We first went to Las Alturas, a 25,000 acre preserve in the mountains. It's a pretty strange set-up: the reserve was bought by this billionaire from the States. The vast majority is conserved rainforest, with an abandoned coffee plantation and a cattle and dairy farm stuck in there as well. Most of the cultivated land is a personal hobby of his, and he grows lots of organic food. He hires lots of workers, mostly Ngobe people from Panama, to come work the land for him, and they live in the small town of about 100 permanent residents.
The first day we took a tour of the town, learned a lot about the plants being cultivated there, and learned that you can get facepaint dyes out of a certain kind of plant, achote, demonstrated here:
Lots of Ngobe women came to the clinic while we were there. In Ngobe culture, they get "married" around age 12 or 13 (I put married in quotes because they don't have monogamous unions like we do; while they use the terms esposo/a, Ngobe men can live with many different women and have children with many different women as well (although the women usually live in separate houses). It was incredible to think that the twenty-one year old pregnant woman who came in was barely older than me and already had three children and one on the way. Another twenty-eight year old woman had six children at home!
The patients trickled in whenever -- there were no appointments, but they were told that Dr. Benavides was at the clinic and they could come in for the next two days and get checked out. Indigenous groups are one group that gets free health care coverage under Caja (along with children, the elderly, and pregnant women), but most of the indigenous people here had coverage from their husbands/fathers who were employed at the ranch.
A lot of cases were dietary -- three children in one family had anemia -- and one man's problems (dizziness, weakness) stemmed from lack of food (the prescription was the snacks that I had carried in my bag -- Chikys save the day). Other appointments involved a brand new baby (two weeks old) and a pregnant mother, so we got to watch Jorge do the newborn baby exams (reflexes, cataracts) and fill out the prenatal paperwork.
We were going around to the houses and the neighborhoods as well, compiling information for the Ficha Familiar. This is basically a checklist that the ATAP (Asistente Tecnica de Atencion Primaria) normally completes. The ATAP, as I may have mentioned earlier, is a super-technician. He or she actually goes around to houses, knocks on their doors, and checks to see that vaccinations are up to date (required by law for Costa Rican citizens) and they are on time for their doctor's appointment.
It was an assignment that felt a bit awkward to complete, because we were basically knocking on doors and asking people to give strangers personal information. They had no problem with revealing their health history though. There's no way you would see this level of cooperation in the United States, but then again many Costa Ricans have trust in their health care system -- except for hospital births, which I'll get to later.
The next day, we went on a hike around Las Alturas. From the summit, everything you can see is untouched forest (yes, even that shadowy place). The hike was only about 2 kilometers, but the whole way was up a steep hill! While it took about 2 hours to get up, it took about half an hour to go back down. All in all our elevation at the top was around 2000 meters (1550 m elevation at our little cabin).
Nights at Las Alturas consisted of watching Rx for Survival and playing bananagrams (or, going with platanos, the Spanish word for banana....platanograms?). Although we didn't have electricity or Internet, we DID have a generator that went on from 6 pm to 9 pm every night, so we only had one lecture by candlelight.
Right now our group has learned about various diarrhoeal diseases as well as Chagas disease and tuberculosis, so the hypochondria is starting to kick in. The main casualty, however, has been the chigger invasion. Luckily I've managed to avoid it - thanks for the DEET-ing of my field pants and socks, Mom!
In other news, I've started/am 75% through reading The Girl With The Dragon Tattoo. I'm not wild about Mr. Larrsson's characterizations, but I can't deny that the book is incredibly gripping. Somehow even with all our daylight hours filled up I've managed to cover 450 pages.
This is already a pretty hefty post, so I'll save the Boruca story for tomorrow!
Hasta mañana!
Anya
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