Contemporary accounts of friendship differ on whether family members, in particular one’s children before they become adults, can be friends



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Despite the lack of oxygen and health risks, high-altitude locations are home to at least 140 million people around the world. From Bolivia’s El Alto to Lhasa in Tibet, what’s urban life like at such dizzying elevations?
At 3,640 metres above sea level, the city of La Paz sits in a canyon resembling something of a bowl within the Bolivian altiplano – a high altitude, windswept plain that dominates the southern and western territory of the country. It’s the world’s highest administrative capital, yet more of the metropolitan population lives in the even higher city of El Alto at 4,150 metres, on the rim of the canyon.
El Alto was uninhabited at the start of the 20th century, but as land became more expensive in neighbouring La Paz, the city grew: for the last 50 years, new development has spiralled out of control into a chaotic mix of winding streets through which water and sewer services struggle to extend.
Yet the indigenous communities at these dizzying heights have benefitted from Bolivia’s recently, rapidly improving economy, an overall reduction in poverty and better integration into Bolivian society. Newfound wealth has seen a boom in the construction of dozens of flashy mansions: these mostly five-storey, mixed-use townhouses – many designed by local starchitect Freddy Mamani – feature futuristic façades plastered in tinted glass and Andean symbols in relief.
Altitude affects every aspect of life in in the conjoined cities of El Alto and La Paz. Even the class structure is based around what elevation someone lives at: the more affluent neighbourhoods are found at the lowest reaches of La Paz, where high-rise condos and gated suburbs sprawl southwest from the city centre. As you move up into the hills, makeshift brick and adobe houses become more common.
City planners in La Paz, of course, needed to keep altitude in consideration when designing a mass transit grid, which is why they installed a $234 million (£140m) cable car system in 2014 to transport residents more than 500 metres between El Alto and the city centre. Known as Mi Teleferico, it’s the longest urban cable car system in the world, and has considerably cut down the time spent in traffic and money spent on fuel.
Tourists visiting La Paz, if walking up to Cerro Cumbre to visit the Mercado de Hechicería (Witches’ Market), will immediately recognise how much more difficult it is to breathe here than at sea level. Every step is a challenge; sleeping becomes difficult too, as do simple bodily functions like digesting food. Some will get soroche, or altitude sickness, with all of its unpleasant symptoms.
“Even cooking at altitude is tricky,” says Kamilla Seidler, head chef of Gustu restaurant in La Paz. “The lack of oxygen affects the rising process in bread making – and our insisting on only using sour dough, not yeast, doesn’t help. Another interesting challenge I found out is that water boils at 86C in La Paz, which means that starch doesn’t really break down, and that rice, potatoes or wheat are generally overcooked on the outside and crunchy on the inside: not nice. So there is a lot of pressure cooking and sous vide going on.”
Despite numerous challenges associated with altitude, humans are able to adapt to lower oxygen levels, both in the short and long term, resulting in settlements with populations that reach into the millions. It is estimated that at least 140 million people in the world live permanently above 2,400 metres. These cities can be found primarily in three mountainous regions: the Himalayas in Asia, the Andes in South America and the Ethiopian Highlands of Africa.
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