis A or immune globulin (IG).
"Hepatitis B, if you might be exposed to blood (for example, health-care workers), have sexual contact with the local population, stay 6 months in the region, or be exposed through medical treatment.
"Rabies, if you might be exposed to wild or domestic animals through your work or recreation.
"Typhoid, particularly if you are visiting developing countries in this region.
"Yellow fever vaccination, if you will be traveling outside urban areas.
"As needed, booster doses for tetanus-diphtheria and measles.
To Stay Healthy, Do:
"Wash hands frequently with soap and water.
"Drink only bottled or boiled water, or carbonated (bubbly) drinks in cans or bottles. Avoid tap water, fountain drinks, and ice cubes. If this is not possible, make water safer by BOTH filtering through an "absolute 1-micron or less" filter AND adding iodine tablets to the filtered water. "Absolute 1-micron filters" are found in camping/outdoor supply stores.

"Eat only thoroughly cooked food or fruits and vegetables you have peeled yourself. Remember: boil it, cook it, peel it, or forget it.
"If you will be visiting an area where there is risk for malaria, take your malaria prevention medication before, during, and after travel, as directed. (See your doctor for a prescription.)
"Protect yourself from insects by remaining in well-screened areas, using repellents (applied sparingly at 4-hour intervals) and permethrin-impregnated mosquito nets, and wearing long-sleeved shirts and long pants from dusk through dawn.
"To prevent fungal and parasitic infections, keep feet clean and dry, and do not go barefoot.
"Don't eat food purchased from street vendors.
"Don't drink beverages with ice.
"Don't eat dairy products unless you know they have been pasteurized.
"Don't share needles with anyone.
"Don't handle animals (especially monkeys, dogs, and cats), to avoid bites and serious diseases (including rabies and plague).
"Don't swim in fresh water. Salt water is usually safer.
What You Need To Bring with You:
"Long-sleeved shirt and long pants to wear while outside whenever possible, to prevent illnesses carried by insects (e.g., malaria, dengue, filariasis, leishmaniasis, and onchocerciasis).
"Insect repellent containing DEET (diethylmethy ltoluamide), in 30percent-35percent strength for adults and 6percent-10percent for children, as well as a bed net impregnated with the insecticide permethrin. (Bed nets can be purchased in camping or military supply stores.) Bed nets may also protect against insect bites that transmit Chagas disease.
"Over-the-counter antidiarrheal medicine to take if you have diarrhea.
"Iodine tablets and water filters to purify water if bottled water is not available. See Do's above for more detailed information about water filters.
"Sunblock, sunglasses, hat.
"Always use condoms to reduce the risk of HIV and other sexually transmitted diseases.
"Prescription medications: make sure you have enough to last during your trip, as well as a copy of the prescription(s).

After You Return Home:
If you have visited an area where there is risk for malaria, continue taking your malaria medication weekly for 4 weeks after you leave the area. If you become ill with a fever--even as long as a year after your trip--tell your doctor that you traveled to a malaria-infected area.
MOUNTAIN TREKKING AND CLIMBING SAFETY: U.S. citizens are advised to exercise extreme care when trekking or climbing in Bolivia. If reasonable precautions are taken, mountain trekking and climbing in the Bolivian Andes can be a safe and enjoyable way to experience the countryside and culture. Travelers should inquire about conditions in the high country before leaving La Paz
Many popular trekking routes in the Bolivian Andes cross passes as high as 16,000 feet. Trekkers must have adequate clothing and equipment, not always available locally, and should be experienced mountain travelers. It is not prudent to trek alone. Solo trekking is the most significant factor contributing to injuries and death. Trekkers have been robbed on popular routes, most notably on the Illampu circuit, and are more vulnerable when alone. The safest option is to join an organized group and/or use a reputable firm to provide an experienced guide and porter who can communicate in both Spanish and English.
There are few telephones in remote areas of Bolivia. Make sure others (especially family and friends in the United States) know your trekking itinerary. The U.S. Embassy strongly encourages trekkers and climbers to register upon arrival in Bolivia. A registration file with your passport information, emergency numbers and travel itinerary is very useful if the Embassy needs to relay emergency information from home or locate you in case of a natural disaster or evacuation.
TRAFFIC SAFETY AND ROAD CONDITIONS: While in a foreign country, U.S. citizens may encounter road conditions that differ significantly from those in the United States. The information below concerning Bolivia is provided for general reference only, and may not be totally accurate in a particular location or circumstance.
Safety of Public Transportation: poor
Urban Road Conditions/Maintenance: poor
Rural Road Conditions/Maintenance: poor
Availability of Roadside Assistance: poor.

Road conditions in Bolivia are extremely hazardous. Although the major population centers of La Paz, Santa Cruz, and Cochabamba are connected by improved highways, less than five percent of all roads in Bolivia are paved. For trips outside the major cities, especially in mountainous areas, a four-wheel-drive vehicle is highly recommended. Travel during the rainy season (November through March) is extremely difficult, as most routes are potholed, and many roads and bridges are washed out. Added dangers are the lack of formal training for most drivers, lack of lights on speeding vehicles at night, and drunk drivers, including commercial bus drivers. Fatal crashes, fender-benders, and car/pedestrian accidents are commonplace.
For additional general information about road safety, including links to foreign government sites, see the Department of State, Bureau of Consular Affairs home page at http://travel.state.gov/road_safety.html.
AVIATION SAFETY OVERSIGHT: The U.S. Federal Aviation Administration (FAA) has assessed the Government of Bolivia Civil Aviation Authority as Category 2 not in compliance with international safety standards for oversight of Bolivia's air carrier operations. While consultations to correct the deficiencies are ongoing, Bolivia´s air carriers are permitted to conduct limited operations to the U.S. subject to heightened FAA surveillance. For further information, travelers may contact the Department of Transportation within the U.S. at 1-800-322-7873. The U.S. Department of Defense (DOD) does not permit its personnel to use air carriers from Category 2 countries for official business except for flights originating from or terminating in the U.S. For information regarding the DOD policy on specific carriers, travelers may contact the Pentagon at 1-703-697-7288.
CUSTOMS REGULATIONS: The Bolivian Government has very strict laws concerning attempted theft or removal from Bolivia of any item that it considers to be a national treasure. The Bolivian and U.S. Governments are currently completing renewal of a cultural property protection agreement. In addition to the traditional examples of pre-Columbian artifacts, certain historical paintings, items of Spanish colonial architecture and history, and some native textiles, the Bolivian Government also considers certain flora, fauna, and fossils as national treasures. It is illegal to remove any such items from Bolivia without prior written permission from the appropriate Bolivian authority. Any type of fossil excavation, even picking up a fossil, without prior written authorization from the appropriate Bolivian authority, is also illegal. Violation of the law can result in lengthy jail sentences and fines. Contact the Embassy of Bolivia in Washington or one of Bolivias consulates in the United States for specific information regarding customs requirements.

CRIMINAL PENALTIES: While in a foreign country, a U.S. citizen is subject to that country's laws and regulations, which sometimes differ significantly from those in the United States and may not afford the protections available to the individual under U.S. law. Penalties for breaking the law can be more severe than in the United States for similar offenses. Persons violating Bolivian laws, even unknowingly, may be expelled, arrested or imprisoned.
Penalties for possession, use, or trafficking in illegal drugs in Bolivia are strict and convicted offenders can expect lengthy jail sentences and fines. Incarcerated persons can expect to wait longer than two years before being sentenced. Prison conditions are very primitive and prisoners must pay for their own room and board.
OTHER LEGAL ISSUES: It often takes years to reach a decision in Bolivian legal cases, whether involving property disputes, civil, or criminal matters. The court sometimes orders a defendant held in jail for the duration of the case. Lists of local Bolivian attorneys and their specialties are available from the Consular Section of the U.S. Embassy in La Paz and the U.S. Consular Agencies in Santa Cruz and Cochabamba. Civil marriage in Bolivia of U.S. citizen non-residents to Bolivians is possible if all documentary requirements are met. The Bolivian potential spouse should check with the Office of the Civil Registry in La Paz at (591) 2-316-226 to determine what documents are required. An affidavit that the U.S. citizen is single is required and may be notarized at the U.S. Embassy. The U.S. Embassy does not, however, authenticate U.S. civil documents, such as birth certificates, for local use. All required U.S. documents must be translated and authenticated by a Bolivian consular officer in the United States.
EMBASSY LOCATION: U.S. citizens living in or visiting Bolivia are encouraged to register at the Consular Section of the U.S. Embassy in La Paz and obtain updated information on travel and security in Bolivia. The Consular Section is open for citizen services, including registration, from 8:30 a.m. to 12:30 p.m. weekdays, excluding U.S. and Bolivian holidays. The U.S. Embassy is located at 2780 Avenida Arce in La Paz; telephone (591) 2-433-812 during business hours (8:30 a.m. to 5:30 p.m.), or (591) 2-430-251 for after-hours emergencies; fax (591) 2-433-854. There are also U.S. Consular Agencies in Santa Cruz and Cochabamba, which are open weekday mornings from 9:00 a.m. to 12:00 noon, excluding U.S. and Bolivian holidays. The Consular Agency in Santa Cruz is located at Calle Guemes 6, Barrio Equipetrol; telephone (591) 3-363-842 or 3-330-725; fax (591) 3-325-544. The Consular Agency in Cochabamba is located at Avenida Oquendo 654, Torres Sofer, Room 601; telephone (591) 4-256-714; fax (591) 4-257-714.