Friday, September 19, 2014

A Sweaty Trek to Fight Dengue



"This week, three of my classmates and I were assigned to the work with a guest professor for this semester's very first Faculty Led Project! On Tuesday, our entire class met our new professor to learn a little more about the research topic, "Knowledge, attitude and practices associated with dengue infection in the rural community of La Trinidad, Sarapiqui." Our project consisted of traveling to the local rural community of La Trinidad to do a house-to-house campaign that would collect data regarding the local knowledge of dengue fever. This is where the "knowledge, attitude, and practices (KAP)" aspect comes into play. Our voluntary, anonymous, verbal survey asked questions that tested their knowledge about dengue symptoms and transmission, test their attitude towards preventing and combating dengue in their community, and finally test their knowledge of practices that can be done to prevent dengue. Once we practiced explaining and giving the survey, our class got crafty and created dengue mosquito traps out of recycled empty plastic soda bottles. We worked quickly and diligently. We rapidly perfected the process of cutting off the top fourth of the bottle, wrapping the main body of the bottle with black plastic, and then inverting the top back into the bottle. The bottle must be filled with a smelly mixture of warm water, brown sugar and yeast that serves to produce carbon dioxide which then attracts and traps mosquitoes inside. We learned how to explain this process in Spanish to offer these little experiments to each community member after giving the survey.


The next morning, Wednesday morning, the nerves were setting in of approaching and speaking with community members as complete strangers. Not to mention we looked like aliens to the area in our outfits of pants and long-sleeved shirts to prevent mosquito bites while the locals lounged in tank tops and shorts because of the blistering heat. We worked in groups of four students to orally give the survey. I was quickly surprised by the willingness of the community to work with us. I'll have to get used to these small moments of culture shock. In the span of 3 hours, every inhabitant of the 17 different households my group reached calmly agreed to our 10-minute spiel. In the United States, it seems as if we are constantly pressed for time. A 10-minute survey would likely seem like an eternity to an American. On a weekday, forget about it. This different perception of time was suddenly crystal clear. But my goodness, the community was very knowledgeable about dengue. Question after question, the majority of people knew all the dengue symptoms, knew what the Aedes aegypti mosquito that transmits dengue looks like, and knew how to prevent dengue mosquitoes from biting. It was interesting to note that the majority of the community members believed that this is a problem that every community member must help to fight against. But some of the minimal living conditions we saw made it clear that this is no easy task. How do you fight a mosquito borne illness when several houses don't have windows to keep mosquitoes out in the first place? By the end of our sweaty labor, our overall group of 12 students in the field completed 50 questionnaires in the community that Wednesday morning. Back at the station, while in inputting our newly attained data into an excel spreadsheet; we had a clashing but fruitful discussion about the validity of some of our data. Some groups explained some questions differently so we wondered if this would affect the response that was received. Through our first-handed experiences we removed and edited questions that we all believed clearly caused confusion. All in all, this was the first time we were truly pushed outside our language barrier comfort zone. Performing community research first-hand made us truly see how the manner, the attitude, the fluency of the language of the surveyor, and many more factors can affect the data we receive. This only made more excited to work with and improve future community campaigns!
Jocelyn Vargas

Tuesday, September 16, 2014

A Day In La Trinidad

We stepped onto the bus one by one, clad in our long sleeve shirts and field pants with clipboards in hand. The bus smelled of bug spray and sunscreen as we pulled out of the La Selva gates and headed for La Trinidad. In class, over the past three weeks, we had been learning about a disease common to many tropical countries around the world called dengue. This disease has become particularly common amongst many of the small communities in Costa Rica. Anyone living in communities such as La Trinidad is at risk of contracting dengue, for the mosquitoes that carry the virus have no age or gender preference. These nasty little white-stripped mosquitoes can cause a lot of pain and even in some cases death. However dengue can be prevented, it is just a matter of becoming educated on the disease and putting what you know into practice. Our mission for the day was to test the community's knowledge and observe their practices. We split into our groups and scattered in various directions, each set of four surveyors making their way down one of the dirt-paved streets of La Trinidad. My group made it to the end of our street where we stopped in front of a wooden house. 'Upe' 'Buenas' we hollered from outside the home. A man opened the door wearing only a pair of athletic shorts, a common trend we would come to find in the community. We told him we were students from OET and asked if he wouldn't mind answering a couple questions about dengue. As he agreed his wife appeared in the doorway helping her son mount his bicycle and take off down the street. We started by asking his age and level of education, as we did with every survey, and then continued on to the dengue questions. These questions were designed to test the community member's knowledge, attitude, and practices all in regard to the dengue virus. We started off by asking the man whether he had ever had dengue, he responded no, so we continued on with questions aimed at gauging his knowledge of the symptoms of dengue. There were a couple symptoms that he was confidant were side effects of dengue, but for the most part seemed unsure. We furthered tested his knowledge by asking questions such as 'what time of night do the mosquitoes that transmit dengue bite' this question seem to have stumped the man as it did many of the other community members. Most people answered that they bite at night, very few responded with the correct answer of early in the morning and again at dusk. As tiny beads of sweat began to form on our brows we moved to the second part of the survey, attitude. As I mentioned previously dengue can be prevented, and the way to do this is by not giving the mosquitoes a place to breed. These crafty little mosquitoes can lay their eggs in any sort of standing water, so anything from a tire to an empty coconut. Unfortunately, these are things commonly found in yards of these communities. So the questions regarding attitude asked things such as whether they believed it was the responsibility of the Ministry of Health to prevent dengue. Much to my surprise and delight everyone we interviewed answered no, it was not the Ministries responsibility it was theirs and their neighbors. And finally as our clothing became a strange pattern of blotchy sweat patches we asked the man our final set of questions. These focused on practices, what sort of things was he doing to prevent the spread of dengue.  For the most part the man knew what sort of things he should be doing to stop the mosquitoes from multiplying. However, as we thanked our first participant and headed off through his yard to his neighbor's house we spotted many empty coconuts and open containers filled with rainwater. This was something we found at many of the homes we visited. After our 18th house we made our way back to the bus exhausted and drenched in sweat, but most importantly we headed back to La Selva with a feeling of accomplishment. The number of dengue cases in La Trinidad can be diminished; it is just a matter of relaying important information and reminding people to put their knowledge into practice.


Emily Becker 

Monday, September 15, 2014

Lost in Translation?

I have perfected the art of walking such that the river water hovers just two centimeters below the tops of my boots with each step I take away from the dock. It is a needed distraction, but once we have boarded the boat that will take us into Bribri territory and gotten onto the bus on the other side, I can no longer continue my game. Instead I focus on spotting chickens. Humans are not chickens, but I keep looking at them anyway. They're looking at me too. If I want to stop worrying, I shouldn't look at the people. I see, or perhaps imagine, the proof of my fears reflecting back at me in their faces.
            I've been looking forward to visiting indigenous shamans for months. I spent years of my life searching for edible and medicinal plants and my first four semesters of college navigating the never-ending process of becoming an ally to people who are disempowered, so it should have been perfect for me. I'd been telling my family, friends, and anyone who would listen about this since deciding to go on the program. Suddenly, all my excitement was replaced by worry.
            When we got to our destination in the Bribri town of Cachabri, things got worse instead of better. I felt like I should be thrilled and awed like everyone else, but I was missing it because of this feeling that something wasn't right. My head was a confused mix of memories from my philosophy class, my summer internship, and Amber's lectures on ethics and cultural appropriation. They had invited us, so there shouldn't be anything blatantly wrong, but I still felt I wouldn't be able to calm down until I could ask the awapa directly. Finally I got my chance. "Why do you choose to welcome people like us into your community?"
            I would witness much over the course of our visit that emphasized the questions that sparked my concerns. The Bribri men and women performed a traditional dance for us (What does it mean to do a spiritually significant dance for show rather than to serve its true purpose?), took us on a plant walk (Why did they bother to teach people who wouldn't use their valuable medical knowledge in the first place?), and let us watch a woman grinding corn (How does it feel to have visitors crowded around taking pictures as you do housework?).
            The awa looked at me as he spoke, addressing me for the first time in my experience in a language I didn't understand a word of. When the answer came back to me, however, it did not feel sufficient. After transitioning from Bribri into Spanish and then English, the response was that they liked having students who were interested and wanted to learn about their culture. It sounded so simple, like a politician's answer designed to please everyone. It was hard for me to trust a response such as that.
There was, however, one thing about his answer that caught my attention. I could have sworn I heard in the Spanish version that it was important to them to have young people be able to respect and learn from them rather than cause harm. That statement had a completely different connotation than the importance of education alone. How much did I miss in the Spanish version? How much was lost before it even got that far?
As I considered the necessary messiness of translations over the course of the day, I began to realize that I could never know the true reasons they chose to welcome us in and would never understand all the dimensions and historical implications of that decision. If I couldn't understand the meaning, I had to depend on the respect I had for the choices they made. Instead of worrying over details, maybe it was better that I focus on not repeating past mistakes myself. After all, it was a lack of respect from outsiders that had caused all the Bribri's problems in the first place. If I truly respected them, I should certainly trust them to make the decisions they felt were best for their people.
Once again, here I was forgetting the most basic ideas behind being an ally. Lesson #1: Listen. You are not the expert on the issues that affect others.

Submitted by Casey Morrison

Picture: Keeping my feet dry waiting for the boat. Photo credit: David Monroe

Flying Assassins

Flying Assassins 
It is no secret back at home that while I love basically all creepy-crawlies (spiders included), I hate mosquitos. The way they hover totally creeps me out, and their simple presence makes me shiver. Even given my strong dislike of them, I had always had difficulty killing them—because extinguishing the life of any creature has never sat well with me—so I suffered in silence. Or at least I used to. Life in Costa Rica means being on mosquitos' home turf 24/7, so needless to say, I've had to get over my aversion.
The realization that I had made peace with the flying little bloodsuckers came to me as I looked around myself in the shower a week or two ago. As a rinsed out my hair, I glanced over my shoulder and realized I was sharing it with at least six of them. There were four resting on the walls at various heights, and two nonchalantly buzzing around my torso. Now I knew that there is only a 50% chance that any of these small insects were at all interested in drinking my blood because only the females bite, but it was only a small comfort. Nevertheless, I was still strangely detached from them given my opinion of them for the last 19 years of my life.
My new indifference to mosquitos, while a logical adaptation to my new surroundings, comes at strange time given that we are learning how dangerous they actually are. I know that for various reasons I am not at serious risk of dying from any mosquito-transmitted disease, but the million deaths that they are responsible for every year, and the hundreds of millions of people they infect with said potentially lethal diseases are devastating. Forget being scared of bears, sharks, or spiders, if you want to fear the creature responsible for most human deaths, mosquitos are your organism[1].
It also put my petty annoyance with them back home in perspective when compared to the life-altering impact that a single bite can have in so many countries. I don't mean to insinuate that the US is immune to mosquito-borne diseases, but on the whole our problems pale against countries suffering from epidemics of chikungunya, malaria, or hemorrhagic dengue fever.
With risks as severe as these, the need for serious prevention techniques became ever more clear. I by no means think that the few days of Dengue awareness and distribution of homemade mosquito traps made much of a discernible different in the fight against such diseases, but it still felt like a step in the right direction. I myself didn't know about the severity of mosquito-borne diseases, or how easily preventable they are. Clearing standing water, bed nets, and putting lids on wells and containers when not in use all can save lives.
Armed with newfound knowledge about such small assassins, and a healthy wariness instead of unfounded hatred for their existence on this planet, my excitement regarding a possible career in global health has only increased. Our environments and the creatures that live there are integrally linked to our wellbeing, so why not embrace the fact that we will have to continue to coexist with mosquitos, while actively working to prepare ourselves and others. I think I've been able to take the first step.

Isabel Obrien

 




[1] AMCA. "Mosquito-Borne Diseases." Mosquito-Borne Diseases. American Mosquito Control Association, 2014. Web. 14 Sept. 2014.

A Silent Killer vs. A Killer Silence

            You're flying. You're in the air and you're flying. The world is massive, far beyond the scope of your perspective. There are enormous trees and magnificent flowers and indescribable wonder all around you – but you're looking for blood. You sniff the air and that irresistible scent comes toward you. You follow it, hoping that it takes you to that glorious prize. You arrive, and before you stands a mountain of sweet, succulent flesh, as though it were waiting for you to appear. You land; you salivate; you penetrate; and finally, you drink. You engorge with blood until you can't swell any more, and you swiftly detach from your feast without it ever noticing. The blood swims in your gut and you're happy; you know not that the blood was not normal blood, and there are now stowaways in your body. You are unaffected, but the next food you visit will be infected with dengue because of you.
            As humans, it is inherently impossible for us to fathom what goes on in the mind of a mosquito. They could be simple, or they could be thoughtful; they could be malicious, or they could be innocent. We will never be able to know for sure, but it is highly likely that they have very little conception of the good or evil they bring about. However, in our society, we tend to demonize these creatures because they seemingly cause so much destruction. They bite us incessantly until we are red, puffy, swollen, and itchy, and they carry so many diseases that threaten our lives. Dengue, malaria, and West Nile virus all affect millions of people worldwide on a daily basis. We call mosquitoes pests, we call them annoying, we say we hate them, and yet they likely have absolutely no awareness of the harm they cause. They are as innocent as dogs or cats or sloths or most other animals, but their bad reputation is indomitable.
            When I went to the communities surrounding La Selva (La Trinidad and Naranjal), so many aspects of the projects amazed me. The warmth of the people was unfamiliar. The knowledge of dengue and sanitary practices was surprising. The poverty was astounding. And yet, I could not help but think about this peculiar relationship between humans and mosquitoes. Mosquitoes seem like horrible, invisible little creatures that relentlessly pester us and constantly ruin our lives, and yet they are animals as much as dogs are animals. As far as we know, they act on instinct and instinct alone, and yet we treat them as though they make a conscious effort to wreck our day.
            Our activities in these communities focused on knowledge, attitude, self-efficacy, and practices regarding the effective reduction of the incidence of dengue. I found it absolutely fascinating how people treat the disease differently based on their perception of the mosquito. We spoke to one woman, for instance, who could not stop talking about how much she hated mosquitoes. She was one of the few women in the community who consistently gets bitten by mosquitoes despite having lived in the region her entire life. She therefore took all the precautions we outlined for her and knew every practice before we even suggested it. Another woman, on the other hand, expressed very little aversion towards mosquitoes. She was gifted with naturally repellant skin, so she almost never gets bitten; as a result, her home was littered with open containers of standing water and many similar bad practices.
            I learned several main lessons from this experience. First, people view diseases and vectors in very different ways. Second, these differences drastically change the way they treat those factors. And third, these differences need to be ameliorated before real progress against dengue and other contagious diseases can be made. Community-based initiatives are essential, for a community cannot be truly safe from such diseases unless everyone is actively involved in their containment. While the mosquito may be a "silent killer," it is this lack of awareness of a contagious disease that is truly a "killer silence."
This was a truly eye-opening experience that made me question myself and change my worldview. I crave these kinds of opportunities, and I have no doubt that I will carry them with me for the rest of my life.
David M.


Dengue Wars Episode V: The Mariposas Strike Back

​Anne Boldt

Dengue Wars Episode V: The Mariposas Strike Back

            With the scorching sun blazing overhead, sweat slowly dripping down our faces, and, for one of us, resisting the urge to answer nature’s pressing call, we made our way through the streets of La Trinidad, Sarapiquí. The Mariposas, our group of five brilliant female scientists, led by the infamous Pia Paaby-Hansen, set out on a mission—a mission to gather data about the villainous, mosquito-borne dengue disease.
As scientists and Global Health enthusiasts, we were determined to understand the correlation between knowledge about dengue and the likelihood of suffering through the dangerous disease. Some may ask, why would the renowned Mariposas be involved in such a study? Well, it just so happens that there were almost 50,000 cases of dengue in Costa Rica in 20131, with a recent major outbreak in La Trinidad, and though it may not always be a killer, it can be prevented with the help of community and individual activism. It also meant that we could valiantly fight dengue one household at a time.
            As excited as we were about our endeavors to collect data, tensions arose as we approached the first house. Though we were accompanied by the expertise and fluency of our leader Pia, the rest of the Mariposas couldn’t help but feel a little nervous as we were about to explain an informed consent wavier, a three-page survey, and how to construct a home-made mosquito snare solely in Spanish. Nevertheless, our determination to destroy dengue overpowered our nerves.
            “¡Upé! ¡Buenas!” We called as we neared the neatly manicured lawn. A few moments later, a woman stepped outside. Following a short introduction and the granting of permission, it was our time to take the lead. I confidently went up and began reading the consent form. Unfortunately, during my stumbled and muffled explanation, Pia had to take over to clarify what exactly we were doing. Though the rest of my group finished the interview stupendously well, I couldn’t help but feel discouraged and conquered. Fortunately, the rest of the Mariposas encouraged me and we still had plenty of houses to visit where I was ready to face the language barrier to defeat dengue.
            At the next house, it was my turn to do the bulk of the talking—explaining the survey which would assess the knowledge, attitudes, and practices of the community members in regards to dengue. As my cohorts introduced us and we were given consent, I took a deep breath and began to explain the questions in the survey and the types of responses we were looking for. In just a few minutes, and to my surprise, I was able to competently complete the survey with the community member; in fact, we even got a little chatty during the interview. After my fellow Mariposa explained how to create a homemade mosquito trap, we ventured on to eight more houses in the allotted time.
            When we finally returned to La Selva, feeling famished, dehydrated, and yet giddy about our accomplishments, we gathered our data and scored the surveys using a point system. Each correct answer was given a positive score and the scores in each subsequent category were compared to factors such as age, gender, and education levels. Though the statistical evaluation of the data did not show any significant trends, the work we had done was a gateway to future, more in-depth studies to be done in Costa Rica to bring us all closer to defeating the menacing dengue disease.
            Despite the lack of statistical results we were hoping for, we are still determined to defeat dengue, even if we have to dump water out of one coconut at a time.

Photo credit: Kelsey Sumner                                                              Sources: 1. http://www.ministeriodesalud.go.cr


Saturday, September 13, 2014

Hard to Swallow

At home, there was one place I feared most, more than a closet or a space under the bed full of monsters.  That place was the medicine cabinet.  Along with the Tylenol, Dayquil, and gummy vitamins, my family kept our stock of traditional Chinese medicine, full of dried herbs and pungent dark syrups.  They smelled bad and tasted worse.  In my family the first line of care is to drink lots of water with honey, of which I was a big fan.  But on the rare occasions I had a sore throat that just wouldn't quit or that one memorable summer when I got pneumonia, I had to force down a nasty spoonful with many assurances that yes, it works, so don't spit it up.  I have always been proud of my Chinese heritage and its influence on my life.  But when it comes to its medicine, I remained a skeptic. 

4,000 miles away from that medicine cabinet, Sebastian, our guide through the forests of Kekoldi and indigenous Bribri knowledge, highlighted many medicinal plants in the lush green surrounding forest.  We clambered up hills, stood in the shadows of 700 year old trees, and waded through creeks, all the while scribbling notes on the many medicinal plants that surrounded us.  Some were universal, like ginger to help with stomachaches.  But other plants were entirely new.  Thanks to local Bribri knowledge, we tasted the sharp bite of sourcane, admired the hombre grande for its awesomeness as a natural mosquito repellant, took pictures of the pastora de montagna which helped with arthritis and many many more. 

Among the many things Sebastian told us that day, one adage stuck with me the most: the worst tasting plants make the body stronger.  What I was hearing in Spanish I had only previously heard in Chinese, a saying that had withstood the test of time, repeated around the world, from Costa Rica to my home in California and my roots in China.  After plunging into the tropical rainforests of Costa Rica on strenuous, educational hikes and doing community outreach, it took traveling all this way for me to realize something that was in my life all along: sometimes biomedicine is not the only answer.  In fact medicine stretches far beyond measurable observations.  Medicine is also a personal choice integrated into our cultural belief systems.  I am learning more than I ever anticipated about not only the culture of Costa Rican health care but also my medicinal culture, using both culture and biology based medicine.  And finally, the worst tasting medicine can help more than anything else. 
Emily Y.

Ants




They are everywhere. They are in the sugar and the shower. They know where I eat and sleep (though frankly, I shouldn't flatter myself into thinking they care). I've grown accustomed to them but I'm still wary. I mean, they hurt when they bite (though admittedly, some worse than others).
They are everywhere. They are the most purposeful beings I have ever witnessed. Imagine the noise. The clickity click click of all six legs. The chemp, chemp, chachemp chemp of the mandibles. Then imagine the constant whir of an entire colony—industrial, destructive and cleansing— everyone working with Swiss Army precision.
Sometimes, they actually are everywhere. Hoards of them skedaddle up and down and around and through your bed and under the toilet seat and over you, if you let them. And then they leave, without a backwards glance. When you return to your room it is spotless. Nature's little housekeepers don't miss a single insect, a solitary spider, not a one.
An hour into our hike to Kèkoldi, Sebastian, our guide, stopped us in a clearing and told us to look down. We were standing on a leafcutter ant nest. But it was more like a fortress. Sebastian told us how important the leafcutter ants are for the forest. They are constantly excavating nutrient rich soil to build their tunnels as well at cultivating more organic matter underground. Because when they take those leaves, that are taller and wider and heavier then they are, and take them underground, the leaves decompose and grow fungus and that's what the leafcutter ants eat. Can you imagine if we ate our compost? 
An ant has approximately 250,000 braincells1. I have roughly 100 billion. The average leafcutter colony contains over 5 million ants2. This means that in that clearing, I was potentially standing on over 12 times more brainpower than I will ever possess. You argue it doesn't work like that. I know. But I do not know precision, and social structure, and hard work like they do. Most importantly, I do not know how to destroy and then create again. I am four weeks into this tropical medicine and public health program. Ideally, by December, I will be a more conscientious consumer, a global player, an advocate for giving back, and cultivating this symbiotic relationship with the earth that we must maintain if we hope to flourish. I hope so. I just don't think I'll ever be as effective as an ant. 
Keelin M.
 
Sources:
1. All About Ants. (n.d.). Retrieved September 12, 2014, from       http://dnr.maryland.gov/wildlife/education/projectwild/pdfs/allaboutants.pdf
2. Leafcutter ant fact file. (n.d.). Retrieved September 13, 2014, from  http://www.nhm.ac.uk/kids-only/naturecams/antcam/ant-facts/

Hombre grande

It's still early, and we're all just finishing breakfast in our first morning in Kekoldi. Field pants, water bottle, camera: there's a checklist running in my head of everything I'll need for our plant
walk this morning. One final checkmark on my list: dousing with insect repellent. Our guide, a member of the Bribri indigenous group, waits as we finish getting ready. He has one cryptic comment for us: by the end of this walk, we'll know why the Bribri don't use bug spray. What does he mean by that, I wonder as I put on my boots.

Mosquito-borne illnesses are a huge problem in Costa Rica and worldwide. In the past few weeks we'd been learning about dengue, a disease spread by the Aedes aegypti mosquito, which causes flu-like symptoms and, in extreme cases, hemorrhagic fever. We've learned about malaria as well, a parasitic disease that's also transmitted to humans by mosquitoes. It's a huge problem in Africa and South and Central America. Both of these diseases are especially dangerous in young children, and unfortunately there's no reliable vaccine widely available for either one.

Soon we're all ready to go, and our guide leads us into the forest. Every so often we stop and he points out something new: a vine that's full of water, and the tree species that green iguanas live in, among many others. We take notes as we go, interesting details to remember for later. The trail is well-marked but I'm glad we have a guide who knows where he's going. He asks us to be quiet so we won't scare away the wildlife. It's been over three hours (but doesn't feel like that long) and our guide stops for the last time. He picks some branches of leaves and passes them around to us. We taste it: extremely bitter. At this point I've forgotten his earlier comment about mosquitoes, but then he reminds us: this plant is the reason that the Bribri don't get bitten by mosquitoes. It's called Hombre Grande and they dissolve it in water and drink it. Once it circulates in the blood: No mosquito
bites, no need for insect repellent. Just this bitter plant.

It's amazing to learn from someone who knows the rainforest this well. For the Bribri, the resources they need to prevent diseases like malaria and dengue are all around them. It makes me wonder what else the Costa Rican rainforest holds, secrets known by only a few or no one at all. There's a balance here, and indigenous groups like the Bribri demonstrate living within this system instead of drastically altering it. Human intervention has thrown off the balance in the world, but for now both are here in Kekoldi: the mosquito and the plant that repels it, coexisting.
Stephanie P.

References:

1. http://www.who.int/mediacentre/factsheets/fs117/en/

2. http://www.who.int/mediacentre/factsheets/fs094/en/

Stopping Dengue, One bottle at a time


Standing in a Sarapiqui street, a group of OTS gringos tried to get a bearing on their surroundings, with clipboards and strange-looking bottles in hand. 
We were dropped off in the middle of a Dengue hotspot, hoping to inform the community of simple preventative methods from this terrible virus.  In our hands were Maynilad's brilliant "Dengue Bottle" inventions, created to trap and kill Dengue-spreading mosquitoes.  Constructed from common household items, the "Dengue Bottle" is a simple fix to a serious problem.  Here's how you make it:
1) Cut off the top part of a plastic bottle and remove the cap.
2) Add brown sugar to warm water and let it dissolve.
3) Pour yeast into the sugar-water solution, and add the solution to the bottle.
4) Cover the bottle in black plastic wrap.
5) Place the top of the bottle back on to the bottle in the inverted direction, and voila, your very own "Dengue Bottle". 
The Philippines Department of Health reported that Dengue cases were reduced by 60% from one year to the next in the Philippines after the introduction of the Dengue contraption.  It seems unbelievable that such easily accessible items can have such a large impact, but it turns out that mosquitoes love the CO2 that the yeast produces, so they fly into the bottle, but then get stuck inside.   
Dengue is a virus transmitted by Aedes mosquitoes that causes severe pain, vomiting, and fever, among other symptoms.  There is no current vaccine against dengue, and treatment involves supportive care, lots of hydration, and painkillers such as acetaminophen.  Costa Rican citizens have universal primary healthcare, but that does not mean that they should leave their health simply in the hands of their healthcare workers.  People need to be responsible for their health and take necessary preventive measures, and simple fixes such as solution-filled plastic bottles have saved tens of thousands of lives.
Equipped with water bottles, hats, and "Dengue Bottles", my classmates and I were ready to present our latest DIY to the community and show the locals how to make their own Dengue-fighting bottles. Walking from door to door, we called "Oopé" in order to announce our presence and waited to be invited onto the resident's property.  While in New York if a group of strangers showed up with clipboards and suspicious black bottles someone would probably call the police, here in Costa Rica the residents happily invited us into their homes, giving us chairs to sit in, and one woman even let us pick coconuts from her yard!  As we explained how to construct the mosquito traps, we looked like flight attendants giving safety instructions, hand-motioning each of the steps.  The ticos were grateful that we shared our projects with them, and most were committed to utilizing the contraption around their homes.
Today was a gratifying and fun way to share information with the local community and really make a difference.  Hopefully the community uses their Dengue-fighting bottles and this Dengue hotspot won't be hot for much longer.
Rebecca P.
"Maynilad Water Services Inc." Maynilad Water Services Inc. Maynilad, 26 June 2013. Web. 11 Sept. 2014.
"Maynilad Wins Intl Award for DIY Dengue Mosquito Trap." GMA News Online. GMA News Online, 17 Aug. 2014. Web. 11 Sept. 2014.




Photo 1 Caption:  The "Dengue Bottles"
Photo 2 Caption: Talking with a Sarapiqui resident.  Photo Credit:  Tanya Lobo