Dashing Data

My last and final leg of my semester abroad in Costa Rica ended with a bang. We were instructed to start our data collection process for out independent projects in the Las Cruces Biological Station in Coto Brus. Although this period was stressful, I am overjoyed with the quality of results my group was able to receive. Here is some background on our project: my group studied the influx of frequent users that were using the primary health care clinics, or the EBAIS clinics. These patients attended the primary care clinics an inappropriate amount of times and in Coto Brus alone over the past five years, were costing the social security system of Costa Rica about $500,000. This research was particularly interesting to me because Costa Rica has universal access to health care. Frequent users are commonly found infiltrating other countries with similar health care systems. This problem is extremely relevant in United States, where there has been movement towards a more public health care system.

Our data collection involved reviewing and analyzing the demographics of about 6000 patients that attended all 16 primary care clinics in the Coto Brus canton. I learned so much about Excel and data collection than I ever thought I would. Our group would be up late just analyzing data and organizing it with pivot tables and statistical analysis. I started to develop an interest in computer science! But, I had the most fun when we visited four clinics to collect data from patients for their chronic disease history. It was interesting to see how most patient records were not digitized. We also got to meet ATAPs, or community health care workers. ATAPs are responsible for making primary care home visits. I was so amazed because the ATAPs knew every single one of their patients by name, and where they lived! When we asked for patient records, they just pulled the files out like it was nothing. We even traveled to the clinics with one of our professors, Dr. Nicolas Lopez. He gave us insight into the Costa Rican health care system as a practicing physician. We had a great time just bonding and learning about his love for pizza!

The primary care system, although impressive, needs modernization to reduce this frequent user dilemma. I hope that our research can be made available to the social security system of Costa Rica and health care workers so that cost effective interventions can be institutionalized. I look forward to sharing my research to my professor and friends and Smith.

Meghna Purkayastha

Looking back on Las Alturas

During our last visit to Las Cruces we took a few days to visit the Las Alturas research station. Las Alturas is in a remote village in Coto Brus where only a handful of families, both indigenous and non indigenous, live. The town is very small but remarkably beautiful. All the houses and businesses are bright pastel colors that pop amongst all the greenery. Las Alturas has all the makings of a self sufficient town including an adorably small cinema, a supermarket, and a an EBAIS.

We stayed in the OTS base a few minutes away from the town and during our time in Las Alturas. The cabin was even quainter than the town. All built very recently, there was no electricity and was comprised only of a few rooms. The wraparound porch looked out into a field, remnants of the old coffee fields that had once dominated the land before it was bought up, and the primary forest where we hiked our first day. Every night when the generator powered lights went on we could sit inside our cabin looking at moths as big as our hands thumping on the windows trying to get in.

While there, we got to explore the forest we were surrounded by on two hikes. The first day we hiked uphill for an hour until we got to an amazing view surrounded by mist. The second day we walked and until we found a river that was was running due to the recent rainfall. Each time, when we reached our destination we sat and watched what we had come to see for several minutes just taking in our surroundings.

We also got to hang out a lot as a group. There's something about waking up in the middle of the night to your bunkmate thrashing around for a beetle in her hair that really brings you together. Card games abounded since we had nothing but time. We commiserated as we each took our turns taking showers in water that was so cold it took your breath away. And on our last night there we sat around a bonfire and roasted marshmallows as a group. It was a great time to spend all together, the thirteen of us, before heading back to Las Cruces where we would begin our research projects. Our time in Las Alturas was one of my favorite parts of these past few weeks and made me realize how quickly the program would be ending. Now with only a few days left before the program ends I remember how long ago that seemed and it sound crazy that it was only about 2 weeks ago.

Marcela Zegarra-Ballon

The Importance of a Smile

One of my favorite experiences on this trip has been conducting interviews for our final independent project. A few months ago, I never would have imagined saying this. Back in February, the night before our first set of interviews investigating people’s perceptions toward Dengue, I was a nervous mess trying to memorize key Spanish phrases. Then the next day, I was completely intimidated by the language barrier and barely spoke anything besides what was written down. Every time I tried to construct a sentence, the interviewee would give a confused look before turning to my partner to ask what I was saying. It was very discouraging, but I continued to try, and if nothing worked, I would at least maintain a friendly face.

I am proud to say that three months later I have had a completely different experience. For our research project we conducted interviews consisting of: a 49-question survey, an informed consent form, and supplemental materials, all of which needed to be explained in Spanish. Not only could I speak and be understood, I could also build rapport and hold a conversation with each interviewee. This would never have been impossible at the beginning of the semester, but now, from all our hard work at CRLA, faculty led projects, and even just with conversational Spanish with staff, my Spanish improved immensely.

In case of confusion during interviews, I was able to explain each question in a different way and when the moment allowed, I even cracked jokes. As a result, I could see my interviewees visibly relax and actually enjoy our conversation. Likewise, with such a small community, I started getting recognized and people even started helping me recruit others for interviews. I had a moment of pride when I heard myself referred to as “that friendly girl” and they said, “you should help her, she knows what she’s talking about” to their friends.

From this experience, I have gained a different kind of confidence. I know now that I have the ability to communicate despite language and cultural barriers, and I think at the root of this ability, is knowing how to be friendly in new situations.

Elizabeth Stratton

One for the Books

These past couple weeks we had a full work load with our final independent projects. My group’s investigation looked at weaning practices and their relationship to social and cultural factors and occurrence of childhood disease in Coto Brus, Costa Rica. We had to go door-to-door in the Sabalito community, interviewing mothers about the weaning of their oldest child. As we walked down this one road to look for houses to “upe,” we saw this lady cleaning her car with her two daughters, who looked 8 and 10. She was a perfect candidate for our survey, however, we we’re worried that she was too busy to want to help her. We said good morning to her and told her what our survey was about and without hesitation she invited us into her home. Her house was one of the prettiest houses I’ve ever seen. It was on the edge of cliff with a gorgeous view of the valley below with hammocks on her back porch facing the viewpoint. She also had garden down a little hill behind her house. After we got to her back porch she offered my partner and I drinks then we proceeded with the survey. Once we finished giving her the survey she offered us fruit for the road. This woman epitomizes the Costa Ricans friendly personality and hospitality.

We have had projects like this throughout the semester and I am always so nervous about having to interview people in Spanish. I was afraid that they might not understand me, or that I would not understand the person I was interviewing if their answers were not yes or no. However, after doing the first couple of interviews I had everything down, both pronunciation and comprehension. My group completed 109 surveys. It’s amazing to me how much I’ve learned here especially when it came to Spanish. I always thought I was one of those people who simply could not learn another language. But completing the Spanish courses and being submerged into the language for four months, I actually have the confidence and vocabulary to speak in Spanish.

As the semester starts to wind down I start thinking about my first week in Costa Rica and meeting everyone for the first. On the first day I got here a day early and had to figure things out on my own, lacking the ability to communicate and even understand some accent in Spanish. The next day other girls in the group started to trickle in, and I never thought we would be as close as we are now. I am going to miss everyone so much even our professors. Costa Rica is such a great country. I have met amazing people, ate amazing food, especially the fruit, learned amazing things and had amazing adventures. This experience was definitely one for the books.

Le'Shauna Y. Phinazee 

Bittersweet Ending

Prior to the program, the research practicum sounded really intimidating to me because I had not had too much experience with research before. Having finished my independent project this past week, I can say with confidence that research was definitely one of my favorite aspects of the course. My group’s research involved looking into patients who visit the primary care clinics of the Coto Brus canton too often. These patients are called frequent users and our projects main objective was to create a definition and profile of these patients so that the Social Security Administration of Costa Rica can better manage the problem and control their budget deficit. This project gave me the opportunity to see how the universal healthcare system in Costa Rica runs first-hand. I got to interact and here opinions from various doctors, community health workers, and locals about the healthcare system which I thought was extremely interesting. Then getting to present our research to these same people was really rewarding because it was well-received and taken seriously. Our research presentation has given me the confidence to pursue research in the future.

The last leg of this journey has been a mix of different emotions. The past few weeks have been busy with independent projects, traveling, and enjoying the last moments together as a team. While I am excited to be going home to see my family and friends in a couple days, I am extremely sad about having to leave such a beautiful country. I have met some of the most incredible people on this program and am beyond thankful for the relationships that have stemmed from these past four months. I never would have thought that I would have gotten as close as I have to all thirteen of the girls on the program, this semester has truly been a special one. Every time someone mentions something related to us leaving, they immediately get scolded (jokingly, but not really) because no one wants face the fact that we’ll all be separated soon. On a brighter note, we have already planned a giant reunion on the east coast in October over our fall breaks which all happen to correspond on the same weekend. I am looking forward to the beginning of a long-standing tradition with these wonderful ladies.

Coming on this program has been one of the best decisions of my life. I have gotten so much exposure to many different aspect of biology and medicine and I would not trade the experiences I have had here for anything in the world.

Karina Handal

The Las Alturas Experience

A few weeks ago, we had the privilege of spending a couple of nights at the Las Alturas station which is a satellite station of the Las Cruces Biological Station in San Vito. Las Alturas is extremely close to the Panamanian border and is near a small town (called Las Alturas) that consists of half indigenous and half non-indigenous people. The station is a small cabin in the middle of a clearing twenty feet from the primary forest. There was no hot water and electricity only for a few hours every evening.

On our first day there, Zach (Las Cruces Station Director) led us on a hike to a look out point. It was cool temperature nice for hiking and there was lots of fog we could see rolling in into the mountains at the look out point. As we ascended the mountain it was very interesting to see how the foliage changed. Zach explained it as the plants becoming 'dwarfed'. Zach told us that in this area the jaguar population is thriving. Luckily, there is heavy security to protect jaguars as well as other animals from poachers.

Our second day in Las Cruces, we split into three groups and rotated activities throughout the day. In the morning my group and I went on a 'plant identification' walk with Zach. Just on the edge of the clearing surrounding the cabin he was able to show us countless different leaf patterns and leaf arrangements. What was most interesting to me was that many of the plants he showed us were closely related to plants such as tomatoes, strawberries, avocados, and many more. After we worked on our plant identification skills we went on a short hike to the river. The river was beautiful with clear, mountain run-off water. It was a unique experience to be able to sit on a large rock in the middle of the river for a few minutes.

That afternoon we rotated to the clinic where we worked in various positions. First I shadowed Dr. Nicolas Lopez, our program's resident professor, as he treated patients. When I was shadowing he mostly treated indigenous children. Then I rotated to the 'child-care' position where I colored with children and played with stickers. The last rotation was working as a secretary doing paper work and stamping various documents.

The last day our professor Jessica Arias led us in an ethnobiology activity where we made skin products out of nature. First we made an orange sugar scrub that serves as a skin exfoliant. Then we made a beeswax/tea tree/vitamin E butter to heal insect bites and dry skin. Lastly, we made a chamomile face steam bath.

Overall, Las Alturas was a great experience and I'm so glad we took a few days out of our time at Las Cruces to go there.

Hailey Alexander

Research and Results

In the center of downtown San Vito my partners and I began our interviews about the knowledge, attitudes and practices of men regarding prostate cancer screening. The OTS driver had just dropped us off and, as we walked across the street to the park, minor worries and hesitation began to set in. Would it be difficult to find many men over the age of 40 (a requirement for our study)? How would men react to our survey topic? Would many of them be impolite or inappropriate? We could feel each other’s uncertainty and, as a result, decided not to split up during our first day. With that decision and a collective random burst of confidence we introduced ourselves to our first survey participant. The interview went surprisingly well, took only seven minutes to complete and left us feeling confident. Most of the men we surveyed were polite and when we did interview people who were inappropriate we were able to ignore comments and keep the survey on track. After all, we had chosen the topic knowing prostate cancer screening is a sensitive subject with some cultural taboo surrounding it. 

At the end of our first morning we had collected 30 interviews, a number that surprised our professors who had expected data collection to be a challenge. We thus set our daily goal to 30 surveys a day and as each day went by we learned more and more from our interactions with the community. We wanted to leave our participant feeling educated and informed and so we began handing out information pamphlets about prostate cancer after each interview. (The Costa Rica Ministry of Health created the pamphlets). The new Spanish vocabulary we used became second nature, the slightly offensive comments from certain participants became easier to casually dismiss, and our understanding of popular misconceptions and issues improved considerably. We even overheard men talking after we interviewed them about the importance of getting tested!

Every afternoon we entered data and reflected on the morning interviews. We began our analysis, discussed the misconceptions we had recorded during interviews, and prepared for our final research papers. After our analysis and papers were complete we had the pleasure of presenting our findings at a poster session open to the community and received feedback from some local community health workers. As we told them, what we found most interesting and important were the misconceptions surrounding our topic of study. Within the next few days we will be creating educational posters to counteract these misconceptions and inform the San Vito community. We went into this topic of study hoping to assist the local health system and give back to the community. With our limited time and resources we feel we’ve done just that.

Erica Rayack

"Excuse me sir, do you have a minute to talk about prostates?"

During our five days of research collection in San Vito, my group members and became the talk of the small downtown park in the town by the research station. For our study on prostate cancer screening practices in the local community, we only spoke to Costa Rican men over 40.We made friends with the taxi drivers, the vendors, the men relaxing in the park or waiting for a bus and even the farmers in the city for their weekly errands. As three young women, we weren’t sure how we would be received, especially since we wanted to ask men about their prostates and about their thoughts on rather uncomfortable medical exams. We didn’t know what to expect from our survey participants. Would they even be willing to talk to us? We set off for San Vito early Monday morning, proud of the survey that we had designed, but a nervous to see how the week would go. The first interview was the hardest but I got more and more comfortable at stopping men on the street as the days went by, people were incredibly receptive and welcoming to us. Back in our U.S. hometowns, people with surveys or petitions aren’t usually given the time of day by the busy crowds running errands or rushing to work. Men in San Vito were happy to pause, get to know us a bit, and take some time to do something for their community.

Our survey participants were actually very open and honest with us. They didn’t just answer our questions, they shared their stories and concerns with us. We heard many men attribute the lack of screening in their community to machismo”or “mala cultura” surrounding the rectal exam in particular. One participant told us that “men here are so uncomfortable and ashamed of the rectal exam that men would rather die from prostate cancer than get a rectal exam.”Although we only met a few men who had themselves been diagnosed with prostate cancer, most of the men that we spoke to knew a friend, neighbor or family member who had struggled with prostate cancer. Men who knew of people with prostate cancer often mentioned seeing how painful and terrible the disease was, and mentioned the importance of early detection for the best outcome.

It was interesting to gauge what men knew and what they didn’t; For example, almost every man we spoke to knew that screening is recommended after age 40. This key piece of health information seems to have “stuck” in the community, and yet many potentially lifesaving facts about prostate cancer and the screening process aren’t common knowledge yet. My favorite part of our research week was, without a doubt, seeing small groups of men who we had interviewed in the park going over the health information sheets that we distributed and discussing the screening amongst themselves. It really felt like our study had started an important conversation, and many men told us that they were going to schedule a screening and tell their friends to as well.

I’m planning to go into environmental or health policy after college, but this was my first experience with public health research. I saw firsthand how education empowers individuals to advocate for their own health, and how good information can change lives within a community. Open communication about scary, uncomfortable or hard-to understand health issues is key, and it can start with a simple conversation between friends on a park bench,

Abigail Mahoney

Who's Benefitting?

A few weeks ago we were given the amazing opportunity to go to Nicaragua and help set up a clinic to treat people with otherwise very limited access to medical care. We worked in groups of 2 or 3 students with a translator to record patient history and take vital signs. We then presented our findings to the doctors who determined the diagnosis and prescribed medicines. During only a few short days I learned more about common medical issues in the area and about how to take blood pressure and pulse or examine a patient than I ever expected to. This was, by far, the most hands-on experience I've ever had with medicine. It was exhilarating, challenging, and fun. And yet, I'm not sure I'm totally comfortable with it. We are not trained physicians or nurses or even medical students. Most of us had never taken blood pressure before or been taught patient privacy protocols. We had one day of orientation to learn all the things we were expected to do and then we were released into the clinic. We were supervised in the sense that there were doctors present, and the patients were informed that we were only volunteers before we began any exam, but I'm not sure if these measures were sufficient.

The patients were grateful to have the opportunity to go to a clinic, and we were grateful to have the opportunity to view the work of a doctor first-hand. Some could argue it's a win-win situation, but is that what we want? When it comes to treating sick people, is it okay for everyone to benefit a little or should nothing less than patients solely benefitting be acceptable? In the United States there are strict rules about patient privacy and what students can and cannot do, and these rules exist for a good reason—we are untrained.

The patients were treated while we learned. They were given medicine while we were given the opportunity to play doctor for a week. I can only hope that the patients feel that they got something out of this experience, because I know my classmates and I did. If this program is designed to benefit the community and truly needs volunteers to help, then I can only support it. But how much did we really help and how much were we in the way? Were we important or did they just need the money we paid for the trip to support the clinic and allow the doctors to do their jobs? At the end of the day this experience left me with a lot of questions. I loved my experience and I am grateful to have been given such a unique opportunity. But I have to ask: who do these clinics really benefit?

Rachel Krcmar

Doctors in Training

One of my favorite experiences in OTS Program was working for the Vida organization in Nicaragua. Two weeks ago, we all arrived in Nicaragua to volunteer with Vida, a non-profit organization that provides free basic medical service to impoverished, rural communities. Looking back on it, I realize I had no idea what I was getting into. In the past I have volunteered at hospitals before; however, I have never been able to have as hands-on of an experience as I had working for Vida. As volunteers we did not only observe, but rather took medical histories, interviewed patients, took vital signs, and provided basic health education to patients. I also, did not realize the large impact that can be made with so few resources. With only two doctors, five interpreters, and us, the volunteers, we were able to see over 150 patients during the four clinic days.

The first day of work I was anxious, wondering if I would be able to take the blood pressure correctly and ask the right questions. I was also wondering how a group of young, American students would be perceived. But then the patients began coming in, opening up about their health concerns and histories, and I realized my nerves had disappeared as I spoke openly and frankly with the people about their health. I was able to learn about how Nicaraguan life and culture may impact health and common diseases and ailments in Nicaragua.

Overall the community was extremely accepting and grateful for the work Vida was doing. As I continued working throughout the week, I discovered my passion for directly interacting with patients and working on the frontlines within a community, and the experience confirmed my desire to pursue medicine as a career. By the end of the week, I understood we were affecting not only the individual patients, but influencing an entire community through the spread of knowledge and hope.

Symone Stephens

Experiencing Nicaraguan Culture

We not only had the opportunity to explore Costa Rica, but we also spent a week in Nicaragua. Although it was for a short time, I felt as if I was able to gain a small perspective of the Nicaraguan culture. First, let’s talk about the people! The communities set up are like none I had ever seen before. The houses were half inside and half outside, the doors were always open, everyone knew everyone on the street, the elderly would sit in their rocking chairs outside and watch the adolescents, and there was always some activity going on outside the houses. It felt so authentic and as if it came out a movie back in the 50’s. In the United States, and even in Costa Rica, barrios like this are not common to find. I really felt as if the community was one big family, and they were just as welcoming to us as well. The families were very accommodating and really cared for us for the little time we spent with them. For example, when I felt sick one night, my host family went out of their way to make sure I had everything I needed, and they even called the coordinator to make sure there was not anything else they could do. This type of kindness is deeply embedded in their culture.

I also discovered another part of their culture; the food. Working in the clinics with the rural community gave me true insight to the Nicaraguan food. The majority of health problems that existed stemmed from the traditional food. For example, most everything eaten is fried, contains enormous amounts of salt, and the consumption of fruits and vegetables is scarce. Mix this combination together and you end up with a population that has a high rate of obesity, hypertension, and gastrointestinal issues. Therefore, as no surprise, the majority of our patients had one or multiple of these conditions. While this food may be traditional, it is a public health issue that needs to be addressed in these communities.

Finally, we experienced a little of the musical culture with salsa and merengue classes. After a one hour class, we mastered (more or less) the steps and felt like professionals (or so we thought)! However, after watching some children dance folklore correctly a couple nights after, we quickly realized we had a ways to go. It was beautiful to watch the children dance these traditional songs in the traditional clothing. The bright colors and elegant movements made for an enjoyable night.

I loved experiencing the Nicaragua culture for a week, and I hope to have the opportunity to explore more in the future.

Morgan Drew

The Pressure was on!

These past three weeks have been full of memorable experiences. First, we visited Nicaragua for a week to volunteer with VIDA, who provide free clinics for people in poor underserved communities. Then we visited Palo Verde National Park and went back to Costa Rican Language Academy (CRLA) to finish out our last week of intensive Spanish classes in San Jose. After 3 weeks at CRLA I learned what four years of Spanish in the US could not teach me, how to communicate.

Our first day with VIDA we learned about the Nicaraguan cultures and norms in the morning, and then we learned how to take vitals and make diagnoses based on the symptoms patients may present in the afternoon. I knew how to take temperature, heart rate, and etc., but I had a little trouble taking blood pressure. After practicing the day before, it was time for me to put everything I learned to the test. We drove into these rural communities, where we had our clinic in classroom like settings with only chairs.

When it was time to see our first patient I was so nervous because I was the first one on vitals in my groups and I didn’t want to screw it up. My group members proceeded with the medical history of the patient, asking her what brought her here to the clinic that day and what symptoms she presented. Of course the patient’s reason for coming to the clinic was because she was having problems with her blood pressure. The pressure was on, because I knew it really important for me to get an accurate measurement because the doctor was going to double check her pressure since that was the problem she presented. I measure her blood pressure first and got 130/100. When the doctor measured it she got 130/ 90. At I was nervous because one of my numbers was off by 10, but the doctor informed me that my measurement was good because sometime the blood pressure changes 10 units or so when it’s taken at different times. I was really proud of myself and my group was proud of me as well. Practice paid off because by the end of the clinic I became really good at taking vitals.

I learned so much from this experience. At first I didn’t see how we were really helping these people by only giving them medication. However, in the bigger scheme of things we cared and we did our best with the resources we had to help the people and the people were so grateful. It was such a great honor to be able to help others in needs. This experience reassured me of how much I want a career in the medicine and/or global health field. This experience showed me that a small group of caring people can make huge difference in the lives of people in need.

Le'Shauna Y. Phinazee

Sugarcane Contemplation

What is it like to start work at 5a.m., to endure the heat of the tropical sun, to rest and drink water only at midday, and to end each day having earned only about eight dollars? Most of us will never know, but for sugarcane workers this experience is all too familiar. When our group went to visit a sugarcane field near Palo Verde Biological Station we saw these men, steadily swinging machetes, their arms covered in the black soot left by the burning of the last crop’s residue. As I watched them work I thought of what we had learned about Mesoamerican Nephropathy, an epidemic of cases of chronic kidney disease (CKD) occurring in the Mesoamerican region. This CKDu (the “u” denoting the unknown cause of the disease) has a high mortality rate and mostly affects male manual workers, especially those that work in sugarcane fields (Torres et al. 2010, Peraza et al. 2012).

Our guide, a man who had once worked in sugarcane fields, told us these men avoided resting and drinking to appear more manly and that they did this taxing physical labor every single day from December to April. Rather than being paid by the hour, as is the case for other sugarcane workers, the workers in this field were paid by the amount of cane they could cut. This, along with the previously mentioned attitudes toward resting, deters workers from giving their bodies the breaks they need to remain healthy. We had learned this two days before in class where our professor had said that the US Occupational Safety and Health Administration recommends 45 minutes of rest for every 15 minutes of labor in these conditions. It was clear that these men did not and could not afford to follow these recommendations. They mainly come from other provinces and Nicaragua because they need the work in order to support their families. Yet, for the little they earn there is a great cost to their health.

While standing in the oppressive heat for only about thirty minutes I wondered how these men went through this physical strain every day. I thought of their risk of Mesoamerican Nephropathy and for the briefest of moments I wished machines could take over their hard labor. I shook off the idea, knowing that putting these people out of the only work they could find was no solution at all. I thought about how their situation needs the service of local public health organizations, worker rights organizations and researchers. Local public health organizations could campaign to help with the stigmas around rest and re-hydration. Workers rights organizations could work to demand fair hourly pay so that breaks are not taken at the expense of wages. Researchers may further investigate hypotheses regarding the cause of the disease, including possible factors such as pesticide usage, heat stress and chronic dehydration, the use of non-steroidal anti-inflammatory drugs and arsenic (Landau 2014).

I realized I find this research inspiring and that I may like to work with agricultural workers in the future, either in public health or public health research. Before this experience I found it difficult to imagine working conditions such as this or a mysterious illness so specific to certain populations. Now, I find myself imagining the ways we might begin to help.

Literature Cited

Landau, E. 2014. Mysterious kidney disease plagues Central America. CNN.
http://edition.cnn.com/2014/06/11/health/kidney-disease-ckdu/

Peraza, S., Wesseling, C., Aragón, A., Leiva, R., García-Trabanino, R.A., Torres, C., Jakobsson, K., Elinder, C.G., Hogstedt, C. 2012. Decreased kidney function among agricultural workers in El Salvador. American Journal of Kidney Diseases 59(4): 531-540

Torres, C., Aragón, A., González, M., López, I., Jakobsson, K., Elinder, C.G., Lundberg, I., Wesseling, C. 2010. Decreased kidney function of unknown cause in Nicaragua: a community based survey. American Journal of Kidney Diseases 55(3): 485-496

Erica Rayack

Mosquito Misfits

Palo Verde, located near the Cañas region of Costa Rica, was our third most awaited biological station visit. Out of all the stations we visited, it had the most different climate and forest. Located in the Palo Verde National Park, Palo Verde has a dry and humid temperate forest within its wetlands. The station prizes its gracious chef, mango trees, and the bountiful monkeys and iguanas roaming casually around the station. Arriving with our only male professors, drivers, and teaching assistant, our group of 13 girls were suddenly faced with an intense dry heat, and of course…mosquitoes.

Unlike the more humid and pleasant climates of Costa Rica, Palo Verde was the hottest place we had ever been to within our 4-month trip. Despite it being the dry season, Palo Verde frequently experiences the rise and fall of the river, and subsequently, also the wetlands. We learned that when the water rises, it brings with it the mosquitoes. For about 4 of the 7 days we were in the station, the water had risen in the wetlands and in came the beasts. I had never seen this quantity of mosquitoes in my life, even in India, where they are most hated! I was mostly surprised that there could be this amount even in the dry season. Of course each night we had to tuck ourselves into our mosquito nets, and we even had to rush our toilet time because the bathrooms were just swarming with mosquitoes. My classmates even brought mosquito nets to class. By the end of each lecture, there was always a shocking mosquito graveyard. By the end of our week at Palo Verde, our bodies were covered with swollen mosquito bites!

As much as I complained about the mosquitos, I began to understand how they truly contributed to the biodiversity of the wetland environment. Without them, there would be no frogs, iguanas, or monkeys that could eat them. No frogs or iguanas, leads to the absence of birds. The entire ecosystem falls apart without these blood-sucking misfits! We, as humans, have truly impacted the environment with our presence and infrastructure. Mosquitoes were constantly attracted to light, and they knew exactly where to find us. With this human impact, there is no way we can stop these mosquitoes. I asked one of the Palo Verde rangers about the quantity of mosquitoes during the wet season; he mentioned that we only experienced 2% of what he usually encounters. I couldn’t believe how nonchalant the workers at the park seemed, and how they just accepted their bites. They knew how important mosquitos were to the dry forest biosphere, and there was nothing they could do about. I admire there attitude and their research at the station.

I know now that when I see the next mosquito, I will think twice about killing it!

Meghna Purkayastha

Mí VIDA en Nicaragua

The week we spent in Nicaragua has definitely been one of the highlights of this trip so far. Working with Vida, an organization devoted to bringing health clinics to rural communities in Honduras, Costa Rica, and Nicaragua, was such a rewarding and enriching experience. Throughout our stay in Nicaragua we were all placed in homestays. My host mo was named Jeanine and she as the sweetest, happiest, and hospitable lady—the epitome of Nicaraguan culture.

Three of our days in Nicaragua were spent doing clinics in rural communities. During these clinics we were split into groups of two or three people with one translator. All members of the group would each take turns being responsible for filling out the patient’s medical history chart, asking appropriate questions about the reason for the patient’s visit, and then taking vital signs. Once all three task were completed, one of the two doctors leading the clinics was then called over so that we could present the patients’ medical history and current symptoms. After presenting each case, the doctors would always give us the opportunity to diagnose the patient. Whether our diagnosis were correct or not, the doctors were always extremely encouraging and more than willing to spend time explaining and teaching us things that we did not know.

I loved how hands-on this experience at the clinics was and how much it challenged me to really critically asses each patient symptoms and try to come up with a diagnosis for each patient based on my previous knowledge and experiences. I really loved seeing the way that the doctors interacted with each patients, they were very patient, endearing and so compassionate. I learned a lot from the way they deduced what the patient had, how they prescribed medication, and how to create treatment plans form the patients to follow. Because it was so evident how passionate the doctors were about their jobs and also about teaching us what they knew, I was newly affirmed that I am definitely in the right field and have been motivated to continue pursuing my career of being a Physician Assistant with more drive than ever before.

Karina Handal

Medical Clinic in Nicaragua

Two weeks ago while in Nicaragua we participated in a volunteer based medical clinic run by the Vida organization. The day before we were to start working, we had an orientation day in which we learned how to take vital signs and reviewed diseases and illnesses we would most likely see. The first day of the clinic was in a very small, rural town by the name of Papayal. Our clinic environment was a small community room. We set up five circles of plastic chairs, each circle included two or three of us: one person to scribe, another to interview, and another to take vital signs. Each circle also had a translator who translated anything we said in English into Spanish for the patient and vice versa. Each circle would work with one patient or family at a time and two doctors rotated through our groups to make the final diagnosis and subscribe any needed medications for patients as well as educate them about their illness or disease. We appreciated the doctors because before making a prognosis they would as us what we thought and why. This was a great learning experience for us.

It was very obvious that Papayal was a very poor neighborhood. Many of the mothers with small children were still in their teens. The first case my group saw was an 18 year old mother with two toddlers. After doing the extensive medical history questionnaire we asked her why she came to the clinic and she told us she just wanted some vitamins for her and her children. Many of the children were prescribed vitamins. In another case, a mother brought in her 12 year old daughter and 4 year old son. Both children had had recurring diarrhea and lack of appetite. The doctor concurred that they both were infected with Giardia, a parasite. In these communites most children take a de-worming medicine every six months. The clinics were very successful and we were able to treat all persons who came seeking medical attention. It was an extremely rewarding experience and because of it I absolutely plan on volunteering in a medical environment in the future.

This experience has been one of my favorites so far this semester. It solidified my desire to become a doctor. It was a great feeling to be part of a team of individuals providing healthcare to people that otherwise wouldn't have it. In addition, I felt very appreciated for my efforts and enjoyed being able to talk to patients about day to day life while we were waiting for the doctor. I hope for another experience like this soon in life. `

Hailey Alexander

Nuestro Tiempo en Nicaragua

Our time in Nicaragua was one of the most enriching and exciting of our experiences on our semester long OTS program. Not only were we able to have hands-on experience in the clinic setting, we were also able to live and experience for ourselves what life in the country was like with our host families. I had some of the most fun and most difficult moments of my semester while there in Nicaragua and it deepened my passion for studying medicine.

When we first entered the country, I was shocked at the drastic differences there are between Nicaragua and Costa Rica. The dryness of the land, evident poverty in the cities, and intense heat all signified we were no longer in the country we had become so accustomed to for the past three months. However, there was still beauty beneath the dust and dirt in the form of beautifully colored homes and an expressive, outgoing people. We were able to experience the amiableness of the people first hand in our homestays. My host mom was a kind, generous woman who loved us like her own daughters. In her home I discovered such a beautiful simplicity of living that transcended unnecessary comforts like hot water and air conditioning. As silly as it sounds, the lack of these things was at first a distraction for me, but once that wore away, I grew to appreciate so much more the love and warmness of the home.

I have traveled to both Mexico and Bolivia for medical missions trips and have helped run free medical clinics many times before. However, in none of these experiences was I able to do as much as I was with Vida Volunteers in Nicaragua. Not only were we able to interview patients ourselves and learn what things to look for, but we were able to make our own proposed diagnosis, and the doctors respected and critiqued our estimations. It made me feel so useful and valued as a student. Although I am not yet a professional, the knowledge I have been taught can still be useful in helping another in need. One of the biggest things I learned through the interviews were how closely linked nutrition is to health. I also had a first hand “taste” of this in my homestay and was able to see the amount of sugars and fats that fill many Nicaraguan diets. Seeing this first hand link between poverty, nutrition and overall health gave me so many new ideas for my future in Medicine.

Overall, my time in Nicaragua not only taught me more about myself and health in a poorer country, but it has driven my passion for pursuing medicine and nutrition with a focus on helping those most in need.

Stephanie Hynes

Gringas in the Central Market

Before resuming our Spanish classes at CRLA in San Jose, we spent a full day learning about global nutrition. It was a very interesting topic, although very sad to think about. There is a large percentage of the world’s population that has to live on less than $2 per day, so even if they have food available to them, they cannot afford it. It was very humbling to think about, and I realized how blessed I am.

But we didn’t just learn about this problem. We got some hands on experience, which was a really fun experience. We split in to four groups and were given one thousand colones (less than $2) to spend in the central market. Then we were told to go and try to buy food for one person for a day. My first thought was that there was no way that was even remotely possible. But I was a good sport and followed my group in to the central market. The first stop was eggs. We got four eggs for 400 colones, which left us with about a dollar left for the rest of our food. We then proceeded to the fruit stand, where we bought a carrot and some potatoes. After this purchase we were left with 120 colones, which is about $0.25.

Finally, we decided to buy cheese with what little we had left to spend. But as we were asking the cheese sellers to cut 120 colones worth of cheese, a lady passed by us and overheard our conversation. When she heard that we only had 120 colones to spend, she turned around with the most concerned face I have ever seen. She thought that was all we had for lunch between the three of us and then started to offer to buy us something to eat. Her concern was so adorable and kind! We had to try and explain in our broken Spanish that it was only for a project and that we actually did have money. She laughed about it, but I think she thought we were a little weird for trying to buy such a small amount of cheese. And the vendors definitely did. But we finally got our cheese and met up with the rest of the group.

I thought that we wouldn’t be anywhere near the 1500 calorie recommendation (which we weren’t), but we weren’t as far off as I thought we would be. We came in around 1000 calories, which I thought was pretty impressive for being so terrible at bartering. But it was an eye opening experience to try and buy food for so little. I am so blessed in my life in the States, and I now see that even more clearly.

Emily Leytham

Diseases Left Behind

Equity in healthcare is a key part of the global health agenda, one that we have approached over and over this semester. Despite great strides in battling disease epidemics, reducing infant mortality and increasing life expectancy, the health needs of certain marginalized groups remain unaddressed. The Tropical zone, including Central America, bears the enormous burden of a class of diseases know as Neglected Tropical Diseases. These diseases are often vector-borne and associated with poverty, lack of clean water, sanitation and/or basic preventative care. So-called “developed” nations have the technology and resources to combat NTDS, but may be blind to the burden of NTDs on the productivity and wellbeing of afflicted nations.

During our time in the agricultural zone surrounding Palo Verde, I learned about Mesoamerican Nephropathy, a neglected Tropical health issue, for the very first time. Thousands of people in Mexico and Central America with no other cause of chronic kidney disease are suffering or dying due to kidney function complications, and doctors don’t know why. I was shocked that I had never heard of this critical health and social justice issue. Chronic Kidney Disease of Unknown Causes (CKDu) primarily affects young male agricultural workers in the lowland pacific side of Mesoamerica. No cause has been identified yet, although chronic dehydration, manual labor under the sun and heavy metal or toxin exposure have been suggested as possible risk factors.

Little funding or research attention has been devoted to solving the puzzle of CKDu, and the incidence and mortality rates keep rising. The Area de Salud that we visited in Guanacaste has organized an investigative committee to find answers and decrease the incidence of CKDu in the community. However, without the attention and resources of major research organizations and drug companies, progress in the fight against CKDu will likely be slow going. Meanwhile, each year more otherwise healthy Costa Ricans will end up hospitalized, hoping for a new kidney and undergoing daily dialysis as their body mysteriously fails them. Many of the afflicted agricultural workers in Costa Rica are migrant workers, who likely have no one to advocate for their unique needs and challenges.

Women, minorities, the disabled, indigenous groups, and those in poverty all face extra challenges when it comes to health care access and attention. Developed world chronic diseases, including cancers and COPD, are the main concern of more privileged populations and thus are the focus of cutting edge medical innovation and discovery. Less research resources are directed toward Neglected Tropical Diseases and conditions specific to marginalized groups. We need to start prioritizing the health of the voiceless, and turn our attention toward sadly overlooked epidemics.

Abigail Mahoney

The Choice

During our time in San Jose this past week we had the opportunity to go to the Central Market as a group. Earlier in the day we had a brief lesson on nutrition where we learned how the history of Costa Rica impacts the common diet of residents of the country. For example, how a typical breakfast of Gallo Pinto or lunch of Casado each have up to a thousand calories in order to historically feed agriculture workers who would use a lot of energy in their daily work. Today the average person in Costa Rica needs only about 1500 calories based on the amount of work they do a day. We also learned how individuals living in poverty live on 2$ a day for all expenses. In order to really see in action how difficult it is for people in poverty to live on this low income and eat well and sufficiently we went to the Central Market.

Once there we broke into groups and with only 1000 colones (2$) we set off to buy as much nutritious food as possible for the most calories and the most food groups. In my group we ran through the colorful and crowded marketplace to find produce. We bounced through colorful and loud stalls where vendors called out their wares of fresh fish, flowers, and tourist crafts. Finally stumbling upon a vegetable stand, we bartered with the salesman about the price of two carrots and a banana. A little disgruntled about our excellent bargaining strategy he told us “Not everyone bargains here, you’re lucky you got me”.

We walked along to find our next food group and found a stall selling cheese. I asked the man to cut me as small a piece as possible. He told me it would be 350 colones. I showed him 200 colones, take it or leave it. We left with the cheese. At our next stall it was Abigail’s turn to do the bartering. She handed him 150 colones and in return was handed a sizable bag of lentils for our grain and protein food group. Left with 500 colones, we decided to get an avocado and sweet potato at the same lentil booth. I felt pretty confident with our purchases and tried to not feel regretful as we found our classmates who were armed with eggs and shrimp.

Back at OTS base we presented each of our purchases. We were told that our entire budget had only bought 1400 calories of food. This was the most calories of any other group, but was still not enough! It was discouraging to see how hard it is to find enough food for an individual, much less a family, but it gave us all a good opportunity to see how food security actually works in the real world. Overall, our excursion to the Central Market was my favorite program activity in San Jose.

Marcela Zegarra-Ballon

Traditional, western, or another path?

Which path should I take to treat an illness, “taking prescription medication, following traditional practices such as shamanism, listening to a homeopath, visiting an acupuncturist or bone setter (chiropractor), or using technique based on humoral medicine?” Often times in our society, one’s culture defines the “correct” path to treat an illness. There seems to be little incorporation of the different practices in order to achieve desired results. For example, a typical “western” doctor prescribing medicine usually would not also advise a patient to go to a sukkiah to heal his or her spirit; there is only one “right” path.

If someone wishes to take different approaches to healing a sickness, he or she has to actively seek out both approaches and confirm whatever treatment prescribed does not interfere or cause side effects with the other treatment. I know for me, this extra work greatly reduces my desire to use two different methods. Upon this realization, I began to question why this was the case and whether or not it was possible for two medicinal techniques to coexist.

I discovered my answer when we took our visit to the EBAIS in Coto Brus. The district of Coto Brus has a high population of Ngobe tribe who immigrate from Panama and non-indigenous peoples as well. In order to address both populations, this EBAIS has a shaman and a “western” medical doctor. As well, the buildings are set up in cone shapes and look almost identical to the houses the Ngobe tribes reside. Not only does it have a shaman and western doctor, but it also has a kitchen where concepts such as preventative care can be practiced. Finally, resources for midwives to help give births are provided. It is the only one of its kind. All of these facets of the EBAIS work together to encourage the public to be able to choose which cure or health care practice he or she prefers to use. Due to this systematic set up, there have been declines in the number of hospitalizations and a reduction in infant and mortality rate in the Ngobe community. As well, it has allowed a more amiable relationship between leaders of different cultural beliefs understanding perspectives from the others’ culture.

Making multiple medicinal paths easily available to patients gives patients the power to choose which or both practices he or she prefers. It also makes it easier for a patient to learn more about a different practice if he or she has been curious to test it out.

This EBAIS helped answer my question; it is possible for two methods of treating medicine to coexist. Hopefully in the future the United States can incorporate some type of healthcare system in which the patients do not have to choose only one “right” medicinal path.

Morgan Drew

The Free Time Dilemma

Having now been in Costa Rica just over two months, I have come to the realization that I still struggle with a common dilemma: what do I do with my free time? At first, the program was densely packed with activities, so the need to fill time rarely arose. Endearingly called the “day-by-day”, our group is provided with a weekly schedule that allocates when activities, lectures, or research projects will occur. However, once we all adjusted to the schedule and we started designing our own research projects, I realized that there were frequent blocks of time where no set activity was planned. By no means am I saying that balancing free time is a new concept for me, nor for any college student I would imagine, yet being in Costa Rica poses a different time management priority.

Here, we are not only research students, we are also foreigners and tourists. There is urgency in our actions to see and experience as much of the environment and culture as possible while still managing the requirements of the course. Everyday that I have been at this biological station in Las Cruces, I find myself making a decision to either go for a walk through the botanical gardens or study lecture material. It is often possible to do both, but then, which takes priority?

The formal education we receive through research and lectures is important, but so too is the informal education that we discover for ourselves when we explore our environment. For example when we go on group nature walks, there is both informal and formal education at the same time, but with other activities, there is a more obvious distinction in what type of education the activity provides. But then I wonder, is one more important than the other? When I leave here, what will I remember more, the material I learned in class or the times I spent outside in the forest? Realistically, I know it will be a mix of both, so I think that I need to maintain a balance between the two. I consider myself extremely fortunate that deciding how best to use my time is one of my tougher struggles here.

Liz Stratton

The Choice

          The sun is shining and the topical birds are chirping at Las Cruces Biological Station but the other students and I aren't paying any mind. We're eagerly awaiting the beginning of the presentation; the one that will tell us what independent project topics we can choose from. The decision each of us makes today will determine how we will spend much of the next month and a half in Costa Rica. As the lecture begins we sit quietly and listen to each topic as it's announced. There were eight available topics: weaning practices of breastfeeding mothers, patient overuse of the healthcare system, adherence to medication, plant-made insecticides, and more. Once all topics were explained we were told to pick which one we'd like to research. The other students jumped up to form groups and talk about their first choices. The room filled with chatter and commotion, but I was still sitting quietly. I was busy thinking. This was as important me me as it was for everyone else but I couldn't choose so quickly. I knew that I was curious about all of the listed topics and that in any group I would be able to drive into whatever research with enthusiasm. I didn't know what to choose, so I sat.

          After a minute we decided to discuss our options in a more organized way, so all 13 of us marched upstairs to our common room to talk. As we went around the circle naming our top choices I thought about one project in particular: "Knowledge, attitudes, and practices regarding prostate cancer screening." One of our professors had explained the importance of this topic, how for some men it was taboo and how the regional health director had specifically suggested it.

          I'd thought before about the lack of conversation around prostate cancer in the United States, especially compared to breast cancer, and it seemed interesting to learn more about it in Costa Rica. I began to have an inner battle. On one hand a part of me wanted to do this research project. As a young woman, coming to OTS from an all women's college I'd spent more time researching women's health topics and general health topics than men's health. Picking this topic would be a perfect way to begin learning more about issues specific to male populations. It was also especially interesting due to its taboo aspects and all of the misconception about masculinity that surrounded it. Still, an opposing part of me was nervous and cautious about choosing without fully thinking it through. Would I feel comfortable surveying complete strangers about this sensitive topic? Would I be making them feel uncomfortable? I talked with the two friends I'd be working with. They were both patient with my uncertainty. We discussed the possible benefits of the study with our professors. They assured us that it was a very interesting and useful study and even said that men may be more comfortable talking about this topic with us, three female student researchers, rather than other men. We went confidently into our days of initial online research of similar studies, and this week we handed in our formal research proposals. We are now waiting, enthusiastic and eager to go into the local communities and learn more

Erica Rayack

A Hidden Paradise

As we began to approach the next house for our interviews, I was reminded just how long this day would feel. In a small farming neighborhood in the rolling hills of San Vito, we set out for the day to conduct door-to-door surveys for our third faculty led project. Our surveys were about wild edible plants, and how many the people we interviewed could list for us. This was all to measure the amount of traditional ecological knowledge in this community. As excited as I was to conduct the surveys, it was a hot and dry day with an agenda of about 100 interviews total ahead of us. I had no idea that during this calculated afternoon we would have an unexpected experience that would change my perception of that day.

At this house in particular, we began to interview a woman, in her mid 50s, who very eagerly began to list as many wild edible plants as she knew. If we didn’t recognize the name, she took us to her garden and happily pointed it out. About 15 minutes into our conversation, she informed us that her family owned a farm that was connected to the back of the house. As her memory of the plans began to slow, she remembered that her husband would be able to recall more than her. “He’s out working on the farm”, she remarked “I’ll bring you to him!” Before we knew it, we were following her through rolling pastures and coffee fields to where her husband was working. A small wind sparked in the trees bringing to life this hidden paradise that I’m sure few eyes from the outside world have seen. As soon as we reached the top of the hill, her husband greeted us, setting aside the small coffee saplings he was planting. His wife explained why we were there and he immediately left his work, picked up a machete and told us to follow him. He led us through more of their property, pointing out plants as we went until we reached a small section of dense forest. In we went to find the wild plants we were in search of. We wandered about for almost 45 minutes with the couple sharing their livelihood with us and letting us try wild fruits like guava and guanabana.

As we left their house after our excursion, I was reminded of the beautiful hospitality Ticos share with complete strangers. This kind man and woman were so eager to share their little patch of heaven with a few researchers from America hoping to learn a little more about their culture. I will never forget this experience nor the immense kindness they showed us that afternoon.

Stephanie Hynes

Drugs or Culture?

          After an entire day of sitting in one room listening to lectures, the last thing you want to hear is that there is a lecture scheduled for after dinner as well. And yet that was exactly what our schedule looked like on our second day at the Las Cruces Biological Station. That evening, as we filed back into the classroom after dinner, the thought running through everyone's heads was simple: let's hope this is quick so we can finally relax. Moments after entering, however, that exhaustion slipped away and was replaced by curiosity mixed with excitement and a little bit of trepidation. The first slide was titled “Psychoactive plant use” and filled with colors in a manner which can only be described as trippy. The lecture proceeded to define words I've only ever heard thrown around colloquially, such as psychoactive, hallucinogenic, and psychedelic, and to discuss a variety of plants, their properties, and their current and historical uses. We learned how Shamans in the Amazon believe that Ayahuasca allows users to see the plant spirits coming alive in the forest. We learned how Iboga in Africa causes a frightening hallucination that is believed to connect users to their ancestors. And we learned how the Spanish conquistadors outlawed the peyote cactus to break the connection between the indigenous peoples and their gods.

         Drugs, in our time and especially in our place in life, are something which we are going to have to face. As an American college student, it is inevitable that I will encounter people who use and abuse drugs. But I've never considered them in the context of spiritual gateways or as ways to connect with a deity. The connotations around these substances in our society are clear. Adolescents may choose to experiment with illicit substances, but under no circumstances are they beneficial or important aspects of a cultural worldview.

         This stigma against hallucinogenic plants and drugs in general causes a dangerous lack of research into these important topics. I can feel this stigma just writing this blog post and knowing that there are people who are going to judge me for choosing to use my free writing to talk about drugs. But in our day in age I think we need to work past this stigma. Drugs are becoming increasingly dangerous because current regulation systems aren't stopping their use and are only serving to push them underground where the practices surrounding them are dangerous. At the very least we need research into the effects of these substances so that we can speak educatedly about them instead of just speaking from our fears and culturally engrained beliefs. Hallucinogens have been around forever. It's unrealistic to believe they are going to disappear now, so we might as well accept it and work with the system instead of against it.

Krcmar, Rachel

Seeing Ethnobiology in New Colors

   

Having a father in the military meant that I spent my childhood in a different country and a variety of states. As a result, I have had an interest in learning about cultures and ways of life different from mine since I was young. So far, this program has provided me with countless opportunities to do that, including: meeting other students and researchers at the stations, learning about Costa Rican life through living two weeks at my homestay in San Jose, and also through interacting and visiting indigenous communities. While in Las Cruces, we once again had the opportunity to visit and interact with an indigenous community, this time the Brunka people.

Our guest professor, Hector, first taught us about the Brunka of Costa Rica and how they have repurposed their ethnobiological knowledge. Because of tourism and conservationist policies of Costa Rica government, they have been increasingly using their useful organisms for economic purposes. An example would be the masks, or diablos that they make as well as sell, and the bags they weave. I enjoyed learning about how this shift and repurposing impacted women and the community and led to the revival of certain traditions like women’s groups, and found it extremely interesting.

Before the visit, we were told to bring some type of white, cotton material because we would have the opportunity to dye it. I have tie-died shirts before, but the process the Brunka women showed us was completely different than any I had seen before! When I had tie-died shirts as a kid it involved store bought dye or a tie-dying kit and a lot of rubberbands. In contrast, the indigenous women showed us how their process of dying was all-natural. They used different plants and leafs to make different colors. In their demonstration they died yarn, and showed how they may rub the plant against the yarn with water and the color begins to seep into it. The most remarkable part came next; they would lie the yarn out to dry in the sun and the colors would either change or become darker.

Then came the fun part. We had a chance to get involved and try it out for ourselves. They had set up a small fire with pots on top filled with yellow and blue dye. They used sticks to dip our pieces of clothing in the dye. It was very exciting to be a part of the cultural activity of the Brunka people. It is also neat that I now have a cool tie-died shirt to take back to the states to remind me of the Brunka women and the experience!

Symone Stephens

Expect the Unexpected

One of the most interesting things about Costa Rica thus far has been the hospitality. After just a short conversation with someone, they will tell you almost anything. I discovered this fact our first week in Las Cruces when we were conducting our interviews in the local community for our last Faculty Led Project. We were going door-to-door asking people about their knowledge of wild edible plants. We started pretty early in the morning, splitting in to groups of two or three, and we were expected to get a lot of interviews done before lunchtime. Interviewing people in Spanish always makes me a little nervous, so the thought of interviewing all morning was a little scary.

However, on my group’s third interview, our morning took an unexpected turn. The woman we were interviewing gave us a tour of her garden, naming different edible plants as she went along. Once she had exhausted all of her knowledge of edible plants, she then offered to take us to where her husband was working because he would know more plants than she would. Her husband was working on the other side of their three-hectare (7.5 acres) farm, which meant we had to trek down about half a mile in order to meet her husband. But this is when it got very interesting. He then insisted upon not just telling us the edible plants he knew, but showing them to us. So he began giving us a tour of basically their entire farm.

The walk was so interesting, although I was definitely not prepared for it. At one point, we had to walk straight through the woods, with the husband using his machete to cut a path for us because there was not an actual path. My converse shoes did not quite cut it for the walk through the forest, but it was totally worth it. He pointed out a lot of different plants that they had on their farm. We eventually came across a guava tree, where we could see this huge, almost ripe guava fruit. It was kind of high up in the tree, but he scaled the tree trunk and cut it down for us. He also climbed another tree in order to get us a guayaba fruit. It was a little bit funny to watch this grown man climb a tree, but mostly it was just awesome. He also picked about 10 lemons for us, although I’m not entirely sure what we are going to do with that many lemons…

All in all, it was a fantastic break from our interviews. We took an hour walking around the farm, where we had only planned on taking five minutes. I guess you have to expect the unexpected when you talk to complete strangers in a foreign country!

, Emily Leytham

Pesticides en los Plátanos

On the afternoon of January 30, 2015 our group of thirteen college women (a.k.a. Las Gringas) had the privilege of visiting a large scale banana plantation. Jaime, a guest lecturer taught us about the banana's growth cycle, environmental problems concerning bananas, and health problems in banana plantation workers. I found it ironic how little any of us knew about banana farming despite bananas being the most widely eaten fruit in the world. I have eaten bananas my entire life yet I knew absolutely nothing about them prior to this field trip other than the simple facts that they were delicious, yellow, and knew no seasons (they are always in supermarkets). Jaime taught us that bananas are the largest herb in the world. Much deforestation has happened in order to make room for banana plantations. Jaime said that the 'Coryoyo' bananas most commonly grown in Central American originated from the Philipines and that there are millions of strains of bananas since they are so easy to cross with both animal pollinaters and the wind. What interested me most on this field trip was learning about the health risks of the plantation workers and the enviromental implications of using extravagant amounts of pesticides on the crops.

The worker population consists of roughly half Nicaraguans. Costa Rica is the 2^nd country in the world with the most immigrants (mostly Nicaraguans). The workers in these plantations have little protection from the harsh chemicals they administer the plants. In most cases the only thing between them and the chemicals is their long sleeve shirts and pants. These chemicals can cause the plantation workers to become infertile and their babies to have complications.

            

Illegal chemicals are still frequently sold under the table. The genetically modified banana plants cannot survive without the use of chemicals to protect them from insects, fungus, etc. It is common for the plantations to hide the actual chemicals they are using from the inspectors and show them legal chemicals instead. Aside from pesticides, a substantial amount of fertilizer is used. When it rains, the fertilizer is washed into the river which causes an increased amount of algae. The increased amount of algae kills the fish and in turn disrupts ecosystems and habitats alike. During the hour visit we saw many planes fly overhead and drop clouds of chemicals over the plantation.

           

Upon departing from the plantation I had a sick feeling in my stomach. Is this the future of agriculture: a system that harms both the workers and the environment? If not, where does change begin? How long will it take to secure an agriculture system that is safe? These are difficult questions that don't have answers.

Hailey Alexander