Feel free to read student reflections from our time in Costa Rica. You are also welcome to comment on a reflection. The 2020 trip is forming now and applications are currently being accepted.
¡Pura vida!, the trademark slogan of Costa Rica, translates to “pure life” in the English language and describes the simplicity of the Costa Rican lifestyle. Pura vida is not just a phrase but rather a feeling found in the center of your heart that is filled with emotion, a positive attitude, and happiness. t I not only learned about the healthcare system but the country and its entirety this past week while studying abroad. Today, however, was the most bittersweet of all—the final goodbye.
As we adventured and trekked through Costa Rica one last time, all of the students tried to ignore the impending future—saying goodbye. First we occupied our minds with Catarata Rio Fortuna, a large waterfall located on a biological reserve in La Fortuna. With each descending step, the sound of the waterfall rushed through our ears providing a soothing melody of water and nature. Swimming, hiking, climbing on rocks—oh my, we spent this cultural immersion activity taking nature’s beauty all in. During this trip, we learned about the importance of the preservation of nature and its wildlife so others may also have these types of experiences for many years to come. After a long morning of expending energy at Catarata Rio Fortuna, we stopped for lunch at Cafeteria Flory. The fragrant scent of homemade tortillas and pinto gallo mixed perfectly with the warm sunshine as the strumming of a guitar created tones of soul and happiness which danced peacefully through the restaurant. Here we learned about a small family owned luncheon business and the importance of serving authentic Costa Rican food to their customers. Our last cultural visit was spent at the Herpetological Refuge Costa Rica in San José where animal biologists and volunteers spend their time rehabilitating native animals to Costa Rica back into the wild. Walking through the refuge was like taking a stroll through a “mini” rainforest—scarlet macaws squawking in the background, colorful flowers spread throughout trees so tall and full you can barely see the sun as the sound of trickling water runs in the background. From monkeys, snakes, sloths, and crocodiles—this refuge educated all of us on the uniqueness and importance of each animal to Costa Rica’s ecosystem.
We concluded with a final dinner where we all reminisced on the memories of the trip with our phenomenal tour guides Juan Pablo, Maria, Carola, and Fernando (Chino). While we all left that night with some tears, we realized how this trip has come full circle for all of us. We all came to Costa Rica to explore the healthcare system; however, we all took away so much more from the trip. Collectively, not only were we fortunate enough to learn and understand about Costa Rica but also see it applied in the multiple settings throughout the country as well. While I took away a lot of valuable information from this trip, the most moving piece I finally understand is that anyone can say pura vida; however, it is another thing to feel and understand the true meaning of pura vida—this is simply not obtained until you visit and take the time to enjoy Costa Rica’s beauty and wonder. Until next time Costa Rica–¡pura vida!
Today we went to the Area de Salud Tilarán clinic in which Fernando, the director of the clinic, relayed various information of the clinic to us and we were given a tour of the clinic which included a pharmacy, vaccination room, laboratory, emergency room, and large waiting room occupied with many Costa Ricans. It was at the clinic that we picked up the ATAPs that we would be joining for the home visits.
We learned that the goal of the ATAPs is preventative care and that the home visits are carried out to make sure the homes and yards are in good condition. The neighborhood we traveled to contained houses that were paid for by the government and the neighborhood consisted of identical-looking homes. Families were moved from areas of extreme poverty to these houses in which residents only had to pay for water and electric. The ATAPs made rounds to these homes not only to ensure the health of families but also to examine living conditions.
An analysis of how the family lives are carried out to determine overall health. The analysis includes general information such as professions, birth dates, heights and weights, as well as documentation of vaccines and illnesses or family violence. The various health and living conditions of the families are totaled up to give an overall risk level of either one, two, or three for each household. Risk one is the highest risk and would mean that a social worker or police officer would be notified to do a follow-up visit and institute the necessary changes to ensure a healthier lifestyle.
The ATAPs carry a cooler bag filled with vaccines to the home visits. We got to see firsthand a Tetanus vaccine administered to a lady. This was performed because of lost vaccination records. I learned that if an individual loses their vaccination booklet containing the history of their vaccines and is not able to present it directly to the ATAPs, then the ATAPs administer necessary vaccines for free since vaccinations are mandatory in Costa Rica. I learned that pap smear exams and mammograms are offered for free under the Costa Rican Caja Security System; however, families that do not contribute money towards the Caja will only be told by the ATAP about the importance of the tests and encouraged to pay. They will not receive a reference form to get the given test under the Caja, as normal protocol, until they contribute towards the system.
The ATAP that I was following had not yet obtained a tablet and so data was collected in a paper file. A new record file had to be created for the one family as they had recently moved to the region. There is not enough technology or resources to transfer files from one clinic to the next and so the ATAPs must go through the extensive process of gathering all data from scratch. I also witnessed the ATAP give pills to individuals of the homes in which they were instructed to take them two times a day for three consecutive days. The pills were given in order to rid their bodies of parasites as a form of prevention. The work of the ATAPs is highly important and I admire their emphasis on preventative care. I truly enjoyed joining the ATAPs on their home visits and I learned so much.
As a World Campus Student, I never thought that I would participate in a study abroad program, but I am very glad that I am. As a Health Policy Major studying Healthcare in Costa Rica surrounded by other students that are mainly nurses and are much younger than myself, I thought that this would be awkward for me, but we are all able to learn from each other and share in this awesome experience together. I have met some interesting people and we all seem to have our own story.
Wednesday May 8, 2019, I thoroughly enjoyed my experiences with our ATAP (Technical Assistant to Primary Care) Jairo Martinez. Shadowing Jairo has truly been the highlight of this trip to me. As Jairo visited homes of citizens I was able to accompany and participate first hand in one of Costa Rica’s preventative measures, and also another form of creating access to healthcare. This is particularly important to me because as a healthcare worker for so many years, I have seen the need for more preventative measures as well as greater access to healthcare.
As I followed Jairo and listened to him coaching patients on the importance of making doctors’ appointments, the importance of being up-to-date with their vaccinations, and making sure that everyone in the household is being compliant in order to ensure good health, what I found to be really important was that Jairo didn’t only ask questions regarding health, but he also focused on the living conditions and the quality of life. In Costa Rica, the health of people and the quality of their lives are equally important. I really found that to be amazing that here in Costa Rica with limited resources and manpower, they still find a way to do much more in terms of access and prevention.
Being an HPA major I thought that the natural next step would be for me to become some form of manager or director in a healthcare facility, but being here in Costa Rica has made me think differently about my future career goals. I feel that my eyes have been open to options that I hadn’t even considered. Why limit myself to a hospital job? Maybe I can focus on public health, or work abroad in the same form as the ATAP’s in Costa Rica. I feel refocused and re-energized with that “Save the World” mentality and I am looking forward to a more focused career path.
Today consisted of going to the coffee plantation, going to Hospital Monseñor Sanabria in Puntarenas, and hiking to Poás Volcano.
In this post, I am going to focus on the hospital. In this hospital, we were able to meet with one of the main doctors who specialize in management and overseeing the hospitals numbers. We were also able to meet with one of the journalists that represent the hospital in the daily news.
During this conversation, we talked about cancer and how they screen. We also talked about the regional hospital and how it works within the community.
After that, we walked around the intensive care unit and saw how the rooms were set up. Following this, we were able to experience the pediatric burn unit. Here we saw a couple of kids and their parents who were stuck in the burn unit. Some parents were okay with us watching them and some allowed us to watch. Seeing their maternity floor was very similar to the ones I have seen in the United States.
Something I also found interesting was the fact that the hospital has little cars that the kids can ride into the emergency room. The nurse explained that the ride was utilized to help the children not feel scared. This is something that I wish I saw more in hospitals because the idea seems more fun than scary for children who have to go through something traumatic like the OR.
One of the nurses was kind enough to show us the Pre-OP room that the mothers go into before giver birth, whether through C-section or natural birth. We were able to experience some of the private birthing rooms that included the yoga balls and bed to have the baby in. One of the rooms had stirrups that were utilized as a way to see how dilated the mother is. The nurse was able to show us a video on how the mothers birth without epidurals and no screaming. The way they do this is by playing relaxing songs and bouncing on a ball to calm the mother down.
In Costa Rica, they have found ways to treat pain without medications. I found this amazing because of how different we treat labor and delivery in terms of pain. We always dramatized birth by showing the “pain” on TV shows and movies. Many women in the US “require” an epidural or some form of medicine to deal with the trauma. Here, birth is a different experience.
Finally, after the delivery area, we were able to see the morgue. At first, I was a little nervous at the thought of seeing dead bodies, but luckily there were only jars of hearts and a fetus. We also had the opportunity to see the place where the family washes the body before they either put it in a casket or they burn the body to ash for the urn. The room felt very plain and a little awkward to be in because they are so casual about the idea of death. Following this, we were able to take a picture for the hospital of our trip before continuing to the bus.
Today we went to a volcano first and then on a coffee tour on our way to Las Juntas. It started with a sample of their coffee and the tour guide took us to see what coffee trees look like and then showed us the process.
The trees are usually kept there for 25 years (even though they can last around 100 years) in order to keep the best quality coffee. They harvest for 5 months starting in October.
The beans are green originally but turn red when they are ready to be picked. The beans are picked by hand for the best quality. They are put into a canasto which weighs about 28 pounds. This measuring unit of the coffee is called a cajuela.
The workers are only paid $2 for every basket (of 28 lbs). However, the 28 pounds ends up only being about 7 pounds once everything is removed and once they are roasted, the beans expand but they end up weighing less (about 6 lbs).
This system works because most of the workers come from Nicaragua for the harvesting season and the workers are provided with free housing, healthcare, water, etc. All they pay for during this time is their food so they end up making more in Costa Rica during harvesting season. They only have two chances to pick a good basket and if there is too much green beans or leaves then they will be fired.
During the process of making coffee, the good beans will sink in water and the bad quality will float on top. The quality usually relies on the density of the beans. After the coffee goes through all the machines, the beans are laid outside to dry for 5 days and they are raked every 45 minutes. Most of the coffee (85%) is high quality, 10% is medium and 5% is not good but they don’t waste anything produced there. After the tour, we went to another hospital and then to Las Juntas for the night!