Walking through the streets of Santa Cruz, Bolivia, is a journey through a cacophony of car horns, blaring inside an endless cloud of dust. The sizzle of barbecue and saltinas (something like a chicken soup empanada) beckons from sidewalks, and roaming dogs of all shapes and sizes offer a surprisingly warm welcome to this incredibly diverse country.
In some ways Santa Cruz resembles the urban sprawls of Nairobi or Accra or Tijuana. Roundabouts teem with crisscrossing vans, 4×4 vehicles, and brilliantly colorful 80’s Honda motorcycles. It’s chaotic to watch (or to try crossing the street), but somehow there is a method to the madness.
The Bolivian countryside offers a landscape kaleidoscope, sometimes resembling terrain familiar to Americans from western states (Zion National Park in Utah, or Hanalei Bay, Hawaii), sometimes taking your breath away with majestic, Montana-like mountain traverses, sometimes taking you back to a scene that could have come from the Greek countryside or the sculpted red rocks of northern Arizona’s Navajo country.
Now imagine all of that – and more – compacted into a country one and a half times the size of Texas. Mile after mile of sand and gravel roads connect these incredibly diverse scenes, taking you past small mining towns that resemble the 1800s Wild West in America, or into the heart of a landscape that seems far closer to Iceland or the Scottish Highlands.
An hours-long drive through red, Mars-like desert brings you to Uyuni, a small city at the edge of Bolivia’s iconic salt flats, an endless white sea of salt where sky meets earth – somewhere very far off in the distance. Space and time bend here; you feel suspended in a place between heaven and earth. Uyuni itself feels more like Star Wars’ Mos Eisley than an actual city. Half-built brick structures, Soviet-style industrial statues, hordes of boisterous dogs disrupting traffic, colorful markets, and parades of off-road trucks can make you feel you’ve landed in a Mad Max film. Life here is an adventure, sometimes a wild one. Bolivia is a wilderness that neither Che Guevarra nor Butch Cassidy could conquer.
Below the surface of these landscapes and urban scenes, there are deep cords of struggle. The vistas are beautiful, but the people are longing for deliverance from poverty and turmoil. On yardsticks measuring health, malnutrition, poverty, education, and other social conditions, Bolivia ranks near the bottom among Latin American countries.
Politics have hit Bolivia hard in the last few years, beginning with the 2019 ousting of President Evo Morales, and the COVID pandemic has damaged health and economic well-being, as it has everywhere. There are rising political tensions still; every city wall, it seems, is stamped, painted, or stenciled with the blue and while crest of the socialist party.
Now on to why I am in Bolivia. I do business development and outreach for Roadworks Collective and Latitude Recovery Center in Carlsbad, CA. We are establishing a partnership with NOVO Communities rehabilitation center and ministry here in Santa Cruz, exploring ways to make behavioral healthcare, addiction services, and treatment modalities available around the world. Bolivia is our first stop toward this ambitious goal. For the last two weeks I have been settled at NOVO Communities rehabilitation center, a whitewashed compound known as the “Quinta,” living with the guys at the program. Community meals, late night soccer tournaments (where I successfully ripped my new pants and twisted my ankle during a flying slide tackle on the colorful concrete), listening to the guys create poetry and worship songs to Jesus, playing with one of the many dogs living on the premises, making empanadas, and many late night Spanish-dubbed Alpha course videos and cheesy US actions movies are the norm here at the Quinta.
Last week I facilitated a group session with the men, sharing my own personal testimony of addiction, sobriety, and salvation. I answer any questions they may have for me during their daily therapy groups. I have also been participating in the clients’ relapse prevention plan groups.
As a developing country, Bolivia has few services like NOVO. A 2014 study of psychiatric care in Bolivia, published in the International Journal of Mental Health Systems, noted that alcohol abuse and mental health accounted for a large majority of hospitalizations, while the number of treatment facilities and licensed mental healthcare professionals was tiny. That report cited earlier research showing that substance abuse was the most frequently reported cause of admission to psychiatric hospitals in Bolivia, with “alcohol consumption…responsible for 90% of these admissions, in addition to being a major cause of deaths in traffic.”
I have had plenty of time to talk about all of this – with Oscar Hurtado, NOVO’s staff psychologist and a local professor, and with Bruno Ramirez, NOVO’s group facilitator and addiction counselor. They tell me that, as in many developing countries, there is still a cultural stigma around mental health care in Bolivia. More tolerant attitudes among younger people reduce stigma, but there are still very serious barriers to receiving care. Openly acknowledging you have mental health issues, and seeking care for them, is considered a sign of weakness to many Bolivians. And Bolivia does not provide good public health services, so those who can afford Oscar’s private therapy practice are usually wealthier and have structured established lives – unlike many poor and homeless people in need of dire care. Many Bolivians still visit shamans to address issues like alcoholism – including the alcoholic who recently phoned Bruno for help, ater a shaman failed to reduce his symptoms.
The center’s staff plan to visit churches and develop training courses for local pastors and congregations to identify and address addiction. The men working with NOVO’s clients say that many churches and pastors tend to over-spiritualize mental health issues. The NOVO team agrees that addiction treatment needs to be holistic – absolutely spiritual, but also psychological, social and emotional. Addicts don’t fall neatly into a single category, as the factors that lead to each individual’s addiction are unique. The odds of finding this type of individualized approach to addiction and mental health care elsewhere in Bolivia are slim to none.
David Salazar, NOVO’s onsite manager and milieu director, is known as “pastor” by the residents. He has a desk piled high with documents he is preparing to present to the United Nations Office on Drugs and Crime (UNODC) – the agency that recently visited NOVO. The center was also recently visited by Robin Shackell BEM, Deputy Head of Mission for the British Embassy in La Paz to discuss needs, accomplishments, and struggles.
David worked for many years running Christian summer camps for children in Bolivia. This weekend I went with him and the NOVO residents to Dios con Nosotros, a large local church here in Santa Cruz where David’s wife works as a counselor.
I have been out witnessing street outreach ministry with Lily Fluharty and her team at Anchor of Hope. Lily had big plans from a young age to open an orphanage, and after doors closed for her to travel to the African continent, she decided to come to Bolivia. An initial three month trip turned into 4 months, and she has now been in Bolivia for 10 years. They make daily rounds in the streets, pulling drug addicted children out of storm drains and off of curbs, inviting them to their community center and helping them find new life. At their center, the team provide devotionals from local pastors, community meals, mentorship and family counseling, connections to rehabs and other services, art classes, games, and competitions. Most importantly, they provide a safe, clean, family atmosphere for the street children to get away from the street life. Her team, Ellie Veldhuizen, Anelise Schrammen, and Romina Mendez have dedicated themselves to walking alongside these children in their struggles.
The Anchor of Hope staff were largely mentored by Lincoln Teceros, another NOVO staffer and leader of Conpasion, a veteran street outreach ministry in Santa Cruz. I’ve also gone out with Lincoln on a late night adventure through the Santa Cruz slums, reaching out and ministering to the city’s homeless and addicted population. Lincoln, Lily, and the others are the local rebel saints of Santa Cruz. Rarely do we meet such people that carry a fearlessness, willingness to take risk, and enter the darkest places. Their love is tangible as they roam the canals, internet cafes turned drug dens, the violent tent encampments in Santa Cruz or hostels turned into brothels and shelters littered with street children, high on glue and cocaine. The dark places they explore are the trauma, hurt, and neglect these people endure day in and day out. People like Lily, her team, and Lincoln are there on the front lines, literally sticking their hands into storm drains and pulling out children, providing them a tether, a relationship, a hope amidst the chaos.
I’ve also visited Alalay Foundation, a 30-year old organization and ministry, founded by Claudia Gonzales, that has housed and changed the lives of thousands of street children in Bolivia. Kids from ages 6 to 18 bounce around in fresh soccer jerseys donated by the Real Madrid Foundation, which has trained Alalay to educate the children through soccer camps. Each player wears a jersey naming a different value they are expected to uphold on the team – responsibility, unity, communication, emotional health. Classes are taught before each practice. Soccer camps are also used as outreach to the many addicted children living on the streets. At the homes run by Alalay, social workers and counselors coordinate with children’s families and teachers to ensure comprehensive long term care addressing trauma, addiction, sexual health, hygiene, emotional regulation, artistic expression, and vocational skills. Alalay has recently partnered with Many Hopes, a multi-national organization addressing vulnerable children across the globe.
I had the pleasure of attending the Trinity International Church, a small congregation with a mix of Bolivian families and ex-pats where Andy Partington, NOVO director, once was pastor. The current pastor delivered a powerful and apropos message on one’s identity in Christ as a chosen child of God, a message I will be sharing with the Quinta residents. Andy, like his father before him, is the former director of Yeldall Manor, a well known Christian rehab center in the UK. He’s adapted many of the therapeutic, addiction treatment and discipleship curriculums of Yeldall, to NOVO Communities here in Bolivia. Years of experience working in the Christian recovery world have given him a unique perspective on the Church’s role in alleviating this issue. We are both very excited to see how resources can be brought to more ministries and rehab centers abroad.
Overall, I have been thrilled and challenged connecting, partnering, sharing, documenting, photographing, and most importantly, participating in the diverse and multi-faceted network of ministries here in Santa Cruz, Bolivia.