Alajuela

Around 9:00am, we arrived at the hospital in San Ramon, Alajuela.  In contrast with my group’s hospital visit last week, the hospital in San Ramon was well managed, highly competent, and well prepared for us. The staff quickly led us to a conference room, where the senior engineer and several technicians gave a presentation about the hospital in San Ramon and Costa Rican healthcare in general. The senior engineer presented in Spanish, but prepared the presentation notes (powerpoint) in English for our convenience. He was proud that Costa Rica (population 4.5 million) was able to economically support public healthcare and a medical infrastructure, and told us that Costa Rica served as a healthcare model for other nations. More preeminently, I wish that his hospital would serve as a model for other hospitals in Costa Rica, such as the one we visited last week.

Until lunch, we worked with Ric to diagnose problems with an electrical surgery unit, an infant incubator, and an anesthesia machine, all of which had just arrived from other hospitals. Since this hospital’s techs didn’t need any help fixing stuff, they saved some equipment which was sent to them from elsewhere for us to look at. During this time my partner, Tom, and I talked to Ric and learned more about his background. He has worked as a medical technician for over 30 years, having received his undergraduate degree in aeronautical engineering. Using his expertise, he quickly found the problems with each machine and told us and the hospital technicians how to fix them. Of course, we had to test the electrical surgery unit, so we used it to slice through a raw potato in lieu of flesh.

About five of us from the EWH group were joined for lunch by the hospital technicians. I ended up talking mostly with Marcelo, who spoke to me primarily in English while I spoke to him mostly in Spanish. He has a latin band for which he plays bass and sings on weekends, and we enjoyed talking about different instruments. We also talked about the differences between the weather and food in Costa Rica compared with that of the United States, as well as the similarities between Costa Rica and the United States concerning government corruption (jailed Illinoisan governors and Costa Rican presidents).

After lunch we were given a hospital tour, and I was especially excited by a “butterfly garden” in which nearly 30 species of Costa Rican butterflies fluttered therapeutically around us. Just as we were getting ready to leave, a large butterfly landed on Tom’s face. Despite his uncomfortable groans and facial contortions, the butterfly remained on him and began to climb down the bridge of his nose. Reaching the tip, the investigative creature put a couple of its feet into his nostrils (butterflies taste with their feet). Apparently unsatisfied with the taste of Tom’s nose, the butterfly crawled further down, uncurled its proboscis, and proceeded to feed from the surface of his teeth. Meanwhile, as Tom continued to openly display his discomfort, we laughed while taking pictures and videos of the incident. I only wish that it had instead happened to me.

After the butterfly garden, we went to the x-ray area to learn about various kinds of x-ray machines and their uses (the basic funness-factor of our journey today was paramount to a grade school fieldtrip). We saw standard, fluoroscopic, and mammography machines before returning to the shop to learn more from Ric before leaving.

Immediately following our most delicious supper at the homestay (and the food seems especially good now that my stomach has been feeling better) most of us began our anti-malarial course of chloroquine. Taken once weekly as a small pill, this drug prevents malaria from metabolizing hemoglobin, thereby effectively starving the blood-borne parasites. Initially classified as too toxic for human use when discovered in 1935, chloroquine has expected side-effects that include itchiness, headaches, nightmares, and blurred vision—a fair trade for preventing malaria.