Midterm Break: Puerto Viejo and Bocas del Toro

I was surprised to find that there were only eight of us staying in San Jose for the first night of break. The hotel we stay at whenever we’re in San Jose is pretty far from where we stayed during our homestays so we weren’t familiar with the bus system there. This meant we spent far more than we intended taking taxis to buy bus tickets for the following day and finding a place to eat. Being so far from everything we didn’t want to go back out in the evening and we were leaving early the next day. We didn’t have anything to do so regretted not bringing our computers and not leaving with the 2:30 bus earlier that day.

We woke up the next morning around 5 to take the 6:30 bus to Monteverde. Around 6:20 someone walked into the waiting area and informed us that the bus would not be running. He couldn’t tell us whether the 2:30 bus (the only other one scheduled for that day) would go. Now we really regretted not leaving the day before. We didn’t want to wait another day in San Jose and heard some English speakers talking about going to Puntarenas and then taking a bus to Monteverde from there. Some guys volunteered their cars to take us to the other bus station. If only all the buses left from the same station. So we took him up on the offer although we were a bit sketched out and may’ve paid more than it was worth. We finally got on the bus for Puntarenas which was packed and fortunately managed to situate ourselves right in front of a child who threw up multiple times. We hung out in the bus station for four hours until we found out that the bus to Monteverde wasn’t going to come. A guy and his son came up to us with a torn up map offering us advice about how to get to Monteverde but we weren’t convinced that it would work. They kept following us everywhere trying to tell us where to go which was frustrating because we didn’t want their help. As we were leaving they asked for money. I felt bad when we didn’t pay them but we were already annoyed about losing lots of money on bus tickets and I had prepaid the hostel in Monteverde. Realistically a few dollars probably wouldn't have set us back much. Maybe we were just being stingy tourists. Wanting to escape the rain we decided to go back to San Jose and then to Puerto Viejo on the Caribbean coast, where we had been planning on going at the end of break.

The hostel we stayed at that night in San Jose (Hostel Pangaea) was really nice. For $13 we had key card access to our room and really nice new facilities and hot showers. There was also a bar and restaurant that looked out over the pool and the city. The only downside was that it was pretty cold and the hostels tend to only provide a single sheet. The next morning we left at 5:30. It was quite a relief when we were finally on the bus. When we arrived in Puerto Viejo it was super hot and humid and we had to walk over a kilometer to our hostel with our bags. We dropped our stuff off in our room and headed straight to the beach.

That evening we met up with some other girls from our program for dinner and then hung out at our hostel. The place had been swarming with people when we arrived but apparently it cleared out during the week (it was Monday) because there was hardly anyone there that night.

Punta Uva beach in Puerto Viejo

I suppose turning 21 in Costa Rica seemed a little bit anticlimactic. But having vacation and spending the day on the beach was an unexpected benefit. That never happens during October in New England. After going for a run we ate breakfast at a little restaurant where I had eggs benedict and a passionfruit smoothie. Then we rented bikes and biked half an hour to the beach. It was my favorite biking geography – so flat that the bikes didn’t even need gears. On our way back we stopped at a delicious organic restaurant/market. We had more smoothies- this time almond milk (which I hadn’t had since I left the states) with papaya and shared an incredible plate of lasagna, salad and garlic bread. It seems that at nearly every restaurant there’s an American who came and then never left. It’s a pretty cool place but I’m not sure it’s for me… it’s almost too laid back. The next day included more time on the beach and at least one more smoothie (the best food for the hot weather).  

The following morning we headed to Bocas Del Toro in Panama. We again experienced positive discrimination at the border since the couple from Israel who was traveling in the same van with us had to have our bags searched. We were waiting in line too but when they found out we were from the United States they let us go.

At our hostel we told the woman at the front desk that we were waiting for four friends. There was another guy at the desk who was also waiting for four friends. It turned out we were waiting for the same people. He had been neighbors with one of the girls in our group in New Mexico but was from Panama and living there. We got pizza for lunch for fairly cheap. It was nice not to have to do currency conversions but weird to be paying in dollars again and even stranger to get US change back. After using colones for so long quarters look TINY!!

That afternoon the others arrived. After we had dinner people on the street came up to us with a bunch of flyers advertising whatever events and bar specials were going on that night. It seems like it’s lady’s night at some bar somewhere every night so we drank pretty much for free. This town doesn’t seem like it’s dead even on weeknights. I’ve never been to a typical spring break event but I’d imagine this is somewhat similar. The bars are even directly on the water. One is called Barco Hundido (sunken ship) and it’s actually built around a small ship. You can even jump in and swim around it if you don’t mind getting wet. From there you could see another bar across the water. We had to take a water taxi to get there.

During the day on Friday and Saturday we took boat tours and explored the other islands of Bocas. We saw dolphins and macaws, went snorkeling, and later got dropped off at what was nearly a private beach. It was unbelievably gorgeous. My favorite was riding the motor boat. In the US I think I’ve been trained not to like them because of the noise and fuel pollution. Among the people I know there seems to be a preference for kayaks and canoes, but I’m not going to lie, I was a big fan of the motor boat. Having the wind and water spray across your face is a really enjoyable feeling.

A lot of people seem to be traveling around together. We saw one woman who had been trying to get to Monteverde at our hostel in Puerto Viejo. Others who were at Puerto Viejo we saw in Bocas. Some people even were traveling alone but met up and befriended groups of people wherever they go. A lot of them were Europeans taking a year off before university. It’s an interesting lifestyle but I’m glad it only lasts a week for us.

See the dolphin fin?

It’s incredible how focused this town is around tourism. I talked to a local Panamanian for a bit who complained to me that no one stays in Panama. Everyone just seems to be on vacation from Costa Rica. I suppose that is a valid point. He made fun of the Costa Ricanisms too like “Eh, mae! Pura vida.” It’s interesting how different the Spanish is from country to country. I think the worst is the different verb conjugations like vos and vosotros. Although Australian and British English sound different and there are some minor regional differences within the United States at least we don’t change our verbs.

The cat calls here and in Puerto Viejo were about equivalent to those in Nicaragua. They kind of dissuade me from running on my own. Also, being in Central America, particularly outside of the city, has made me more aware of my Asian appearance. First of all there weren’t many Asians in Costa Rica and I don’t think I saw any when we were in Nicaragua or Puerto Viejo. There were surprisingly a lot in Bocas del Toro but I’ve been told that the construction of the canal made Panama somewhat of a mixing pot. Getting referred to on the bus or street as China/Chinita and then being greeted by ni hao in Bocas aren’t things that I expect in the US. I wouldn’t say I minded but I definitely noticed that there isn’t quite the focus on being political correct as there in the US, or at least not in super liberal Amherst, MA. Later on in the semester while I was running some guys pretended to speak Chinese. I didn’t appreciate that.

We spent Sunday getting back to San Jose. Although the week in the heat and on the beach had been fun the cool temperature of San Jose was a welcome change. 

NIcaragua and the Soltis Center

After a few more days at Las Cruces we headed towards Nicaragua, stopping at San Jose for a night to break up the 14+ hour bus ride. We had to leave at 4 am from San Jose to Nicaragua in order to beat the rush at the border. Fortunately it only took us about an hour to get across the border. Here we experienced our first moment of discrimination in favor of United States residents. Only the student with a Bangladeshi passport had her bags searched.

Our room was at the end of the hallway

On the way to the hotel stopped at a Nicaraguan clinic. Although there were always people waiting in line in Costa Rica, it was surprising to see the volume of patients there. Another difference was the government propaganda lining the walls. Apparently Costa Rica manages to keep its health care system separate from the government. I still don’t quite understand how this works. Regardless, apparently a problem with having health care tied to what’s happening in government is that there tend to be a lot of changes every time the group in power changes (something I’d never considered before).

Cathedral outside the hotel

When we arrived at the hotel it was shockingly nice. There was even a pool which was salty and almost too warm… in other words easy to get in but uncomfortable to swim laps in. I wouldn’t have minded having it be a bit cooler since the Nicaraguan weather was consistently hot. The internet was better than anywhere else we’ve been so I got to watch grey’s anatomy and private practice for the first time. The town we were staying in, Granada, reminded me a lot of Europe. There were even some delicious Italian and Mediterranean restaurants. Where we were there wasn’t too much evidence that the country is the second poorest in this hemisphere.

The most shocking part of the trip was going to a gigantic market in the capital Managua. I was in a group that required us to walk around the food sections. Meat was hanging from hooks with flies swarming around it, chickens ran around the ground and some vendors were shoeless and/or shirtless. The smell was unpleasant to say the least. Additionally, although we were warned about cat calls in Costa Rica they were nothing compared to Nicaragua. Those of us wearing shorts got an unwanted amount of attention.

Main street of Granada

We had some lectures but also got to do a fair bit of sightseeing. We took a boat ride on Lake Nicaragua, which takes up something like a quarter of the area of the country and took a trip up to Volcán Masaya. It was fairly impressive (although I liked Poás better) although we weren’t allowed to stay more than half an hour because the fumes can cause vomiting. We also went to some other markets that were dedicated to crafts and souvenirs (fortunately there was no meat). Even on the streets of the hotel there were people approaching us selling handmade bracelets, earrings and hammocks. Some of us managed to buy hammocks for a mere $5.  Getting used to the córdoba (currency) was difficult having finally gotten used to colones (in Costa Rica) and at this point I’m not sure I even remember the exchange rate… 20 córdobas for a dollar… I think?

View from Soltis

After Nicaragua we went to the Soltis Center which is owned by Texas A&M. The ride had an awful amount of twists and turns but on the way we got a view of Arenal Volanco and Lake Arenal which were impressive sights. The facilities rivaled Hotel Granada. I stayed in a double where we each had our own bunk bed, sink and huge bathroom and shower. Perhaps the biggest perk was consistently hot water with good water pressure. It was kind of a strange portion of the semester since we were really only there for reading period (which I had never had for midterms before) and midterms.

During reading period we went on a night walk where we got to see tiny blue jeans frogs, our first snake, a bullet ant and a tarantula!

Boruca

My favorite "mask"

 After Las Alturas we went straight to Boruca, an indigenous territory where the Brunka live. It’s probably the wealthiest indigenous group in Costa Rica. They have really promoted tourism and make a lot of crafts, the selling of which comprises a big portion of their income. Unlike many of the communities we visited there was public transportation directly into the center of the town if you could call it that. We never got to see where the most isolated houses were but the road system seemed decent. There was also running water, electricity, an EBAIS, a small indoor soccer field and two bars.  I was surprised to see a TV and videogames in the living room of my homestay. The homestay itself was a bit awkward because most of us seemed to be kicking the kids out of their bedrooms and we had limited interaction with the family because were kept occupied by group activities and ate with everyone else on the program. An interesting discovery was realizing that the little salamanders that ran up and down the walls make quite loud noises.

Naturally tie-dyed

In addition to conducting interviews with the residents of Boruca we got to do lots of fun little projects like tie dye shirts using their natural dyes and paint balsa wood masks. The dyes worked impressively if you left it in long enough and had a newish shirt (the yellow is turmeric). They use them to dye the fibers they use to make the bags they sell. They also sell masks which you can find all over Costa Rica. Originally they were used for a traditional celebration and appear like devils but now many are merely decorative. The carving is incredibly detailed and the colors are striking. I ended up buying one for myself. A lot of the masks are jaguars, which have spiritual significance to them. We all got to paint a mini jaguar mask. 

Las Alturas

Home

After returning to Las Cruces for a few days we went to Las Alturas which was about a two hour drive away. This was my favorite of the places we stayed. Thirty of us stayed in a cabin with four rooms, no hot water or internet and a generator that only ran from 6-9pm. Something about the rolling hills and pastoral landscape was incredibly beautiful. Of course I can’t disregard the aspects that aren’t so perfect such as some of the living conditions in the community and access to healthcare. When I wasn’t faced with evidence of substandard housing, most of it was gorgeous. I loved visiting the organic farm and a stream rushed by, sending clear water over rocks. For some reason the place seemed unreal. In the morning I would wake up to go running and from the hill where we were staying I could catch the sunrise fading at the horizon above a body of water I never identified. There were also three horses who would always be grazing along the dirt road where I ran and sometimes they would trot along in front of me. To top it all off the weather was nearly perfect. It was cool, even chilly in the evenings. At times it was slightly warm during the day but tolerable. Minus the black flies and ice cold showers I could’ve stayed there.

 

It was nice to be away from the internet and most electricity because it meant we didn’t have any readings for the week. Instead we all got to know each other better, forced to come up with creative ways to pass the time. Also, when you go on tours of most liberal arts schools they advertize the fact that some professors invite classes to their house for dinner. Here we get to eat nearly every meal with them and sometimes live in the same building. It certainly makes for an interesting experience.

 

Our objective in being there was running a clinic and getting health information from the community. I’ve mentioned that most places have an EBAIS (clinic) but in more remote areas where the community isn’t large enough (>4,000) to support an entire clinic or too spread out, they have “Casas de Salud.” These populations also have EBAISes that they can go to but they are usually far away and the people often lack transportation to get there.

Casas de Salud are staffed infrequently. Once a month is typical. The two days we were there would be the only time the clinic would be open that month. While our physician professor saw patients we got to observe, take blood pressure (we learned to do it manually which was fun), height and weight, fill out forms and teach groups of children about the importance of washing hands. Another group walked around serving as the ATAPs (one of the five members of the team that makes up the EBAIS). The ATAP is a role that all of us from the United States are particularly surprised by. They go around house to house filling out a form for Caja (the health care system) that includes information such as vaccination status of household members, whether anyone has a chronic disease, materials and quality of the house itself, whether there’s a toilet or latrine, etc. I think to most of us this doesn’t seem like information we would freely give out to someone who came up to us and asked for it but here it doesn’t seem particularly problematic since people are used to it as the way things work. Normally though the ATAPs are members of the community. For example, in an indigenous community Caja tries to find an indigenous person to train as an ATAP. So being obvious foreigners with limited Spanish ability and having little experience asking those personal questions it was a bit uncomfortable.

The clinic 

Part of the reason it was so important to get information was that the community was largely made up of Ngöbe migrants from Panama (the vast majority of the Ngöbe live in Panama). Among other issues, migrants might not be aware of the access they have as indigenous people to health care in Costa Rica. The place itself was strange in that it was funded by a wealthy American. He started the organic garden where most of the residents work. The town if you can call it that is also separated seemingly in half between the non-indigenous and indigenous and the poverty was certainly more apparent on the indigenous side. 

CRLA, Homestays and San Jose

I was the first to be dropped off at my homestay. I was a bit disappointed since I didn’t get to see where everyone else lived. My tico dad (Luis) greeted me at the door and then my mom (Mariana) showed me around the house. The house was nice although packed with fake animals and other little decorations. My room was one of three that they keep for students although I was the only one there at the time. As she described her house and family I was a bit depressed to realize how much Spanish I don’t understand. I had thought my comprehension abilities were decent but I couldn’t even make out the family structure. Eventually I think I did work out the details. Luis and Mariana are both retired and their eldest adult son (Diego) lives at home. Diego has a son (also Diego) who lives with his mother elsewhere in San Jose. Their daughter (Johanna) lives nearby alone. Their youngest, Mauricio lives somewhere more rural with his wife. I think what was initially confusing was that the first night there was a teenage boy and his mother eating dinner there. At first I thought this was Diego Jr. but was confused by the fact that I'd been told that Diego was 10. I think I finally figured out that the boy was Mauricio’s nephew and the woman his mother-in-law. Still not entirely sure though…

It was hard at first as I think it always is when living in someone else’s home. I wasn’t sure whether to study inside or outside my room. Should I stay in the kitchen for longer and be social? Should I say goodnight before going to bed? Should I help with the dishes? For the first few days it was also difficult because I wasn’t sure where to run and didn’t know how to get anywhere on my own.

I liked being the only student there.  At dinner time Mariana would warm up my food in the microwave and then sit with me while I ate. She usually ate a tiny bowl of whatever she was serving. She never seemed to lack a topic to talk about which worked for me since I like listening and usually prefer it to talking.  I learned about the different diseases she was suffering from – mainly hypothyroidism and gastritis which seemed to prevent her from eating just about everything. She would say how her hypothyroidism has made her fat and I was never really sure how to respond. Weight doesn’t seem to be such a taboo subject here. Our Spanish teacher at one point asked me how much I weighed which caught my entire class and me off guard. Another benefit of being the only student there was that I had my own bathroom, which was great except that there was no sink so I had to go to Luis and Mariana’s bathroom to wash my hands or brush my teeth.

One day I came home to find two Canadians eating dinner in the kitchen. For the first time in my life I got to translate Spanish to someone else. I never expected to be the translator. They were also vegetarians… apparently they frequently give vegetarians to Mariana. As my time there went on I came to regret having told her on the first day that I eat chicken. I wanted to try it and not be an inconvenience to her but while I don’t mind a little bit of white meat in rice I really dislike the dark meat and cutting it off the bone. Otherwise the food was delicious. For breakfast I had cornflakes with milk and a plate of cubed papaya, pineapple and watermelon. Dinner varied. They don’t seem to have the same concept of carbs. On multiple occasions I was served a huge pile of rice AND spaghetti. Other students in the groups shared similar frustrations.

The homestays are nice because it’s the only time we have our own room. Some of us didn’t have internet though which meant we had to download our readings before heading home and since most of us didn’t have cell phones we had to resort to landlines to stay in contact. Doing research for our Spanish class was the hardest part. Wireless is such an invaluable convenience.

Three mornings a week we had global health lectures at the OTS office or field trips. My least favorite activities were the anthropology exercises. The first wasn't quite as bad. We had to observe people somewhere in the city for an hour. I went to a bar with a friend and we sat in an empty corner where she watched the bar itself and I watched people walking by. I felt like a creep and that's probably how we looked.  I mean really, who has their notebook out at a bar? More awkward than that was going to the Mercado Central (Central Market) on a Saturday morning to the section where they sell fresh meat and produce. We had to observe what the shoppers were buying and interview them about why they came to the market. The vendors gave us funny looks for being in the way and everyone seemed to be in a hurry to get out of there. We were the only foreigners and it was pretty obvious that we had no intention of buying anything. I confirmed that I never want to be an anthropologist- not that I was considering it before.

Most of the time we had class at the Costa Rican Language Institute (CRLA). I was in the largest group and there were only five of us. I really enjoyed the course. It was a great opportunity to practice conversation and our teacher was fabulous. She made sure to give us essential advice like where to buy food, travel and which bars to go to and always had interesting stories about her own life. She also told us about a soda, a little local restaurant, near CRLA where we can get lunch for really cheap. It cost me only $2 for a plate of rice, beans, plantains, and the vegetable dish of the day or picadillo (chopped flavored vegetables) and a glass of juice. 

Volcán Poás

I’ve been impressed with my ability to figure out the public bus system although I had help from my tico family the first day. Although I don’t consider myself to have good direction skills I think they’ve improved by necessity. It feels strange to be an obvious foreigner when I’m on the bus or walking in the city. It’s pretty clear that our group sticks out. Very few of the locals wear shorts but must of us do. In general it’s just much more formal. Is the United States unique in its degree of lack of formality? The woman here all wear makeup and most seem to have jewelry and heels. Sweatshirts or sweatpants are nonexistent.

After a few days Luis finally showed me where I could run. It’s only two minutes away from my house and it’s part of the UCR sports complex. It’s nice because there are a lot of other runners and the sidewalks on the streets tend to be falling apart or nonexistent. It’s also sad to see the numerous stray dogs that wander around probably hungry and sad.

A lot of the other students at CRLA (mainly from Germany and elsewhere in Europe) only had classes from Monday through Thursday so they were always traveling during the weekend. We were jealous because we only had Sundays off as would be the case for the entire semester. I guess I’ve gotten used to class on Saturdays and it’s not so bad since the workload isn’t too heavy.

The beach at Manuel Antonio

The first Sunday we went to Volcán Poás. It was an impressive smoking crater about two hours outside of San Jose. The only downside was that rained pretty much the entire time we were there and was colder than I’d been anywhere else in Costa Rica but it was fun to venture out of San Jose. The third weekend we went to Manuel Antonio. It was our only two day weekend for the entire semester so we were going to take advantage of it. It started off eventfully since we were taking taxis in rush hour traffic that was nearly at a standstill. We got on literally two minutes before the bus took off. Fortunately the rest of the time went very well. We woke up to find monkeys running across the roof of the hotel. Then we went ziplining. I was initially a little bit scared since heights aren’t my think and for anyone who watched Off the Map one of the first episodes was about a ziplining disaster. But I actually felt completely safe and it was really fun. In the afternoon we went to the beach. To our amazement it was not raining and it was gorgeous! For dinner I tried ceviche (fish "cooked" in lime), but was not impressed. Maybe it was just at that restaurant that night but I haven’t tried it since. On Sunday we ended up passing on the actual Manuel Antonio park to go to the beach for a few hours before taking the bus back to San Jose. Of course it was raining when we returned. 

The Courses

First of all I miss blackboard and the in depth syllabi we get at Bowdoin. Here we are often expected to know which readings to do based on the topic of the upcoming lectures and rubrics for papers are usually no more than a sentence. But I think the interesting subject matter makes up for it.

Tropical Medicine and Global Health is pretty much as it sounds. We’ve learned a lot about the Costa Rican health care system which makes me realize just how much I don’t know about it in the US. Although learning about tropical diseases like cholera, malaria, TB, soil transmitted helminths, etc. can be at moments unpleasant it’s fascinating and useful information that I can (although hopefully won’t have to unless I’m working as a healthcare professional) apply to real life situations. It also makes us aware of potential health hazards that we might not have worried about before- like getting parasites from walking barefoot or being bit by a chagas bug while sleeping in sub-standard wooden housing.

The ethnobiology course relates somewhat to my interest in traditional medicine systems but it has opened my eyes to issues in ethnomedicine that I was never aware of. Bioprospecting is probably the largest topic I had never given much thought to. I’ve always thought that many complementary or alternative treatments haven’t been sufficiently investigated and have felt that scientific research has a hard time acknowledging the interactions that multiple plant compounds used in conjunction might have, but I never considered what would happen if treatments were proven to be effective. Do the traditional knowledge holders get compensation and if so in what form? Are communities exploited in order to obtain useful species? Also, I never really gave serious thought to the treatments that may be found through non-plant species such as fungi, insects or animals.  A lot of the classes fall under the category of what I would consider medical anthropology. We’ve discussed how local healers or shamans may be able to work with providers of the system we are accustomed to. For example, in one culture, oral rehydration therapy for children with diarrhea was considered bad because of humoral classifications but if people who understood the traditional beliefs could slightly modify the ORT recipe it may be able to become acceptable to the local people.

The research practicum course has involved many more lectures than I anticipated and is probably the driest component, but maybe (big question mark) it’ll be useful in the future. We turn in observations for all our field trips and have done some mini projects. For the actual practicum part I’m working with three others on a project that has us comparing the composition and structure of indigenous and non-indigenous medicinal gardens in the southwestern portion of Costa Rica. This is the final portion of the program. This week we’re collecting data in order to present our findings and write our paper next week.

The field trips we have taken have related to all three courses. It’s been a neat way to familiarize ourselves with the country. We’ve visited a number of indigenous territories, EBAISes, a hospital, banana and pineapple plantations, a water purification plant and an infectious diseases lab (perhaps other places that aren’t coming to mind right now). It makes me wish that I knew what comparable places were like in the U.S.

There are three other rather large components of our course. These are projects that we research and present to the class.

The first is Plants- we research a local plant family and group and present it to the class. Since mostly everyone here is premed and not ecology majors this tends to be the most dreaded subject. It’s interesting to learn some random facts though. For example cacao, marshmallow, and cola (as in coca cola) are all in the same family (Malvaceae if you were curious).

The second is something called Know Your World where we present on the health care systems of other countries. This is really fascinating information but I don’t feel like I’ve retained that much from the presentations earlier on in the semester. Even after having an hour lecture on the Costa Rican system it took me a while and many visits to the local clinics to really internalize how the system works. I presented on Canada though which I really enjoyed and I think I got a lot from it. It’s more similar to the US than I thought in that the doctors don’t work for the government and the system varies depending on the province. We’ll be learning about France tomorrow.

The third is Journal Club. This is where we’re divided in partners, choose a topic related to medicine, have our classmates read a few articles on the subject and then discuss it for an hour. We’ve had issues ranging from medical tourism, sex ed, medical tv shows, obesity, etc. It’s really interesting to hear everyone’s opinions and different experiences since many of them have had a fair bit of exposure to health care in the US and elsewhere and have taken related classes at their colleges. 

The Beginning

Everyone was talking about flights on the program facebook page and it appeared that I was going to be the last to arrive (at least of those who posted) so I was glad to get to baggage claim and see someone with a Duke sweatshirt on- fortunately he and two others who had been on the same plane were indeed on my program. On the drive to the hotel we were most surprised by two things: fast food chains we knew from the United States and barbed wire surrounding the schoolyards. When we arrived at the hotel I again regretted how much I had packed because we had to drag our luggage up two flights of stairs.

In the morning we had our first Costa Rican breakfast with gallo pinto (rice cooked with beans and spices/herbs), scrambled eggs and fresh papaya, watermelon and pineapple. I’m a fan and definitely plan on learning to cook gallo pinto when I get back to the states.

We spent the day at the headquarters for OTS, or OET (organización para estudios tropicales) in Spanish, which is located at the University of Costa Rica, the largest university in the country. They told us what anyone would expect from an orientation… don’t walk alone after dark, wear rubber boats when walking outdoors so you don’t get snake bites, don’t wear your field pants twice to avoid chiggers, watch your stuff on public buses, etc. We also learned some typical Costa Rican phrases such as ticos (what Costa Ricans call themselves, apparently due to the fact that the use diminutives for many of their words… for example aguita- little water, cafecito- little coffee, pancito - little bread, ahorita – little now?, anyways, you get the point), mae, pura vida and that it’s best to ignore the cat calls/piropos.

Las Cruces

The trip from San Jose took us 6 hours by bus. We took the road that went by the coast. Although we’d make the trip five more times during the semester that was the only time we were able to take that route because it deteriorated too much during the rainy season, which lasts through November.

The first morning a dozen of us went running. The hills are intense. I wish we had ones half that size to train on in Brunswick or Amherst. The roads are fairly narrow and curvy so it’s a bit nerve-wracking when big trucks speed by. The views are nice though. Everything’s extremely green and in the mornings it’s really pretty with mist still hanging over the valleys.

The weather pattern became fairly predictable. The morning was usually sunny or overcast and the rain would start in the afternoons. I was surprised that it was dark by 5. I guess I had expected that countries closer to the equator would have more hours of daylight although in retrospect I should’ve expected the twelve hour split.

Las Cruces is primarily a botanical garden so during that first week we got to take a tour of the area. We started to recognize the now familiar heliconia flowers, the variety of palms and the agoutis (fairly large rodents) that run around the gardens.

The food is delicious, served what we call “family style” because the dishes are put out on each table, all of which seat seven. The vegetarian options have been quite good, including stuffed zucchini, lasagna and other dishes I didn’t expect in Costa Rica. Despite how much I like rice and beans I always enjoy the spaghetti and pizza days. The rice seems to be cooked less than I am used to (different variety or method of cooking than Asian rice?) and I miss brown rice. They commonly serve what is frequently translated as “natural drink” which is usually a heavily sweetened juice. We made a daily game out of guessing which fruit it was made out of. Passionfruit is my favorite.

Our dorms remind me of what a typical summer camp might be like. Rooms sleep 3-6 and they’re all bunked. There’s not so much space for luggage so suitcases end up scattered about the common area. It reminds me of freshman year in a way. Everyone congregates in the common area, studies together, walks to meals together, etc. Even more, we all take the same four classes.

Overall I think the hardest thing to get used to was throwing toilet paper in the trash (the septic systems are sometimes narrower here than we’re used to in the U.S.)

During that first week we went on our first field trips for the semester. We visited an EBAIS (Equipo Básico de Atención Integral en Salud), which is the name for the team of health care workers that provide their primary level health, in an indigenous territory for the Ngöbe and another that serves non-indigenous people nearby. When we were at La Casona, the Ngöbe territory, it struck me how much warmer it was than at Las Cruces even though we had driven slightly less than hour. Even now, Costa Rica’s microclimates continue to amaze me. Also notable was that although there was a stream that ran right by the community, they did not have running water in their homes.

To put EBAISes in context let me give a few details about the health care system here. Every community of 4-5,000 has a building for the EBAIS and at least five people who work as part of the equipo (team): a physician, a nurse, a primary care technician (ATAP), a records technician and a pharmacy technician/pharmacist. Costa Ricans health expenses are covered through Caja Costarricense de Seguro Social through paying part of their income and their employer paying another part. Children, students 18-25, spouses of workers and indigenous people are all automatically covered. The regular payment also covers disability, maternity and the elderly. At the primary level patients are referred to secondary level clinics or regional hospitals or to the tertiary level at hospitals in the capital. So in summary there is a level of similarity in care that I would not expect in the United States but infrastructure does vary from place to place and transportation and culture can affect the ease at which health services are accessed. 

Summary

So for anyone interested I’ve decided to start a blog. I’m not sure whether it counts as a blog since I’m starting it two weeks prior to returning home but hopefully it will hold me accountable to record my experiences before I forget many of the details.

People asked me prior to my departure what exactly I would be doing in Costa Rica but I was unable to give much of an answer besides the names of the courses listed in our syllabus (Spanish Intensive, Tropical Medicine and Global Health, Ethnobiology, and Research Practicum), that we would be traveling around the country and visiting clinics. Those parts still hold true, but I can give a little more detail now. The program is through the Organization for Tropical Studies (OTS) through Duke University so about a third of us (23 in total) are from Duke.

After arriving in San Jose, the capital, we went south (close to the western border of Panama). It seems to be about a six hour drive to reach the border in any direction. There at Las Cruces in San Vito (one of the three field stations that OTS has) was to be our home base. We are currently here for the last time. After Las Cruces we spent the next three at homestays in San Jose while taking Spanish classes at the Costa Rican Language Academy and continuing our regular lectures three times a week. Between San Jose and our weeklong midterm break we traveled to indigenous territories, an organic farm, Nicaragua, and a biological station owned by Texas A&M. After break we returned to San Jose to have lectures and go on field trips, went to La Selva (another OTS field station), more indigenous territories, an ecolodge, and are now finally back at Las Cruces.

Overall it has been a fabulous experience and easily my favorite semester so far. Although it can be exhausting always traveling around, living out of a suitcase and having a schedule that seems to change daily, the stress level is definitely lower than at Bowdoin. I have confirmed that I never want to do anthropological field work or spend my life devoted to any sort of field research for that matter. It has been interesting although sometimes perhaps a bit intense to be living with mostly pre-med students. Perhaps because of this I have thought about medicine in ways I never did before and now am more devoted to pursuing a career in health care.