Penn State students studying health policy in Costa Rica

November 28, 2012 

Editor’s note: Sara Young is a Penn State student who will be writing updates from San Jose, Costa Rica, as part of a trip with members of her health policy and administration class.

Day 4: Touring the Abanganres Clinic in Los Juntas

Our road trip yesterday resulted in amazing views of the countryside, but we were unable to visit the crater of the volcano on our route due to thick cloud cover. After arrival at our hotel (complete with outdoor roosters, kittens and lizards), we ate dinner together and reflected on the people who helped make this amazing opportunity possible. We are extremely grateful to the Health Policy and Administration Undergraduate Program, the Stanley Mayers Endowment, the Pennsylvania Commonwealth Scholarship Fund, the Schreyer’s Honors College, the Office of Global Programs, and our families and friends that have supported us.

We rose with the roosters and started our morning early at the Abanganres Clinic in Los Juntas. After splitting into teams of two and three, each team was assigned a health care worker to shadow. Some of us stayed at the clinic to observe some of the nurses and their patient check-in process. Others went out into the village of Las Juntas with community nurses (translated as assistant technical attention primary, or ATAPs,) who provide regular home visits for all individuals who cannot make the trip to the clinic for primary care. All of our teams were able to see the preventative emphasis of the Costa Rican health care system in action through the individual and personal approach of the nurses.

Christine Comizio, a senior HPA major from Vienna, Va., was especially touched by the large impact of the technician, Jairo Martinez, she followed.

“I found it incredible to learn the ATAP we shadowed today visits 741 houses per year, and many of those multiple times per year,” said Comizio.

Tomorrow we will rotate teams and all students will be following a different nurse or technician.

What we have seen thus far is impressive, and we are starting to learn why Costa Ricans’ enjoy a long and healthy life, with a similar life expectancy to ours. In a country with no military, they have the resources to provide health care to everyone, as well as a high level of education. We’re halfway done with our trip, and although we’re exhausted, we can’t wait to see what else Costa Rica has in store for us.

Day 3: Visiting San Jose’s Hospital Dr. R. A. Calderon Guardia

This morning we visited San Jose’s Hospital Dr. R. A. Calderon Guardia. There we met with Dr. Oscar Saenz Quesada who gave us much insight into the different types of hospitals and physician education available in Costa Rica.

The Calderon Guardia hospital is a public hospital that serves part of the 90 percent of citizens without private insurance. We toured the facilities, and saw the truth behind Quesada’s sentiments that the appearance of the hospital doesn’t demonstrate the high quality outcomes they produce.

We also met with Dr. Alejandra Mendez, a resident in training to be a gynecologist, who showed us the delivery rooms. We were impressed to learn that none of the women who give birth in public hospitals are given epidurals, and that it is a country policy that the baby must stay with the mother for 24 hours immediately following birth.

This afternoon we will travel three hours to the small city of Las Juntas. On the way, we will have lunch at a coffee plantation. If weather permits, we will also visit the Poas volcano, which is the second largest crater in the world at 1 mile wide. We are all looking forward to seeing the rural side of Costa Rica, more of the healthcare system and more beautiful sights.

Day 2: Touring the Hospital Nacional de Ninos

After an outdoor breakfast with Costa Rican coffee, our day began at the Hospital Nacional de Ninos, the major children’s hospital serving all of Costa Rica. We toured the 314-bed facility including the neonatal unit, the operation waiting area and the in-house tutoring center. We then visited the Ministry of Health and spoke with Dr. Valverde, ministry psychiatrist, and Dr. Castillo, vice minister, about Costa Rica and its health care system. The nation currently has a population of 4.5 million, a female president and no military. Costa Rica has been providing health care for all residents — including illegal residents — since the 1920s.

The Ministry of Health works to promote health, develop and enforce health care policies, and ensures adherence to health codes. It was an exciting first day in the country, and we are looking forward to tomorrow.

Day 1: Arrival in Costa Rica

Today was the first day of Penn State’s health policy and administration class trip to Costa Rica. This travel course will involve visits with the Ministry of Health officials in Costa Rica, tours of public and private hospitals, meetings with health administrators, public health workers and physicians and nurses.

We arrived safely in San Jose tonight, and are eager to start our experience tomorrow morning at a children’s hospital. We are especially grateful to the health policy and administration department for sponsoring our trip, and we can’t wait to get started!

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