Costa Rica 2017

*Photo from lookout point near Manzanillo Beach*

Our time on the Caribbean coast in Puerto Viejo was the best part of the trip for me. I really loved the relaxed feel of this town. The people were so friendly and welcoming. The beaches were beautiful and the food was delicious! Puerto Viejo seemed to have its own culture entirely. I was also glad that we were able to help the community by volunteering to pick up trash on one of the beaches. One of the days in Puerto Viejo, we were able to ride bikes to Manzanillo Beach. On the way my bike broke and two locals who were at the side of the road did not even hesitate to come help me. This really showed me the importance of community, and the pure kindness of this town.

*Photo above shows some of the Bribri people roasting cocoa over the fire*

It was so amazing to be immersed directly into the Costa Rican culture, this really allowed me to learn so much about it. I was able to learn about the strong family values and work ethic of the Costa Rican people. I was also exposed throughout my trip to the continuous kindness and positivity that these people possess, it was very inspiring. The people of Costa Rica have such an optimistic outlook on life, and to share this idea they say “Pura Vida!” We were also able to learn about the unique culture of the Bribri indigenous people. These people really valued the use of plants for many purposes, such as food and medicine, as well as natural dyes for making clothes and goods. This trip was such a learning experience, and there was no better way to do it than to jump right into the Costa Rican culture!

*Photo from hanging bridge walk in the rainforest*

Ecotourism is the utilization of natural resources as a source of income. Some examples of this that we experienced in Costa Rica are the hanging bridges in the rainforest, rainforest and volcano hikes, farm tours, and touring the Bribri indigenous reservation. All of these activities require little investment from the country, as they are all naturally occurring, but they bring in a good income from tourists. Utilizing natural resources like this is a good strategy to help the economy in tourist areas in many countries.

*The photo above shows two  women working hard making tortillas to sell at a small stand in La Carpio*

It was extremely eye-opening to visit La Carpio. Upon meeting Gail Nystrom at the Costa Rican Humanitarian Foundation we learned more about the Nicaraguan immigrants living in La Carpio, and how the Cycle of Poverty relates to their daily struggles. The decay and unsanitary conditions that existed in La Carpio was shocking. The streets and river were filled with trash, and the town was located right next to the garbage dump. Many garbage trucks traveled through the town each day to reach the dump, creating a dusty, garbage filled environment as well as noise pollution for the people of La Carpio. Many children were seen playing on the streets, while the women sold food and goods out of small stands in front of their houses. Some med were seen on the streets, but many were not present. One state-run health clinic is located in La Carpio, but with limited operating hours. Through all of the poverty, it amazed me how optimistic and hopeful the women and children were that I met. These women had hopes and dreams for a better future. They were also extremely open to our presence in their town, and our willingness to learn more about the way they lived. I think that the women and children learned from us through the projects and activities that we presented to them, but mostly I feel that we learned so much from them. I learned what its like to struggle and to overcome unimaginable losses, but above all else I learned about perseverance and HOPE.

I  early January, 2017, I will be traveling to Costa Rica! This will be part of my Public Health clinical experience, as I am a nursing student. The main purpose of this trip is to implement public health interventions and projects to populations in need. Prior to my trip, I have done quite a bit of research on the country and compiled a preliminary Needs Assessment for the city of La Carpio, Costa Rica. My Needs Assessment consists of a Windshield Assessment and a SWOT (Strengths, Weaknesses, Opportunities & Threats) Analysis of La Carpio. In my Windshield Assessment I identify many aspects of La Carpio, which helped me to better understand the area.

*The photo above shows the streets of La Carpio. Poverty and instability is evident.

My Windshield Assessment is as follows:

La Carpio, Costa Rica – located in San José, Costa Rica. San José is a province of Costa Rica, as well as the capital of the country and Costa Rica’s largest city (“San José, Costa Rica,” 2016).

• Housing- age, architecture, materials, similarity, general condition. 

 

• Old materials that appear to be recycled from other uses are used to build houses in La Carpio; such as tin panels and wood. Single level houses. Housing is close together, area seems to be densely populated. Homes do not appear to be very weather resistant or sturdy for extreme weather conditions. No real security for homes. Some electricity. Use outdoor plumbing/ outhouses.

• Boundaries- where does the community begin and end 

 

• The northern border of Costa Rica meets Nicaragua, and the southern edge meets Panama (“Costa Rica,” n.d.). The northern boundary of La Carpio is defined by Río Virilla, while the southern and eastern borders runs along Río Toíres (“La Carpio,” n.d.).

• Commons- neighborhood hangouts, hours open, restaurants, parks, drugstores, etc. 

 

• Kids hangout on the streets playing games with local children. Appears to be a paved park/sports area for children to play. There are two known drugstores with pharmacies in La Carpio.

• Transportation, major highways, road conditions, public transportation, gas stations 

 

• Some paved road, others are dirt. Some cars and busses for transportation. Most people get around on foot to local destinations. Foot bridge for residents to cross the river.

• Service centers- social service agencies, rec centers, schools, and activities at the schools, health care providers, spiritualists, palmists, dentist, doctors 

 

• Appears to be one church and some schools, but no high school or college/universities. Costa Rican Humanitarian Foundation volunteers at local schools in La Carpio. Library was pictured to be in La Carpio. A few health clinics, but not having the same standards as our hospitals in the U.S. The poor residents try to find any jobs they can get, including garbage pickup, house cleaning and outdoor maintenance for richer homes. Police presence for protection. Police have authority to remove children from unsafe homes; similar to our CPS system.

• Stores 

 

• Some small shops. Vendor carts sell groceries.

• Street People- who do you see outside, how many, animals, pets, etc.

 

• People living in La Carpio include “thousands of refugees from the Nicaraguan civil war of the 1980’s and 90’s have settled.  They are mostly undocumented immigrants, and they have been mostly ignored by the governments of San José and Costa Rica” (Miller, 2015). Many children play in the streets as this is their only form of entertainment. Stray dogs running around the streets.

• Signs of decay 

 

• Housing falling apart, graffiti, garbage, not well kept.

• Race 

 

• “White (including mestizo) 94%, black 3%, Amerindian 1%, Chinese 1%, other 1%” (“Ethnicity and Race by Countries,” 2000).

• Ethnicity 

 

• Nicaraguan immigrants and Central American.

• Religion and religious houses 

 

• Christian. Multiple churches.

• Health and morbidity- do you see signs of chronic diseases or conditions, accidents, alcoholism, drug addiction, mental illness etc., where are the hospitals and clinic 

 

• No hospital in La Carpio, but Hospital Mexico is to the east. Hospital Mexico is a 13-minute drive, or about an hour walk from La Carpio. Disease is easily transmitted because of the lack of education, close living conditions, and lack of sanitation. The Costa Rican Humanitarian Foundation (CRHF) has a community clinic in La Carpio. This clinic includes many health services and therapies (“La Carpio,” 2016). Yellow fever is prevalent in La Carpio.

• Politics- do you see any campaign posters, a headquarters, and predominant party affiliation? 

 

• Democratic government. Costa Rica does have a president who is elected every 4 years, as well as two Vice Presidents at a time.

• Media, do you see satellite dishes, antennae, types of media in stores. What TV and radio reception is available? Cell phone availability?

 

• La Carpio is a poor community. They do not have cell phones or advanced technology. They do have some electricity, but it is not always reliable. Many families cannot afford electricity.

 

 

Costa Rica. Retrieved October 20, 2016, from Google Maps,             https://www.google.com/maps/place/Costa+Rica/@9.622939,- 86.4987101,7z/data=!3m1!4b1!4m5!3m4!1s0x8f92e56221acc925:0x6254f72535819a2b! 8m2!3d9.748917!4d-83.753428

Ethnicity and Race by Countries. (2000). Retrieved October 20, 2016, from InfoPlease, http://www.infoplease.com/ipa/A0855617.html

 

La Carpio. (2016). Retrieved October 20, 2016, from Costa Rican Humanitarian Foundation, http://www.crhf.org/

 

La Carpio. Retrieved October 20, 2016, from Google Maps,             https://www.google.com/maps/place/La+Carpio,+San+Jos%C3%A9+Province,+San+Jos  %C3%A9,+Costa+Rica/@9.9632005,-84.1550686,17z/data=!4m5!3m4!1s0x8fa0fb98a09e5e37:0xb88f5c59c7edc3ef!8m2!3d9. 9611015!4d-84.150109

 

Miller, M. (2015, January 30). La Carpio may be Costa Rica’s worst ghetto – the real San José.    Retrieved October 20, 2016, from The Real San José, http://www.therealsanjose.com/la-carpio-may-costa-ricas-worst-ghetto/

 

San José, Costa Rica (2016). . In Wikipedia. Retrieved from            https://en.wikipedia.org/wiki/San_Jos%C3%A9,_Costa_Rica

Throughout our trip we will be working with the Costa Rican Humanitarian Foundation to implement interventions, that we have created, to populations in need of support.  I have been working on a SWOT (Strengths, Weaknesses, Opportunities & Threats) Analysis of La Carpio. Performing this SWOT Analysis made it easier to identify strengths and, more importantly, areas in need. This analysis helped us to focus in on our projects and interventions.

 

My SWOT (Strengths, Weaknesses, Opportunities, and Threats) Analysis of La Carpio is as follows:

Strengths:

• Costa Rican Humanitarian Foundation – non-for profit organization; put in place to work with the community of Costa Rica to provide support and resources, “developing creative and economical solutions to a wide range of social problems” (“La Fundacion Humanitaria Costarricense Inicio Voluntariado en Costa Rica,” 2015).
• Police presence – have authority to remove children from unsafe homes; similar to our CPS system.
• Sense of community; everyone looks out for one another; importance of religion; strong work ethic
• Agricultural – coffee and pineapples bring in a profit

 

Weaknesses:

• Living in poverty – results in lack of access to resources (poor housing conditions, healthcare, jobs, food, etc.)
• Lack of education
• Lack of technology
• No hospital in La Carpio – closest hospital is an hour walk away (most people do not have their own cars), or 13-minute drive if they’re able to catch a bus
• Undocumented Nicaraguan Immigrants – not recognized as citizens, this effects their access to jobs and resources
•  

Opportunities:

• Volunteer work – to educate and empower women and children; building houses; improving common hangout spots for kids; provide assistance with food, healthcare, resources
• Creating jobs – would provide a reliable income, resulting in access to healthcare, food, and other vital resources

 

Threats:

• Health – Close living conditions and lack of sanitation results in an increased risk for the spread of disease

• Location – surrounded by polluted rivers and landfill; cannot use contaminated water
• Safety – drug use and violence
• Isolation – ignored by government as immigrants; lack of information received from public and government; no voice
• Money – lack of revenue to the area of La Carpio r/t not being a common tourist destination

 

 

 

 

 

 

3 main health concerns of the region:

1. Domestic violence

• Trauma Theory (Judith Herman)
• Project – empower women in La Carpio who have experienced domestic violence. Using art therapy and group discussion.
• Healthy People 2020 objective related to your project: “Reduce physical violence by current or former intimate partners” (“Injury and Violence Prevention,” 2014).

1. Violence amongst children
2. Self-esteem, not drugs

La Fundacion Humanitaria Costarricense Inicio Voluntariado en Costa Rica. (2015). Retrieved    November 1, 2016, from Costa Rican Humanitarion Foundation, http://www.crhf.org/

 

The prevalence of domestic violence around the world is alarming. According to WHO, “about 1 in 3 (35%) women worldwide have experienced either physical and/or sexual intimate partner violence or non-partner sexual violence in their lifetime” (WHO, 2016). Throughout the semester we have been working to create a project or intervention to implement while in La Carpio, Costa Rica. Working with a support group, that has already been formed by the Costa Rican Humanitarian Foundation, we will be working with survivors of domestic violence. Our goal is to empower these women through holistic art therapy projects. We will be making domestic violence awareness bracelets, as well as decorating comfort bags for the women to fill with useful items. The women will also be provided with a “Tips and Resources” card, which will include local resourced for domestic violence support. Finally, we will be allowing women who choose to do so to tell us their personal stories. I am so excited for this part of our visit because I am very interested to learn more about these women.

We integrated Judith Herman’s Trauma Theory to support our project. According to the Trauma Theory, domestic violence is a psychological trauma, which may result in the victims blaming themselves. The public health professional is responsible for shifting their mindset to realize they are in need of healing through empowerment and support.

WHO. (2016, November 29). Violence against women. Retrieved December 5, 2016, from          World Health Organization, http://www.who.int/mediacentre/factsheets/fs239/en/