Househunting in Batuco

Yesterday we drove around Lampa and Batuco again in search of house options. I should say in search of liveable house options.  We have a very small budget to play around with but we have to use the subsidio or we will lose it,  We have had to come to terms with the fact that we will either get the land but not the house, or we will get a semi-properly constructed house but not the space. Yesterday was pretty dismal. To recap:

House 1 – refused to be viewed. Owner said the only option was to buy it based on how it looked from the road. Then he abruptly disappeared. This attitude has been pretty consistent with our experiences so far, with people barking “just look from the road” down the phone or hanging up because they can’t be bothered going through the effort of showing someone the house. This goes back to customer service in general here, which I have pointed out a few times: it just doesn’t exist.

House 2 – was completely enclosed. The entrance was a wire cage and the sitting area was completely windowless and dark. There was not a spec of light anywhere in the house. The yard was also enclosed and flled with junk all balancing precariously on top of one another. You reached the top floor via a steep staircase that was completely exposed to the elements. I left this one feeling incredibly depressed because I was struggling to find any redeeming qualities, or even common ground with the owner. I just cannot understand who would want to live like that? It couldn’t be for a lack of money as the entire house was outfitted in quality goods and flat screen televisions. I just don’t get it.

House 3 – this mood persisted with the third house, that had a lot of land but a barely-there house. We didn’t enter this one, just looked from the road as the elderly gentleman who lived there never came to the door. This one almost made me cry. Absolutely everywhere I looked was filled with mountains of junk: in front of the house, to the side of the house, in the house … one would barely be able to squeeze through the gate because of all the rusty chair frames, broken toys, tyres, metal sheets etc. This was clearly the home of a hermit who ( I deduced in a moment of Freudian expertise) was burying himself away from the world. Luis agreed that he maybe had some issues, but the unfortunate fact is that EVERYWHERE we looked we witnessed this same thing. People are not throwing broken things away, instead just pile them up in mountains in their gardens to spoil beneath the rain, wind and sun. Beautiful spaces of green are spoilt by paper and plastic rubbish, ruining what would be lovely surroundings. What is going on here??

House 4 – we suddenly left the dusty streets of what I had assumed was all of Batuco and entered a poblacion, a residential area where all the houses looked the same. The roads were narrow and busy, and there was row after row of white, 2-storey houses. House 4 was built relatively well and would only need minor tweaking. The living space was small but the bedrooms and kitchen were large, and there was plenty of space outside to make a patio and tiny garden. The house was behind a fence and the street was gated. We could easily see ourselves living there and it was well within our budget, with room to spare to make the minor adjustments it needed. We looked up and the air was clean and clear. But the area was not so good, we had to admit. Flaites do seem to exist everywhere. We will probably buy this house, but I highly doubt I’ll want to make the commute to Santiago every day. It feels very, very far away.

House 5 – we didn’t enter. It was in Lampa, a small town that I really like. I get good vibes in Lampa. But the house we saw had no outside space, the area was very poor, and we saw people selling pasta base. Nearby was house 6 but we couldn’t go in as it is occupied by renters, who were very rude to us and the owner said were likely to make problems about leaving.

So there you go! We desperately want to get out of the city and into the fresh air. Maybe plant some veges. We are going to look at Melipilla next, which is much further away but a nicer area. It’s a scary thought to think about living somewhere else, especially with a toddler. It makes me realise how much of a home we have made for ourselves in Recoleta, the barrio I hated at first but have now come to love. I’d be very interested in hearing anyone’s stories about their big move, especially if its to someplace away from Santiago. So get commenting!

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Sojourn to Lampa

Anyone who reads this blog will realise how much I love living in Santiago, my home of two years and three months. However, it is an unrelenting city in that it’s summers are brutal, the costs are sky high and in winter it becomes a playground for happy germ families (seriously, the metro in winter is filled only with sick people).  The smog that looms as an oppresive blanket over the city is an issue every summer and winter, when anything faster than a casual stroll will leave you struggling to find a breath.  Coupled with the lack of greenery (in the suburbs we can afford) and open spaces, and it all can become quite concerning when you are the parent of a small child.

Luckily, Emilio hasn’t struggled with anything too serious, although he has had a chest infection that saw him suffer through an inhaler strapped to his face, and he’s had croup dozens to times that has forced us into the hospital’s emergency department on numerous occasions (always a fun experience).  But we do worry about him, and we both desire a garden and a life slightly outside the city.

Luis has received the subsidio, which is basically like a government top up to your savings so that you can buy your first home (you don’t pay it back but must live in the property for 5 years). Our options are limited because we don’t have alot and Santiago is pricey everywhere (even in Recoleta). We also need to make sure that we can commute into the city because that is the only place where there may be work for me as an English teacher, and Luis would still be driving the taxi. The villages on the north of Santiago’s periphery make good options as the land is very cheap and they are much closer than anything to the south (Lampa by car on a good day is only 30 minutes drive from Recoleta, for example). So last week we dropped off Emilio at the suegros and borrowed a car to have a look at our options.

It was a glorious day.  The sun was shining brightly and the sky was a deep, endless blue that seemed close enough to touch. In this kind of sunlight even the ugliest of things are transformed into pieces of unbelievable beauty and we felt this strongly as we left the city, our hopes soaring high.

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 Looking out over Huechuraba

This high ended the moment we got stuck in traffic at the Pedro Fontova Norte exit, where we were stuck for a few days (a wee joke but it felt like it!). It is when you leave Santiago that you realise just how staggeringly huge it is. It really shakes up the little bubble of existence ALL of us build when you drive by so many different homes and suburbs. I like to imagine myself stepping into their shoes and living in their lives for a day.

So a few years later (!) and we finally arrived in Batuco.  Driving over a little river was almost an emotional moment for me as it seems like forever since I’ve seen water that’s not the Mapocho (kiwi’s are used to being near the sea!).  Batuco is a dusty village with quaint houses, flowers in full bloom and fences that are interspersed with green vines. The things I have come to expect from a Chilean settlement are also present: barking street dogs, swarthy youths in fake sports labels and something that always brings tears to my eyes … fields filled with litter. I don’t what that is about, do you? Who sees a beautiful, lush slice of greenery and thinks it would make a perfect dumping ground?  All the sides of the roads were lined with cardboard and plastic as well. It was really disappointing.

We looked at a few houses and all of them refused the subsidio. Why? Because all of them were built by a process known as autoconstruccion, whereby the houses have been built by the owners and often have not been through the usual legal channels. Many actually built by the subsidio as well but, as numerous owners told us, the reality of selling their homes along this channel means endless delays, checks and paperwork that the majority of them simply don’t have. You can learn more about this process here

I think sometimes people in Santiago forget or simply don’t realise the truth about many of the houses here. In all of the ones that we visited that day, and in many of the houses I have entered in Santiago, the construction has been lacking. Often walls are paper thin, windows are not double glazed or even sealed, there are cracks in walls, and openings to the sky beyond around the ceiling. Most of the houses are tiled and so freezing that it is really no wonder that sickness spreads like wildfire here.  In saying that, even these poorly built buildings are strong enough to withstand earthquakes. Two nights ago there was a magnitude 7 earthquake in Santiago (8.4 in its epicentre in the north) and everything is still standing. What I find more concerning regarding the safety of homes is that whenever there is rain everything floods, and the slightest puff of wind sends bits flying (I once watched as a particularly strong gust blew a huge piece of my neighbour’s roof away into the horizon – what became of it I never found out).

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A flood-prone city

Anyway, we ate a rather miserable lunch on the outskirts of Lampa and drove past a huge swamp that’s also an ecological reserve (and I bet a haven for birdlife!).  There is a zoo with a good reputation in Lampa that I hope to one day check out, and generally its a nice little town with spectacular views of planted fields, stark hills and the Andes (but a different part to what we are used to – exciting!). We had no joy with our house hunt but I can’t think of a better place to live than Lampa – it really was like a slice of paradise!

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Lampa

An Introduction to Musica Latina

A post on The Chile Experience Facebook page about favorite songs has got me thinking about the most iconic music to come out of Chile. I have always listened to Latin Music, ever since I was about 12 and bought my first Ricky Martin CD then decided no more singing in English for me. This is a list of the must listen to songs that I can think of now, to introduce you to the musical wonders of Latin America, and the diverse spectrum of Latin Music.  By no means is this list extensive, it is just small slice of the amazingness that can be found here!

Chile:

  1. La Constentida: Traditional Cueca song – its Fiestas Patrias after all!
  2. Todos Juntos by Los Jaivas
  3. El Verdadero by Tiro de Gracia
  4. Te Vas by Americo
  5. Buen Soldado by Francisca Valenzuela
  6. Quiero Ser Libre by Grupo La Noche
  7. Loca by Chico Trujillo
  8. Gracias por la Vida by Violetta Parra
  9. Canto Libre by Victor Jara
  10. Estrechez de Corazon by Los Prisoneros

Latin America:

  1. El Secreto by Plan B
  2. Gasolina by Daddy Yankee
  3. Ojala by Silvio Rodriguez
  4. Tic Tici Ta by Carrapicho
  5. Latin America by Calle 13
  6. Danza Kuduro by Don Omar
  7. Amor de Madre by Aventura
  8. Corazon sin Cara by Prince Royce
  9. Colgando en tus Manos by Carlos Baute
  10. Me Gustas Tu by Manu Chau
  11. La Vida es un Carrnival by Celia Cruz
  12. Fico Assim Sem Você by Adriana Calcanhotto.

NOTE: to be fair, Los Prisoneros deserve a post all of their own  – their music is wonderful and provides an interesting snapshot into Chile. Check out Corazones Rojos, to see how they captured and twisted the machista attitude. For another excellent song that seems more like a poem than a song, is “Mazurquica Modernica” by Violetta Parra. A must-listen!

Paranomormal Chile Top 7

I love anything that is out of the ordinary.  So when I read today that “Chile is one of the few countries on earth that has a government-supported UFO research organization” (Journey Latin America), I thought I would compile my top picks for the adventurous traveller.  Here we go!

1). El Enladrillado

This is an elevated spot so well-known for “UFO landings” that numerous books argue that its smooth volcanic slabs are too perfectly cut to be made by our mortal hands.  It now forms part of San Clemente’s “UFO Trail” which opened in 2008 and takes in several sights of the Reserva Nacional Altos de Lircay, including Colburn Lake.  Read more here

2). Cochiguaz

Lonely Planet describes this secluded spot in the Elqui Valley as Chile’s new-age hotspot.  This is a spot that is said to be continually haunted by the extraterrestrial, as well as home to numerous powerful leylines and assorted cosmic energies. This is a great spot in nature as it is little visited unlike the rest of the Elqui Valley, and the numerous therapies on offer mean that it is an unbeatable location to unwind and relax.

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3). Valle del Encanto Petroglyphs

A stroll through this secluded and quiet landscape will introduce you to numerous Chilean flora and fauna, as well as many excellently preserved pre-Colombian rock drawings, many of which depict non-human entities. There are also giant slabs filled with holes known as tacitas.  The valley is located outside of Ovalle.

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4). Geoglifos Chug Chug

Worth a visit if you make it to San Pedro de Atacama, these geoglyphs are believed to depict a visitor from another planet.

5). El Gigante de Atacama

Located east of Iquique, this sight is said to be the largest representation of a person in the world and is said to date back to AD900. It has an owl-like head with vertical rays reaching to the sky and bears an appearance of shock.

6). San Pedro Mummies

The world’s oldest mummies can be found in Museo Arqueológico de San Miguel de Azapa, and date to BC7200.  For photos, have a look here.

7). Museo Precolombino de Arte, Santiago

Definately worth a visit to make up your own mind about whether South America’s original people were visited by extraterrestials. The museum is excellent.

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10 Common Misconceptions about Chile … and 10 Reasons to To Visit!

The Misconceptions:

  1. If your expecting bronzed and oiled butt cheeks on show at the beach, you may be disappointed. For thong-spotting, you’d be better served in Brazil.
  2. Similarly, you will be surprised to find Chilenas do not possess “mamacita” hourglass figures. Try Colombia.
  3. If your after tropical days and warm beaches, you will be baffled by Chile’s freezing cold waters and icy breezes. Maybe Ecuador?
  4. If your idea of culture is panpipes and ponchos, you will find them in Bolivia.
  5. There are no archaelogical sites of great mention. The best options are in Peru.
  6. Ready to dance the night away to salsa? Not all Chileans like to dance and when they do its usually to cumbia, reggaeton or rock.
  7. Think Latin America and spicy food? Bar pebre and merken (both sublimely delicious!), Chilean food tends towards salty or sweet, rather than picante.
  8. The reality: Santiago is a costly place to live
  9. Downtown Santiago is like a suburb of Sydney rather than the South American fantasy you may be picturing (but the mountains are extraordinary)
  10. It can be a pain in the butt to travel – Chile is HUGE!

The Reasons to Love:

  1. Spectacular vistas, from the extreme and arid landscapes of the desert to the utterly breathtaking and surreal open spaces of Patagonia
  2. Birds. It may not have a jungle, but Chile possesses a remarkable array of bird life making it a wonderful visit for ornithologists
  3. Stability. A thriving economy means that there are exceptional services from education to healthcare (if you pay – public leaves alot to be desired), and many work opportunities
  4. Lush and green spaces, tranquil and clear lakes, and friendly people in the south of Chile
  5. Its easy peasy to find work even without a TEFL or a valid visa!
  6. Wine, wine and more wine. This blog is excellent for more information
  7. If your interested in the unexplained, Chile has oodles of paranormal sights for you to see
  8. Outside of the main tourist spots, many places are relatively untouched by visitors.
  9. A vast diversity in culture from the Andean, the Mapuche and the lingering traces of the Fuegians
  10. This is a country that has inspired award-winning poets, writers and musicians over the years, and that are today still beloved by young and old.  Why not come and see what all the fuss is about?
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Ornithologist’s paradise
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Cochiguaz, Chile’s UFO capital
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In Monte Grande, birthplace of the beloved Gabriela Mistral
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Ancient rock drawings in Ovalle

E’s Ordeal in a Santiago (Public) Hospital

The moment when my son stopped breathing was also the moment when I left my body.

I had pictured this happening a thousand times before. When he was a newborn and so helpless in my arms, I’d race to check on him every time he slept, paranoid about ill-fitted sheets and mattress gasses. As he grew, every cough weighed on my mind like a heavy stone, pressing to the corners every other thought. I suddenly saw danger everywhere; I had changed. I was no longer Helen but Mummy, and I was a lioness, ready at all times to protect my cub.

But when Emilio’s eyes glazed over and widened until the eyelids could open no further, my reaction was not how I would have expected. As his lips turned purple and his mouth spewed forth foam, I was helpless on the sidelines as Luis shrieked “What do we do?! He’s not breathing, he’s not breathing!!” His tiny body, just one year and a half old, writhed and shook on the floor as Luis began pumping his chest. I remember Luis screaming at me to find someone – anyone – but his voice was so faint in my ears next to the dull ringing that had begun.  Suddenly, I was looking down at the room from somewhere else, watching Luis give CPR to Emilio, but he was not the Emilio that I knew.

Luis screamed at me to go and I ran from the house, barefoot and in my pajamas. First I ran to the store below us. I will never forget the look of disbelief and fear on the face of the woman that works there.  We both ran into the street. The first car I saw was Manuel’s, and he was eating a sandwich. “Manuel! My son is not breathing! We need a hospital now!” I shrieked and he threw his sandwich from the window. The next moment Luis was there, also barefoot and also in his pyjamas, and we got in the back. Manuel raced at the speed of sound to Roberto del Rio public hospital, in Recoleta, tooting the whole time so that he parted the cars on Avenida Recoleta like a Chilean Moses. Emilio was alternating between states of breathing and not-breathing, his eyes opening and then disappearing from his swollen face. The moment we arrived we raced through the doors without noticing the guards or other people. Doctors and nurses dropped their cases and came running, and Emilio was immediately hooked up to the IV.

“Why would you come here like that?” One of the nurses asked me when Emilio was stable.

“What do you mean?” I replied, confused.

“What happened that you could not get dressed and put shoes on?” She asked again, her eyebrow raised pointedly to the sky, like a bow shooting an arrow straight at my heart.

I couldn’t find the words at first. All I could think was how much I wanted to wipe her face clean of that smug look.

“My son was not breathing, had turned blue and was having a seizure. There was no time to put our shoes on.”

She just looked at me. “But why couldn’t you put your shoes on?”

The next hour passed in a blur as we waited, spoke to doctors and waited some more. No-one was very friendly and especially not the nurses. Emilio had chronic diarrhoea that one time covered all of my clothes and the floor, so Luis left to go home, and bring us back supplies and (of course) our shoes.

I was holding Emilio when it happened again. Like the calm before the storm, I knew something was about to happen because I remember turning to Luis with panic and saying “Something’s going to happen!” A minute later his head arched back and he began shaking and arching uncontrollably in my arms. I gave him to Luis who put him down on the bed and I ran from the room to find help. I saw a doctor in the corridor ahead and I screamed to him for help and he came running. This time, the room flooded with doctors, and Luis and I were pushed to the side. It was like a scene from a movie.

We were asked to leave the room so that they could do a lumbar puncture into his back to test for meningitis. Even though there were people and children crying all around us, all we could hear on the other side of the door were the inhuman sounds that Emilio made.

Almost straight after, we went with Emilio to the other side of the hospital for a CT scan. There was a delay because Emilio took a very long time to fall asleep with the aneasthetic. I remember the doctor – who was with us thoughout Emilio’s ER stay – thought this was highly amusing.

Luis went in with Emilio while I waited outside. At this point, the morning’s events finally caught up with me, and I turned around into the wall and just sobbed. I stood there, barely able to breathe under the weight of the fear and exhaustion I felt, until I felt a hand on my shoulder. A middle-aged woman stood there with a tissue. “Tranquila,” She told me, “everything will be all right.” Her friendly face was like a beacon of hope for me in that moment of despair.

Emilio did not have meningitis but he did need to be hospitalized to be tested further. We were then transferred to the children’s ward. This was a long corridor with rooms off of it to the left, each one containing four beds/cots. Every wall was lined with windows into the other rooms, and there was one television and one basin. Beside each bed was a single plastic chair. The toilet was on the first floor (we were on the fourth) at the end of a very long hallway. It had no toilet paper or soap. The doctors we saw spoke English (to a degree), were young and very personable. They read me our rights and the rules of the hospital and asked me to sign on the dotted line. I did so. They then asked Luis to leave because only one person could be inside the ward at a time.

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Lovely view from our window

Seven days and seven nights were passed there. The first night was agonizing because I could not figure out how to sleep on the chair without a) falling off and b) breaking my neck.   The other parents rolled down the side of the cot and lay their heads on the mattress beside their baby, but Emilio was far too unstable to have a side down.   I had taken a small suitcase (carry- on size) filled with spare clothes for Emilio and it was on the floor beside the chair. I opened it and sat in it on top of the clothes, and was asleep instantly. Moments later a kick to the leg woke me up to a hissing woman who told me it was the chair or leave. I did not fall back to sleep.

By the time Luis arrived the next morning I was almost delirious. I was desperate to talk to him however, to hear some support and tell him how Emilio had been. I also wanted to tell him that the 20minute window when all parents had to leave their child (morning and night) had actually been 1 hour and a half. All the parents had to wait outside the children’s ward during this time, as it was a time when all the doctors did their morning rounds. We all stood like sardines against the open door, craning our necks for the sounds of our crying children. I heard Emilio hysterically screaming, and the doctor came running to me in shock. Emilio had gone crazy when he had seen me leave, and was now flailing about in his cot, banging his head into the bars viciously hard and pulling his IV out. His eyes were circles of fear. Seeing him like this was enough to break my heart for a second time.

Luis and I managed two words before angrily being told to get out. Our absence caused Emilio to lose the plot again. We didn’t talk, and I went home. I hadn’t wanted to, but I was desperately tired and I wanted to speak to my parents. We had no hot water at that time so I talked to them while I boiled water for a bath on the stove and returned to smoking cigarettes, and then slept in a stupor for several hours.

At the hospital, Luis told me he had absolutely no idea what was going on. Emilio had had numerous tests done but no doctor had spoken to him. This worried me because Emilio did not seem to be improving in any way – in fact he looked ten times worse than when we had come in! He couldn’t stand, he shook, he could barely open his eyes, and all he did was make this horrible noise. He didn’t want cuddles either and just writhed when I held him, but he didn’t want to sleep either. He was desperate for something. I had been forbidden to breastfeed him because of his earlier vomiting, but I could see he wanted something. He had been staring at something fixedly for a while when he began banging his head on the cot. I picked him up and immediately he began to struggle against me. He is trying to walk, I thought, but where to? I put his feet on the floor and supported him and in amazement he went straight to my bottle of water and tried to pick it up. With that I knew there was something he was not getting from his IV, so I went out to the nurses, who immediately told me to go away. Ignoring them, I walked the ward until I found a doctor and strongly requested he see my son. He did so, and agreed to increase Emilio’s IV dose of water. Literally a minute after doing so he was asleep. It was the first moment of silence in a long time.

Night time was a struggle for everyone. It was impossible to sleep when the lights were barely dimmed, when the radio blasted all night, and when assistants and nurses came in constantly singing and whistling. In our room there was a newborn baby who must have been born premature. The mother, a young girl, visited every day but at night the baby was always alone. It screamed almost the entire night, every night and no-one came to look after it. Across from me, there was a mother of four, who had a daughter a few months older than Emilio. She had a number of health issues, and the mother held and breastfed her constantly, to the point where I could only be in awe of her mothering. She later said that her milk had dried up long ago but it was the only thing that could calm her daughter down when she was hospitalized.

Most of the week we didn’t know what was going on because no-one came to see us or answer our questions. I grew to resent the nurses who were very rude, but more so the technical assistants, who lorded about. Very few of the workers had patience with my Spanish ability and often they would talk and make jokes about me while standing right in front of me. After days of non-stop Spanish and emotional stress, I felt as though I was slowly losing my grip of the language. I started to not care. One time I asked an assistant to repeat a question, and she shouted at me, “Why are you here if you don’t speak Spanish? You have no right to be here!” I cried.

I was allowed to breastfeed again once Emilio stopped vomiting. The nutritionist then swiftly arrived and told me it was unhealthy to do so at his age. Luis and I had now taken to arguing during the five minutes we had together every day, and he started questioning all of our parenting decisions. He told me I had been feeding Emilio wrong all this time, and that he needed to be having more sugar. “What the f*** are you talking about?!” I screeched, unable to believe my ears. Turns out the nutritionist had told him that Emilio should be drinking fruit juices instead of water, and that every meal needed to have a sweet treat afterwards.

The expat community really reached out to me during Emilio’s hospitalization, and I cannot even begin to express my gratitude. I had no internet in hospital so every time I came home and waited for the bath water to boil, I would read messages that people – some I didn’t even know – would send. The people down Zapata rallied around us too, and Luis’ father and stepmother provided a further pillar of support.   After a week of endless exams and tests, misinformation about Emilio’s condition (“he has “X” and needs to stay here for another week”), rude staff and 2am treks to the toilet, we finally got some answers. Emilio was having febrile convulsions without fever being present, an extremely rare occurrence but not impossible. Or so they thought. They really didn’t have any idea. But they said he was much better and all the tests were coming back fine so we could leave … after all the forms had been completed and we had paid.

“Great! You stay here and I will go and clean the house, and get it ready for Emilio’s return” I told Luis and raced home, with a skip in my step.Our house was a pigsty but I dutifully cleaned it and waited. It was dark by the time these “forms” were completed. There are no words for the look of joy when Emilio returned but the journey was not yet over. As well as having a week’s worth of drugs still in his system and still barely eating, he had also developed an extreme fear of pretty much everything. He refused to sleep in his room, refused to be away from my side, shrieked in terror whenever he saw another person besides me and Luis, and barely smiled for weeks afterwards. He was like a shell. It took months before he recovered emotionally.

Roberto del Rio is one of the best public hospitals in Santiago. It has faster access to resources than the local private hospital. It also costs tuppence in comparison to the cost of going private. I cannot fault any of the doctors, really, who dealt with a high influx of patients very well. The doctors in Emergency were kind and responsive. When the case turned serious, tests were organized without delay. The staff that worked in the canteen were pleasant enough, and the food decent. There were small acts of kindness by several nurses and assistants that I will always remember. Everything else was a shambles. I do not know if the staff were overworked (to be fair, most of the time the nurses just sat around talking) but what I do know is that many times I felt unfriendliness and even animosity from them. Being forced away from my son for indeterminable periods twice a day while doctors poked and prodded seemed unbearably cruel for someone so young that couldn’t understand what was going on. I am thankful that Emilio was looked after and I am thankful that these services exist for people who do not have the funds to afford better, but I am also angry. I am angry that most of the people were too accustomed to not asking questions that they suffered in silence. I am angry that the young girl who left her baby at night did so thinking he was being looked after, but he wasn’t. I am angry that Emilio was forced to hurt himself, day after day, while alone in his cot and no-one tried to help him. I am angry that I was not respected because I am foreign. I am angry on behalf of all the mothers and fathers who cried outside the ward waiting to go back in, or who crept outside to sleep on the floor. I don’t know what the answer is, all I know is that we deserve more. A smile, after all, costs nothing.

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View from our window.

Spotlight On Political Refugee , Claudia (An Interview)

It is difficult to escape the history of Chile. I was approached by the daughter of a political refugee, eager to share her story with the world. This post is not intended as a political stance, instead it should offer a glimpse into the past and the life of one family as they leave to settle in Britain.

Claudia

1) To begin Claudia, could you tell us where you are based?

I live in Santiago Centro, 4 streets from Alameda behind the metro Union Latino Americana.

2) Your family left Chile when you were a child. Why did they leave?

The Canadian Embassy helped my father to leave Chile as a political refugee because he was on three blacklists. He left in January 1974 and we followed in September 1974. In the UK, we were supported by the Chile Solidarity Campaign and the Chile Campaign for Human Rights (a charity).

3) Can you tell us a little about your life before you left Chile?

Both of my parents are from small villages on the outskirts of Valdivia – my father is from Corral and my mother is from Huellehue. At the time of our departure, my father was Professor of General Elementary Education at the University of Chile and my mother was a primary school teacher. I was six years old when we left, my brother was nine and my sister was seven.

4) What can you remember from that time?

I have many memories. I remember the day of the coup and how nervous my mother was. I can remember soldiers coming into our house and seeing a dog gunned down. I also remember going to see the big annual Christmas tree exhibition despite the curfew and having to hide from the military who were always patrolling.

5) What happened when you first arrived in England?

Everything was very strange. We were adopted by a family of Quakers. I have memories of “Sugar Puffs” cereal and being given a lovely Mickey Mouse marionette for my birthday. I remember our first day of school and being surrounded by children all asking us “What’s your name?” I remember having to play alone a lot and that my brother got beaten up every day. I had to learn to defend myself too, but I also remember the kindness of a friend from Russia. I can also remember strongly the Language Centre where we had to go to learn English along with lots of people from China.

6) How did your parents adjust to England?

Our parents were in shock – they had lost everything. While my father was flown out        for free, my mother had needed to sell everything – including our flat – to buy the airfares. We were scared and worried about our loved ones because there were so many arrests, deaths and disappearances. Our host family, however, were very kind and we found a way to communicate. My mother would sit and talk for hours with our hosts. We had to adjust not only to the language but to our new status as outsiders.  My parents also had to deal with suddenly being unemployed. We moved around a lot initially until we finally settled in Hoylake when I was 10. Over the years we adjusted to living in Britain. My father began a PhD which was supported by a programme for Chilean refugees. My mother eventually went into nursing. She started off as just as a hospital cleaner, but she then worked up to being auxiliary nurse, followed by SEN, SRN and then Ward Manager in Fazakerly Hospital. The Chile Solidarity Campaign (CSC) and the Chile Campaign for Human Rights (CCHR) provided a lot of spaces for meeting with not only other Chileans but with British people who were sympathetic to our cause. There was a huge network of party members, trade unionists, churches and other institutions that together pressured the government (Labour 1974-1979) for support and the provision of foster families and homes for Chilean refugees.

Throughout our time in England my parents never forgot their Chilean heritage. We          continued to listen to Chilean music and eat Chilean food, and we had many discussions about Chile. As a teenager my friends and I were awestruck listening to the stories about people we had known . We also attended workshops with other Chilean families and learnt to make traditional crafts. The Chilean community held a lot of ‘peñas’ (get togethers) with vino navegado, empanadas and Chilean folk music. The topic of the dictatorship was always discussed and we always tried to do what we could to help Chile and Chilean             expatriates, for example we donated any money raised from these parties and events to people in Chile.

7) Did you have much contact with family in Chile?

No. The only way to make contact was by letter and most were censured. Every new letter was a reason to cry.

8)  Why did you return to Chile?

My father returned to Chile in 1983 with the first ‘opening’of Chilean frontiers to political refugees. He went back to fight against the dictatorship. I returned to Chile in 1997. The truth is that I was considered a ‘problem child’ and it was thought it would be better for me to live with my father in Chile for a year … but I stayed.

9) Were there any difficulties returning?

The hardest thing to adjust to in Chile initially were issues of discrimination, namely, classism, sexism and racism. It was very difficult to cope with some of the men because of their sexist remarks, and the macho culture in general. After I had my children I began to see the absolute craziness of our education system, especially when I could compare with the standards I’d grown up with in the United Kingdom.

10) How do you view the Chile of today? What is the single most pressing issue in your opinion?

I see Chile as a country divided into those who are rich and those who are poor. I think there is a great distortion on what it really means to be Chilean due to years of campaigning on a Chilean image that does not exist. There are people who live in houses that are fast deteriorating and that they cannot maintain. There are broken roads and pavements, and people who die in public hospitals due to lack of staff or provisions. There are schools with leaking roofs and broken down toilets – these are things that are very common but you won’t hear about them. So in my opinion I think there is a mentality that excludes the poor but there are too many poor people in Chile that suffer from this exclusion. Chile is also still politically divided and many of us feel that we are fighting a losing battle as we witness public services being phased out.

I now live close to Estacion Central, with the beggars, petty thieves and rubbish piled high. But there is a lot of culture to be found here and you can see this in the many murals, workshops, restaurants, cafes that are around. I also view the young people of today as having a freedom that didn´t exist during the Pinochet regime. They now have the time and space to discuss student issues. I see a lot more alternative ways of life than 20 years ago. I am happy because I know that there is a mass of very conscious young people who are now just starting to take new positions in society as adults.

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The People of Tierra del Fuego

Time for a wee history lesson!

Now I am not one who takes the history books at their word. I am sceptical of everyone and everything (hence why I am making my own volunteer organization!) but I have to admit that this does not always apply. I think we can safely say that the indigenous people of many nations had a terrible time, and none more so than the people of Tierra del Fuego, the region in the extreme south of Argentina and Chile.

It is difficult to obtain much information about them – indeed, Chileans don’t really talk about them. So I was happy to see a small section on the numerous groups at The Natural History Museum, in Quinta Normal.

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Some Background

Tierra del Fuego is the bottom-most part of Patagonia, the cold, vast expanse that is shared by southern Chile and Argentina. It was inhabited by numerous indigenous groups such as the Ona, Selknam, Qawasgar and the Yagan. The organisation Cultural Survival describes this region as having each year: 80 blizzards, (up to) 5 metres of rain and snowfall and just 20 days of sunshine (1987). There is few fish, no arable land, and the Qawasgar Indians, for example, had no clothes, no musical instruments and only a few stone tools to use.

Today, small numbers of Qawasgar survive and many were brought to the island of Chiloe to work as boat hands (Cultural Survival, 1987). However, Cultural Survival reports that these workers are discriminated against and easily fall prey to alcoholism, which is encouraged by either low wages or by being paid in spirits (Cultural Survival). This prevailing attitude of racism is most likely connected to past ideologies which were noticed in 1853 by the ethnographer Samuel Kirkland Lothrop who wrote that Tierra del Fuego was viewed as a “strange and romantic land, peopled by unmitigated cannibals (…) the very distance of Tierra del Fuego from the places where most of us live is a gap (…) not only geographical, but racial and cultural as well” (210).

When Charles Darwin sailed through this region this gap would be noted down, in “The Voyage of the Beagle”, perhaps the most well known and most pervasive account of this area. Some of his descriptions may appear a little shocking to today’s sensibilities. In a 1833 letter he wrote: “In Tierra del [sic] I first saw bona fide savages; & they are as savage as the most curious person would desire.—A wild man is indeed a miserable animal, but one well worth seeing.”11 He wrote in his account that: “I could not have believed how wide was the difference between savage and civilised man: it is greater than between a wild and domesticated animal, inasmuch as in man there is a greater power of improvement. … Their skin is of a dirty coppery red colour. … The party altogether closely resembled the devils which come on the stage in plays like Der Freischutz.” (in Grigg, 2009).   Many of his statements were based on second-hand accounts, for example he stated that “The different tribes when at war are cannibals. From the concurrent, but quite independent evidence of the boy taken by Mr Low [a Scottish sealer], and of Jemmy Button, it is certainly true, that when pressed in winter by hunger, they kill and devour their old women before they kill their dogs: the boy, being asked by Mr Low why they did this, answered, “Doggies catch otters, old women no.” (in Grigg, 2009). This was false information but the idea spread like wildfire in the colonised world.

Today

It is beyond sad to me that today nearly all of these original groups are extinct.  Please go here to hear recordings by the last of the Ona/Selk’nam people, Lola Skejpa.

I find it even more shocking when I go to a nightclub in Bellavista that uses images of sacred coming-of-age rituals as their decor, or when I visit museums and have the option of buying mugs and tshirts with these same pictures on.

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These are the most popular images that we see of them today, in their traditional gear worn during the HAIN ceremony. In a nutshell, the Hain was a coming-of-age ceremony held by the Selk’nam. The Selk’nam had a fiercely patriarchal society that was re-enforced each year when young men would undergo a terrifying ordeal facing off demons ^. At the end of the ceremony, these ‘demons’ would disrobe and the adolescents would feel shock at the deception. This was then blamed upon the women of the tribe, who are blamed for misfortunes and as deceitful. Their beliefs can be read in more detail here.

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The Natural History Museum

10931400_10153006196655097_1479809962739681015_nThe museum itself isn’t anything special but it is worth a trip even if you don’t speak Spanish. It’s one of many museums in Quinta Normal, which in itself is a lovely park to while away a few hours.  It’s also the place where I saw this shocking but evocative display:

10624823_10153006202620097_3787910348521634862_nThere is always some cool shops in front of the park gates. One of them sells lovely natural honey products such as soap.

The Milk Chain

Following the Milk Chain in Chile

The first thing I noticed about Chilewhen I moved here in 2012 was the absence of fresh milk, and I was not the only one. This topic is laboriously moaned about by expatriates new and old, who are confounded not only by the overwhelming presence of long-life milk (a treatment of ultra high processing known as UHT) but also by the general indifference of the Chilean populace. At some point in the last few decades, UHT milk has become irreversibly part of the stereotypical Chilean diet. When I began working on this essay and asking questions, I received countless different answers as to why the fresh milk had been withdrawn. Digging deeper, I found that there was no single reason. Instead, I have found that the relationship between corporate Chile and the national diet to be unavoidably connected. What anthropologists’ label ‘the Second Food Regime’ has resulted in a nation that has industrialized, homogenized and manufactured not only milk but all dairy products to the point whereby small producers are excluded (Friedmann & McMichael 1989: 106). I have attempted here to trace the chain of milk from its initial production on farms to its point of sale in supermarkets until it is bought by the average Chilean consumer.

To begin, let us understand what treatment processes can be used on milk. The International Dairy Federation (Harding 1995: 114) advises that all raw milk be pasteurised in order to minimize “possible health hazards arising from pathogenic microorganisms associated with milk by heat treatment (…) with minimal chemical, physical and organoleptic change to the product.”   The reason for this process is because raw milk is an ideal ground for the growth of microorganisms, some of which may be harmful such as Salmonella, Listeria and Tuburculosis (Harding 1995: 115). Pasteurised milk undergoes heating at a certain temperature to destroy pathogenic microorganisms, as well as ones that can spoil the taste, and thus its durability (Harding 1995: 115). Thermoduric bacteria is not affected by this process and needs to be removed via microfiltration, which also increases its shelf time (Harding 1995: 115). Sterilized milk is a further form of processing, most often used in hotter countries, however the “Maillard reaction’ spoils its colour and taste, as well as its vitamin content (Harding 1995: 115). UHT is considered by many to be the ideal treatment: it’s safer than raw milk, has a longer shelf life than pasteurised milk, and tastes better than sterilised milk. Processing plants use a closed system to heat the milk between 135-150C for 1-4 seconds, achieved in a continuous flow rather than by batches (Harding 1995: 116). It is preheated, sterilised, homogenised (the mixing of cream and milk together), cooled and then filled into sterile containers (Harding 1995: 116). With the pros, there are cons, however. All forms of treatment involving heat for periods of time causes a chemical reaction on some scale, and during UHT ‘heat denaturation’ occurs (Harding 1995: 116). This means that the temperature causes the protein to move away from their original chain or globular shape (Milk Facts 2014).   “Post-Pasturization Contamination’ (PPT) may also occur between processing and packaging, therefore strict monitoring, testing and sterilising is necessary (Harding 1995: 118). Gram-negative bacteria are very microscopic but can rapidly grow and develop into listeria, however there currently exists no testing that can effectively measure things of their size (Harding 1995: 118). This means that contamination and therefore illness is still possible with UHT milk.

To turn now to the situation in Chile, Marta Jimenez grew up in the 1940’s and remembers regularly consuming fresh (raw) milk purchased by street sellers direct from the animal. However, she remembers the general feeling of annoyance at the time when sellers began mixing it with water (and not always clean) in order to sell more. Meanwhile, Viviana Saavedra admits that she stopped giving her family regular milk in the 1980’s as prices soared. The consumption of milk generally decreased until boxed milk began to be sold everywhere from markets to street stores. The people little noticed this change, however, given that milk was not an important factor in their cooking or in their beverages (tea is always drunk without milk for example).

In the present, a paradox certainly exists. Street markets are still held daily where many families purchase their fruit and vegetables, and on every street in the cities one can find a general store selling everything from one slice of cheese to freshly baked bread. Often, sellers will purchase their items either direct from the manufacturer, or from other vendors to sell on – as is the case for the multitude of stall holders in ‘La Vega’, Santiago’s grand central market. However, supermarkets can be found in every suburb in every area of Chile and are a mega industry, despite the first one opening in 1995 (Wikipedia 2014). Business ChileMagazine reveals that there are more supermarkets per capita in Chile than anywhere else in the Americas, with sales reaching US$10 million a year – although interestingly, only 62% of all food sales come via supermarkets (Dowling 2008). The rise of the supermarket has resulted in a change in the general eating habits. A study by The American Journal of Clinical Nutrition (Albala et al. 2008:1) explains that the Chilean diet changed at a much faster rate than in other developing countries, due to rapid modernization and overall improved living conditions. The study furthers that the ‘nutrition transition’ resulted in a high-energy, nutrient-poor diet consisting of a marked increase in the consumption of sugar-sweetened beverages (Albala et al. 2008: 1). In actual fact, sugar-sweetened beverages are among the top three items most bought today by Chilean families (Albala et al, 2008: 1). Overall, the stable condition of the economy has increased the potential buying power of the populace, in turn attracting the attention of large companies. Of the supermarkets, there are several groups: Cencosud (owns Jumbo, Santa Isabel), Falabella (Tottus) and the SMU Group, which owns Unimarc (Dowling 2008). Walmart Chile purchased D&S in 2009, which runs the leading Lider, Ekono and Bodega Acuenta discount stores (Walmart 2014).

Milk is sourced on farms such as Fundo Cantarrana in the south of Chile which processes some million litres of milk each year (Fundo Cantarrana 2014). It is then bought by either of the two leading distributors of dairy goods: Nestle Chile and Fonterra (New Zealand). Nestle trades directly with some 1, 200 milk producers while also supplying technical assistance and training in order to better their milk products (Nestle 2012). This includes pressure on the Chilean government to change health and safety standards, whose policies enable the fusion of agribusiness input/output, manufacturing/processing firms to enhance corporate capital (Burch & Lawrence 2005: 11). Nestle Chile itself is part of the wider Nestle Group, which in turn has a substantial profit margin: in 2011, the Nestle Group took in some US$90 billion (Nestle 2012). Some of the milk products Nestle Chile then sells on to supermarkets include infant formula, cream, manjar (sweetened milk spread), condensed milk, powdered milk, evaporated milk and ‘light’ options. Similarly, Fonterra operates in Chile through subsidiary companies notably Soprole. Soprole is Fonterra’s longest running offshore investment (twenty years) and in 2008. Fonterra increased their shareholding to 99.4 percent in order to “further develop Chile as source of fresh dairy” (Fonterra 2014). The result is that by placing themselves in between product and consumer, and enforcing specific requirements, Fonterra and Nestle share the title of being monopsonistic (Friedberg 1995: 20). Furthermore, as the market for milk grows more and more concentrated, farmers are forced to sell to a limited number of companies (Burch & Lawrence 2005: 1). This relationship thus excludes other (specifically smaller) producers who cannot compete (Friedmann & McMichael 1989: 106).

The question remains: why no fresh milk? According to some, the reason is due to the health scare of the 1970’s, when cheap milk powder was imported from Europe that was contaminated. Mistrust of milk (and a fear of the government resulting in ‘turning a blind eye’) has contributed to the rise of the UHT products. Others, such as a spokesperson for Nestle Chile, explained that it is because many people in Chile are without refrigerators. Flaherty Wines explains it thus: “The use of this process [UHT] is ubiquitous in the Chilean dairy industry because the chain of refrigeration is not reliable. The large dairies generally purchase milk from small independent producers, so the milk may not be properly refrigerated before it reaches the main dairy. Not all retail outlets have reliable refrigeration. Finally, not all households have a refrigerator” (2010). It is true that the nature of the country’s geography makes transportation of anything challenging. In the north exists the world’s driest desert, the Atacama, while in the south conditions are freezing and even inhospitable, such as in Patagonia. Furthermore, the extreme south of Chile is broken up by the sea making transportation even more difficult.

However, it is evident that Chile’s predilection for manufactured goods has meant that this is an extremely lucrative business. Within the realm of processed milk exists opportunity for expansion. Demand is steadily rising for fat-free and low-calorie options, which is being readily provided by the manufacturers. In fact, Euromonitor International has labelled this as the leading area for investment in Chile (2014). Proof of this is evident by the large-scale injection of funds by companies. For example, in 2012 more than US$140 million was poured into a new Nestle factory in Osorno that would “produce a range of milk products and ingredients with added nutritional value for domestic consumption and for export to the United States, Central America, the Middle East and Asia” (Nestle 2012). This factory can manufacture some 30, 000 tonnes of milk powder and is considered one of the most technologically advanced plants in the world (Nestle 2012). Nestle Chief Executive Officer Paul Bulcke explains that Nestle continually invests in Chile due to their increasing confidence in the Chilean market, with the desire to create products that can be used at every stage of their lives” (Nestle 2012).

The power held by this sector is known as ‘financialisation’, whereby “private capital markets have become a major source of influence and control over the (…) food system” (Burch & Lawrence 2009: 268). The general fear of mercantilism – of a static market – prompts the drive for increasing profitability (Mintz 1995: 162). For this reason, businesses are looking to expand their opportunities more and more. For example, Claudio Hohman of Cencosud admits that “We’re developing different formats to adapt better to the needs of different market segments,” something which could be beneficial if companies wanted to expand (Dowling 2008). Professor Claudio Pizarro of the University of Chile explains that “There’s a window during which no one is looking hard at Latin America… there are huge opportunities for Chilean firms in Peru, Colombia and Brazil.” (Dowling 2008). Peru is looking especially promising given that it has lower supermarket penetration. UHT milk, with its easy transportability and long shelf life, would suit not only exportation but also the variety of conditions found in other countries. This striving for constant growth is evident by the 2012 Market Indicator Report issued by the Government of Canada, which reveals “Latin America’s vigorous agriculture and manufacturing sectors were expected to boost the economy, starting in 2011, helping to drive rising levels of disposable income and increasing retail sales. This could encourage the mid-market consumer base to recover its confidence and its taste for luxury” (2012). This same report postulates that the future will see the hypermarkets looking to widen their reach to lower-income customers, most notably in second tier cities with populations of 50, 000 people and lower (2012).

UHT processed products are stringently marketed as having added health benefits, despite mounting evidence otherwise. For example, the Centre for Disease Control and Prevention admits that outbreaks of illnesses have been connected with pasteurised milk, which through being treated also has lower nutrients and even missing enzymes (FDC 2014). The effect of these lost enzymes is not yet known, however the FDC maintains that the regular diet in countries such as the United States makes up for what is lacking in the pasteurised milk (2014). However, given that the United States is ranked as the sickest nation in the developed world by a report by the Institute of Medicine this raises some questions (Woolfe & Laudon 2013). In Chile, the World Health Organization explains that rapid nutritional transitions has resulted in a stark change of the nation’s general health (Bambs et al. 2008). It furthers that dietary change has lead to a 32.7% increase in obesity between the years 1960-2000, with approximately 205, 000 morbidly obese in 2003 (Bambs et al. 2008). The “progressive industrialization (…) associated with changes in lifestyle towards unhealthy dietary (…) patterns” has lead to a marked increase in health problems such as hypertension and diabetes (Bambs et al. 2008). It is for this reason that value-added products (such as ‘fat-free’) are growing in demand. However, many of these products contain sugar. An experiment conducted in Chile by the American Journal of Clinical Nutrition found that, in order to increase the health of children by getting them to drink milk, only flavoured milk would be drunk (Albala et al. 2008). This sugar-laden beverage resulted in no improvement whatsoever to their health at the end of the experiment (Albala et al. 2008). It is evident, then, that the Outside Meaning lies here with the manufacturing giants such as Nestle, “whose reach and power transcend both individuals and local communities”, at the risk of the nation’s general health (Mintz 1995: 6).

To a business, long-life milk offers easier transportability and easier storage, particularly if they are to be exported worldwide and across varying conditions. Entire aisles in supermarkets can be filled with numerous types of milk that can sit for months. Customers can safely buy and store cartons, stockpiling them in case of a natural disaster, such as the 2010 earthquake which saw entire suburbs become inaccessible. Most tellingly, a nation of individuals traumatised after the years of Pinochet can consume their milk without any fears that may lead them back to their government. However, it also means that Chile is entirely dependent upon the seedy world of corporations and capitalist gain. The result is a rapidly changing diet with varying health disadvantages. Children are growing up in a nation of the increasingly obese while becoming addicted to the very ingredients that make them that way. UHT milk, while perhaps not as at fault as aspartame laden Coca Cola, can be viewed as a symbol of this relationship. The reality this symbol denotes is that food is consumed not as a means to satisfy the hunger and needs of the many, but as a tool to make profits for the few.

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The rise of the supermarket, and processed goods.

References

Agriulture and Agri-Food Canada, 2012. International Market Bureau [online], Market    Indicator Report August 2012. Available:          http://www5.agr.gc.ca/resources/prod/Internet-Internet/MISB-DGSIM/ATS-            SEA/PDF/6240-eng.pdf, accessed 31 August 2014.

Bambs, Claudia and Jaime Cerda, Alex Escalona, 2008. Morbid Obesity in a developing              country the Chilean Experience [online],. Bulletin of the World Health Organization.    Volume 86. Available: http://www.who.int/bulletin/volumes/86/10/07-048785/en/, accessed 31 August 2014.

Burch, David, and Geoffrey Lawrence, 2005. Supermarket Own Brands, Supply Chains and        the Transformation of the Agri-Food System. International Journal of Sociology of       Food and Agriculture, 13 (1): 1-18.

Dowling, Julian, Chile’s Supermarkets: Stocking Up at Home, Growing Abroad [online]    2008. Available: http://www.businesschile.cl/en/news/reportaje-          principal/chile%E2%80%99s-supermarkets-stocking-home-growing-abroad, accessed       31 August 2014.

Euromonitor International, Milk Products Chile [online], 2014. Available: http://www.euromonitor.com/drinking-milk-products-in-chile/report, accessed 31     August 2014.

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Fonterra. Our Companies [online], 2014. Available:             https://www.fonterra.com/global/en/About/Our+Companies, accessed 31 August   2014.

Friedmann, Harriet, and Philip McMichael, 1989. Agriculture and the State System: The rise        and decline of national agricultures, 1870 to the present. Sociologia Ruralis, 29 (2):          93-117).

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Harding, Frank (ed), 1995. Milk Quality [online]. Chapman and Hall Food Science Book.            Available:             http://books.google.cl/books?id=PWmQTKDWPz0C&pg=PA116&lpg=PA116&dq=            disadvantages+of+uht+milk&source=bl&ots=P0z2ZrPY7a&sig=gd3l72fq27TvJVgiC            fU9rJr960&hl=es419&sa=X&ei=dXYDVNG6HonisAS4p4Bw&sqi=2&ved=0CHcQ            6AEwCQ#v=onepage&q=disadvantages%20of%20uht%20milk&f=false, accessed 31      August 2014.

Milk Facts. Heat Treatments and Pasteurization [online] 2014. Available: http://milkfacts.info/, accessed 31 August 2014.

Mintz, Sidney, 1995. Food and its Relationship to Concepts of Power. In Phillip McMichael      (ed), Food and Agrarian Orders in the World Economy. Westport: Praeger, pp.3-14.

Nestle, Chile Investment [online], 2014. Available:   http://www.nestle.com/media/newsandfeatures/chile-investment April 5 2012,   accessed 31 August 2014.

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Woolf, Steven H and Laudon Aron. US Health in International Perspective [online], 2013,          The National Academies Press. Available: http://obssr.od.nih.gov/pdf/IOM%20Report.pdfaccessed 31 August 2014.

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