My kingdom for a toilet roll…

Who’d have thought that toilet paper would become a preoccupation on our travels? In most of the countries we visited we were instructed not to throw toilet paper down the toilet. We got used to this, sort of…

Often there was no toilet paper provided where you might expect it. In some places the paper was outside the cubicles, in the place where you wash your hands. (Someone outside could pass it under the door if necessary.) Elsewhere, a few sheets were sold to you, along with the toilet entrance fee of 1, 2 or 3 sols, bolivianos or pesos – fees proportional to the distance to the next usable public toilet.

Eventually we stole wads of hotel paper; my left trouser pocket bulged with tissues. In one place, a notice explained that South American toilet paper was not biodegradable unlike that in other countries, but it seems more likely it is something to do with the plumbing.

In pre-toilet-tissue days (many of you have repressed this memory) we had squares of newspaper – or worse, magazine pages – hanging by a string in the outhouse. This didn’t work all that well. I think this explains my current toilet paper obsession – I like to have at least 18 spare rolls at home.

Our very best South American toilet was a hole in the ground, fronted by a tarpaulin for modesty, into which we could drop our used paper etc. and cover it up with the dirt dug out to make the hole.

This was prepared by the thoughtful porters who accompanied us up the Lares Trail (Peru), breathlessly over the 4200m summit. Which brings me to the altitude – another fixation. Why are so many major South American cities built so high up? Bogota in Columbia is at 2582m (8471 feet), Quito (Ecuador) is higher at 2,850m (9350 feet).

Cusco near the Sacred Valley is about 3100m and amazing La Paz is 3,640m. We hyperventilated up the streets of these cities, stopping often to take a really deep breath. The air being dry and cold meant my nose clogged up making breathing more of a challenge and, requiring even more toilet paper to blow it.

We took our altitude sickness pills and avoided getting ill. The pills work this way: because you are breathing more deeply and frequently to get sufficient oxygen, you blow off more than the usual amount of carbon dioxide. CO2 dissolved in your blood forms a weak acid and if there is less of it your blood becomes alkaline.

This gives you the headache, dizziness and nausea, symptoms of  “acute mountain sickness”. Acetazolamide (Diamox), the usual altitude sickness medication, makes the blood more acid again (metabolic acidosis) to return it to the usual PH. Eventually the kidneys manage this acid-base change, so after a few days you can stop taking the pills. But you don’t stop being short of breath.

La Paz was developed on the site of an Inca city and on an Inca trading route, Quito has been occupied since around 8000 BCE and Bogota was founded by the indigenous Muisca people a millennium before the Spanish arrived around 1500. These high cities are there because they’re there.

We saw the president of Bolivia run to his car in La Paz and listened to our guides debate their Government’s performance. It seemed healthy, democratic… In Ecuador and Colombia they were pleased with their new stable governments, but in Peru they complained about corruption. It was a relief to get down to sea level in beautiful Buenos Aires, where walking is easy and your energy returns in leaps and bounds, but the Argentinians seemed unhappy with their government.

We are two fit ladies, each in our 70th year. We are both a bit deaf making understanding our guides difficult. We are too slow to learn much Spanish beyond hello, goodbye – and where is the bathroom?

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Specialist Psychiatrist and Clinical Advisor to Dementia Auckland. Old Age Psychiatrist and Dementia. Auckland Clinical Services Advisor.