Use a taxi.
But seriously. We live in the core of Seattle and are used to a certain amount of public transit. Medellin also boasts one of the best Metro (aka subway) systems in South America. The problem is that for the most part this isn't a pedestrian friendly city. It's getting better, but that's the reality.
It has been fairly troubling to not be able to walk to interesting parts of the city. I want to be able to access something on foot. For the first few days while we adjusted our time zone I walked to many areas. God help you if you do this once the sun has crested the mountains! The climate is temperate, but huffing up a 200-300 foot elevation gain is no joke in 75 degree (F) weather.
I thought Seattle had hills. San Francisco has hills. Neither has anything on Medellin. There are some flatish neighborhoods, but for the most park, the city is built inside a steep high-mountain valley. If you do much walking they will be bouncing quarters off your ass. I read a conversation thread about riding a motorcycle in Medellin and the quote was "some streets are not so much a steep downhill as sliding down a cliff".
So how about those taxis? There are so many in the city. I mean, so many. If you've ever watched some footage of NYC in the depression before the taxi medallion system was put in place you get an idea. The other thing is that they are dirt cheap. From our place in the Poblado, anywhere one would want to go in the city is about 10-12K pesos (~$4-6 USD). With four of us we can't afford to figure out public transit. It's cheaper and faster to take a taxi.
To date I have not had good luck with the taxi apps (Easy Taxi and that other one). I've had better luck walking down to a major intersection and waving my hat.
In terms of the drivers, most are awesome. The people in general are muy amable (very friendly) and very helpful. Every single driver gives you change on the fare and will always round down to your benefit. After a while I finally figured out how to give them a tip without being insulting. No one expects a tip, but they appreciate it. Round up the change, or around 5-10% is nice.
We still haven't taken the cable car, but I'm looking forward to it.
In terms of longer hauls, we paid the equivalent of $35-40 for transport from the international airport to the city. One driver has offered us 275K pesos (~$100 USD) to be our driver for the day and take us to some regional sights. It ends up being less of a PITA than a rental and is probably comparable in price once you factor fuel and insurance.
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