As the group walks though the overly packed streets of El Alto, I remember that first day looking down on the shanty town from the airplane. I am walking among the poorest of the poor and the most forgotten people. The streets are lined with blue carts each cart identical selling exactly the same trinkets. The telephone poles are tangled with hundreds of wires going every which way. Now it is all so real, the campesino women trying to make their daily profit, the indigenous people, the street kids. They live in hell and do whatever they can to survive.

            Our group is a mix of Asians and Americans. We stick out like a sore thumb among the Bolivian people. I continuously take deep breaths of thin, heavily-polluted air. We walk along the choked streets and dart between the thousands of cars and minibuses that roam El Alto. With us, we have brought a garbage bag filled with bread rolls, a large bag of sliced meat, mayonnaise, and ketchup. There are thousands of people here who need food, only a lucky fraction will receive some from us. Dr. Huang and Michael, who is our “street guide”, lead us to a gathering of benches between two street vendor carts. Emma, a third-year medical student and Kaya volunteer from the UK, goes over to a street boy who looks no older than 11 and tries to start a conversation. I look at the boy and notice his eyes are glassy and unfocused. He is high, probably on paint thinner. Emma tells us that this boy ran away from one of the homes provided by Kaya. Many people are unable to understand why kids who have the chance to live in a home with three meals a day would choose to remain on the streets where the chances of survival are slim. The answer: freedom. On the streets, the kids can do what they want and say what they want; they control themselves. When the kids come into a home, they enter a family—a family with rules and structure. In the homes provided by Kaya, the kids have chores to do, schoolwork to complete, and “parents” to obey.

            Emma has come often to the streets with Dr. Chi while her stay in Bolivia to treat street kids. A man comes over to her. His mouth is covered with a piece of paper. When he lowers the paper, we see his lip. It is two times bigger than it should be and there is an open wound on the inside part of his lip. She explains that his sort of wound is common and is caused by an allergic reaction to paint thinner. After she gives him medicine to take, she finds a boy who she had been treating since the beginning of her stay. The teenage boy has two slits on the base of the left side of his neck. Emma tells us that the boy was stabbed through his neck by a knife. The two slits are where the knife went in and where the knife came out. She starts pushing the pus out from the wounds with her bare hands. Although using bare hands is dangerous, using gloves would be offensive. She continues to squeeze. I look at the boy’s face. He shows little emotion of pain or delight, he just endures it. The street kids realize they can choose between either a little more pain or death.

            We form an assembly line to make sandwiches. One cuts the bread, another spreads mayonnaise, another spreads ketchup, another puts the meat on, and the rest distribute them. The meat looks inedible. Very little of the slice is red, most is fat and specks of mysterious brown. I am glad I will be eating spaghetti tonight. At first, we try to give them to the younger children, but soon we give them to the first person we spot. Multiple times, people would come back to us with their bread and ask “Mayonesa por favor.” Every time I look at a street kid I always think about their future. “What will become of him?” or “What will she be doing in a few years?” I cannot let myself think of the worst.

            When all the bread rolls have been eaten, Dr. Huang leads us to a bridge. When we walk under the bridge we run across to a strip of grass and dirt enclosed in a green and yellow metal fence. On the pillars supporting the bridge are burn marks from violent attacks from the police and graffiti. We have to watch our step so we don’t step into the human feces scattered on the ground. There is a cluster of small, white bottles. These bottles were filled with paint thinner earlier this week. Between a pillar and the fence there is burnt, torn up futon. Dr. Huang tells us that as many as twenty street kids pile up here to keep warm each night. Surrounding them are their dogs who protect them from the police and others who plan on harming them.

As we walk back to where our taxis are waiting, I feel like I am in a horrible dream. I keep on trying to imagine what the kids have to go through everyday just to live.

The next few days fly by as we are busy teaching the boys whiffle ball, the solar system, and art and crafts. Everyday the boys show me a new side of life, a side so simple I had been missing it my whole life, but a side that makes all the difference in the way I view life. The boys gave me a new purpose.

At the end of the trip, Dr. Huang asks, “So, is El Alto, Bolivia the real world, or is America the real world?” I’ll let you decide.