Costa Rica

We have been out to sites in Costa Rica for four days now. Surprisingly, many of the people are poor, but they seem to have access to healthcare. The government mandates that businesses provide all employees with health insurance. The employees pay a set percentage of the premium so those who make more pay more. Those who are not employed do not have insurance and have to pay cash for healthcare unless there is a life threatening emergency. Still, it seems that most of the people coming to us have had appropriate care. The problem arises when they have to wait several years for non-emergent surgery. Non-emergent and unnecessary are not synonymous. I have seen several women with cervical dysplasia who had to wait two years for treatment. A 19 month old with congenital hip dysplasia was on a four year wait list for surgery; the mother had been told by then it would be too late. There is a private system where they can pay to have surgeries performed for cash but most cannot afford it. In some ways, this is more frustrating than those who have no healthcare at all because their expectations for what we can do for them are higher. Scores of surgeries are performed on the Comfort but they are limited to those with a quick recovery which does not require extensive follow up.

The people of Costa Rica are warm and happy. They love to joke and laugh. Our translators are medical students from San Jose who give us great insight into the culture, the health system, and the daily issues that the people of Punta Arenas face. They have also helped me compile a list of great places to visit in Costa Rica. Unlike El Salvador, we are allowed to leave the ship at night and eat at the nearby restaurants. This makes living on the ship a lot easier since the food is the greatest hardship of all!

Last night one of the physicians traveling with Project Hope gave a commemorative presentation on 9/11. He was on the disaster relief team that was present at the World Trade Centers for two weeks immediately following the disaster. His pictures and heartfelt descriptions put a personal twist on the event that one just cannot get by watching the news. This is one example of what has made this excursion so out of the ordinary. I have met people from all parts of the world and they all have fascinating stories to tell.

It is hard to believe that we will be leaving for home next week and graduating on Saturday! I am quite homesick, but not yet ready to leave.