Costa Rica part 1

*** apologies for the length, I'm trying to cut it down by putting it up as 4 parts, but even then... I tend to be wordy.

Day 1 (Thursday)
Thursday never actually started... that might seem weird, but let me explain: I didn't sleep at all on Wednesday night. Wednesday was our last physiology exam, and there was so much to do and not enough time that I just kept going until I got home at 4 am (at which point I realized I actually had to pack... stuff was on my bed but no where near in my suitcase, a problem, seeing as my ride was coming at 5 am to take me to the airport).

We all got to the airport by 5:30 for our 7:30 flight. What was really nice was that the Ecuadorian team was on the same flight to Miami with our teams, which meant lots of friends (including my roommate) to hang out with and keep us all awake.

We arrived in Miami, where we said goodbye to our friends going to Ecuador, and headed to our connecting flight to San Jose. At this point everyone was still rather quiet (we hadn't gotten use to the whole group dynamic yet, although that would come very soon).

Three hours later we were in Costa Rica! We met up with Gail, our contact and head of the humanitarian foundation we were working with. We climbed in the bus as we saw all our suitcases being loaded into the back of a truck (all hoping that nothing would fall off) and made our way to the main clinic we would be affiliated with while in country.

A view of San Jose right before landing

Paige and Me, so excited to be in Costa Rica

When we arrived at the clinic Gail gave us some introductory information about La Carpio, where we'd be for the next 3-4 days. It is an area where the Nicaraguans were squatting land. The location of the main clinic was were the first wave of immigrants started living, this meant that it was more developed than some of the other areas. The other main area we would be working in was called La Libertad, this is where the third wave of immigrants were living, and was the poorest of the three areas in La Carpio.

Some of the girls at the main clinic getting ready to learn about La Carpio

After some more general information, we made our way to Santa Ana, where we would be staying in homestays. When we got there we were introduced to our moms and started walking to our houses. What seemed like a long trip (which Natanya and I soon realized was not at all) led us to a small blue gate. Inside there was a common party area, pool, basketball court and futbol (soccer) field, all this was shared by the few houses on the property.

Once we got to the house we started getting to know our family a little better. Our mom, Nena was a sweet lady who made clothes in her own sewing room (off to the side of the house) and our sister, Gloriana, was a senior in high school about to finish her accounting certification. The dad (we would later find out) worked as a maintenance man at one of the hotels in San Jose.


Day 2 (Friday)
Friday morning we woke up early (7 am) and had rice and beans for breakfast (the first of many, but it was good). Our mom gave us our lunches and we walked our bus stop (aka Broadway Beauty, which had a nice large parking lot that we all met up at). We got on the bus and headed back to La Carpio.

Roommates on our first day of clinic

Waiting for the bus... or rather, waiting to get on the bus.

My team was sent down to La Libertad for the first day, while the other team sorted drugs and ran the main clinic. We walked the 15 minutes down to the clinic and got ready to see patients. What was really nice was that since it was a small clinic we got to work in groups of 3-4 (meaning each group could easily either get a translator or had someone who spoke good Spanish). The only problem that first day was that we didn't have drugs for the awhile, and even when we did, we didn't have what we really needed. Other than that, everything went smoothly.

Walking down to the clinic, through La Libertad

Where we held our makeshift clinic in La Libertad

Berger and Murph taking some HPIs
(aka history of present illness for you non-medical folk)

Patient of the Day: We saw was a women complaining of headaches lower and back pain. Normally I would have just assumed general muscle pain, but Dr. Rainer (who is a PMR... aka, physical and medical rehabilitation doctor) specializes in this stuff and showed us all otherwise.

We went back to the examining room and ran a few tests. In one you put your hands on the top of the pelvis and your thumbs at the sacro-iliac joint. He then had her lift her legs, you could feel the sacro-iliac joint moving, which is not a good thing. Diagnosis: mobile SI joint. This is what was causing the lower back pain. Treatment: Muscle relaxants and building up her ab muscles. We also managed to diagnose migraines, so we gave her some more hard core meds than acetaminophen for her headaches.



That afternoon we all got on the bus and headed to Juan Sanchez's house. Mr. Sanchez is a traditional healer. He talked to us about the importance of western medicine healing diseases while he helped to heal the spiritual problems. He also mentioned how people called into medicine are called by God and have a special purpose in their lives.

Inside the main hut
(Juan's the guy in the yellow shirt on the right)

He then walked us around his grounds. We got to see the "isolation" tepees, where sick people go to get better, the burial grounds, and this wood structure that had "holy bones" on it. He also showed us a little museum he had of artifacts, some dating thousands of years... it was really interesting to hear about the history of some of the pieces. It was a very interesting afternoon, but I really enjoyed it.
The Traditional Burial Grounds
(Costa Rica has just re-allowed for traditional burial to be reinstated)

The Powerful Bones

We finished the trip off by Mr. Sanchez showing us how they extract sweet water from sugar cane, and then let us all try... We also sucked on the bark a little bit and then got a little cup of the sugar can juice.

Pressing the Sugar Cane

Enjoying our Sugarcane Juice

The Whole Team

That night we all (minus Natanya, who was sick) went our to the bar to hang out and relax. There was a really funny show on called Fist of Zen... the premise is pretty much the same as Jackass only it was a group of friends in a church, which meant they couldn't make any noise. While there two of the guys got drinks called La Cucaracha, which was tequila that they set up fire... they had to drink it up through a straw. Overall it was lots of fun.

Paige and Jamie enjoying huge frozen margaritas

Buggia drinking down his flaming tequila
(I promise it was actually on fire)

Day 3 (Saturday)
Saturday we found ourselves back at La Libertad, only this time we had all the drugs we needed. I spent most of the morning setting up and running the pharmacy, which was crazy busy and involved way more math than I was planning on doing. But it went well and we figured everything out (mostly to the thanks of Dr. Rainer).

La Libertad

The pharmacy, and the group taking a lunch break

Patient of the Day: After finally turning over the pharmacy to another student, the first patient I got to see was an elderly women complaining of knee pain. She said that she had been taking acetaminophen, but it wasn't really helping the pain at that much. We noticed some swelling in her knee as well. When we presented to Dr. Rainer - Diagnosis: Pes Anserinus Bursitis, Treatment: Steroid Injection. Dr. Rainer then asked whether the patient would be okay with getting an injection, she said yes. His next question: Who wants to do it? My answer: Yes!!

A few minutes later I had cleaned the area of the knee overlying the pes anserinus and got ready to do the injection with the instructions of: go in until you hit bone and then pull out a few millimeters. Nervous?! Uh.. YEAH!

And then I did my first injection.

The procedure was a success!!!


Right after Joel, Dr. Rainer and I got to do a home visit. There was a lady who was having a reaction to an influenza vaccine the day before. We walked through La Libertad to her house and got to see first hand the conditions that these people live in... it was a very sombering experience. But the lady was super cute, she didn't know how old she was and was partially blind... she was also been struggling with allergies since she arrived in Costa Rica two years ago. We gave her instructions to put a hot rag on top of the injection site, gave her a whole bunch of allergy meds, and also some acetaminophen for general pain that she was also having.

That night we all went out and did a little dancing, but instead of hitting up two bars (with the rest of the group) Natanya and I headed back to get some much needed sleep.